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. 2021 Aug 19;10(16):3685.
doi: 10.3390/jcm10163685.

Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss

Paula Juiz-Valiña  1   2 , María Cordido  1   2 , Elena Outeiriño-Blanco  3 , Sonia Pértega  4 , Paula Urones  1   2 , María Jesús García-Brao  5 , Enrique Mena  5 , Lara Pena-Bello  1   2 , Susana Sangiao-Alvarellos  1   2 , Fernando Cordido  1   2   3
Affiliations

Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss

Paula Juiz-Valiña et al. J Clin Med. .

Abstract

The most frequent endocrine disease in obese patients is hypothyroidism. To date, there are no clear data regarding what happens to the dose of levothyroxine (LT4) after bariatric surgery (BS). The objective of the present study was to evaluate thyroid hormone replacement dose in morbidly obese hypothyroid patients after BS-induced weight loss. We explore the best type of measured or estimated body weight for LT4 dosing. We performed an observational study evaluating patients with morbid obesity and hypothyroidism who underwent BS. We included 48 patients (three men). In morbidly obese hypothyroid patients 12 months after BS-induced weight loss, the total LT4 dose or the LT4 dose/kg ideal body weight did not change, while there was a significant increase in LT4 dose/body surface area, LT4 dose/kg weight, LT4 dose/kg adjusted body weight, LT4 dose/kg body fat, and LT4 dose/kg lean body weight. There were no differences in LT4 dose and its variation between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The present study strongly suggests that LT4 dosing in obese hypothyroid patients can be individually adapted more precisely if it is based on ideal body weight.

Keywords: bariatric surgery; hypothyroidism; obesity; thyroid hormone replacement.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Levothyroxine (LT4) dose (median, interquartile ranges) change in hypothyroid patients before and 3, 6, and 12 months after bariatric surgery total and adjusted to different weights. BSA, body surface area. °, are outliers.
Figure 2
Figure 2
Levothyroxine (LT4) dose (median, interquartile ranges) change in hypothyroid patients after bariatric surgery (BS), according to BS type, sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). ●, are outliers.
See this image and copyright information in PMC

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