Levothyroxine Dosing Following Bariatric Surgery
Background Based on the mechanisms of drug absorption, increased levothyroxine requirements are expected after bariatric surgery. However, there are conflicting data on this topic. This review evaluates the effects of bariatric surgery on levothyroxine dosing. Methods Data were obtained from PubMed,...
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| Veröffentlicht in: | Obesity surgery 2016-10, Vol.26 (10), p.2538-2542 |
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| creator | Gadiraju, Silpa Lee, Clare J. Cooper, David S. |
| description | Background
Based on the mechanisms of drug absorption, increased levothyroxine requirements are expected after bariatric surgery. However, there are conflicting data on this topic. This review evaluates the effects of bariatric surgery on levothyroxine dosing.
Methods
Data were obtained from PubMed, Scopus, and review of published bibliographies.
Results
Six of 10 studies demonstrated decreased postoperative requirements. Most demonstrated correlations between weight loss and dose. Only 3 case reports and 1 case series demonstrated increased levothyroxine requirements, attributed to malabsorption.
Conclusions
The loss of both fat and lean body mass may counteract malabsorptive effects from surgery, resulting in decreased postoperative levothyroxine requirements. In addition, the reversal of impaired levothyroxine pharmacokinetics and an altered set point of thyroid hormone homeostasis may also contribute to postoperative levothyroxine reductions. |
| doi_str_mv | 10.1007/s11695-016-2314-x |
| format | Article |
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Based on the mechanisms of drug absorption, increased levothyroxine requirements are expected after bariatric surgery. However, there are conflicting data on this topic. This review evaluates the effects of bariatric surgery on levothyroxine dosing.
Methods
Data were obtained from PubMed, Scopus, and review of published bibliographies.
Results
Six of 10 studies demonstrated decreased postoperative requirements. Most demonstrated correlations between weight loss and dose. Only 3 case reports and 1 case series demonstrated increased levothyroxine requirements, attributed to malabsorption.
Conclusions
The loss of both fat and lean body mass may counteract malabsorptive effects from surgery, resulting in decreased postoperative levothyroxine requirements. In addition, the reversal of impaired levothyroxine pharmacokinetics and an altered set point of thyroid hormone homeostasis may also contribute to postoperative levothyroxine reductions.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-016-2314-x</identifier><identifier>PMID: 27475799</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bariatric Surgery ; Brief Communication ; Dose-Response Relationship, Drug ; Drug dosages ; Gastrointestinal surgery ; Humans ; Hypothyroidism ; Hypothyroidism - complications ; Hypothyroidism - drug therapy ; Medicine ; Medicine & Public Health ; Obesity ; Obesity, Morbid - complications ; Obesity, Morbid - surgery ; Postoperative Period ; Surgery ; Surgical outcomes ; Thyroid Hormones - administration & dosage ; Thyroid Hormones - pharmacokinetics ; Thyroxine - administration & dosage ; Thyroxine - pharmacokinetics ; Weight control ; Weight Loss - physiology</subject><ispartof>Obesity surgery, 2016-10, Vol.26 (10), p.2538-2542</ispartof><rights>Springer Science+Business Media New York 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-p212t-46d633a16444a805b99287bf1603bf5f0cb3b6d6535f01c1197d16c58fccb6293</cites><orcidid>0000-0001-8011-2106</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-016-2314-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-016-2314-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27475799$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gadiraju, Silpa</creatorcontrib><creatorcontrib>Lee, Clare J.</creatorcontrib><creatorcontrib>Cooper, David S.</creatorcontrib><title>Levothyroxine Dosing Following Bariatric Surgery</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
Based on the mechanisms of drug absorption, increased levothyroxine requirements are expected after bariatric surgery. However, there are conflicting data on this topic. This review evaluates the effects of bariatric surgery on levothyroxine dosing.
Methods
Data were obtained from PubMed, Scopus, and review of published bibliographies.
Results
Six of 10 studies demonstrated decreased postoperative requirements. Most demonstrated correlations between weight loss and dose. Only 3 case reports and 1 case series demonstrated increased levothyroxine requirements, attributed to malabsorption.
Conclusions
The loss of both fat and lean body mass may counteract malabsorptive effects from surgery, resulting in decreased postoperative levothyroxine requirements. In addition, the reversal of impaired levothyroxine pharmacokinetics and an altered set point of thyroid hormone homeostasis may also contribute to postoperative levothyroxine reductions.</description><subject>Bariatric Surgery</subject><subject>Brief Communication</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug dosages</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Hypothyroidism</subject><subject>Hypothyroidism - complications</subject><subject>Hypothyroidism - drug therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - surgery</subject><subject>Postoperative Period</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Thyroid Hormones - administration & dosage</subject><subject>Thyroid Hormones - pharmacokinetics</subject><subject>Thyroxine - administration & dosage</subject><subject>Thyroxine - pharmacokinetics</subject><subject>Weight control</subject><subject>Weight Loss - physiology</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpNkE1Lw0AQhhdRbK3-AC9S8Lw6s9971GpVKHhQz0s2TWpKm9TdRJt_75ZW8DQD8_AO70PIJcINAujbiKispICKMo6Cbo_IEDUYCoKZYzIEq4Aay_iAnMW4BGCoGDslA6aFltraIYFZ8d20n31otlVdjB-aWNWL8bRZrZqf3XafhSprQ5WP37qwKEJ_Tk7KbBWLi8MckY_p4_vkmc5en14mdzO6YchaKtRccZ6hEkJkBqS3lhntS1TAfSlLyD33iZE87ZgjWj1HlUtT5rlXzPIRud7nbkLz1RWxdcumC3V66dCgASEhFRuRqwPV-XUxd5tQrbPQu7-CCWB7IKZTnQr8iwG3s-j2Fl2y6HYW3Zb_AmDbYSY</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Gadiraju, Silpa</creator><creator>Lee, Clare J.</creator><creator>Cooper, David S.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0001-8011-2106</orcidid></search><sort><creationdate>20161001</creationdate><title>Levothyroxine Dosing Following Bariatric Surgery</title><author>Gadiraju, Silpa ; Lee, Clare J. ; Cooper, David S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p212t-46d633a16444a805b99287bf1603bf5f0cb3b6d6535f01c1197d16c58fccb6293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Bariatric Surgery</topic><topic>Brief Communication</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug dosages</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Hypothyroidism</topic><topic>Hypothyroidism - complications</topic><topic>Hypothyroidism - drug therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - surgery</topic><topic>Postoperative Period</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Thyroid Hormones - administration & dosage</topic><topic>Thyroid Hormones - pharmacokinetics</topic><topic>Thyroxine - administration & dosage</topic><topic>Thyroxine - pharmacokinetics</topic><topic>Weight control</topic><topic>Weight Loss - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gadiraju, Silpa</creatorcontrib><creatorcontrib>Lee, Clare J.</creatorcontrib><creatorcontrib>Cooper, David S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gadiraju, Silpa</au><au>Lee, Clare J.</au><au>Cooper, David S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Levothyroxine Dosing Following Bariatric Surgery</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>26</volume><issue>10</issue><spage>2538</spage><epage>2542</epage><pages>2538-2542</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
Based on the mechanisms of drug absorption, increased levothyroxine requirements are expected after bariatric surgery. However, there are conflicting data on this topic. This review evaluates the effects of bariatric surgery on levothyroxine dosing.
Methods
Data were obtained from PubMed, Scopus, and review of published bibliographies.
Results
Six of 10 studies demonstrated decreased postoperative requirements. Most demonstrated correlations between weight loss and dose. Only 3 case reports and 1 case series demonstrated increased levothyroxine requirements, attributed to malabsorption.
Conclusions
The loss of both fat and lean body mass may counteract malabsorptive effects from surgery, resulting in decreased postoperative levothyroxine requirements. In addition, the reversal of impaired levothyroxine pharmacokinetics and an altered set point of thyroid hormone homeostasis may also contribute to postoperative levothyroxine reductions.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27475799</pmid><doi>10.1007/s11695-016-2314-x</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-8011-2106</orcidid></addata></record> |
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| subjects | Bariatric Surgery Brief Communication Dose-Response Relationship, Drug Drug dosages Gastrointestinal surgery Humans Hypothyroidism Hypothyroidism - complications Hypothyroidism - drug therapy Medicine Medicine & Public Health Obesity Obesity, Morbid - complications Obesity, Morbid - surgery Postoperative Period Surgery Surgical outcomes Thyroid Hormones - administration & dosage Thyroid Hormones - pharmacokinetics Thyroxine - administration & dosage Thyroxine - pharmacokinetics Weight control Weight Loss - physiology |
| title | Levothyroxine Dosing Following Bariatric Surgery |
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