{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:29:06Z","timestamp":1784122146070,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T00:00:00Z","timestamp":1591056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Because of contradictory results, clinical significance of elevated levels of macroprolactin (macroprolactinemia) remains unclear. The aim of this study was to investigate whether macroprolactinemia determines levothyroxine action on hypothalamic\u2010pituitary\u2010thyroid axis activity and thyroid antibody titers in women with autoimmune hypothyroidism. The study population included 2 age\u2010, body mass index\u2013, hormone\u2010, and thyroid antibody\u2013matched groups of premenopausal women with untreated autoimmune subclinical hypothyroidism: 15 subjects with coexisting macroprolactinemia and 29 individuals with prolactin levels within the reference range. All included patients were then treated with levothyroxine for 6 months. Serum levels of thyrotropin, free thyroid hormones, prolactin and 25\u2010hydroxyvitamin D, titers of thyroid peroxidase and thyroglobulin antibodies, as well as macroprolactin content were assessed at the beginning and at the end of the study. Except for 25\u2010hydroxyvitamin D levels and macroprolactin content, there were no significant differences between both study arms in the investigated markers. All participants completed the study. In both treatment arms, levothyroxine treatment decreased thyrotropin levels, increased free thyroxine and free triiodothyronine levels, as well as reduced thyroid peroxidase titers, but this effect was less pronounced in women with macroprolactinemia. In women with normal prolactin levels, levothyroxine reduced also thyroglobulin antibody titers and increased 25\u2010hydroxyvitamin D levels. In this group of patients, treatment\u2010induced changes in hormone levels and thyroid antibody titers correlated with treatment\u2010induced changes in 25\u2010hydroxyvitamin D levels. The obtained results suggest that macroprolactin excess attenuates the impact of levothyroxine on hypothalamic\u2010pituitary\u2010thyroid axis activity and thyroid autoimmunity.<\/jats:p>","DOI":"10.1002\/jcph.1655","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T10:05:08Z","timestamp":1591092308000},"page":"1496-1501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Macroprolactinemia Attenuates the Impact of Levothyroxine on Hypothalamic\u2010Pituitary\u2010Thyroid Axis Activity and Thyroid Autoimmunity in Women With Autoimmune Hypothyroidism"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5454-2620","authenticated-orcid":false,"given":"Robert","family":"Krysiak","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Clinical Pharmacology Medical University of Silesia  Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Kowalcze","sequence":"additional","affiliation":[{"name":"Department of Pediatrics in Bytom School of Health Sciences in Katowice Medical University of Silesia  Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogus\u0142aw","family":"Okopie\u0144","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Pharmacology Medical University of Silesia  Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/edrv-16-3-354"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.2.8272"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2013.07.002"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2017.10.002"},{"key":"e_1_2_10_6_1","first-page":"167132","article-title":"Macroprolactinemia: diagnostic, clinical, and pathogenic significance","volume":"2012","author":"Shimatsu A","journal-title":"Clin Dev Immunol"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1258\/0004563053857969"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2005.02243.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-016-0898-5"},{"issue":"2","key":"e_1_2_10_10_1","first-page":"270","article-title":"Macroprolactinaemia in diabetic patients","volume":"31","author":"Gulcelik NE","year":"2010","journal-title":"Neuro Endocrinol Lett"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5603\/EP.a2019.0013"},{"key":"e_1_2_10_12_1","article-title":"Cardiometabolic risk factors in men with elevated macroprolactin content: a pilot study [published online ahead of print June 11, 2019]","author":"Krysiak R","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.07.017"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13036"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-2730000003002"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2015.10.008"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12217"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1555877"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2014.55.2.476"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP12376.OR"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-123038"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.280.6210.277"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pbiomolbio.2006.02.016"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2016.1151072"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5699(95)80183-9"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-2986"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.12349"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2011.11.009"},{"issue":"2","key":"e_1_2_10_29_1","first-page":"156","article-title":"Polish council for control of iodine deficiency disorders. 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