skip to main content

Levothyroxine malabsorption — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

EasyThyroidLevothyroxine malabsorptionSCE Endocrinology

A 59-year-old man with primary hypothyroidism takes levothyroxine with breakfast and omeprazole. TSH remains 14 mU/L despite dose escalation. He feels well and admits taking tablets with calcium supplements. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Separate levothyroxine from calcium and optimise administration timing

Calcium, iron, food and some gastric pH changes can reduce levothyroxine absorption. Correcting administration timing may normalise TSH without unnecessary dose escalation. Carbimazole and radioiodine are inappropriate for hypothyroidism.

Reference: BNF; NICE NG145