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.
- general practice / family medicine
- drug therapy related to surgery
- endocrine system
- thyroid disease
- gastrointestinal surgery
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Contributors LB performed the data acquisition, analysis and interpretation of data for the work with oversight from CLG. LB was involved in the drafting, CLG and AP in the revising of the work. LB and CLG are general practitioners of the described case, AP is resident in family medicine. All authors put an estimated equal amount of work in the case report. All authors gave final approval of the version to be published.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Obtained.
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