Open AccessMajor imbalance of thyroid function after laparoscopic sleeve gastrectomy
Author(s) -
Laurent Brutus,
Armelle Poupard,
Clément Le Glatin
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-230515
Subject(s) - medicine , thyroid , sleeve gastrectomy , hormone , gastrectomy , thyroid function , thyroid stimulating hormone , surgery , weight loss , gastroenterology , endocrinology , general surgery , gastric bypass , obesity , cancer
In patients with substituted hypothyroidism, laparoscopic sleeve gastrectomy may interfere with thyroid balance by varying body weight or by altering the absorption of hormone therapy. A 58-year-old female patient presented with a major thyroid imbalance after sleeve gastrectomy, manifesting itself in large-scale changes in thyroid stimulating hormone (TSH) levels. The transition from a tablet treatment to a liquid form alleviated burden of treatment, unfortunately without normalising TSH. Our case emphasises the importance of the understanding of hypothalamic-pituitary-thyroid feedback control mechanisms together with good galenic choice, management of associated conditions and the elimination of other causes of variations of TSH levels during the management of hypothyroid patients after sleeve gastrectomy.