Don’t forget iron deficiency and thyroid function with gastric acid suppression

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Pharmacotherapy

Don’t forget iron deficiency and thyroid function with gastric acid suppression

31 March 2021

By Leanne Te Karu

Wednesday 31 March 2021, 12:39 AM

Vegetarians are potentially more susceptible to iron deficiency in the context of gastric acid suppression

The absorption of medicines for iron deficiency anaemia and hypothyroidism is affected by long-term proton-pump inhibitor use. This case study describes these interactions and the effect the prescribing cascade can have on thyroid function

Key points, A sometimes neglected adverse effect of proton-pump inhibitors is iron deficiency anaemia. As with oral iron replacement preparations, the absorptio

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References

Schade SG, Cohen RJ, Conrad ME. Effect of hydrochloric acid on iron absorption. N Engl J Med 1968;279(13):672–74.
Centanni, M. Thyroxine treatment: absorption, malabsorption, and novel therapeutic approaches. Endocrine 2013;43(1):8–9.
Guzman-Prado Y, Vita R, Samson O. Concomitant use of levothyroxine and proton pump inhibitors in patients with primary hypothyroidism: a systematic review. J Gen Intern Med 2021; 19 January online.
Virili C, Antonelli A, Santaguida MG, et al. Gastrointestinal malabsorption of thyroxine. Endocr Rev 2019;40(1):118–36.
Irving SA, Vadiveloo T, Leese GP. Drugs that interact with levothyroxine: an observational study from the Thyroid Epidemiology, Audit and Research Study (TEARS). Clin Endocrinol 2015;82:136–41.

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