I am writing you in response to your question regarding how certain calcium supplements will interact with levothyroxine so that you can finish developing your clinical trial. As you likely know, understanding organic chemistry interactions such as acidity and basicity is vital for deciding how compounds interact. Levothyroxine is a drug which is used to treat hypothyroidism, and many patients taking this drug simultaneously take calcium supplements. Understanding how multiple drugs interaction is important to know whether there will be any undesirable effects. I plan to explain how calcium carbonate and calcium citrate supplements interact differently with levothyroxine and how the environment of the stomach and small intestine affects its absorption. Analyzing the neutral form of levothyroxine, there are three sites which have the possibility of being deprotonated. Deprotonation refers to the loss of a proton, or a hydrogen, by another chemical. For a site to be completely deprotonated and exist solely in that form, the base with which it is interacting must have a pKa at least three orders greater than that of the site on the molecule. Each of these three sites has a different relative acidity due to the structure of …show more content…
Therefore, the Ca2+ will continue interacting with the citrate molecule and will not prevent the absorption of levothyroxine as it will not interact with the negative charge on the levothyroxine molecule. Another reason the calcium associated with the carbonate would be more likely to interact with the levothyroxine is that there is a 1:1 ratio of Ca2+ to carbonate whereas there is a 3:2 ratio of Ca2+ to citrate. Therefore, the citrate molecules hold on tighter to the Ca2+ ions and do a better job of preventing the interaction of calcium with levothyroxine, allowing the drug to still be