Gezer Emre
Darica Farabi Training and Research Hospital, Division of Endocrinology and Metabolism, Kocaeli, Turkey.
Endocrine. 2024 Jul;85(1):267-271. doi: 10.1007/s12020-024-03698-3. Epub 2024 Jan 27.
Levothyroxine (LT4) is the first-line hormone replacement therapy for hypothyroidism. Several factors which have an influence on oral LT4 absorption have been previously described; however, the influence of exercise on oral LT4 absorption has not been reported, yet. It was aimed to investigate the possible effect of morning exercise, right after LT4 ingestion, on the absorption of LT4 tablets in this study.
Patients with primary hypothyroidism who fulfilled the inclusion criteria were offered to participate in a 6-week morning exercise programme and those who agreed to participate were enrolled in our study. Patients were required to have a walk for 30 min with a regular speed right after taking their daily LT4 treatments and start having breakfast the first hour after LT4 intake. Pre- and post-exercise TSH levels were recorded and TSH percentage change was calculated.
All patients had decreased TSH levels after the exercise programme. There was a significant decrease in TSH levels (p < 0.001). A significant positive correlation between TSH percentage change and daily dose of LT4 per kg of body weight was also shown.
This is the first study which demonstrates the significant positive effect of morning exercise on the absorption of LT4 tablets. In addition to that, it was also found that as the daily dose of LT4 increases, the percentage decrease of TSH level becomes greater.
左甲状腺素（LT4）是甲状腺功能减退症的一线激素替代疗法。先前已描述了几种影响口服LT4吸收的因素；然而，运动对口服LT4吸收的影响尚未见报道。本研究旨在探讨LT4摄入后立即进行晨练对LT4片剂吸收的可能影响。
符合纳入标准的原发性甲状腺功能减退症患者被邀请参加为期6周的晨练计划，同意参加的患者纳入本研究。患者在每日服用LT4治疗后，需以正常速度步行30分钟，并在LT4摄入后的第一小时开始吃早餐。记录运动前后的促甲状腺激素（TSH）水平，并计算TSH百分比变化。
所有患者在运动计划后TSH水平均下降。TSH水平有显著下降（p < 0.001）。TSH百分比变化与每日每千克体重LT4剂量之间也显示出显著的正相关。
这是第一项证明晨练对LT4片剂吸收有显著积极影响的研究。此外，还发现随着LT4每日剂量的增加，TSH水平的下降百分比变得更大。
