TSH normalization in bariatric surgery patients after the switch from L-Thyroxine in tablet to an oral liquid formulation
Open accessAbstract
Objective Drug malabsorption is one of the potential troubles after bariatric surgery. Evidence for diminished levothyroxine (L-T4) absorption has been reported in patients after bariatric surgery.Methods This study reports 17 cases of hypothyroid patients [who were well replaced with thyroxine tablets (for >1 year) to euthyroid thyrotropin (TSH) levels before surgery (13 Roux-en-Y gastric bypasses (RYGB); 4 biliary pancreatic diversions (BPD))]. From 3 to 8 months after surgery, these patients had elevated TSH levels. Patients were then switched from oral tablets to a liquid L-T4 formulation (with the same dosage, 30 min before breakfast).Results Two-three months after the switch, TSH was significantly reduced both in patients treated with RYGB, as in those treated with BPD, while FT4 and FT3 levels were not significantly changed (RYGB group, TSH μIU/mL: 7.58 ± 3.07 vs 3.808 ± 1.83, P < 0.001; BPD group, TSH μIU/mL: 8.82 ± 2.76 vs 3.12 ± 1.33, P < 0.01).Conclusions These results first show that liquid L-T4 could prevent the problem of malabsorption in patients with BPD and confirm those of previous studies in patients submitted to RYGB, suggesting that the L-T4 oral liquid formulation could circumvent malabsorption after bariatric surgery.
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Levothyroxine personalized treatment: is it still a dream?
Cappelli, C., Gatta, E., & Ippolito, S. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1334292 · Cited by 4 · see citing works
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Comparative Bioavailability of a Novel Solution and a Tablet Formulation of Levothyroxine
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Effect of bariatric surgery on TSH levels and levothyroxine dosage in patients with thyroid diseasePreprint
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A Shot at Convenience: Once-Weekly Subcutaneous Levothyroxine Enters Phase 2
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- Authors
- Fallahi, P., Ferrari, S. M., Camastra, S., Politti, U., Ruffilli, I., Vita, R., Navarra, G., Benvenga, S., & Antonelli, A.
- Affiliations
- University of Pisa (IT)
- University of Messina (IT)
- Corresponding author
- Antonelli, Alessandro
- ORCID
- Venue
- Obesity Surgery
- Published
- 2016-06-07
- Volume
- 27
- Issue
- 1
- Pages
- 78-82
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2411859531
- Cited by
- 81
- References
- 36
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 9 · 2023: 5 · 2022: 7 · 2021: 11 · 2020: 5 · 2019: 15 · 2018: 10 · 2017: 8 · 2016: 3
- FWCI
- 13.28
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (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, oral liquid formulation
- MeSH terms
- Adult, Dosage Forms, Female, Humans, Hypothyroidism, Malabsorption Syndromes, Male, Middle Aged, Obesity, Morbid, Tablets, Thyrotropin, Thyroxine, Gastric Bypass, Bariatric Surgery
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