Factors Affecting T4 Therapy

The Importance of T4 Tolerability

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Excipient ingredients in traditional T4 tablet formulations often contain ingredients like gluten, lactose, sugar and food dyes can cause stomach problems for some patients. Many patients who experience these side effects simply stop taking their medication. Lack of medication compliance is one of the most common reasons for undesirably low TSH levels among patients who have been prescribed T4 therapy.⁸

Click here to see a list of ingredients commonly found in traditional levothyroxine tablets.

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Common Ingredients in T4 Tablet Formulations

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Unlike Tirosint®, traditional levothyroxine tablet formulations may contain a variety of excipient ingredients. These ingredients include:

  • Lactose
  • Food dyes
  • Alcohol
  • Magnesium stearate
  • Sulfa
  • Sugar
  • Povidone (PVP)
  • Sodium
  • Talc

Comorbidities That Complicate T4 Therapy

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Many patients are affected by GI conditions

  • An estimated 2.1 million Americans have celiac disease¹⁰
  • As many as 13% of adult Americans are lactose intolerant¹¹
  • As many as 9.1% of adult Americans suffer from food allergies¹²
  • Millions of Americans are affected by H pylori infection¹³

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Medications That Inhibit T4 Absorption

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  • The addition of omeprazole led to a statistically significant increase in TSH levels (P=0.002)
  • 37% increase in T4 dose was required to achieve the desired TSH level when omeprozale was present¹⁴
  • The above chart supports the hypothesis that gastric acid is necessary for the effective absorption of oral T4¹⁴

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