TRANSRECTAL ADMINISTRATION OF THYROID HORMONE

Abstract

Transrectal administration of thyroid hormone was successfully performed for a patient who could not take any drugs from oral route due to anastomotic leakage. A patient had received a subtotal colectomy for familial polyposis and a total thyroidectomy for a cancer. One year after the operation, the patient underwent a resection of the small intestine for desdmoid. Because of the leakage of anastomosis, oral administration of thyroid hormone became to be impossible. The serum T3 and T4 levels decreased. So she was given levothyroxine sodium in a form of suppository. The serum T3 and T4 levels increased to normal range. For transrectal admininstration, the patient needed thyroid hormone preparation at a dose of 200-300mg which might be equivalent to 2 to 3 times the oral dose. It should be considered not only that the trasrectal absorption of the drug is simply inferior to that per oral route, but also that the metabolism in postoperative patients is accelerated. This patient repeated constipation and diarrhea that might participate with her requirement of large dose in suppository form. Transrectal administration of suppository close form of thyroid hormone seems to be useful for a hypothyroidism patient who can not take oral route administration.