Management of Resistant Hyperthyroidism Following Obesity Surgery

  • Mehmet Çelik
  • Atakan Sezer


The number of bariatric surgical procedures performed in recent years has increased significantly, because bariatric surgery is still the most effective and permanent treatment for severe obesity. A comprehensive surgical screening by a multidisciplinary team of bariatric surgical patients is important in order to prepare patients for successful outcomes. Although postoperative thyrotoxicosis is rarely seen in morbidly obese patients, hyperthyroidism has not been reported. Bariatric surgery, especially malabsorptive type, may result in mineral deficiency and malabsorption of medications used in treatment, about which clinicians must be alert.

In this report, we aimed to present the difficulties in oral medical replacement treatment after thyroid surgery for hyperthyroidism in a patient with previous bariatric surgery.


Obesity Bariatric surgery Hyperthyroidism Management Hartley-Dunhill procedure 


  1. 1.
    Garrow JS. Obesity and related diseases. London: Churchill Livingstone; 1988. p. 1–16.Google Scholar
  2. 2.
    Blackburn GL, Kanders BS. Medical evaluation and treatment of the obese patients with cardiovascular disease. Am J Cardiol. 1987;60:55–8.CrossRefGoogle Scholar
  3. 3.
    Fakhouri TH, Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among older adults in the United States, 2007–2010 (no. 106). Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2012.Google Scholar
  4. 4.
    Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.CrossRefGoogle Scholar
  5. 5.
    Domienik-Karlowicz J, Dzikowska-Diduch O, Lisik W, Chmura A, Pruszczyk P. Short-term cardio metabolic risk reduction after bariatric surgery. Hell J Cardiol. 2015;56:61–5.Google Scholar
  6. 6.
    World Health Organization. Controlling the global obesity epidemic. 2003. Available: Accessed 3 June 2014.
  7. 7.
    Prospective Studies Collaboration, Whitlock G, Lewington S, Sherliker P, Clarke R, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083–96.CrossRefGoogle Scholar
  8. 8.
    Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363:2211–9.CrossRefGoogle Scholar
  9. 9.
    Poirier P, Cornier MA, Mazzone T, Stiles S, Cummings S, Klein S, et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation. 2011;123:1683–701.CrossRefGoogle Scholar
  10. 10.
    WHO Expert Committee. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO technical report series: 854. Geneva: WHO; 1995. p. 1–452.Google Scholar
  11. 11.
    World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8–11 December 2008. Geneva: WHO; 2011.Google Scholar
  12. 12.
    Sonmez A, Bayram F, Barcin C, Ozsan M, Kaya A, Gedik V. Waist circumference cutoff points to predict obesity, metabolic syndrome, and cardiovascular risk in Turkish adults. Int J Endocrinol. 2013;2013:767202. Scholar
  13. 13.
    Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults. The evidence report. National Institute of health. Obes Res. 1998;6(Suppl. 2):51–209.Google Scholar
  14. 14.
    Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341:427–34.CrossRefGoogle Scholar
  15. 15.
    Nguyen NT, Magno CP, Lane KT, Hinojosa MW, Lane JS. Association of hypertension, diabetes, dyslipidemia, and metabolic syndrome with obesity: findings from the national health and nutrition examination survey, 1999 to 2004. J Am Coll Surg. 2008;207:928–34.CrossRefGoogle Scholar
  16. 16.
    Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-Vliegen E, et al. Obesity management task force of the European association for the study of obesity. Management of obesity in adults: European clinical practice guidelines. Obes Facts. 2008;1:106–16.CrossRefGoogle Scholar
  17. 17.
    Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E, Obesity Canada Clinical Practice Guidelines Expert Panel. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176:1–13.CrossRefGoogle Scholar
  18. 18.
    Lyznicki JM, Young DC, Riggs JA, Davis RM, Council on Scientific Affairs, American Medical Association. Obesity: assessment and management in primary care. Am Fam Physician. 2001;63:2185–96.PubMedGoogle Scholar
  19. 19.
    Villareal DT, Apovian CM, Kushner RF, Klein S, American Society for Nutrition, NAASO, The Obesity Society. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr. 2005;82:923–34.CrossRefGoogle Scholar
  20. 20.
    NICE clinical guideline 43 Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. Issue date: December 2006. pp. 1–84.

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Mehmet Çelik
    • 1
  • Atakan Sezer
    • 2
  1. 1.Department of EndocrinologyTrakya University Medical FacultyEdirneTurkey
  2. 2.Department of SurgeryTrakya University Medical FacultyEdirneTurkey

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