Malabsorption of Thyroid Hormone After Small Bowel Resection

Hypothyroid patients on stable long-term oral levothyroxine (T4) dosage are at risk of developing overt hypothyroidism after small bowel (SB) resection. This can happen despite equivalent peri-operative intravenous (IV) supplementation and resumption of preoperative oral T4 dosage when post-operative oral medication is tolerated. This situation is not specifically addressed in any of the major guidelines for T4 oral replacement in this setting and may be underrecognized, leading to diagnostic and management challenges.