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Cited by 70Bariatric Surgery and OutcomesThyroid Disorders and TreatmentsThyroid and Parathyroid Surgery

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

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AMTCO Group, Neves, João Sérgio, Castro Oliveira, Sofia, Souteiro, Pedro, Pedro, Jorge, Magalhães, Daniela, Guerreiro, Vanessa, Bettencourt-Silva, Rita +6 more·2018·Obesity Surgery
DOI 10.1007/s11695-017-2792-5
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Abstract

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 (86.1% female; age 42.0 ± 10.3 years, BMI 44.3 ± 5.7 kg/m 2) with morbid obesity submitted to bariatric surgery (laparoscopic adjustable gastric band, Roux-en-Y gastric bypass, or sleeve gastrectomy). Patients were subdivided in two groups: normal TSH group (TSH <2.5 mU/L) and high-normal TSH group (TSH ≥2.5 mU/L). The impact of anthropometric parameters, comorbidities, TSH, free thyroxine (FT4), free triiodothyronine (FT3), type of surgery, and excessive body weight loss (EBWL) on TSH variation 12 months after surgery was evaluated.Results The high-normal TSH group (24.3% of patients) included more women, presented a higher BMI, higher systolic blood pressure, and higher FT3 levels. There was a significant decrease of TSH 12 months after surgery that was more marked in the high-normal TSH group (normal TSH group: 1.57 ± 0.49 to 1.53 ± 0.69 mIU/L, p = 0.063; high-normal TSH group: 3.23 ± 0.59 to 2.38 ± 0.86 mIU/L, p < 0.001). In a multivariate analysis, after adjusting for relevant covariates, EBWL, baseline BMI, and baseline FT3 were significantly associated with TSH decrease 12 months after bariatric surgery.Conclusion Bariatric surgery promotes a decrease of TSH that is significantly greater in patients with high-normal TSH and is independently associated with EBWL after surgery.

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  • In obese patients, a weight-related increase in serum TSH is common, which is not due to glandular failure and returns to normal after weight loss.

    “In obese patients, a weight-related increase in serum TSH is common, which is not due to glandular failure and returns to normal after weight loss (96).”

    From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [96]

    The Discussion reports that higher TSH levels in patients with morbid obesity and normal baseline thyroid function tend to normalize after bariatric surgery. It says these levels may reflect a compensatory response rather than subnormal thyroid function, but does not establish that they are never due to glandular failure. The claim also extends the finding from morbid obesity and bariatric surgery to obese patients and weight loss generally; page numbers are not provided in our copy. (LLM, conf=0.85)

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Authors
AMTCO Group, Neves, J. S., Castro Oliveira, S., Souteiro, P., Pedro, J., Magalhães, D., Guerreiro, V., Bettencourt-Silva, R., Costa, M. M., Cristina Santos, A., Queirós, J., Varela, A., Freitas, P., & Carvalho, D.
Affiliations
  • Hospital de São João (PT)
  • Universidade do Porto (PT)
Corresponding author
Neves, João Sérgio
ORCID
Venue
Obesity Surgery
Publisher
Springer Science and Business Media LLC
Published
2017-07-19
Volume
28
Issue
1
Pages
97-103
ISSN
  • 0960-8923 (ISSN-L)
  • 1708-0428
DOI
10.1007/s11695-017-2792-5
OpenAlex
W2736766435
Cited by
70
References
5
Citations by year
2026: 7 · 2025: 8 · 2024: 7 · 2023: 4 · 2022: 8 · 2021: 11 · 2020: 8 · 2019: 8 · 2018: 6 · 2017: 2
FWCI
6.72
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • Obesity Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (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
bariatric surgery, thyroid-stimulating hormone
MeSH terms
Adult, Female, Humans, Male, Middle Aged, Obesity, Morbid, Postoperative Period, Retrospective Studies, Thyroid Gland, Thyrotropin, Thyroxine, Weight Loss, Bariatric Surgery

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