Volume 28, Issue 150, August 2024

Using the liquid form of levothyroxine in patients after bariatric surgery: An overview of the latest knowledge

Karolina Szczerkowska¹, Justyna Chwiejczak², Aleksander Górny³, Anna Seroka⁴, Maria Rybicka⁵, Jan Kościan⁶, Julita Młynarska⁷, Anna Wójcik⁸, Jakub Langa⁹, Michał Obrębski⁵, Maria Mitkowska¹⁰, Bartosz Górecki¹¹

¹Military Institute of Medicine - National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
²Memorial Bielański Hospital Cegłowska 80, 01-809 Warsaw, Poland
³Prague Hospital of Lord's Transfiguration, Aleja, Solidarności'' 67, 03-401, Warsaw, Poland
⁴The National Institute of Medicine of the Ministry of Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland
⁵University Clinical Centre of the Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
⁶Independent Public Hospital them. prof. W. Orlowski Medical Centre of Postgraduate Education, Warsaw, Poland
⁷Saint Anna Hospital of Trauma Surgery, Barska 16/20 Street, 02-315, Warsaw, Poland
⁸Warsaw Southern Hospital, Rotmistrza Witolda Pileckiego 99, 02-781 Warsaw, Poland
⁹Józef Struś Hospital, Szwajcarska 3, 61-285, Poznań, Poland
¹⁰HCP Medical Centre, 28 Czerwca 1956 r. 194, 61-001, Poznan, Poland
¹¹Cardinal Stefan Wyszyński University in Warsaw, Wóycickiego 1/3, 01-938 Warsaw, Poland

ABSTRACT

Hypothyroidism is a common condition affecting approximately 5% of the global population, with an estimated 5% remaining undiagnosed. This disease does not exclude the group of patients after bariatric surgery, the number of whom is constantly growing, posing new challenges to practitioners providing medical care to them. Bariatric patients previously treated for hypothyroidism should theoretically have their drug dosage reduced due to postoperative weight loss. In practice, it is often the opposite, and the doses are increased. In recent years, levothyroxine in the liquid form (LT4) was introduced for the treatment of hypothyroidism. Liquid levothyroxine, such as Tirosint SOL and Althyxin, has shown promising results, especially by improving absorption in bariatric patients. The present work contains the latest reports on the treatment of bariatric patients with liquid levothyroxine, focusing on such factors as the microbiome, polypharmacy, and the administration of proton pump inhibitors (PPI). It explains the mechanisms influencing the outcome of the above-mentioned medication.

Keywords: Liquid levothyroxine, bariatric surgery, hypothyroidism, novel levothyroxine

Medical Science, 2024, 28, e89ms3402

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DOI: https://doi.org/10.54905/disssi.v28i150.e89ms3402

Published: 07 August 2024