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Thyroid surgery, bariatric surgery.

Alex Zendel, Yasmin Abu-Ghanem, Joseph Dux, Eyal Mor, Douglas Zippel, David Goitein
BACKGROUND: Bariatric surgery (BS) is effective in treating obesity and its associated comorbidities. However, there is a paucity of data on the effect of BS on thyroid function in hypothyroid patients, specifically in those treated with thyroid hormone replacement therapy (THR). The aim of this study was to assess the effect of BS on thyroid function and on THR dosage in patients with hypothyroidism. METHODS: A retrospective analysis of prospectively collected data of all hypothyroid patients who underwent BS between 2010 and 2014 was performed...
March 2, 2017: Obesity Surgery
Marko Skelin, Tomo Lucijanić, Daniela Amidžić Klarić, Arnes Rešić, Miro Bakula, Ana-Marija Liberati-Čizmek, Hossein Gharib, Dario Rahelić
PURPOSE: Levothyroxine (LT4) is a drug with a narrow therapeutic index, applied in small amounts (micrograms), which makes interactions in the absorption phase clinically significant. The main aim of this article was to review and present the latest information on factors that affect the gastrointestinal absorption of this drug. METHODS: Relevant data were collected by using the MEDLINE, PubMed, EMBASE, Web of Science, Science Direct, and Scopus databases with the key words levothyroxine and absorption...
February 2017: Clinical Therapeutics
Ewen M Harrison, Thomas M Drake, Stephen O'Neill, Catherine A Shaw, O James Garden, Stephen J Wigmore
OBJECTIVES: There is controversy on the proposed benefits of publishing mortality rates for individual surgeons. In some procedures, analysis at the level of an individual surgeon may lack statistical power. The aim was to determine the likelihood that variation in surgeon performance will be detected using published outcome data. DESIGN: A national analysis surgeon-level mortality rates to calculate the level of power for the reported mortality rate across multiple surgical procedures...
October 31, 2016: BMJ Open
Mathew B Vansant, Melda Kunduk, Andrew J McWhorter
PURPOSE OF REVIEW: This article reviews current literature regarding postsurgical dysphagia in nonmalignant disease examining the current recommendations, risk factors, and potential implications. RECENT FINDINGS: Surgical interventions including anterior cervical spine surgery, thyroidectomy, laryngeal and pulmonary, cardiac, esophageal and fundoplication, gastric and bariatric, and posterior fossa surgeries are known to result in swallowing dysfunction. Postsurgical dysphagia may increase the length of hospitalization, overall cost, risk of pneumonia, and time to oral intake...
December 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Poupak Fallahi, Silvia Martina Ferrari, Ilaria Ruffilli, Francesca Ragusa, Marco Biricotti, Gabriele Materazzi, Paolo Miccoli, Alessandro Antonelli
The most recent advance concerning levothyroxine (L-T4) therapy is the development of novel oral formulations: the liquid preparation, and the soft gel capsule. Areas covered: This review evaluates the most recent clinical studies about these new formulations. The liquid formulation has been shown to overcome: the food and beverages intereference with L-T4 tablets absorption, caused by food or coffee at breakfast; malabsorption induced by the increased gastric pH, resulting from atrophic gastritis, or due to proton-pump inhibitors; and malabsorption after bariatric surgery...
August 30, 2016: Expert Opinion on Drug Delivery
Silpa Gadiraju, Clare J Lee, David S Cooper
BACKGROUND: Based on the mechanisms of drug absorption, increased levothyroxine requirements are expected after bariatric surgery. However, there are conflicting data on this topic. This review evaluates the effects of bariatric surgery on levothyroxine dosing. METHODS: Data were obtained from PubMed, Scopus, and review of published bibliographies. RESULTS: Six of 10 studies demonstrated decreased postoperative requirements. Most demonstrated correlations between weight loss and dose...
October 2016: Obesity Surgery
Christophe Hommel, Etienne Delgrange
We report the case of a 49-year-old female patient with hypothyroidism who underwent bariatric surgery and developed severe hypothyroidism despite high doses of oral levothyroxine (L-T4) tablets. Initially, a high-dose L-T4 tablets absorption test was performed to exclude pseudo-malabsorption. In view of a modest increase in serum T4 levels, L-T4 liquid formulation absorption test was performed, and showed faster and more efficient absorption of thyroid hormones. We discuss the issue of distinguishing malabsorption from pseudo-malabsorption, review the literature concerning the benefits of liquid L-T4 in cases of impaired absorption such as bariatric surgery and consider the socio-economic implications of different liquid formulations...
June 16, 2016: Acta Clinica Belgica
Peter Wolf, Yvonne Winhofer, Sabina Smajis, Renate Kruschitz, Karin Schindler, Alois Gessl, Michaela Riedl, Greisa Vila, Wolfgang Raber, Felix Langer, Gerhard Prager, Bernhard Ludvik, Anton Luger, Michael Krebs
OBJECTIVE: Craniopharyngiomas (CPs) are benign brain tumors presenting frequently in childhood and are treated by surgery with or without radiotherapy. About 50% of cured patients suffer from eating disorders and obesity due to hypothalamic damage, as well as hypopituitarism, necessitating subsequent hormone substitution therapy. Gastric bypass surgery has been reported to be an efficient treatment strategy for morbid hypothalamic obesity. However, so far it is unknown whether oral hormone substitution is affected by impaired intestinal drug absorption, potentially leading to severe hypopituitarism or pituitary crisis...
May 2016: Endocrine Practice
Veronica Alvarez, Fernando Carrasco, Ada Cuevas, Barbara Valenzuela, Giselle Muñoz, Daniela Ghiardo, Maria Burr, Yael Lehmann, Maria J Leiva, Marcos Berry, Fernando Maluenda
OBJECTIVES: Weight regain after bariatric surgery may be associated with behavioral, metabolic, or mechanical factors alone or in combination. The aim of this study was to investigate which factors are related to weight regain in the long-term after sleeve gastrectomy (SG). METHODS: A retrospective case-control study with 40 patients undergoing SG (32 women, 8 men; age 42.9 ± 10.7 y; preoperative body mass index 35 ± 2.8 kg/m(2)), was performed. Patients were grouped according percentile->50% (cases) or <50% (controls)-of weight regain (%WR cutoff: 25% of weight loss)...
March 2016: Nutrition
C Vaurs, C Diméglio, L Charras, Y Anduze, M Chalret du Rieu, P Ritz
AIM: The constituents of weight loss following bariatric surgery are poorly known. There is an expectation of a limited loss of lean body mass (LBM), and a significant loss of fat mass (FM) as well as muscle mass (MM), which could lead to functional loss and metabolic impairment. This prospective study analysed the determinants of MM changes after Roux-en-Y gastric bypass and sleeve gastrectomy. METHODS: The study cohort comprised 114 consecutive candidates for bariatric surgery referred to a bariatric surgery centre...
November 2015: Diabetes & Metabolism
Dina El-Kady, James Laurence Bedell, Eleazar OʼGarro, David Yens
INTRODUCTION: Nausea and vomiting in the early part of pregnancy affects up to 75% of pregnant women. Hyperemesis, the severe form, affects 1-2%. There is a known relationship between transient hyperthyroidism with hyperemesis, owing to the identical alpha-subunit of human chorionic gonadotropin and thyroid-stimulating hormone (TSH). We sought to determine whether the opposite was true: Do women with elevated TSH and hypothyroidism have less nausea, vomiting, and hyperemesis gravidarum? METHODS: A retrospective chart review was performed at Good Samaritan Hospital from 2009 to 2012...
May 2015: Obstetrics and Gynecology
Ignace M C Janssen, Jens Homan, Wendy Schijns, Bark Betzel, Edo O Aarts, Frits J Berends, Hans de Boer
BACKGROUND: Subclinical hypothyroidism (SH), defined as a raised serum thyroid-stimulating hormone (TSH) with a normal free thyroxine (FT4), is occasionally observed in morbidly obese patients. OBJECTIVES: It is currently not known whether thyroid hormone treatment is indicated. The aim of the present study was to assess the changes in thyroid hormone levels in thyroxine-naïve patients with SH in response to weight loss induced by Roux-en-Y gastric bypass (RYGB)...
November 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Nancy F Butte, Mary L Brandt, William W Wong, Yan Liu, Nitesh R Mehta, Theresa A Wilson, Anne L Adolph, Maurice R Puyau, Firoz A Vohra, Roman J Shypailo, Issa F Zakeri
OBJECTIVE: Energetic adaptations induced by bariatric surgery have not been studied in adolescents or for extended periods postsurgery. Energetic, metabolic, and neuroendocrine responses to Roux-en-Y gastric bypass (RYGB) surgery were investigated in extremely obese adolescents. METHODS: At baseline and at 1.5, 6, and 12 months post-baseline, 24-h room calorimetry, body composition, and fasting blood biochemistries were measured in 11 obese adolescents relative to five matched controls...
March 2015: Obesity
Tinne Geens, Alin C Dirtu, Eveline Dirinck, Govindan Malarvannan, Luc Van Gaal, Philippe G Jorens, Adrian Covaci
Bisphenol A (BPA) and triclosan (TCS) were determined in urine of Belgian overweight and obese (n=151) and lean (n=43) individuals. After the first urine collection (0M), obese patients started a diet program or have undergone bariatric surgery. Hereafter, three additional urine samples from obese patients were collected after 3 (3M), 6 (6M) and 12 (12M) months. Both compounds were detected in >99% of the samples. BPA had median concentrations of 1.7 and 1.2ng/mL in obese and lean groups, respectively, while TCS had median concentrations of 1...
March 2015: Environment International
Diogo Guarnieri Panazzolo, Tássia Gomide Braga, Anice Bergamim, Bárbara Pires, Hirlena Almeida, Luiz Guilherme Kraemer-Aguiar
INTRODUCTION: In this report, we describe challenges we encountered in the clinical management of a patient with hypoparathyroidism who had previously undergone a bariatric procedure. CASE PRESENTATION: We report the case of a 38-year-old Caucasian woman who had undergone a Roux-en-Y gastric bypass procedure for treatment of obesity. She also had a past history of right lobectomy to treat a benign thyroid nodule. Another thyroid nodule was diagnosed after her bariatric surgery, so a new thyroid surgery was performed...
October 28, 2014: Journal of Medical Case Reports
Yasmin Abu-Ghanem, Roy Inbar, Vitaly Tyomkin, Ilan Kent, Liron Berkovich, Ronen Ghinea, Shmuel Avital
BACKGROUND: Weight loss in morbidly obese patients is associated with changes in thyroid function. Studies have demonstrated equivalent changes following bariatric surgery. Changes in thyroid function were reported following laparoscopic Roux-en-Y gastric bypass (LRYGB), biliopancreatic diversion (BPD), and laparoscopic adjustable gastric banding (LAGB). No data exists on changes in thyroid function following laparoscopic sleeve gastrectomy (LSG). The aim of the current study is to evaluate changes in thyroid function following LSG in patients with normal thyroid function...
March 2015: Obesity Surgery
Marta Serrano, Maria Moreno, Francisco José Ortega, Gemma Xifra, Wifredo Ricart, José María Moreno-Navarrete, José Manuel Fernández-Real
BACKGROUND: Circulating thyroid hormones have been described to be intrinsically associated with insulin sensitivity in healthy subjects. μ-Crystallin is a nicotinamide adenine dinucleotide phosphate-dependent thyroid hormone-binding protein that has been shown to bind T3 in the cytoplasm. We aimed to study μ-Crystallin expression in adipose tissue and in muscle in association with insulin action and thyroid function. METHODS: μ-Crystallin gene expression was studied in 81 visceral and 75 sc adipose tissue samples and in 26 muscle samples from a cohort of subjects with a wide spectrum of adiposity (cohort 1)...
November 2014: Journal of Clinical Endocrinology and Metabolism
Roberto Vita, Poupak Fallahi, Alessandro Antonelli, Salvatore Benvenga
INTRODUCTION: Levothyroxine (l-T4) is the mainstay of treating hypothyroidism. The tablet is the traditional formulation of l-T4. Tablet l-T4 malabsorption results from either hindered gastric dissolution of the tablet or binding of l-T4 by sequestrants in the intestinal lumen. AREAS COVERED: This review provides an overview of the pharmacokinetics of l-T4 formulations available in the market: the tablet, the soft gel capsule and the oral solution. We review literature on the new formulations and anticipate the areas of future research...
July 2014: Expert Opinion on Drug Delivery
Diego A Vicente, Nancy P Solomon, Itzhak Avital, Leonard R Henry, Robin S Howard, Leah B Helou, George L Coppit, Craig D Shriver, Chester C Buckenmaier, Steven K Libutti, Ashok R Shaha, Alexander Stojadinovic
BACKGROUND: Voice alteration remains a significant complication of thyroid surgery. We present a comparison of voice outcomes between total thyroidectomy (TT), partial thyroidectomy (PT), and non-neck (NN) surgery using a multifactorial voice-outcomes classification tool. STUDY DESIGN: Patients with normal voice (n = 112) were enrolled between July 2004 and March 2009. The patients underwent TT (n = 54), PT (n = 35), or NN (n = 23) surgery under general endotracheal anesthesia as part of a prospective observational study involving serial multimodality voice evaluation preoperatively, and at 2 weeks, 3 months, and 6 months postoperatively...
July 2014: Journal of the American College of Surgeons
M Michalaki, S Volonakis, I Mamali, F Kalfarentzos, A G Vagenakis, K B Markou
BACKGROUND: Bariatric surgery is accompanied by malabsorption of protein, carbohydrates, fats, vitamins, and trace elements. Iodine is essential to the synthesis of thyroid hormones. The aim of this study was to estimate the daily iodine intake in severely obese patients before and after bariatric surgery. METHODS: Thirty-five severely obese patients (obese group) with a BMI of 51.3 ± 8.3 kg/m(2) were studied before, 3 months, and 6 months after bariatric surgery...
November 2014: Obesity Surgery
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