J. C. Lee1,2, P. Chang1, R. Glick1, J. W. Serpell1,2, S. Grodski1 1Monash University,Endocrine Surgery Unit, The Alfred,Melbourne, VIC, Australia 2Monash University,Department Of Surgery,Melbourne, VIC, Australia
Introduction: Weight gain after thyroid surgery is a commonly encountered patient concern in clinical practice, but there is little published data on this topic. Therefore this study aimed to determine bodyweight (BW) change following total thyroidectomy (TTx), and comparing perceived to actual changes. Secondarily, the study also aimed to determine patient satisfaction regarding thyroxine dosing post-operatively.
Methods: Following institutional review board ethics approval, patients were recruited from the Monash University Endocrine Surgery Database between January 2013 and June 2014. All patients who underwent TTx at the Alfred Hospital were eligible. Pre-operative data were extracted from patient files (including BW, TSH, medications), while post-operative data were obtained by surveying the participants 6 to 18 months after surgery (including BW, medications, satisfaction scores). Clinically relevant change in BW was defined as 2 kg gain or loss. Data was analysed using standard statistical methods, including Student’s t-test, Chi-squared, and Fisher’s Exact tests as appropriate.
Results: A total of 107 patients satisfying the inclusion criteria were invited to participate, and were posted the questionnaire. A response was received from 79 patients (74%). The mean age of the respondents was 56 (range 15 – 84) years, with 3 times more females than males. The majority of participants had TTx for benign indications, and 19% had TTx for confirmed or suspected malignancy. Pre-operatively, 32 (42%) patients had a diagnosis of either toxic multinodular goiter or Graves’ disease, and 28 of them were on an anti-thyroid medication. Nearly half (34, 43%) of the participants had stable BW after TTx, while 24 (30%) gained an average of 6.8 kg (9% gain), and 21 (27%) lost an average of 7.8 kg (9.3% loss). There was poor concordance between perceived and actual BW gain or loss. Pre-operative thyrotoxicity did not appear to have any bearing on post-operative BW change. Anti-thyroid medications, gender and TSH levels were also not shown to be predictors of post-operative BW change. Taking their BW and thyroxine dosing into account, the majority of patients (81%) were satisfied with their post-operative management. There was no correlation between satisfaction scores and BW gain or loss.
Conclusion: Bodyweight change following TTx is unpredictable, and only less than one-third of patients experience weight gain. Pre-operative factors, including thyrotoxicosis, were not found to be predictors of post-operative BW change after thyroidectomy. Regardless of their BW status, the majority of patients were satisfied with their post-operative course after total thyroidectomy.