Skip to main content
Top
Published in: Endocrine 2/2014

01-06-2014 | Original Article

Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance

Authors: Mehmet Asik, Fahri Gunes, Emine Binnetoglu, Mustafa Eroglu, Neslihan Bozkurt, Hacer Sen, Erdem Akbal, Coskun Bakar, Yavuz Beyazit, Kubilay Ukinc

Published in: Endocrine | Issue 2/2014

Login to get access

Abstract

We aimed to evaluate the prevalence of lactose intolerance (LI) in patients with Hashimoto’s thyroiditis (HT) and the effects of lactose restriction on thyroid function in these patients. Eighty-three HT patients taking l-thyroxine (LT4) were enrolled, and lactose tolerance tests were performed on all patients. Lactose intolerance was diagnosed in 75.9 % of the patients with HT. Thirty-eight patients with LI were started on a lactose-restricted diet for 8 weeks. Thirty-eight patients with LI (30 euthyroid and 8 with subclinical hypothyroidism), and 12 patients without LI were included in the final analysis. The level of TSH significantly decreased in the euthyroid and subclinical hypothyroid patients with LI [from 2.06 ± 1.02 to 1.51 ± 1.1 IU/mL and from 5.45 ± 0.74 to 2.25 ± 1.88 IU/mL, respectively (both P < 0.05)]. However, the level of TSH in patients without LI did not change significantly over the 8 weeks (P > 0.05). Lactose intolerance occurs at a high frequency in HT patients. Lactose restriction leads to decreased levels of TSH, and LI should be considered in hypothyroid patients who require increasing LT4 doses, have irregular TSH levels and are resistant to LT4 treatment.
Literature
1.
go back to reference M. Ruchała, E. Szczepanek-Parulska, A. Zybek, The influence of lactose intolerance and other gastro-intestinal tract disorders on L-thyroxine absorption. Endocrinol. Pol. 63, 318–323 (2012) M. Ruchała, E. Szczepanek-Parulska, A. Zybek, The influence of lactose intolerance and other gastro-intestinal tract disorders on L-thyroxine absorption. Endocrinol. Pol. 63, 318–323 (2012)
2.
go back to reference M. Centanni, Thyroxine treatment: absorption, malabsorption, and novel therapeutic approaches. Endocrine 43, 8–9 (2013)PubMedCrossRef M. Centanni, Thyroxine treatment: absorption, malabsorption, and novel therapeutic approaches. Endocrine 43, 8–9 (2013)PubMedCrossRef
3.
go back to reference E. Vermeire, H. Hearnshaw, P. Van Royen, J. Denekens, Patient adherence to treatment: three decades of research. A comprehensive review. J. Clin. Pharm. Ther. 26, 331–342 (2001)PubMedCrossRef E. Vermeire, H. Hearnshaw, P. Van Royen, J. Denekens, Patient adherence to treatment: three decades of research. A comprehensive review. J. Clin. Pharm. Ther. 26, 331–342 (2001)PubMedCrossRef
4.
go back to reference T.G. Bach-Huynh, B. Nayak, J. Loh, S. Soldin, J. Jonklaas, Timing of levothyroxine administration affects serum thyrotropin concentration. J. Clin. Endocrinol. Metab. 94, 3905–3912 (2009)PubMedCentralPubMedCrossRef T.G. Bach-Huynh, B. Nayak, J. Loh, S. Soldin, J. Jonklaas, Timing of levothyroxine administration affects serum thyrotropin concentration. J. Clin. Endocrinol. Metab. 94, 3905–3912 (2009)PubMedCentralPubMedCrossRef
5.
go back to reference P. Colucci, C.S. Yue, M. Ducharme, S. Benvenga, A review of the pharmacokinetics of levothyroxine for the treatment of hypothyroidism. Eur. Endocrinol. 9, 40–47 (2013) P. Colucci, C.S. Yue, M. Ducharme, S. Benvenga, A review of the pharmacokinetics of levothyroxine for the treatment of hypothyroidism. Eur. Endocrinol. 9, 40–47 (2013)
6.
go back to reference S. Benvenga, L. Bartolone, M.A. Pappalardo, A. Russo, D. Lapa, G. Giorgianni, G. Saraceno, F. Trimarchi, Altered intestinal absorption of l-thyroxine caused by coffee. Thyroid 18, 293–301 (2008)PubMedCrossRef S. Benvenga, L. Bartolone, M.A. Pappalardo, A. Russo, D. Lapa, G. Giorgianni, G. Saraceno, F. Trimarchi, Altered intestinal absorption of l-thyroxine caused by coffee. Thyroid 18, 293–301 (2008)PubMedCrossRef
7.
8.
go back to reference L. Liwanpo, J.M. Hershman, Conditions and drugs interfering with thyroxine absorption. Best Pract. Res. Clin. Endocrinol. Metab. 23, 781–792 (2009)PubMedCrossRef L. Liwanpo, J.M. Hershman, Conditions and drugs interfering with thyroxine absorption. Best Pract. Res. Clin. Endocrinol. Metab. 23, 781–792 (2009)PubMedCrossRef
9.
go back to reference C. Virili, G. Bassotti, M.G. Santaguida, R. Iuorio, S.C. Del Duca, V. Mercuri, A. Picarelli, P. Gargiulo, L. Gargano, M. Centanni, Atypical celiac disease as cause of increased need for thyroxine: a systematic study. J. Clin. Endocrinol. Metab. 97, 419–422 (2012)CrossRef C. Virili, G. Bassotti, M.G. Santaguida, R. Iuorio, S.C. Del Duca, V. Mercuri, A. Picarelli, P. Gargiulo, L. Gargano, M. Centanni, Atypical celiac disease as cause of increased need for thyroxine: a systematic study. J. Clin. Endocrinol. Metab. 97, 419–422 (2012)CrossRef
10.
go back to reference P. Puri, E.J. Guiney, Transient hypothyroidism associated with short gut syndrome. J. Pediatr. Surg. 17, 22–24 (1982)PubMedCrossRef P. Puri, E.J. Guiney, Transient hypothyroidism associated with short gut syndrome. J. Pediatr. Surg. 17, 22–24 (1982)PubMedCrossRef
11.
go back to reference M. Muñoz-Torres, M. Varsavsky, G. Alonso, Lactose intolerance revealed by severe resistance to treatment with levothyroxine. Thyroid 16, 1171–1173 (2006)PubMedCrossRef M. Muñoz-Torres, M. Varsavsky, G. Alonso, Lactose intolerance revealed by severe resistance to treatment with levothyroxine. Thyroid 16, 1171–1173 (2006)PubMedCrossRef
12.
go back to reference N.S. Scrimshaw, E.B. Murray, Prevalence of lactose maldigestion. Am. J. Clin. Nutr. 48, 1086–1098 (1988) N.S. Scrimshaw, E.B. Murray, Prevalence of lactose maldigestion. Am. J. Clin. Nutr. 48, 1086–1098 (1988)
14.
go back to reference S.J. Mandel, G.A. Brent, P.R. Larsen, Levothyroxine therapy in patients with thyroid disease. Ann. Intern. Med. 119, 492–502 (1993)PubMedCrossRef S.J. Mandel, G.A. Brent, P.R. Larsen, Levothyroxine therapy in patients with thyroid disease. Ann. Intern. Med. 119, 492–502 (1993)PubMedCrossRef
15.
go back to reference S. Ladas, J. Papanikos, G. Arapakis, Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance. Gut 23, 968–973 (1982)PubMedCentralPubMedCrossRef S. Ladas, J. Papanikos, G. Arapakis, Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance. Gut 23, 968–973 (1982)PubMedCentralPubMedCrossRef
16.
go back to reference H. Arola, Diagnosis of hypolactasia and lactose malabsorption. Scand. J. Gastroenterol. 29, 26–35 (1994)CrossRef H. Arola, Diagnosis of hypolactasia and lactose malabsorption. Scand. J. Gastroenterol. 29, 26–35 (1994)CrossRef
17.
go back to reference S.L. Carter, S. Attel, The diagnosis and management of patients with lactose-intolerance. Nurse Pract. 38, 23–28 (2013)PubMedCrossRef S.L. Carter, S. Attel, The diagnosis and management of patients with lactose-intolerance. Nurse Pract. 38, 23–28 (2013)PubMedCrossRef
18.
go back to reference S. Reichlin, R.D. Utiger, Regulation of the pituitary-thyroid axis in man: relationship of TSH concentration to concentration of free and total thyroxine in plasma. J. Clin. Endocrinol. Metab. 27, 251–255 (1967)PubMedCrossRef S. Reichlin, R.D. Utiger, Regulation of the pituitary-thyroid axis in man: relationship of TSH concentration to concentration of free and total thyroxine in plasma. J. Clin. Endocrinol. Metab. 27, 251–255 (1967)PubMedCrossRef
19.
go back to reference M.B. Heyman, Lactose intolerance in infants, children, and adolescents. Pediatrics 118, 1279–1286 (2006)PubMedCrossRef M.B. Heyman, Lactose intolerance in infants, children, and adolescents. Pediatrics 118, 1279–1286 (2006)PubMedCrossRef
21.
go back to reference V. Ojetti, G. Nucera, A. Migneco, M. Gabrielli, C. Lauritano, S. Danese, M.A. Zocco, E.C. Nista, G. Cammarota, A. De Lorenzo, G. Gasbarrini, A. Gasbarrini, High prevalence of celiac disease in patients with lactose intolerance. Digestion 71, 106–110 (2005)PubMedCrossRef V. Ojetti, G. Nucera, A. Migneco, M. Gabrielli, C. Lauritano, S. Danese, M.A. Zocco, E.C. Nista, G. Cammarota, A. De Lorenzo, G. Gasbarrini, A. Gasbarrini, High prevalence of celiac disease in patients with lactose intolerance. Digestion 71, 106–110 (2005)PubMedCrossRef
22.
go back to reference P. Eadala, J.P. Waud, S.B. Matthews, J.T. Green, A.K. Campbell, Quantifying the ‘hidden’ lactose in drugs used for the treatment of gastrointestinal conditions. Aliment. Pharmacol. Ther. 29, 677–687 (2009)PubMedCrossRef P. Eadala, J.P. Waud, S.B. Matthews, J.T. Green, A.K. Campbell, Quantifying the ‘hidden’ lactose in drugs used for the treatment of gastrointestinal conditions. Aliment. Pharmacol. Ther. 29, 677–687 (2009)PubMedCrossRef
23.
go back to reference R. Vita, G. Saraceno, F. Trimarchi, S. Benvenga, A novel formulation of l-thyroxine (L-T4) reduces the problem of L-T4 malabsorption by coffee observed with traditional tablet formulations. Endocrine 43, 154–160 (2013)PubMedCrossRef R. Vita, G. Saraceno, F. Trimarchi, S. Benvenga, A novel formulation of l-thyroxine (L-T4) reduces the problem of L-T4 malabsorption by coffee observed with traditional tablet formulations. Endocrine 43, 154–160 (2013)PubMedCrossRef
Metadata
Title
Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance
Authors
Mehmet Asik
Fahri Gunes
Emine Binnetoglu
Mustafa Eroglu
Neslihan Bozkurt
Hacer Sen
Erdem Akbal
Coskun Bakar
Yavuz Beyazit
Kubilay Ukinc
Publication date
01-06-2014
Publisher
Springer US
Published in
Endocrine / Issue 2/2014
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-013-0065-1

Other articles of this Issue 2/2014

Endocrine 2/2014 Go to the issue

Pros and Cons in Endocrine Practice

Cabergoline treatment in acromegaly: pros

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.