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October 16, 2018 - by - in Bariatric Surgery

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Hypothyroidism, also called underactive thyroid, controls metabolism, which is how the body uses energy from food. When thyroid function is compromised, it can affect:

  • Body temperature
  • Heartbeat
  • How efficiently you burn calories

Hypothyroidism can make you feel sluggish, and if your body isn’t using food efficiently, it can lead to weight gain and obesity. The US Centers for Disease Control and Prevention defines obesity as a body mass index (BMI) of 30 or more, with “obesity class III” or “extreme obesity” characterized as a BMI of 40 or more.

Fortunately, bariatric surgery is among the most effective methods of treating obesity, and it’s widely regarded as a safe treatment. But, does the surgery also improve hypothyroidism?

This article examines whether bariatric surgery impacts patients with a diagnosis of hypothyroidism. In the process, we will further define HO and its management strategies and review the results of medical studies to determine whether bariatric surgery reduces HO.

What Causes Hypothyroidism? What Are the Symptoms?

A common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune disorder that causes the body to create antibodies that damage and eventually destroy the thyroid gland. As the condition progresses, the thyroid is unable to function, causing higher temperatures, heart and weight regulation issues.

Other HO causes include:

  • Radiation applied to the neck as in certain cancer treatments
  • Radioactive iodine treatment used in patients with an overactive thyroid
  • Certain heart and psychiatric medicines, such as amiodarone, lithium, interferon alpha and interleukin-2
  • Thyroid removal surgery (with partial thyroid removal, hormone may still be produced)
  • Iodine deficiency
  • Post-pregnancy due to inflammation during pregnancy
  • Congenital condition
  • Pituitary damage
  • Hypothalamus disorder

Among the symptoms of HO are:

  • Depression
  • Constipation
  • Dry hair or hair loss
  • Dry skin
  • Unexplained weight gain
  • Difficulty losing weight
  • Fatigue
  • Slow heart rate, and more

A doctor diagnoses the disorder through blood tests to determine hormone levels. If the patient has lower than normal thyroxine (T4) levels, then the patient has HO.

How is Hypothyroidism Managed?

After a diagnosis, your physician will look at several factors to determine the dosage of thyroid medication. The drug that is usually prescribed is a levothyroxine, which includes brands Synthroid and Tirosint. These drugs are a manufactured version of T4.

To determine the correct dosage, your doctor will consider your

  • Age
  • Weight
  • Current T4 levels
  • Health

Does Bariatric Surgery Improve Hypothyroidism?     

A research study, The Impact of Bariatric Surgery on Thyroid Function and Medication Use in Patients with Hypothyroidism, published in the Obesity Surgery Journal in 2017, offers great insight into the question. In the introduction, the study’s authors note the scarcity of information about whether bariatrics impact thyroid function and a patients’ thyroid medication use.

The authors performed a retrospective analysis of 93 HO patients who underwent gastric bypass surgery. Of that number, 83 were taking replacement thyroid hormone medication (THR). Average BMI was 43.7 plus or minus 6.4 kg/m at the time of surgery.

Six to 12 months after the surgery, the results were promising. For study participants, the mean thyroid-stimulating hormone (TSH) and patients’ BMI had “significantly decreased” and mean free T4 levels were stable. A year following the surgery, 11 patients did not require the THR, while the remaining participants required a “significantly lower average dose.”

The study’s authors conclude that bariatric surgery could have a “favorable effect” on improving thyroid function while reducing thyroid medication dosages. They also recommend further studies to evaluate the influence on THR absorption and whether the different types of surgeries produce differing results. If you have been diagnosed with hypothyroidism, consult with your primary care physician, endocrinologist and your bariatric surgeon before undergoing weight loss surgery.

Ready to Find Out How Weight Loss Surgery Can Improve Your Health?

If you’re exploring the benefits of weight loss surgery and have been diagnosed with hypothyroidism, the Soma Weight Loss team is available to help you become healthier.

Call toll free, 855-766-2411 (855-SOMA-411) or request a consultation.

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Dr. Joseph Naim

Dr. Joseph Naim is a bariatric surgeon serving patients in the Los Angeles, California area. After completing his undergraduate degree in biology from the University of Southern California, he attended medical school at Mount Sinai School of Medicine in New York City. Dr. Naim went on to become the chief resident at New York Methodist Hospital and completed a fellowship in minimally invasive bariatric surgery at University Medical Center in Princeton, New Jersey. Dr. Naim also served as the medical director of bariatric surgery at St. Mary Medical Center in Long Beach before starting his own practice in 2004.