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The Thyroid Gland01:23

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Updated: Dec 31, 2025

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Thyroid function before and after Roux-en-Y gastric bypass: an observational study.

Paula Carolina Dambros Granzotto1, Cleo Otaviano Mesa Junior1, Rodrigo Strobel2

  • 1Endocrinology and Metabolism Department, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
|January 12, 2020
PubMed
Summary

Bariatric surgery significantly improves thyroid function in obese patients, normalizing thyroid-stimulating hormone (TSH) levels for most. This suggests that thyroid hormone replacement is unnecessary for subclinical hypothyroidism (SCH) in this population.

Keywords:
ObesityRoux-en-Y gastric bypassSubclinical hypothyroidismThyroid dysfunctionWeight loss

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Area of Science:

  • Endocrinology
  • Bariatric Surgery
  • Metabolic Health

Background:

  • Obesity is linked to increased thyroid-stimulating hormone (TSH) and subclinical hypothyroidism (SCH) prevalence.
  • Roux-en-Y gastric bypass (RYGB) shows potential in reducing TSH levels post-weight loss.

Purpose of the Study:

  • Evaluate SCH prevalence in severely obese patients (class II and III).
  • Assess thyroid hormone (TSH, T3, T4, free T4) changes after significant weight loss induced by RYGB.

Main Methods:

  • Retrospective review of 215 obese patients undergoing RYGB (2005-2012) with ≥2 years follow-up.
  • Observational, descriptive study with clinical and lab evaluations at 3, 6, 12, and 24 months post-surgery.
  • Statistical analyses including association, correlation, and variance.

Main Results:

  • Preoperative SCH prevalence was 9.3%.
  • SCH resolved in 89.5% of patients by 12 months post-RYGB.
  • No significant association found between TSH and BMI or metabolic syndrome.

Conclusions:

  • Weight loss following bariatric surgery normalizes TSH levels in the majority of obese patients.
  • No patients developed overt hypothyroidism post-RYGB.
  • Serial thyroid function monitoring is recommended over immediate thyroid hormone replacement for obese patients with SCH undergoing weight loss therapy.