What does this research mean for the field?

Ingestion of acacia gum, a common pharmaceutical excipient, can cause severe systemic hypersensitivity reactions. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Investigate a suspected excipient allergy to acacia gum in a patient presenting with long-standing, unexplained multisystem symptoms following levothyroxine ingestion.

August 22, 2026Allergy Asthma and Clinical ImmunologyOpen Access

Systemic hypersensitivity to acacia gum as a pharmaceutical excipient: a case report

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Authors

MRMarianne Bou Rjeily IAIkram Abow-Mohamed SDSamuel Denis-D’Ortun

Discussion

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Overview

Case report demonstrates systemic allergic hypersensitivity to ingested acacia gum excipient in a patient with hypothyroidism, highlighting inactive ingredients as potential hidden triggers.

Key Points

Investigate a suspected excipient allergy to acacia gum in a patient presenting with long-standing, unexplained multisystem symptoms following levothyroxine ingestion.
Assessed a 37-year-old male with a 10-year history of headaches, presyncope, weakness, and nasal congestion resolving upon discontinuation of commercial Synthroid.
Performed skin prick testing and intradermal testing with Synthroid, acacia gum, and pure levothyroxine.
Conducted placebo-controlled oral challenges with Synthroid (7.5 mcg) and acacia gum (0.5 g).
Skin prick testing was negative, but intradermal testing was positive for Synthroid (6 mm wheal, 12 mm flare) and acacia gum (50 mm wheal), while remaining negative for pure levothyroxine.
Placebo-controlled oral challenge provoked symptoms within 10 minutes of taking 7.5 mcg Synthroid (10% of standard dose), which were reproduced by 0.5 g acacia gum.
Replacement of the commercial drug with compounded levothyroxine lacking acacia gum resulted in sustained symptom resolution.

Cite This Study

Rjeily et al. (2026) studied this question.

synapsesocial.com/papers/6a895eaeca7ade938187cd2e https://doi.org/10.1186/s13223-026-01057-7

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August 22, 2026Allergy Asthma and Clinical ImmunologyOpen Access

Systemic hypersensitivity to acacia gum as a pharmaceutical excipient: a case report

View Full Paper

Ask AI

Bookmark

Authors

MRMarianne Bou Rjeily IAIkram Abow-Mohamed SDSamuel Denis-D’Ortun

Discussion

Member takes

Overview

Case report demonstrates systemic allergic hypersensitivity to ingested acacia gum excipient in a patient with hypothyroidism, highlighting inactive ingredients as potential hidden triggers.

Key Points

Investigate a suspected excipient allergy to acacia gum in a patient presenting with long-standing, unexplained multisystem symptoms following levothyroxine ingestion.
Assessed a 37-year-old male with a 10-year history of headaches, presyncope, weakness, and nasal congestion resolving upon discontinuation of commercial Synthroid.
Performed skin prick testing and intradermal testing with Synthroid, acacia gum, and pure levothyroxine.
Conducted placebo-controlled oral challenges with Synthroid (7.5 mcg) and acacia gum (0.5 g).
Skin prick testing was negative, but intradermal testing was positive for Synthroid (6 mm wheal, 12 mm flare) and acacia gum (50 mm wheal), while remaining negative for pure levothyroxine.
Placebo-controlled oral challenge provoked symptoms within 10 minutes of taking 7.5 mcg Synthroid (10% of standard dose), which were reproduced by 0.5 g acacia gum.
Replacement of the commercial drug with compounded levothyroxine lacking acacia gum resulted in sustained symptom resolution.

Cite This Study

Rjeily et al. (2026) studied this question.

synapsesocial.com/papers/6a895eaeca7ade938187cd2e https://doi.org/10.1186/s13223-026-01057-7

View Full Paper

Ask AI

Bookmark