{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:27:25Z","timestamp":1784723245890,"version":"3.55.0"},"reference-count":45,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T00:00:00Z","timestamp":1558310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FIS PI13\/00322 and PI16\/00884"],"award-info":[{"award-number":["FIS PI13\/00322 and PI16\/00884"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Obesity is associated with several endocrine abnormalities, including thyroid dysfunction. The objective of this study was to investigate the effect of weight loss after bariatric surgery on thyroid-stimulating hormone (TSH) levels in euthyroid patients with morbid obesity. We performed an observational study, evaluating patients with morbid obesity submitted to bariatric surgery. We included 129 patients (92 women) and 31 controls (21 women). Clinical, anthropometric, biochemical, and hormonal parameters were evaluated. The primary endpoint was circulating TSH (\u00b5U\/mL). Fasting TSH levels were higher in the obese group (3.3 \u00b1 0.2) than in the control group (2.1 \u00b1 0.2). The mean excessive body mass index (BMI) loss (EBMIL) 12 months after bariatric surgery was 72.7 \u00b1 2.1%. TSH levels significantly decreased in the obese patients after surgery; 3.3 \u00b1 0.2 vs. 2.1 \u00b1 0.2 before and 12 months after surgery, respectively. Free thyroxine (T4) (ng\/dL) levels significantly decreased in the obese patients after surgery; 1.47 \u00b1 0.02 vs. 1.12 \u00b1 0.02 before and 12 months after surgery, respectively. TSH decreased significantly over time, and the decrement was associated with the EBMIL. In euthyroid patients with morbid obesity, weight loss induced by bariatric surgery promotes a significant decline of the increased TSH levels. This decrement of TSH is progressive over time after surgery and significantly associated with excess BMI loss.<\/jats:p>","DOI":"10.3390\/nu11051121","type":"journal-article","created":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T11:05:07Z","timestamp":1558350307000},"page":"1121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4667-1224","authenticated-orcid":false,"given":"Paula","family":"Juiz-Vali\u00f1a","sequence":"first","affiliation":[{"name":"Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Instituto de Investigaci\u00f3n Biomedica (INIBIC), University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Outeiri\u00f1o-Blanco","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"P\u00e9rtega","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics Unit, University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5350-4534","authenticated-orcid":false,"given":"B\u00e1rbara Mar\u00eda","family":"Varela-Rodriguez","sequence":"additional","affiliation":[{"name":"Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Instituto de Investigaci\u00f3n Biomedica (INIBIC), University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda-Brao","sequence":"additional","affiliation":[{"name":"Department of Digestive and General Surgery, University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Mena","sequence":"additional","affiliation":[{"name":"Department of Digestive and General Surgery, University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Pena-Bello","sequence":"additional","affiliation":[{"name":"Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Instituto de Investigaci\u00f3n Biomedica (INIBIC), University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Cordido","sequence":"additional","affiliation":[{"name":"Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Instituto de Investigaci\u00f3n Biomedica (INIBIC), University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1207-4667","authenticated-orcid":false,"given":"Susana","family":"Sangiao-Alvarellos","sequence":"additional","affiliation":[{"name":"Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Instituto de Investigaci\u00f3n Biomedica (INIBIC), University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3528-8174","authenticated-orcid":false,"given":"Fernando","family":"Cordido","sequence":"additional","affiliation":[{"name":"Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Instituto de Investigaci\u00f3n Biomedica (INIBIC), University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"},{"name":"Department of Endocrinology, University Hospital A Coru\u00f1a, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"GBD 2015 Obesity Collaborators (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med., 377, 13\u201327.","DOI":"10.1056\/NEJMoa1614362"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1001\/jama.2016.6458","article-title":"Trends in Obesity Among Adults in the United States, 2005 to 2014","volume":"315","author":"Flegal","year":"2016","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1467-789X.2011.00964.x","article-title":"Prevalence of general and abdominal obesity in the adult population of Spain, 2008\u20132010: The ENRICA study","volume":"13","author":"Graciani","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.cmet.2016.02.005","article-title":"Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity","volume":"23","author":"Magkos","year":"2016","journal-title":"Cell Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1001\/jama.2017.20513","article-title":"Association of Bariatric Surgery Using Laparoscopic Banding, Roux-en-Y Gastric Bypass, or Laparoscopic Sleeve Gastrectomy vs Usual Care Obesity Management With All-Cause Mortality","volume":"319","author":"Reges","year":"2018","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ejim.2017.06.004","article-title":"Oral glucose-stimulated growth hormone (GH) test in adult GH deficiency patients and controls: Potential utility of a novel test","volume":"44","author":"Cordido","year":"2017","journal-title":"Eur. J. Int. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pena-Bello, L., Pertega-Diaz, S., Outeirino-Blanco, E., Garcia-Buela, J., Tovar, S., Sangiao-Alvarellos, S., Dieguez, C., and Cordido, F. (2015). Effect of oral glucose administration on rebound growth hormone release in normal and obese women: The role of adiposity, insulin sensitivity and ghrelin. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0121087"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.endonu.2011.05.015","article-title":"Endocrine function in obesity","volume":"58","author":"Cordido","year":"2011","journal-title":"Endocrinol. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3614","DOI":"10.1210\/jc.2010-1245","article-title":"Thyroid and obesity: An intriguing relationship","volume":"95","author":"Biondi","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.mce.2009.06.005","article-title":"Obesity and thyroid function","volume":"316","author":"Reinehr","year":"2010","journal-title":"Mol. Cell Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1530\/EJE-08-0734","article-title":"Raised serum TSH levels in patients with morbid obesity: Is it enough to diagnose subclinical hypothyroidism?","volume":"160","author":"Rotondi","year":"2009","journal-title":"Eur. J. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1136\/adc.87.4.320","article-title":"Thyroid hormones before and after weight loss in obesity","volume":"87","author":"Reinehr","year":"2002","journal-title":"Arch. Dis. Child."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1002\/oby.21796","article-title":"Reference values for TSH may be inadequate to define hypothyroidism in persons with morbid obesity: Di@bet.es study","volume":"25","author":"Valdes","year":"2017","journal-title":"Obesity"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1007\/s11695-017-2684-8","article-title":"Effect of Laparoscopic Roux-en-Y Gastric Bypass Surgery on Thyroid Hormone Levels in Chinese Patients, Could It Be a Risk for Thyroid Nodules?","volume":"27","author":"Zhang","year":"2017","journal-title":"Obes. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1007\/s11695-017-2965-2","article-title":"Effect of Bariatric Surgery on Thyroid Function in Obese Patients: A Systematic Review and Meta-Analysis","volume":"27","author":"Guan","year":"2017","journal-title":"Obes. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1097\/SLE.0000000000000432","article-title":"Effect of Sleeve Gastrectomy on Thyroid Function in Chinese Euthyroid Obese Patients","volume":"27","author":"Yang","year":"2017","journal-title":"Surg. Laparosc. Endosc. Percutan. Tech."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1038\/ijo.2017.28","article-title":"Thyroid hormones and changes in body weight and metabolic parameters in response to weight loss diets: The POUNDS LOST trial","volume":"41","author":"Liu","year":"2017","journal-title":"Int. J. Obes."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11695-017-2792-5","article-title":"Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function","volume":"28","author":"Neves","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1038\/oby.2009.320","article-title":"Weight loss through gastric banding: Effects on TSH and thyroid hormones in obese subjects with normal thyroid function","volume":"18","author":"Paganelli","year":"2010","journal-title":"Obesity"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1210\/jc.2004-1306","article-title":"Lean body mass is a major determinant of levothyroxine dosage in the treatment of thyroid diseases","volume":"90","author":"Santini","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s11695-016-2247-4","article-title":"TSH Normalization in Bariatric Surgery Patients After the Switch from L-Thyroxine in Tablet to an Oral Liquid Formulation","volume":"27","author":"Fallahi","year":"2017","journal-title":"Obes. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1007\/s11695-018-3388-4","article-title":"The Effect of the Bariatric Surgery Type on the Levothyroxine Dose of Morbidly Obese Hypothyroid Patients","volume":"28","author":"Pedro","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1210\/jc.2018-01997","article-title":"Can We Link Thyroid Status, Energy Expenditure, and Body Composition to Management of Subclinical Thyroid Dysfunction?","volume":"104","author":"Ylli","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"E514","DOI":"10.1152\/ajpendo.90433.2008","article-title":"Thyroid-stimulating hormone receptor in brown adipose tissue is involved in the regulation of thermogenesis","volume":"295","author":"Endo","year":"2008","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1038\/ijo.2009.140","article-title":"Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and\/or type 2 diabetes: Effects of weight loss","volume":"33","author":"Nannipieri","year":"2009","journal-title":"Int. J. Obes."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Marzullo, P., Minocci, A., Mele, C., Fessehatsion, R., Tagliaferri, M., Pagano, L., Scacchi, M., Aimaretti, G., and Sartorio, A. (2018). The relationship between resting energy expenditure and thyroid hormones in response to short-term weight loss in severe obesity. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0205293"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.diabet.2014.11.009","article-title":"Increased TSH in obesity: Evidence for a BMI-independent association with leptin","volume":"41","author":"Betry","year":"2015","journal-title":"Diabetes Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3965","DOI":"10.1210\/jc.2009-2798","article-title":"Investigations of thyroid hormones and antibodies in obesity: Leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants","volume":"95","author":"Marzullo","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1089\/thy.2017.0600","article-title":"Seasonal Changes in Serum Thyrotropin Concentrations Observed from Big Data Obtained During Six Consecutive Years from 2010 to 2015 at a Single Hospital in Japan","volume":"28","author":"Yoshihara","year":"2018","journal-title":"Thyroid"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4158\/EP-2017-0058","article-title":"Seasonal Variation of Vitamin D and Serum Thyrotropin Levels and Its Relationship in a Euthyroid Caucasian Population","volume":"24","author":"Das","year":"2018","journal-title":"Endocr. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1089\/thy.2014.0589","article-title":"Circadian and Circannual Rhythms in Thyroid Hormones: Determining the TSH and Free T4 Reference Intervals Based Upon Time of Day, Age, and Sex","volume":"25","author":"Ehrenkranz","year":"2015","journal-title":"Thyroid"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1210\/jc.2013-2858","article-title":"Thyrotropin Secretion in Healthy Subjects Is Robust and Independent of Age and Gender, and Only Weakly Dependent on Body Mass Index","volume":"99","author":"Roelfsema","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3088","DOI":"10.1210\/jc.2006-0095","article-title":"Hyperthyrotropinemia in obese children is reversible after weight loss and is not related to lipids","volume":"91","author":"Reinehr","year":"2006","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5037","DOI":"10.1210\/jc.2009-2566","article-title":"Weight regain after a diet-induced loss is predicted by higher baseline leptin and lower ghrelin plasma levels","volume":"95","author":"Crujeiras","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"E333","DOI":"10.1152\/ajpendo.00431.2018","article-title":"Growth Hormone Signaling and Action in Obese versus Lean Human Subjects","volume":"316","author":"Hogild","year":"2018","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1210\/jc.2018-01036","article-title":"Expression of GHR and downstream signaling genes in human adipose tissue\u2014Relation to obesity and weight-change","volume":"104","author":"Glad","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.beem.2017.02.003","article-title":"Focus on GH deficiency and thyroid function","volume":"31","author":"Giavoli","year":"2017","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/1043-2760(93)90107-P","article-title":"Influence of thyroid hormones on the GH-IGF-I axis","volume":"4","author":"Miell","year":"1993","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1530\/EJE-14-0966","article-title":"Effects of GH replacement therapy on thyroid volume and nodule development in GH deficient adults: A retrospective cohort study","volume":"172","author":"Curto","year":"2015","journal-title":"Eur. J. Endocrinol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s12020-017-1495-y","article-title":"Effects of growth hormone on thyroid function are mediated by type 2 iodothyronine deiodinase in humans","volume":"59","author":"Yamauchi","year":"2018","journal-title":"Endocrine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1677\/joe.0.1570053","article-title":"Stimulatory effect of insulin-like growth factor I on proliferation of mouse pituitary cells in serum-free culture","volume":"157","author":"Oomizu","year":"1998","journal-title":"J. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3676","DOI":"10.1210\/en.2017-00528","article-title":"TSH\/IGF-1 Receptor Cross-Talk Rapidly Activates Extracellular Signal-Regulated Kinases in Multiple Cell Types","volume":"158","author":"Krieger","year":"2017","journal-title":"Endocrinology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1089\/thy.2005.15.1035","article-title":"Optimal thyrotropin level: Normal ranges and reference intervals are not equivalent","volume":"15","author":"Dickey","year":"2005","journal-title":"Thyroid"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"5483","DOI":"10.1210\/jc.2005-0455","article-title":"The evidence for a narrower thyrotropin reference range is compelling","volume":"90","author":"Wartofsky","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/5\/1121\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:53:35Z","timestamp":1760187215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/5\/1121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,20]]},"references-count":45,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5]]}},"alternative-id":["nu11051121"],"URL":"https:\/\/doi.org\/10.3390\/nu11051121","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,20]]}}}