Laparoscopic Roux-en-Y Gastric Bypass Surgery on Morbidly Obese Patients with Hypothyroidism

Fazylov, Rafael; Soto, Eliana; Cohen, S.; Merola, Stephen

doi:10.1007/s11695-007-9279-8

Cited by 39 publications

(29 citation statements)

References 18 publications

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“…The observation that weight loss is associated with decreases in TSH and FT3 has highlighted that TSH elevation may be a consequence and not the cause of obesity [11-16, 18, 19]. Even in patients with a clinical diagnosis of hypothyroidism, there are reports of decreased levels of TSH after bariatric surgery [13,14,26,27]. In two studies, all the patients with untreated subclinical hypothyroidism reached normal values of TSH 12 months after bariatric surgery [13,14].…”

Section: Discussionmentioning

confidence: 99%

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

et al. 2017

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Background Several studies have reported that morbid obesity is associated with increased thyroid-stimulating hormone (TSH) levels. However, it is not clear what is the impact of bariatric surgery on postoperative thyroid function. The aim of this study was to evaluate the effect of weight loss after bariatric surgery on TSH levels in euthyroid patients with morbid obesity. TSH, free thyroxine (FT4), free triiodothyronine (FT3), type of surgery, and excessive body weight loss (EBWL) on TSH variation 12 months after surgery was evaluated. MethodsResults The high-normal TSH group (24.3% of patients) included more women, presented a higher BMI, higher systolic blood pressure, and higher FT3 levels. There was a significant decrease of TSH 12 months after surgery that was more marked in the high-normal TSH group (normal TSH group: 1.57 ± 0.49 to 1.53 ± 0.69 mIU/L, p = 0.063; high-normal TSH group: 3.23 ± 0.59 to 2.38 ± 0.86 mIU/L, p < 0.001). In a multivariate analysis, after adjusting for relevant covariates, EBWL, baseline BMI, and baseline FT3 were significantly associated with TSH decrease 12 months after bariatric surgery.Conclusion Bariatric surgery promotes a decrease of TSH that is significantly greater in patients with high-normal TSH and is independently associated with EBWL after surgery.

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Section: Discussionmentioning

confidence: 99%

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

et al. 2017

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“…2) [22], where the frequency of underlying thyroid disease in the population is much lower than in adults. Characteristically, weight reduction by change of lifestyle and diet [22,23] or following gastric banding [24] or gastric bypass surgery [25] tends to ameliorate the small aberration in thyroid function tests in the majority of obese patients.…”

Section: Obesity and Pituitary-thyroid Activationmentioning

confidence: 99%

Thyroid Function and Obesity

Laurberg¹,

Knudsen²,

Andersen³

et al. 2012

Eur Thyroid J

144

121

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Important interaction exists between thyroid function, weight control, and obesity. Several mechanisms seem to be involved, and in studies of groups of people the pattern of thyroid function tests depends on the balance of obesity and underlying thyroid disease in the cohort studied. Obese people with a normal thyroid gland tend to have activation of the hypothalamic-pituitary-thyroid axis with higher serum TSH and thyroid hormones in serum. On the other hand, small differences in thyroid function are associated with up to 5 kg difference in body weight. The weight loss after therapy of overt hypothyroidism is caused by excretion of water bound in tissues (myxoedema). Many patients treated for hyperthyroidism experience a gain of more weight than they lost during the active phase of the disease. The mechanism for this excessive weight gain has not been fully elucidated. New studies on the relation between L-T₃ therapy and weight control are discussed. The interaction between weight control and therapy of thyroid disease is important to many patients and it should be studied in more detail.

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“…The exact mechanism of improvement of thyroid dysfunction status after bariatric surgery related not only to weight loss but also to the hormonal change after LSG, LRYGB as hypothesized by different studies in which the level of TSH reduction was not directly correlated to the EWL [4,8,15].…”

Section: Discussionmentioning

confidence: 98%

“…Fazylov et al [4] have shown a decrease in postoperative L-thyroxine dosage after LRYGB for morbid obese patient with clinical hypothyroidismin 35% of patients (25% complete resolution and 10% reduction in dose) in dose unchanged in 40% of patients and worsened in 25% of patients with thyroid autoimmune disease.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Effect of Laparoscopic Sleeve Gastrectomy on Clinical Hypothyroidism in Morbidly Obese Patients

Elnabil¹,

Ahmed²,

Mostafa³

2017

Thyroid Disorders Ther

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Laparoscopic Roux-en-Y Gastric Bypass Surgery on Morbidly Obese Patients with Hypothyroidism

Abstract: Hypothyroidism appears to improve in the vast majority of morbidly obese patients who undergo LRYGB, except for those whose thyroid disease is autoimmune in nature.

Cited by 39 publications

References 18 publications

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

Thyroid Function and Obesity

Effect of Laparoscopic Sleeve Gastrectomy on Clinical Hypothyroidism in Morbidly Obese Patients

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