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Thyroid surgery, bariatric surgery.

João Sérgio Neves, Pedro Souteiro, Sofia Castro Oliveira, Jorge Pedro, Daniela Magalhães, Vanessa Guerreiro, Maria Manuel Costa, Rita Bettencourt-Silva, Ana Cristina Santos, Joana Queirós, Ana Varela, Paula Freitas, Davide Carvalho
Thyroid function has an important role on body weight regulation. However, the impact of thyroid function on weight loss after bariatric surgery is still largely unknown. We evaluated the association between preoperative thyroid function and the excess weight loss 1 year after surgery, in 641 patients with morbid obesity who underwent bariatric surgery. Patients with a history of thyroid disease, treatment with thyroid hormone or antithyroid drugs and those with preoperative evaluation consistent with overt hypothyroidism or hyperthyroidism were excluded...
May 16, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
David Goldenberg, Robert L Ferris, Maisie L Shindo, Ashok Shaha, Brendan Stack, Ralph P Tufano
BACKGROUND: Morbid obesity is a chronic condition that may be challenging to treat. Gastric bypass surgery is used to treat morbid obesity and its complications. Hypocalcemia, a known complication after thyroidectomy, is usually transient and treatable. There is a growing body of literature indicating that patients with previous gastric bypass surgery are at an increased risk for recalcitrant, symptomatic hypocalcemia after thyroidectomy. The management of hypocalcemia in patients with prior gastric bypass surgery may be exceedingly difficult...
February 8, 2018: Head & Neck
Fangyuan Liu, Jianzhong Di, Haoyong Yu, Junfeng Han, Yuqian Bao, Weiping Jia
BACKGROUND: The impact of bariatric surgery on thyroid hormone levels is poorly understood. OBJECTIVES: To investigate changes in serum-free thyroxine (FT4) and thyroid-stimulating hormone (TSH) after Roux-en-Y gastric bypass (RYGB) in euthyroid patients with obesity and type 2 diabetes. SETTING: University Hospital, China. METHODS: Eighty-one euthyroid Chinese patients with obesity and type 2 diabetes who underwent RYGB, and 20 healthy volunteers were enrolled in this retrospective study...
October 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Bingsheng Guan, YanYa Chen, Jingge Yang, Wah Yang, Cunchuan Wang
We aimed to make a meta-analysis regarding the effect of bariatric surgery on thyroid function in obese patients. PubMed, EMBASE, CENTRAL, and four Chinese databases were searched for clinical studies. Data were pooled using Review Manager 5.3, and subgroup and sensitivity analyses were performed if necessary and feasible. As a result, 24 articles were included into meta-analysis. Bariatric surgery was associated with significant decrease in TSH, FT3, and T3 levels. However, FT4, T4, and rT3 levels were not significantly changed postoperatively...
December 2017: Obesity Surgery
Sofia Manousou, Lena M S Carlsson, Robert Eggertsen, Lena Hulthén, Peter Jacobson, Kerstin Landin-Wilhelmsen, Penelope Trimpou, Per-Arne Svensson, Helena Filipsson Nyström
CONTEXT: Bariatric surgery can lead to nutrient deficiencies. Gastric by-pass (GBP) entails restriction and malabsorption, whereas, vertical banded gastroplasty (VBG) is only restrictive. OBJECTIVE: The objective of this study is to study whether GBP-patients develop iodine deficiency from malabsorption, and if GBP- and VBG-patients develop lower 24-h urinary iodine excretion (24-UIE) than obese non-operated controls (OB-controls) due to lower iodine intake. DESIGN: The Swedish Obese Subjects (SOS) study is a prospective, non-randomized study of 4047 obese patients included 1987-2001, who chose bariatric surgery or non-surgical treatment...
February 2018: Obesity Surgery
João Sérgio Neves, Sofia Castro Oliveira, Pedro Souteiro, Jorge Pedro, Daniela Magalhães, Vanessa Guerreiro, Rita Bettencourt-Silva, Maria Manuel Costa, Ana Cristina Santos, Joana Queirós, Ana Varela, Paula Freitas, Davide Carvalho
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. METHODS: We performed a retrospective observational study of 949 euthyroid patients (86...
July 19, 2017: Obesity Surgery
Jingge Yang, Zhiguang Gao, Wah Yang, Xiangmao Zhou, Shing Lee, Cunchuan Wang
BACKGROUND: Changes in thyroid function following bariatric surgery in euthyroid obese patients have yielded inconsistent results. Nevertheless, no data exist on changes in thyroid function after bariatric surgery in Chinese obese subjects. OBJECTIVES: The objective of this study is to evaluate the influence of weight reduction on thyroid function following laparoscopic sleeve gastrectomy (LSG) in patients with normal thyroid function. PATIENTS AND METHODS: Serum free thyroxine (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels were retrospectively analyzed before and 12 months after LSG in euthyroid patients with morbid obesity...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
S Fosse-Edorh, A Rigou, S Morin, L Fezeu, L Mandereau-Bruno, A Fagot-Campagna
BACKGROUND: Medico-administrative databases represent a very interesting source of information in the field of endocrine, nutritional and metabolic diseases. The objective of this article is to describe the early works of the Redsiam working group in this field. METHODS: Algorithms developed in France in the field of diabetes, the treatment of dyslipidemia, precocious puberty, and bariatric surgery based on the National Inter-schema Information System on Health Insurance (SNIIRAM) data were identified and described...
October 2017: Revue D'épidémiologie et de Santé Publique
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...
August 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...
May 2017: 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...
February 2017: 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
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