Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
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Case Report

Volume 2, Number 6, December 2012, pages 232-234


Marked Improvement of Levothyroxine Malabsorption by Simply Changing the Timing of Thyroxine Ingestion in an Adult Woman With Hypothyroidism After Radioiodine Therapy for Graves’ Disease

Figure

Figure 1.
Figure 1. Clinical course. After radioactive iodine therapy was initiated in July 2009, the patient developed hypothyroidism. In October 2009, she was treated with 50 microgram of levothyroxine (LT4). Although the LT4 dose was increased to 175 microgram, her serum FT4 and TSH levels and clinical signs did not improve. In January 2010, the timing of LT4 ingestion was changed from after breakfast to before breakfast. Since no improvement was observed in her serum TSH levels, the timing of LT4 ingestion was then changed to at bedtime. One month later (in March 2010), her serum TSH level had normalized and her clinical symptoms had disappeared.