Malabsorption of Thyroid Hormones After Jejunoileal Bypass for Obesity

Brief Reports1 June 1979Malabsorption of Thyroid Hormones After Jejunoileal Bypass for ObesityFEREIDOUN AZIZI, M.D., ROY BELUR, M.S., JOSEPHINE ALBANO, M.D.FEREIDOUN AZIZI, M.D., ROY BELUR, M.S., JOSEPHINE ALBANO, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-6-941 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe malabsorption state caused by small intestinal bypass surgery may result in nutritional deficiencies. The drastic loss of jejunum and ileum interferes with normal absorption of various substances, leading to metabolic derangement, vitamin deficiencies, and even nutritional cirrhosis of the liver (1). We have recently seen a patient with hypothyroidism and obesity who developed severe malabsorption of thyroid hormones after a bypass operation.A 38-year-old white woman was referred for evaluation of hypothyroidism in March 1977. She had been grossly obese ( >160 kg) for most of her adult life and had undergone a small intestinal bypass in August 1974....References1. DEWINDPAYNE LJ: Intestinal bypass surgery for morbid obesity. Long-term results. JAMA 236:2298-2301, 1976 CrossrefMedlineGoogle Scholar2. SAWINCHOPRAALBANOAZIZI CDJF: The free triiodothyronine (T3) index. Ann Intern Med 88:474-477, 1978 LinkGoogle Scholar3. ODELLWILBERUTIGER WJR: Studies of thyrotropin physiology by means of radioimmunoassay. Recent Prog Horm Res 23:47-85, 1967 MedlineGoogle Scholar4. JOHANSSONKRAI EJ: Oral contraceptives after intestinal bypass operations (letter). JAMA 236:2847, 1976 CrossrefMedlineGoogle Scholar5. CHOPRASOLOMONCHOPRAYOUNGCHUA TECO IDURG: Alterations in circulating thyroid hormones and thyrotropin in hepatic cirrhosis: evidence for euthyroidism despite subnormal serum triiodothyronine. J Clin Endocrinol Metab 39:501-511, 1974 CrossrefMedlineGoogle Scholar6. PORTNAYO'BRIANBUSHVAGENAKISAZIZIARKYINGBARBRAVERMAN GJJAFRSL: The effect of starvation on the concentration and binding of thyroxine and triiodothyronine in serum and on the response to TRH. J Clin Endocrinol Metab 39:191-194, 1974 CrossrefMedlineGoogle Scholar7. AZIZI F: The effect of dietary composition on fasting induced changes in serum thyroid hormones and thyrotropin. Metabolism 27:935-942, 1978 CrossrefMedlineGoogle Scholar8. LIEBLICHUTIGER JR: Triiodothyronine radioimmunoassay. J Clin Invest 51:157-166, 1972 CrossrefMedlineGoogle Scholar9. HAYSKATZ ML: Thyroxine (T4) absorption in small intestinal disease (abstract). J Nucl Med 14:406-407, 1973 Google Scholar10. CHUNGVAN MIDDLESWORTH SL: Absorption of thyroxine from the small intestine of rats. Endocrinology 74:694-700, 1964 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Elizabeth's Hospital and Tufts University School of Medicine Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEvaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight LossChanges of Drug Pharmacokinetics in Patients with Short Bowel Syndrome: A Systematic ReviewHypothyroidism and levothyroxine therapy following bariatric surgery: a systematic review, meta-analysis, network meta-analysis, and meta-regressionLevothyroxine dose adjustment in hypothyroid patients following gastric sleeve surgeryOral levothyroxine therapy postbariatric surgery: Biopharmaceutical aspects and clinical effectsGastrointestinal Malabsorption of ThyroxineThe Effect of the Bariatric Surgery Type on the Levothyroxine Dose of Morbidly Obese Hypothyroid PatientsLevothyroxine pseudo-malabsorption: testing and treatment in the outpatient settingAdvancements in the treatment of hypothyroidism with L-T4 liquid formulation or soft gel capsule: an updateTSH Normalization in Bariatric Surgery Patients After the Switch from l-Thyroxine in Tablet to an Oral Liquid FormulationLevothyroxine Dosing Following Bariatric SurgeryObese Patients with Hypothyroidism May Require Lower Doses of Levothyroxine After Bariatric SurgeryWeight Loss and Variation of Levothyroxine Requirements in Hypothyroid Obese Patients After Bariatric SurgeryRapid Levothyroxine Absorption Testing: A Case Series of Nonadherent PatientsGuidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone ReplacementTreatment With Thyroid HormoneA Benefit–Risk Assessment of the Use of Proton Pump Inhibitors in the ElderlyOral Liquid l-Thyroxine (l-T4) May Be Better Absorbed Compared to l-T4 Tablets Following Bariatric SurgeryThe Influence of Bypass Procedures and Other Anatomical Changes in the Gastrointestinal Tract on the Oral Bioavailability of DrugsImproved Levothyroxine Pharmacokinetics After Bariatric SurgeryTrends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classesLevothyroxine Absorption in Morbidly Obese Patients Before and After Roux-En-Y Gastric Bypass (RYGB) SurgeryA systematic review of drug absorption following bariatric surgery and its theoretical implicationsConditions and drugs interfering with thyroxine absorptionA Case of Celiac Disease Presenting With Malabsorption of l-ThyroxineHypothyroidismInterference with the absorption of levothyroxineCalcium Carbonate–Induced HypothyroidismLorie E. Butner, PharmD, Patricia Pecora Fulco, PharmD, BCPS, and George Feldman, MDSevere hypothyroidism in patients dependent on prolonged thyroxine infusion through a jejunostomyThyroid Hormone Replacement Therapy for Primary and Secondary HypothyroidismSURGERY FOR OBESITYReview: Medication Delivery in the Short-Bowel SyndromeHypothyroidismLocalization of Human Thyroxine AbsorptionThyroid Hormone and the GutTreatment of Hyper- and HypothyroidismBioavailability of digoxin tablets in patients with gastrointestinal dysfunctionDifferentiated Thyroid Cancer 1 June 1979Volume 90, Issue 6Page: 941-942KeywordsCirrhosisHypothyroidismIleumJejunumLiverMalnutritionObesityOverweightSurgeryThyroid hormones Issue Published: 1 June 1979 PDF downloadLoading ...