The Effect of Coffee on the Absorption of Thyroid Hormone in Patients With Thyroid Carcinoma

NCT ID: NCT01707056

Last Updated: 2021-02-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2016-06-30

Brief Summary

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The purpose of this study is to evaluate whether taking thyroid hormone medication with beverages other than water, decreases absorption of the medication by the intestine. Specifically we are interested in whether coffee, coffee with milk, or black tea affects how thyroid medication is absorbed by the body. Previous studies have suggested that taking thyroid hormone with coffee may interfere with the ability to absorb thyroid medicine. Given that many patients take their thyroid medicine with beverages other than water, and specifically with coffee or tea, understanding whether and how much coffee or tea may decrease thyroid hormone absorption is important for clinical practice.

This study will help determine the safest and most effective way for adults to take their thyroid medication and will guide medical practitioners in how to counsel their patients when they prescribe thyroid hormone.

Detailed Description

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Previous studies have suggested that taking thyroid replacement therapy with coffee potentially hinders its absorption. We already know that food especially a fiber-rich diet, cholestyramine resin, aluminum containing antacids, activated charcoal, and certain herbal remedies among others interfere with the ability to absorb thyroid medicine. These findings have prompted providers to advise patients to take their levothyroxine on an empty stomach in the morning. However, many patients take their thyroid medicine with their morning cup of coffee prior to eating breakfast. A small study has shown that Italian espresso coffee can decrease the absorption of levothyroxine, but the effect of American style coffee is not known. Given that the intestinal absorption of levothyroxine can be hindered by multiple substances and coffee is the most commonly consumed beverage worldwide, it is important to investigate what effect coffee may have on thyroid hormone absorption and thyroid function tests.

Using methods similar to those used in previous studies, this study will measure thyroid function tests in approximately 10-20 subjects (18-60 years of age) over a 6 hour period of time after taking their thyroid medication with the specified study beverage for a 6 week period. Subjects will be randomized to water, black coffee, coffee with milk, and black tea as four specified study beverages, with water serving as the control beverage. Each subject will be recruited to participate with each study beverage for a 6 week period of time in a total of four consecutive 6 week periods. Blood draws will occur at the end of each 6 week period on test days 1, 2, 3, and 4. The coffee will represent the most common household coffee brand, Folgers. Thyroid function tests with each beverage will be compared to thyroid function tests with water to determine if thyroid medication absorption is impaired by coffee, coffee with milk, or tea.

This study will help determine the safest and most efficacious way for adults to take their thyroid medication and will guide medical practitioners in how to counsel their patients when they prescribe thyroid replacement therapy.

Conditions

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Thyroid Carcinoma Hypothyroidism

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Black coffee

Synthroid will be administered with 12 ounces of black coffee for a period of 6 weeks.

Group Type ACTIVE_COMPARATOR

Black Coffee

Intervention Type OTHER

Taking Synthroid with 12 ounces of black coffee for 6 weeks.

Coffee with Milk

Synthroid will be administered with 12 ounces of coffee and 2 ounces of 2% milk for a period of 6 weeks.

Group Type ACTIVE_COMPARATOR

Coffee with Milk

Intervention Type OTHER

Taking Synthroid with 12 ounces of black coffee and 2 ounces of 2% milk for a period of 6 weeks.

Black Tea

Synthroid will be administered with 12 ounces of black Lipton tea for a period of 6 weeks.

Group Type ACTIVE_COMPARATOR

Black Tea

Intervention Type OTHER

Taking Synthroid with 12 ounces of black tea for a period of 6 weeks.

Water

Synthroid will be administered with 12 ounces of water for a period of 6 weeks.

Group Type PLACEBO_COMPARATOR

Water

Intervention Type OTHER

Taking Synthroid with water for a period of 6 weeks.

Interventions

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Black Coffee

Taking Synthroid with 12 ounces of black coffee for 6 weeks.

Intervention Type OTHER

Coffee with Milk

Taking Synthroid with 12 ounces of black coffee and 2 ounces of 2% milk for a period of 6 weeks.

Intervention Type OTHER

Black Tea

Taking Synthroid with 12 ounces of black tea for a period of 6 weeks.

Intervention Type OTHER

Water

Taking Synthroid with water for a period of 6 weeks.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

\- patients with thyroid carcinoma after standard care of treatment on stable dose of Synthroid with a detectable baseline TSH

Exclusion Criteria

* Pregnancy
* Undetectable baseline TSH
* Not willing to drink coffee, coffee with milk, or black tea
* Age less than 18 or greater than 60 years old
* Taking generic thyroid hormone (levothyroxine) and not brand-name Synthroid
* Dose of thyroid medication has been recently changed (less than 3 months ago)
* Currently receiving treatment for gastroesophageal reflux disease, gastritis, stomach or intestinal cancer, inflammatory bowel disease, or H. pylori
* Taking cholestyramine resin, colestipol hydrochloride, sucralfate, iron sulphate, aluminum containing antacids, activated charcoal, raloxifene, and herbal remedies
* History of previous gastric or small intestine surgery
* Diagnosis of kidney or liver disease, congestive heart failure, anemia, biliary disease, pancreatitis
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Georgetown University

OTHER

Sponsor Role collaborator

Medstar Health Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dorota Krajewski, MD

Role: PRINCIPAL_INVESTIGATOR

MedStar Health

Locations

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Georgetown University Hospital

Washington D.C., District of Columbia, United States

Site Status

Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

MedStar St. Mary's Hospital

Leonardtown, Maryland, United States

Site Status

Countries

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United States

References

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Benvenga S, Bartolone L, Pappalardo MA, Russo A, Lapa D, Giorgianni G, Saraceno G, Trimarchi F. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid. 2008 Mar;18(3):293-301. doi: 10.1089/thy.2007.0222.

Reference Type BACKGROUND
PMID: 18341376 (View on PubMed)

Other Identifiers

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2011-338

Identifier Type: -

Identifier Source: org_study_id

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