Endocrine Abstracts

Levo-thyroxine (LT₄) formulations are available on tablets (TAB) or liquid solution (SOL). LT4 TAB absorption could be affected by several gastric diseases as Helicobacter pylori (HP) infection or chronic atrophic gastritis (CAG), instead no data are available on absorption of the LT₄ SOL in these conditions. The aim of the study was to compare the efficacy of TAB or SOL LT₄ formulations in patients with dyspeptic syndrome (DS) and subclinical hypothyroidism (SH) due to chronic autoimmune thyroiditis. 20 naïve patients (15 females, 5 males, 27 to 55 years), with DS and SH were included. All were firstly investigated by esophageal gastric duodenal endoscopy and urea-breath test and divided in: group A n=4 patients had HP infection; group B: n=4 with CAG; group C: n=6 with simple gastritis and n=6 with no organic alterations. LT₄ treatment was randomly (TAB or SOL) started at a fixed dose (1.5 μg/kg per day); TSH and FT₄ were assessed at T₀, T₃ and T₆ months of treatment. On group A HP eradication was performed at the 3^rd month. In all groups, no difference in basal TSH levels were shown within patients assigned to different treatments (group A: TSH_tab=10.1±1.8, TSH_sol=9.6±2.2; group B: TSH_tab=7.1±1.2, TSH_sol=6.9±2.1; group C: TSH_tab=7.9±1.7, TSH_sol=8.1±2.1). At T₃, TSH values on group A (before eradication of HP) significantly decreased on patients treated with SOL, while on group B and C, equally decreased without difference within two formulations (group A: TSH_tab=7.8±2.6 vs TSH_sol=3.1±1.8, P<0.001; group B: TSH_tab=2.4±1, TSH_sol=2.6±1.2; group C: TSH_tab=1.7±1.4, TSH_sol=2.5±1.6). At T₆, TSH levels on group A (after eradication of HP) were in the normal range with no significant changes within two formulations; on group B and C, TSH levels were normal without significant difference within two formulations (group A: TSH_tab=2.5±2.6 vs TSH_sol=3.6±1.8, P=ns; group B: TSH_tab=3.5±2.2 vs TSH_sol=2.1±1.8, P=0.093; group C: TSH_tab=1.9±2.1, TSH_sol=2.0±1.7). In each groups, no differences were shown on FT₄ values within two formulations. In conclusion this preliminary report suggests that LT₄ TAB or SOL are equally efficient to treat SH in dyspeptic patients without gastric alterations or with simple gastritis or CAG, while LT₄ SOL seems to be more efficient than TAB in patients with HP infection, independent of its eradication.