Subclinical Hypothyroidism Post-Bariatric Surgery: A Reversible Case of Iodine Deficiency Without Autoimmune Thyroid Disease

Subclinical hypothyroidism is a common finding in clinical practice, often prompting initiation of levothyroxine therapy. However, not all cases of elevated thyroid-stimulating hormone (TSH) reflect permanent thyroid dysfunction. This report discusses a 39-year-old woman with a history of Roux-en-Y gastric bypass surgery who presented with elevated TSH in the absence of thyroid autoantibodies or classic hypothyroid symptoms. Laboratory and clinical findings suggested iodine deficiency as the underlying cause. Her TSH normalized following potassium iodide supplementation. This case underscores the need for a nuanced approach to managing elevated TSH, particularly in post-bariatric surgery patients where iodine deficiency may be the etiology of subclinical hypothyroidism.