Avaliação da absorção da Levotiroxina em pacientes com Hipotireoidismo e intolerância à lactose: revisão sistemática.

Abstract

Hypothyroidism is a clinical condition, which there isa low production or a reduced action of thyroid hormones. It is one of the most frequent endocrinological diseases in clinical practice. It can be classified into primary, secondary and tertiary, and his treatment consists of the replacement of the hormone in the form of levothyroxine. Lactose intolerance is characterized by the inability to correctly digest lactose, by deficiency or even lack of the enzyme lactase. It has global distribution and increased incidence in recent years. Among other consequences, it can cause disabsorption, including malabsorption of drugs Objectives. Aimto evaluate the absorption of levothyroxine in patients with hypothyroidism and lactose intolerance; to describe the epidemiological profile of patients with hypothyroidism using levothyroxine and lactose intolerance; to observe the effect of lactose intolerance on the metabolism and bioavailability of levothyroxine and toindicate factors that may influence the therapy of these patients. Methodology. We have developed systematic review of clinical studies using the keywords '' hypothyroidism '', '' levothyroxine '', '' lactose intolerance '' in virtual libraries MEDLINE / PubMED, Web of Science, Scopus, LILACS, from january 2006 to january 2017. Results. The epidemiological profile of the patients is almost only women, with a mean age of 46.8 years, using 1.7 μg/kg /day of levothyroxine. In patients put in lactose-restricted diet and maintenance of drug dose, TSH levels were reduced in 58%. The diet when associated with lactose-free levothyroxine formulation had a higher reduction: 78% and 96%, respectively. In the absence of lactose intolerance treatment, a dose increase of 33% of levothyroxine is required to reduce TSH levels by 50%. Conclusion. It is important to observe the efficacy of treatment for hypothyroidism, and when the dose of levothyroxine is higher than usual, especially female patients in the fifth decade of life, it should be investigated for concomitant lactose intolerance.