A 35-year-old woman with Hashimoto thyroiditis started levothyroxine replacement 3 months ago but continues experiencing fatigue and constipation. Vital signs: BP 128/82, HR 58, RR 14, Temp 36.8°C. TSH remains elevated at 8.2 mIU/L despite compliance. She takes her morning medication simultaneously with prenatal vitamins and calcium carbonate. Physical examination reveals no signs of hyperthyroidism. Which of the following best explains her persistent hypothyroid symptoms?
- A)Liothyronine
- B)Potassium iodide
- C)Propylthiouracil
- D)LevothyroxineGABARITO
- E)Methimazole
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 →