Gastric Sleeve and Hypothyroidism

Question
Hello, quick question as I know you have touched on this subject before, just asking if you could elaborate on how the body's metabolism will react to having the Gastric Sleeve. If I already have a very sluggish metabolism due to hypothyroidism(had total thyroidectomy due to papillary carcinoma)to begin with, just how effective will the sleeve be? Aside from the obvious decrease in calories and the limited amount of food I will consume, I expect weight to come off from that prospective, but again, the metabolism factor has me curious. I've asked my Endocrinologist but she totally avoided the hypothyroidism factor and wasn't familiar with the Gastric Sleeve procedure.

Many Thanks!!

Answer
Robin,
It could be that your history of hypothyroidism will cause you to have a persistently slow metabolism and less impressive weight loss, but if the thyroid is treated with thyroid replacement meds then in my understanding you should have a 'normal' level of metabolism.

I think your actual question was if (and how) the sleeve will work in the setting of your potentially deficient metabolism.  In my experience with hypothyroid patients, the Sleeve works quite well.  The more we understand about how the Sleeve works, the more accurate it seems to understand it as a "metabolic correction procedure" rather than an operation that simply restricts food intake.  When I write "metabolic correction" here, I'm not suggesting there will be a direct correction of your hypothyroidism.  However, if we understand obesity itself as an abnormality of the metabolism, a situation where your body "wants" to store excess fat, then it is fair to understand the Sleeve as an operation that helps your body "want" less fat.  Thus, even when your calorie intake is way down after the Sleeve operation, your metabolism is likely to stay up because your body is happy to shed the fat that it now understands to be excessive.  Specific to your situation, it will be fair to expect that your metabolism will remain normal (not suppressed) after Sleeve surgery even though there seems to be the potential for metabolic reduction due to the hypothyroidism.

I hope this is helpful!

Dr JP

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