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Figure 1 Levothyroxine Structure The shared characteristic of all thyroid hormones is the thyronine nucleus, a diphenyl ether in which the two planar phenyl groups are oriented at an angle of 120 degrees ( a ( Interference With Thyroxine Effectiveness Acting at Gastric Level Food and Drugs Several drugs and foods have been proven to interfere with the oral thyroxine absorption [see for rev ( As mentioned above, the mechanisms of interference affecting oral thyroxine during the gastric passage are substantially the variations of gastric juice pH and the binding of thyroxine in an acidic environment

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The microdose protocol is particularly suited for patients with prior GI sensitivity, those new to injectable medications, or individuals with genetic variations that may increase medication sensitivity