Concomitant use of thyroxin and PPI increases TSH in primary hypothyroidism: Study

Yuli Guzman-Prado, International Centre for Medical Research, Dorset, UK, and colleagues aimed to assess the effect of concomitant use of LT4 and PPIs on the levels of TSH in primary hypothyroidism patients. 

For the purpose, the researchers performed a systematic review of interventional and observational studies that compared TSH levels before and after concomitant use of LT4 and PPI. It included articles published upto September 1, 2019. 

Study quality was assessed with the Newcastle–Ottawa quality assessment scale for observational studies and the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) tool was used.

The researchers identified five thousand twelve discrete articles, out of which seven studies met the eligibility criteria and were included. 

"We found that concomitant use of LT4 and PPI showed a significant increase in TSH concentration," wrote the authors. "However, given the small number of studies, further research is needed to clarify the interfering role of PPI on LT4 intestinal absorption."

The study titled, "Concomitant Use of Levothyroxine and Proton Pump Inhibitors in Patients with Primary Hypothyroidism: a Systematic Review," is published in the Journal of General Internal Medicine.

DOI: https://link.springer.com/article/10.1007/s11606-020-06403-y