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Effect of Rifampin Therapy on Thyroid Function Tests in a Hypothyroid Patient on Replacement L-Thyroxine

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▸Requests for reprints should be addressed to William L. Isley, M.D.; University of Missouri-Kansas City School of Medicine (Gold 5), 2411 Holmes; Kansas City, MO 61408.

University of Missouri-Kansas City School of Medicine, Kansas City, Missouri

Ann Intern Med. 1987;107(4):517-518. doi:10.7326/0003-4819-107-4-517
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Normal volunteers treated with rifampin, a potent inducer of liver microsomal enzymes, have significant decreases in serum thyroxine levels and free thyroxine index but no changes in basal or stimulated thyrotropin levels (1-3). We report the case of a patient with primary hypothyroidism receiving a constant replacement dose of L-thyroxine who developed biochemical hypothyroidism when treated with rifampin.

A 31-year-old woman with Turner syndrome and hypertension was admitted with dizziness, nausea, and vomiting. Fifteen months earlier she had had a total thyroidectomy for a rapidly enlarging goiter, which was complicated by hypoparathyroidism and recurrent laryngeal nerve palsy. Pathologic examination of


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