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Levothyroxine and calcium — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsLevothyroxine and calciumGPhC CRA

A 61-year-old woman taking levothyroxine 100micrograms daily buys calcium carbonate tablets after a DEXA scan. She reports recent fatigue and her TSH was above range last month. What would you advise the patient?

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Correct answer: E — Separate calcium and levothyroxine administration by at least 4 hours

Calcium salts can reduce levothyroxine absorption, contributing to poor thyroid control. The medicines should be separated, commonly by at least 4 hours, and levothyroxine should be taken consistently as advised. Stopping levothyroxine would worsen hypothyroidism. Taking levothyroxine with breakfast and calcium may reduce absorption further.

Reference: BNF; NICE CKS Hypothyroidism