Keywords
tiroiditis
hipotiroidismo
interacciones de comida y medicamentos
levothyroxine
thyroiditis
hypothyroidism
food-drug interactions
How to Cite
Abstract
El hipotiroidismo primario es la patología tiroidea más frecuente. El manejo estándar de esta enfermedad es con levotiroxina, cuya absorción puede verse afectada por distintas condiciones médicas, medicamentos e incluso la dieta del paciente. Los requerimientos de levotiroxina podrían variar debido a factores sobre agregados como la tiroiditis subaguda, la deficiencia de vitamina B12 y el uso de medicamentos, elementos que afectan el control del hipotiroidismo. Se presenta el caso de una paciente con hipotiroidismo primario con necesidad de ajuste en la dosis de levotiroxina a través del tiempo debido a comorbilidades agregadas. Se presentan claves para la evaluación del paciente con dificultad para lograr una TSH dentro del rango normal.
Abstract
Hypothyroidism is the most common thyroid disease. This disease is managed with hormonal replacement therapy using levothyroxine, whose absorption can be affected by various medical conditions, drugs and even patient´s diet. Levothyroxine requirements could vary according to co-morbidities such as subacute thyroiditis, vitamin B12 deficiency and the use of drugs, factors that can affect the control of hypothyroidism. The case of a patient with primary hypothyroidism who required dose adjustments of levothyroxine over time due to added co-morbidities is presented. Clues are given for evaluation of the patient with difficulty in achieving maintenance of TSH within the normal range.
References
2. Seo HM, Kim M, Bae J, Kim J-H, Lee JW, Lee SA, et al. A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis. Chonnam Med J. 2012;48(1):69.
3. Umut M, Alptekin G, Cuneyd A. Should neck pain in a patient with Hashimoto?s thyroiditis be underestimated? A case and review of the literature. Indian J Endocrinol Metab. 2012;16(3):444.
4. Lazarus J, Hennesey J. Subacute thyroiditis. In: De Groot L, Beck-Peccoz P, Chrousos G, editors. Endotext. South Darmouth, MA: MDText.com, Inc;
2012.
5. Brunton L, Chabner B, Knollman B. Goodman & Gilman: Las Bases Farmacológicas de la Terapéutica. 12 Ed. México: McGraw-Hill Interamericana Editores S.A.; 2011. 2035 p.
6. Ianiro G, Mangiola F, Di Rienzo T a., Bibbò S, Franceschi F, Greco a. V., et al. Levothyroxine absorption in health and disease, and new therapeutic perspectives. Eur Rev Med Pharmacol Sci. 2014;18(4):451–6.
7. Builes Barrera CA, Palacios K, Barragán F. Dosis de levotiroxina varía según la etiología del hipotiroidismo y el peso corporal. Revista Colombiana de Endocrinología y Metabolismo. 2014;27–32.
8. Liwanpo L, Hershman JM. Conditions and drugs interfering with thyroxine absorption. Best Pract Res Clin Endocrinol Metab. 2009;23(6):781–92.
9. Biondi B, Wartofsky L. Treatment with thyroid hormone. Endocr Rev. 2014;35(3):433–512.
10. Cutolo M. Autoimmune polyendocrine syndromes. Autoimmunity reviews. 2014. 13:85-89.
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