Therapy with pantoprazole doesn't seem to affect the absorption of levothyroxine

What is it about?

Proton pump inhibitors like pantoprazole, omeprazole, lansoprazole or esomeprazole are frequently described drugs for treatment of gastritis or gastrointestinal ulcers. Here, we investigated if treatment with pantoprazole affects absorption of levothyroxine. In this small cross-over trial (PAROS) with healthy volunteers we didn't find any differences in bioavailability between probands who were on pantoprazole and those who weren't.

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Why is it important?

The hypothesis that proton pump inhibitors might impair bio-availability of thyroid hormones is questionable. However, reevaluation of thyroid metabolism in patients on antacid drugs is advisable, since it might be the underlying gastrointestinal disease that impairs absorption of iodothyronines like levothyroxine or liothyronine rather than the antacid drug.