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Marabotto E, Ferone D, Sheijani AD, Vera L, Ziola S, Savarino E, Bodini G, Furnari M, Zentilin P, Savarino V, Giusti M, Navarro Rojas FA, Bagnasco M, Albertelli M, Giannini EG. Prevalence of Lactose Intolerance in Patients with Hashimoto Thyroiditis and Impact on LT4 Replacement Dose. Nutrients 2022; 14:nu14153017. [PMID: 35893871 PMCID: PMC9331471 DOI: 10.3390/nu14153017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: to determine lactose intolerance (LI) prevalence in women with Hashimoto’s thyroiditis (HT) and assess the impact of LI on LT4 replacement dose. Methods. consecutive patients with HT underwent Lactose Breath Test and clinical/laboratory data collection. Unrelated gastrointestinal disorders were carefully ruled out. Lactose-free diet and shift to lactose-free LT4 were proposed to patients with LI. Results: we enrolled 58 females (age range, 23−72 years) with diagnosis of HT. In total, 15 patients were euthyroid without treatment, and 43 (74%) euthyroid under LT4 (30 of them with a LT4 formulation containing lactose). Gastrointestinal symptoms were present in 84.5% of patients, with a greater prevalence in change in bowel habits in lactose-intolerant patients (p < 0.0001). The cumulative LT4 dose required did not differ in patients with or without LI. No significant difference in both TSH values and LT4 dose were observed in patients shifted to lactose-free LT4 and diet at 3 and 6 months compared to baseline. Conclusion: the prevalence of LI in patients with HT was 58.6%, not different from global prevalence of LI. In the absence of other gastrointestinal disorders, LI seems not to be a major cause of LT4 malabsorption and does not affect the LT4 required dose in HT patients.
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Affiliation(s)
- Elisa Marabotto
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Diego Ferone
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 16132 Genoa, Italy; (D.F.); (L.V.); (M.G.); (F.A.N.R.); (M.B.)
| | - Afscin Djahandideh Sheijani
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Lara Vera
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 16132 Genoa, Italy; (D.F.); (L.V.); (M.G.); (F.A.N.R.); (M.B.)
| | - Sebastiano Ziola
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Edoardo Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy;
| | - Giorgia Bodini
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Manuele Furnari
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Patrizia Zentilin
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Vincenzo Savarino
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
| | - Massimo Giusti
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 16132 Genoa, Italy; (D.F.); (L.V.); (M.G.); (F.A.N.R.); (M.B.)
| | - Fabiola Andrea Navarro Rojas
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 16132 Genoa, Italy; (D.F.); (L.V.); (M.G.); (F.A.N.R.); (M.B.)
| | - Marcello Bagnasco
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 16132 Genoa, Italy; (D.F.); (L.V.); (M.G.); (F.A.N.R.); (M.B.)
| | - Manuela Albertelli
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 16132 Genoa, Italy; (D.F.); (L.V.); (M.G.); (F.A.N.R.); (M.B.)
- Correspondence:
| | - Edoardo G. Giannini
- Division of Gastroenterology, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.M.); (A.D.S.); (S.Z.); (G.B.); (M.F.); (P.Z.); (V.S.); (E.G.G.)
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