Clinical relevancy of the levothyroxine-continuous enteral nutrition interaction

Roland Dickerson, George O. Maish, Gayle Minard, Rex O. Brown

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The objective of this study was to determine if patients requiring levothyroxine therapy develop hypothyroidism during concurrent continuous enteral nutrition (EN). Methods: Adult patients with a history of hypothyroidism, given levothyroxine via the feeding tube at the same dose given prior to hospital admission and who were referred to the nutrition support service for EN were evaluated. Thyroid function tests (TFTs) were performed prior to administration of levothyroxine-continuous EN, then approximately weekly thereafter. Patients who received less than 14 days of concurrent EN-levothyroxine therapy were excluded from the analysis. Results: Thirteen patients who received 20 ± 5 days of concurrent EN and levothyroxine were evaluated. Two patients developed subclinical hypothyroidism (thyrotropin [TSH] >6 and <10 mcIU/mL + normal fT 4), and 6 developed overt hypothyroidism (TSH >10 mcIU/mL + low fT 4) within 2 to 3 weeks of concurrent EN-levothyroxine therapy. Five patients remained euthyrotic. Differences between those who developed subclinical or overt hypothyroidism versus those who remained euthyrotic could not be explained by age, weight, levothyroxine dose, type of EN formula, or amount of EN received. Conclusions: More than half of the patients receiving concurrent levothyroxine-continuous EN developed subclinical or overt hypothyroidism requiring therapeutic intervention. Routine weekly monitoring of TFTs for patients receiving concurrent levothyroxine-continuous EN is recommended.

Original languageEnglish (US)
Pages (from-to)646-652
Number of pages7
JournalNutrition in Clinical Practice
Volume25
Issue number6
DOIs
StatePublished - Dec 1 2010

Fingerprint

Enteral Nutrition
Thyroxine
Hypothyroidism
Nutrition Therapy
Thyroid Function Tests
Thyrotropin
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Clinical relevancy of the levothyroxine-continuous enteral nutrition interaction. / Dickerson, Roland; Maish, George O.; Minard, Gayle; Brown, Rex O.

In: Nutrition in Clinical Practice, Vol. 25, No. 6, 01.12.2010, p. 646-652.

Research output: Contribution to journalArticle

Dickerson, Roland ; Maish, George O. ; Minard, Gayle ; Brown, Rex O. / Clinical relevancy of the levothyroxine-continuous enteral nutrition interaction. In: Nutrition in Clinical Practice. 2010 ; Vol. 25, No. 6. pp. 646-652.
@article{f2fd865262ff426ab053bccdb8898062,
title = "Clinical relevancy of the levothyroxine-continuous enteral nutrition interaction",
abstract = "Background: The objective of this study was to determine if patients requiring levothyroxine therapy develop hypothyroidism during concurrent continuous enteral nutrition (EN). Methods: Adult patients with a history of hypothyroidism, given levothyroxine via the feeding tube at the same dose given prior to hospital admission and who were referred to the nutrition support service for EN were evaluated. Thyroid function tests (TFTs) were performed prior to administration of levothyroxine-continuous EN, then approximately weekly thereafter. Patients who received less than 14 days of concurrent EN-levothyroxine therapy were excluded from the analysis. Results: Thirteen patients who received 20 ± 5 days of concurrent EN and levothyroxine were evaluated. Two patients developed subclinical hypothyroidism (thyrotropin [TSH] >6 and <10 mcIU/mL + normal fT 4), and 6 developed overt hypothyroidism (TSH >10 mcIU/mL + low fT 4) within 2 to 3 weeks of concurrent EN-levothyroxine therapy. Five patients remained euthyrotic. Differences between those who developed subclinical or overt hypothyroidism versus those who remained euthyrotic could not be explained by age, weight, levothyroxine dose, type of EN formula, or amount of EN received. Conclusions: More than half of the patients receiving concurrent levothyroxine-continuous EN developed subclinical or overt hypothyroidism requiring therapeutic intervention. Routine weekly monitoring of TFTs for patients receiving concurrent levothyroxine-continuous EN is recommended.",
author = "Roland Dickerson and Maish, {George O.} and Gayle Minard and Brown, {Rex O.}",
year = "2010",
month = "12",
day = "1",
doi = "10.1177/0884533610385701",
language = "English (US)",
volume = "25",
pages = "646--652",
journal = "Nutrition in Clinical Practice",
issn = "0884-5336",
publisher = "SAGE Publications Ltd",
number = "6",

}

TY - JOUR

T1 - Clinical relevancy of the levothyroxine-continuous enteral nutrition interaction

AU - Dickerson, Roland

AU - Maish, George O.

AU - Minard, Gayle

AU - Brown, Rex O.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Background: The objective of this study was to determine if patients requiring levothyroxine therapy develop hypothyroidism during concurrent continuous enteral nutrition (EN). Methods: Adult patients with a history of hypothyroidism, given levothyroxine via the feeding tube at the same dose given prior to hospital admission and who were referred to the nutrition support service for EN were evaluated. Thyroid function tests (TFTs) were performed prior to administration of levothyroxine-continuous EN, then approximately weekly thereafter. Patients who received less than 14 days of concurrent EN-levothyroxine therapy were excluded from the analysis. Results: Thirteen patients who received 20 ± 5 days of concurrent EN and levothyroxine were evaluated. Two patients developed subclinical hypothyroidism (thyrotropin [TSH] >6 and <10 mcIU/mL + normal fT 4), and 6 developed overt hypothyroidism (TSH >10 mcIU/mL + low fT 4) within 2 to 3 weeks of concurrent EN-levothyroxine therapy. Five patients remained euthyrotic. Differences between those who developed subclinical or overt hypothyroidism versus those who remained euthyrotic could not be explained by age, weight, levothyroxine dose, type of EN formula, or amount of EN received. Conclusions: More than half of the patients receiving concurrent levothyroxine-continuous EN developed subclinical or overt hypothyroidism requiring therapeutic intervention. Routine weekly monitoring of TFTs for patients receiving concurrent levothyroxine-continuous EN is recommended.

AB - Background: The objective of this study was to determine if patients requiring levothyroxine therapy develop hypothyroidism during concurrent continuous enteral nutrition (EN). Methods: Adult patients with a history of hypothyroidism, given levothyroxine via the feeding tube at the same dose given prior to hospital admission and who were referred to the nutrition support service for EN were evaluated. Thyroid function tests (TFTs) were performed prior to administration of levothyroxine-continuous EN, then approximately weekly thereafter. Patients who received less than 14 days of concurrent EN-levothyroxine therapy were excluded from the analysis. Results: Thirteen patients who received 20 ± 5 days of concurrent EN and levothyroxine were evaluated. Two patients developed subclinical hypothyroidism (thyrotropin [TSH] >6 and <10 mcIU/mL + normal fT 4), and 6 developed overt hypothyroidism (TSH >10 mcIU/mL + low fT 4) within 2 to 3 weeks of concurrent EN-levothyroxine therapy. Five patients remained euthyrotic. Differences between those who developed subclinical or overt hypothyroidism versus those who remained euthyrotic could not be explained by age, weight, levothyroxine dose, type of EN formula, or amount of EN received. Conclusions: More than half of the patients receiving concurrent levothyroxine-continuous EN developed subclinical or overt hypothyroidism requiring therapeutic intervention. Routine weekly monitoring of TFTs for patients receiving concurrent levothyroxine-continuous EN is recommended.

UR - http://www.scopus.com/inward/record.url?scp=78650468880&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650468880&partnerID=8YFLogxK

U2 - 10.1177/0884533610385701

DO - 10.1177/0884533610385701

M3 - Article

VL - 25

SP - 646

EP - 652

JO - Nutrition in Clinical Practice

JF - Nutrition in Clinical Practice

SN - 0884-5336

IS - 6

ER -