A 35-year-old woman with Hashimoto thyroiditis started levothyroxine replacement 3 months ago. She presents with persistent fatigue, constipation, and weight gain despite medication compliance. Vital signs: BP 128/82, HR 58, RR 14, Temp 36.8°C. TSH 8.2 mIU/L (elevated). She denies palpitations or tremor. She takes her thyroid hormone each morning with prenatal vitamins and calcium carbonate supplement. Which of the following best explains her inadequate therapeutic response?
- A)Propylthiouracil
- B)Methimazole
- C)LevothyroxineGABARITO
- D)Potassium iodide
- E)Liothyronine
Explicação
Levothyroxine absorption is decreased by iron, calcium, antacids, and bile acid resins. Taking it together with a prenatal vitamin and calcium carbonate can lead to inadequate absorption and persistent hypothyroid symptoms despite adherence. Ver explicação completa e trilha adaptativa →