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Levothyroxine administration — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsLevothyroxine administrationGPhC CRA

A 64-year-old woman says her TSH has risen after she started calcium carbonate for osteoporosis prevention. She takes levothyroxine 100micrograms with breakfast and takes calcium at the same time to remember it. She feels more tired than usual. What would you advise the patient?

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Correct answer: D — Separate levothyroxine from calcium and take it consistently before food

Calcium salts can reduce levothyroxine absorption, and levothyroxine is usually taken consistently on an empty stomach. Separating administration times can improve absorption and stabilise thyroid function. Dose changes should be guided by thyroid function tests and prescriber review. Stopping or doubling levothyroxine without review is inappropriate.

Reference: BNF Levothyroxine; NICE CKS Hypothyroidism