Did you know….?

> That having a BMI > 40 is associated with low thyroid function (“hypothyroidism”) and an increased probability of requiring thyroid replacement medication in those undergoing bariatric surgery (ie: oral levothyroxine “Synthroid”)?

> That Levothyroxine (Synthroid) is very susceptible to any changes in the architecture and routing of your GI tract (especially the small intestine)?

Therefore, it is very important to have your Endocrinologist or Medical provider keeping a close eye on your thyroid levels (TSH, T3, and T4) regularly after surgery.

Here are key educational points about the medication Levothyroxine (**Please do not make any changes to your current routine until you’ve reviewed them with your medical provider**)

1. Take the medication on an empty stomach at least 30 minutes before a meal

2. Take Levothyroxine 4 hours apart from medications that can interfere with absorption (such as acid reflux medication, vitamins and mineral supplementation)

3. Ensure you are having regular thyroid function testing starting 6 weeks after surgery and then every 3 months until steady state is achieved

4. Take the crushed or liquid form of Levothyroxine for at least 2 months after surgery.

Usually, your bariatric team will check your thyroid levels before surgery. Depending on the levels, they’ll continue checking them after surgery if they’re abnormal.

Signs of hypothyroidism (low thyroid levels) include:

• Fatigue

• Lethargy

• Cold intolerance

• Weight gain

• Constipation

• Change in voice

• And dry skin

But… your signs or symptoms can always look different than someone else’s due to differences in age, gender, and other factors.

[As always, this post is for educational purposes only. Please do not stop or change taking any of your medications until you have spoken to your medical / surgical team.]