Cited by 74Bariatric Surgery and OutcomesThyroid Disorders and TreatmentsThyroid and Parathyroid Surgery

Oral Liquid l-Thyroxine (l-T4) May Be Better Absorbed Compared to l-T4 Tablets Following Bariatric Surgery

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Pirola, Ilenia, Formenti, Anna M., Gandossi, Elena, Mittempergher, Francesco, Casella, Claudio, Agosti, Barbara, Cappelli, Carlo·2013·Obesity Surgery

Abstract

Drug malabsorption is a potential concern after bariatric surgery. We present four case reports of hypothyroid patients who were well replaced with thyroxine tablets to euthyroid thyrotropin (TSH) levels prior to Roux-en-Y gastric bypass surgery. These patients developed elevated TSH levels after the surgery, the TSH responded reversibly to switching from treatment with oral tablets to a liquid formulation.

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  • A liquid formulation of LT4 packaged in polyethylene ampoules, not available within the United States, has been suggested, based on case reports or uncontrolled studies only, to be better absorbed than tablets if there is malabsorption following bariatric surgery or if LT4 is consumed with breakfast.

    “A liquid formulation of LT4 that is packaged in polyethylene ampoules, and that is not available within the United States, has been suggested, based on case reports or uncontrolled studies only, to be better absorbed than tablets if there is malabsorption following bariatric surgery or if LT4 is consumed with breakfast (115,116).”

    From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [116]

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Authors
Pirola, I., Formenti, A. M., Gandossi, E., Mittempergher, F., Casella, C., Agosti, B., & Cappelli, C.
Affiliations
  • Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
  • University of Brescia (IT)
Corresponding author
Cappelli, Carlo
Venue
Obesity Surgery
Published
2013-07-04
Volume
23
Issue
9
Pages
1493-1496
ISSN
  • 0960-8923 (ISSN-L)
  • 1708-0428
OpenAlex
W2043009591
Cited by
74
References
20
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 10 · 2020: 2 · 2019: 8 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 7 · 2014: 6 · 2013: 2
FWCI
8.22
Type
journal article
Language
en
Open access
Locations
  • Obesity Surgery (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
levothyroxine, liquid formulation
MeSH terms
Adult, Female, Humans, Malabsorption Syndromes, Middle Aged, Obesity, Morbid, Suspensions, Tablets, Therapeutic Equivalency, Thyrotropin, Thyroxine, Gastric Bypass, Treatment Outcome

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