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Thyroid function post-bariatric surgery: an updated systematic review and meta-analysis
Niloofar Seighali1,2,3, Alireza Khodayari Javazm4,5, Sina Kazemian6
1Non-Communicable Disease Research Center, Alborz University of Medical Sciences, Karaj, Islamic Republic of Iran. niloofarseighaly@gmail.com.
Obesity Surgery
|November 26, 2025
Summary
Bariatric surgery significantly reduces thyroid-stimulating hormone (TSH), total T3, and free T3 levels. Total T4 shows a marginal decrease, while free T4 levels remain unchanged post-surgery.
Area of Science:
- Endocrinology
- Metabolic Surgery
- Thyroidology
Background:
- Obesity is a global health concern associated with numerous comorbidities.
- Bariatric surgery is an effective treatment for severe obesity.
- The impact of bariatric surgery on thyroid function requires comprehensive evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the effects of bariatric surgery on thyroid function.
- To quantify changes in thyroid hormones including TSH, T3, and T4.
Main Methods:
- Systematic review and meta-analysis of studies from PubMed, Web of Science, and Scopus databases.
- Inclusion of 67 studies with 8,754 patients.
- Statistical analysis using pooled standard mean differences (SMD).
Main Results:
- Significant decrease observed in serum TSH, total T3, and free T3 levels post-bariatric surgery (p < 0.05).
- Marginal but significant decrease in total T4 levels noted (p < 0.05).
- No significant change in free T4 levels was detected (p > 0.05).
Conclusions:
- Bariatric surgery leads to significant reductions in TSH, total T3, and free T3.
- A marginal decrease in total T4 and no significant change in free T4 are expected.
- These findings highlight the influence of bariatric surgery on thyroid hormone regulation.
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