Maladaptive Hypothyroidism, or The Famine Response, After Bariatric Surgery: TSH Not the Gold Standard for Detection

The document discussed the potential issue of undetected hypothyroidism, referred to as the 'famine response,' in patients who have undergone bariatric surgery. Despite bariatric surgery being an effective treatment for severe obesity, 30% of patients experienced unsuccessful weight loss or weight regain. The study suggested that the traditional measure of thyroid-stimulating hormone (TSH) might not be adequate for diagnosing this type of hypothyroidism. Instead, it proposed using the ratio of Free T3 (FT3) to reverse T3 (rT3) as a more accurate measure. The study aimed to investigate whether a subset of post-bariatric patients met the criteria for hypothyroidism during the rapid weight loss period after surgery, as symptoms such as feeling cold, tired, constipated, hair loss, dry skin, and mood changes were commonly reported.