Levothyroxine in Psychiatry

Article AbstractLevothyroxine (T4) supplementation may be necessary in various psychiatric contexts. There are many circumstances that result in diminished T4absorption after oral dosing. These include drugs and disorders associated with decreased gastric acidity; constituents of food such as fiber; items of consumption such as soy, coffee, and grapefruit juice; and drugs or supplements such as calcium, iron, sucralfate, orlistat, phosphate binders, and others. Patients are therefore best advised to take T4on an empty stomach, as distant as possible from food, beverages, and other medications; if this is not feasible, possible impairment in absorption can be accepted and the dose of T4titrated to target hormonal levels. However, if this is done, an unexpected hyperthyroid state may arise if the circumstances impairing T4absorption change.