Dietary Iodine Absorption is Not Influenced by Malabsorptive Bariatric Surgery

Overview

Journal Obes Surg

Date 2014 Apr 18

PMID 24740595

Citations 13

Authors

M Michalaki

S Volonakis

I Mamali

F Kalfarentzos

A G Vagenakis

K B Markou

Affiliations

Soon will be listed here.

Abstract

Background: Bariatric surgery is accompanied by malabsorption of protein, carbohydrates, fats, vitamins, and trace elements. Iodine is essential to the synthesis of thyroid hormones. The aim of this study was to estimate the daily iodine intake in severely obese patients before and after bariatric surgery.

Methods: Thirty-five severely obese patients (obese group) with a BMI of 51.3 ± 8.3 kg/m(2) were studied before, 3 months, and 6 months after bariatric surgery. Eleven out of 35 patients were subjected to gastric bypass operation Roux-en-Y and 24 were subjected to a variant of biliopancreatic diversion with long limb procedure. The patients did not use any iodine supplements and no iodine antiseptics were administered during the operation. The messmates of the patients, following a similar diet (control group) with a BMI of 31.2 ± 10.7 kg/m(2), were also studied. Serum T3, T4, TSH, thyroid peroxidase antibodies, urinary iodine excretion (UIE) in a spot urine, and thyroid volume were measured in all subjects, at baseline and at 3- and 6-month follow-up in the obese group.

Results: UIE at baseline was similar in obese and control group (median (min-max), 129.5 (24.9-462) vs. 138.9 (30.8-381) μg/L, ns). In the obese group, a transient increase of UIE was observed 3 months after the operation and returned to baseline levels 6-months postsurgery.

Conclusions: The UIE is not reduced after malabsorptive bariatric surgery, although all stomach, duodenum, and a substantial part of jejunum were bypassed. It appears that iodine is absorbed sufficiently along the remaining gastrointestinal tract.

Citing Articles

Thyroid function and iodine intake: global recommendations and relevant dietary trends.

Bath S Nat Rev Endocrinol. 2024; 20(8):474-486.

PMID: 38693274 DOI: 10.1038/s41574-024-00983-z.

The relationship between thyroid and human-associated microbiota: A systematic review of reviews.

Virili C, Stramazzo I, Bagaglini M, Carretti A, Capriello S, Romanelli F Rev Endocr Metab Disord. 2023; 25(1):215-237.

PMID: 37824030 PMC: 10808578. DOI: 10.1007/s11154-023-09839-9.

Micronutrients in Pregnancy after Bariatric Surgery: A Narrative Review.

Breton I, Ballesteros-Pomar M, Calle-Pascual A, Alvarez-Sala L, Rubio-Herrera M J Clin Med. 2023; 12(16).

PMID: 37629473 PMC: 10455502. DOI: 10.3390/jcm12165429.

Changes in Urinary Iodine Levels Following Bariatric Surgery.

Peng C, Han C, Waisayanand N, De Leo S, Srimatkandada P, Kommareddy S Endocr Pract. 2023; 29(9):710-715.

PMID: 37385530 PMC: 10528999. DOI: 10.1016/j.eprac.2023.06.008.

Nutritional iodine status and obesity.

Moleti M, Di Mauro M, Paola G, Olivieri A, Vermiglio F Thyroid Res. 2021; 14(1):25.

PMID: 34838106 PMC: 8626876. DOI: 10.1186/s13044-021-00116-y.

References

Wesche M, Wiersinga W, Smits N . Lean body mass as a determinant of thyroid size. Clin Endocrinol (Oxf). 1998; 48(6):701-6. DOI: 10.1046/j.1365-2265.1998.00400.x. View

Hays M . Colonic excretion of iodide in normal human subjects. Thyroid. 1993; 3(1):31-5. DOI: 10.1089/thy.1993.3.31. View

Furet J, Kong L, Tap J, Poitou C, Basdevant A, Bouillot J . Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes. 2010; 59(12):3049-57. PMC: 2992765. DOI: 10.2337/db10-0253. View

Nguyen N, Masoomi H, Magno C, Nguyen X, Laugenour K, Lane J . Trends in use of bariatric surgery, 2003-2008. J Am Coll Surg. 2011; 213(2):261-6. DOI: 10.1016/j.jamcollsurg.2011.04.030. View

Kalfarentzos F, Skroubis G, Karamanakos S, Argentou M, Mead N, Kehagias I . Biliopancreatic diversion with Roux-en-Y gastric bypass and long limbs: advances in surgical treatment for super-obesity. Obes Surg. 2011; 21(12):1849-58. DOI: 10.1007/s11695-011-0532-9. View

Michalaki M, Vagenakis A, Leonardou A, Argentou M, Habeos I, Makri M . Thyroid function in humans with morbid obesity. Thyroid. 2006; 16(1):73-8. DOI: 10.1089/thy.2006.16.73. View

Perle K, Kim D, Hall N, Bobbey A, Shen D, Nagy R . Modulation of sodium/iodide symporter expression in the salivary gland. Thyroid. 2013; 23(8):1029-36. PMC: 3752512. DOI: 10.1089/thy.2012.0571. View

Zhang H, DiBaise J, Zuccolo A, Kudrna D, Braidotti M, Yu Y . Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009; 106(7):2365-70. PMC: 2629490. DOI: 10.1073/pnas.0812600106. View

Aron-Wisnewsky J, Dore J, Clement K . The importance of the gut microbiota after bariatric surgery. Nat Rev Gastroenterol Hepatol. 2012; 9(10):590-8. DOI: 10.1038/nrgastro.2012.161. View

10.

Ahima R, Osei S . Leptin signaling. Physiol Behav. 2004; 81(2):223-41. DOI: 10.1016/j.physbeh.2004.02.014. View

11.

Nicola J, Basquin C, Portulano C, Reyna-Neyra A, Paroder M, Carrasco N . The Na+/I- symporter mediates active iodide uptake in the intestine. Am J Physiol Cell Physiol. 2008; 296(4):C654-62. PMC: 2670652. DOI: 10.1152/ajpcell.00509.2008. View

12.

Gkotsina M, Michalaki M, Mamali I, Markantes G, Sakellaropoulos G, Kalfarentzos F . Improved levothyroxine pharmacokinetics after bariatric surgery. Thyroid. 2012; 23(4):414-9. DOI: 10.1089/thy.2011.0526. View

13.

DERBLOM H, Johansson H, Nylander G . SMALL INTESTINAL ABSORPTION AND GASTRIC SECRECTION OF IODIDE IN TOTAL SMALL BOWEL OBSTRUCTION IN THE RAT. Surgery. 1963; 54:771-83. View

14.

Kok P, Roelfsema F, Frolich M, Meinders A, Pijl H . Spontaneous diurnal thyrotropin secretion is enhanced in proportion to circulating leptin in obese premenopausal women. J Clin Endocrinol Metab. 2005; 90(11):6185-91. DOI: 10.1210/jc.2005-0003. View

15.

Brunn J, Block U, Ruf G, Bos I, Kunze W, Scriba P . [Volumetric analysis of thyroid lobes by real-time ultrasound (author's transl)]. Dtsch Med Wochenschr. 1981; 106(41):1338-40. DOI: 10.1055/s-2008-1070506. View

16.

de Carvalho F, Quick M . Surprising substrate versatility in SLC5A6: Na+-coupled I- transport by the human Na+/multivitamin transporter (hSMVT). J Biol Chem. 2010; 286(1):131-7. PMC: 3012967. DOI: 10.1074/jbc.M110.167197. View

17.

Braverman L, Ingbar S . CHANGES IN THYROIDAL FUNCTION DURING ADAPTATION TO LARGE DOSES OF IODIDE. J Clin Invest. 1963; 42:1216-31. PMC: 289393. DOI: 10.1172/JCI104807. View

18.

Lips M, de Groot G, van Klinken J, Aarts E, Berends F, Janssen I . Calorie restriction is a major determinant of the short-term metabolic effects of gastric bypass surgery in obese type 2 diabetic patients. Clin Endocrinol (Oxf). 2013; 80(6):834-42. DOI: 10.1111/cen.12254. View

19.

Flegal K, Carroll M, Kit B, Ogden C . Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012; 307(5):491-7. DOI: 10.1001/jama.2012.39. View

20.

Eng P, Cardona G, Fang S, Previti M, Alex S, Carrasco N . Escape from the acute Wolff-Chaikoff effect is associated with a decrease in thyroid sodium/iodide symporter messenger ribonucleic acid and protein. Endocrinology. 1999; 140(8):3404-10. DOI: 10.1210/endo.140.8.6893. View