Our Summary

This research paper examines the link between two types of surgery - weight loss surgery (bariatric surgery) and thyroid surgery - and a condition called hypocalcemia, which is a deficiency of calcium in the body.

The researchers looked at various studies to find out if people who had weight loss surgery before having their thyroid removed (thyroidectomy) were more likely to have low calcium levels afterward. They found 17 studies that included 126 patients who fit these criteria.

The weight loss surgeries studied included Roux-en-Y gastric bypass, biliopancreatic diversion, sleeve gastrectomy, and laparoscopic adjustable gastric band. The results showed that patients who had Roux-en-Y gastric bypass and biliopancreatic diversion were more likely to have low calcium levels after thyroid surgery. However, this was not seen in patients who had the other two types of weight loss surgery.

The study concludes that patients who have had weight loss surgery are at a higher risk of developing hypocalcemia after thyroid surgery. This can sometimes lead to longer hospital stays and the need for more invasive treatments. However, the researchers point out that more studies are needed to confirm these findings.

FAQs

  1. What is the correlation between hypocalcemia after thyroidectomy and previous bariatric surgery?
  2. Which types of bariatric surgery have been found to have higher prevalence of post-thyroidectomy hypocalcemia?
  3. Are patients with previous bariatric surgery at a high risk of post-thyroidectomy hypocalcemia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to ensure they are adequately managing their calcium and vitamin D levels before and after surgery, especially if they have a history of bariatric surgery. Patients with previous bariatric surgery are at higher risk for post-thyroidectomy hypocalcemia, so it is important to closely monitor these levels and potentially adjust supplementation accordingly. Additionally, discussing these risks with the surgical team and ensuring appropriate follow-up care can help prevent complications.

Suitable For

Patients who have undergone previous bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD), are typically recommended thyroidectomy. These patients are at a higher risk of developing post-thyroidectomy hypocalcemia, which can lead to longer hospital stays and may require more invasive treatment options. Patients who have undergone sleeve gastrectomy (SG) and laparoscopic adjustable gastric band (LAGB) procedures may not have as high of a risk for post-thyroidectomy hypocalcemia. Further studies are needed to better understand the relationship between bariatric surgery and thyroidectomy outcomes.

Timeline

Before thyroidectomy:

  1. Patient is diagnosed with a thyroid condition that requires surgical intervention.
  2. Patient undergoes pre-operative testing and evaluation to assess their overall health and suitability for surgery.
  3. Patient may need to adjust medications or undergo other treatments to prepare for surgery.

After thyroidectomy:

  1. Patient undergoes thyroidectomy surgery to remove part or all of the thyroid gland.
  2. Post-operative care includes monitoring for complications such as bleeding, infection, and hypocalcemia.
  3. Patients with a history of bariatric surgery may be at higher risk for post-thyroidectomy hypocalcemia due to calcium and vitamin D deficiencies.
  4. Management options for hypocalcemia may include supplementation, dietary changes, or more invasive interventions.
  5. Patients may experience a longer hospital stay and require additional monitoring and care following thyroidectomy if they have a history of bariatric surgery.

What to Ask Your Doctor

  1. Am I at a higher risk for post-thyroidectomy hypocalcemia due to my history of bariatric surgery?
  2. What specific factors from my bariatric surgery could increase my risk for hypocalcemia after thyroidectomy?
  3. How will my previous bariatric surgery affect the management of my post-thyroidectomy hypocalcemia?
  4. Are there any additional precautions or monitoring that should be taken during my thyroidectomy due to my history of bariatric surgery?
  5. What are the potential consequences of post-thyroidectomy hypocalcemia in patients with previous bariatric surgery?
  6. Are there any specific dietary or supplement recommendations I should follow after my thyroidectomy to prevent hypocalcemia?
  7. Should I be referred to a specialist or have additional follow-up appointments due to the increased risk of hypocalcemia after thyroidectomy with a history of bariatric surgery?
  8. Are there any specific medications that I should avoid or be cautious with after my thyroidectomy, considering my history of bariatric surgery?
  9. What are the potential long-term implications of post-thyroidectomy hypocalcemia in patients with previous bariatric surgery?
  10. Are there any specific warning signs or symptoms that I should be aware of after my thyroidectomy that could indicate hypocalcemia, especially given my history of bariatric surgery?

Reference

Authors: Spartalis E, Thanassa A, Athanasiadis DI, Schizas D, Athanasiou A, Zografos GN, Tsourouflis G, Dimitroulis D, Nikiteas N. Journal: In Vivo. 2019 Jul-Aug;33(4):1373-1379. doi: 10.21873/invivo.11614. PMID: 31280233