Don’t forget iron deficiency and thyroid function with gastric acid suppression

+Practice

Pharmacotherapy

Don’t forget iron deficiency and thyroid function with gastric acid suppression

31 March 2021

By Leanne Te Karu

Wednesday 31 March 2021, 12:39 AM

Vegetarians are potentially more susceptible to iron deficiency in the context of gastric acid suppression

The absorption of medicines for iron deficiency anaemia and hypothyroidism is affected by long-term proton-pump inhibitor use. This case study describes these interactions and the effect the prescribing cascade can have on thyroid function

Key points, A sometimes neglected adverse effect of proton-pump inhibitors is iron deficiency anaemia. As with oral iron replacement preparations, the absorptio

Pharmacology

Education

Endocrinology

Gastroenterology

Medicines and Therapies

References

Schade SG, Cohen RJ, Conrad ME. Effect of hydrochloric acid on iron absorption. N Engl J Med 1968;279(13):672–74.
Centanni, M. Thyroxine treatment: absorption, malabsorption, and novel therapeutic approaches. Endocrine 2013;43(1):8–9.
Guzman-Prado Y, Vita R, Samson O. Concomitant use of levothyroxine and proton pump inhibitors in patients with primary hypothyroidism: a systematic review. J Gen Intern Med 2021; 19 January online.
Virili C, Antonelli A, Santaguida MG, et al. Gastrointestinal malabsorption of thyroxine. Endocr Rev 2019;40(1):118–36.
Irving SA, Vadiveloo T, Leese GP. Drugs that interact with levothyroxine: an observational study from the Thyroid Epidemiology, Audit and Research Study (TEARS). Clin Endocrinol 2015;82:136–41.

Practice archive

How to Treat

+How to treat

COPD: Prevent, treat and comfort

Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management

Wednesday 26 March 2025, 12:50 AM