Levothyroxine with Chromium Interaction Details


Brand Names Associated with Levothyroxine

  • Levo-T®
  • Levothroid®
  • Levothyroxine
  • Levoxyl®
  • Synthroid®
  • Tirosint®
  • Unithroid®

Medical Content Editor
Last updated Nov 05, 2023


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Interaction Effect

Decreased levothyroxine absorption


Interaction Summary

Concomitant use of chromium picolinate and levothyroxine in healthy euthyroid individuals has resulted in reduced thyroxine (T4) absorption by 17%. Therefore, a separation of several hours between administration of chromium picolinate and levothyroxine is advised.


Severity

Moderate


Onset

Rapid


Evidence

Probable


How To Manage Interaction

Concurrent use of chromium picolinate and levothyroxine decreased the absorption of levothyroxine. Patients should be advised to separate the administration of these drugs by several hours.


Mechanism Of Interaction

Unknown


Literature Reports

A) In pharmacokinetics studies of levothyroxine conducted in healthy euthyroid volunteers (n=7; age range: 22 to 40 years), levothyroxine absorption was decreased (i.e., a smaller area under the serum thyroxine (T4) absorption curve) following the concurrent use of chromium picolinate and levothyroxine compared with the use of levothyroxine alone. In four 6-hour studies performed at least 2 weeks apart, participants who had fasted overnight received levothyroxine sodium 1 mg (five 0.2-mg tablets) orally alone in the first study and levothyroxine 1 mg with ezetimibe 10 mg, sevelamer hydrochloride 800 mg and chromium picolinate 1000 mcg, respectively, in the three subsequent studies. Blood samples were collected 15 minutes before, at the time of, and 30, 60, 120, 240, and 360 minutes after administration in each study. The area between baseline and the T4 absorption curve was 2176 +/- 195 mcg-minutes/dL for levothyroxine administered alone compared with 1766 +/- 171 mcg-minute/dL for levothyroxine administered with chromium picolinate (83% of T4 alone; p less than 0.05). The mean baseline serum of thyroid-stimulating hormone (TSH) level was 2.81 +/- 0.59 microunits/mL for levothyroxine alone and 2.16 +/- 0.43 microunits/mL for levothyroxine plus chromium picolinate; none of the participants showed any symptoms of thyrotoxicosis. Although investigators postulated that the mechanism of this interaction between chromium picolinate and levothyroxine was the adsorption of thyroxine by chromium, other possible mechanisms (e.g., via drug-induced alterations in mucosal transport processes) could not be ruled out .

Levothyroxine Overview

  • Levothyroxine is used to treat hypothyroidism (condition where the thyroid gland does not produce enough thyroid hormone). It is also used with surgery and radioactive iodine therapy to treat thyroid cancer. Levothyroxine is in a class of medications called hormones. It works by replacing thyroid hormone that is normally produced by the body.

  • Without thyroid hormone, your body cannot function properly, which may result in poor growth, slow speech, lack of energy, excessive tiredness, constipation, weight gain, hair loss, dry, thick skin, increased sensitivity to cold, joint and muscle pain, heavy or irregular menstrual periods, and depression. When taken correctly, levothyroxine reverses these symptoms.

See More information Regarding Levothyroxine

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.


Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.


Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.


How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.


Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.


Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

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