Levothyroxine absorption is impaired by many GI conditions, including:

  • Atrophic gastritis,
  • Chronic proton pump inhibitor use,
  • Helicobacter pylori infection.
  • Celiac disease
  • IBD
  • etc.)

When H. Pylori is the cause of poor absorption, treatment of H. pylori infection reverses this effect. After eradication of H. Pylori, a reduction of the levothyroxine dose by 30% or more will often be required.

Further Reading / Reference

Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid 2014;24(12):1670-1751.

Helicobacter pylori infection and drugs malabsorption. World J Gastroenterol 2014;20(30):10331-10337.

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