Hormone Levels In Patients Research Articles

Resection of the large bowel suppresses hunger and food intake and modulates gastrointestinal fermentation.

To assess appetite and gut hormone levels in patients following partial (PR) or total resection (TR) of the large bowel. A comparative cross sectional study was carried out with healthy controls (n = 99) and patients who had undergone PR (n = 64) or TR (n = 12) of the large bowel. Participants consumed a standard (720 kcal) breakfast meal at 0830 (t = 0) h followed by lactulose (15 g) and a buffet lunch (t = 210 min). Participants rated the subjective feelings of hunger at t = -30, 0, 30, 60, 120, and 180 min. Breath hydrogen (BH) concentrations were also evaluated. In a matched subset (11 controls, 11 PR and 9 TR patients) PYY and GLP-1 concentrations were measured following breakfast. The primary outcome measure was appetite, as measured using visual analogue scales and the buffet lunch. The secondary outcome was BH concentrations following a test meal. PR and TR participants had lower hunger and energy intake at the buffet lunch meal compared to controls. PR subjects had higher BH concentrations compared to controls and TR subjects. BH levels correlated with circulating GLP-1 levels at specific time points. PR or TR of the large bowel reduced feelings of hunger and energy intake, and PR increased gastrointestinal fermentation.

Effect of eplerenone on parathyroid hormone levels in patients with primary hyperparathyroidism: results from the EPATH randomized, placebo-controlled trial.

Accumulating evidence points toward mutual interaction between parathyroid hormone (PTH) and aldosterone as potential mechanism for increasing cardiovascular risk in primary hyperparathyroidism (pHPT). The Eplerenone on parathyroid hormone levels in patients with primary hyperparathyroidism (EPATH) trial is a single-center, randomized, double-blind, parallel-group, placebo-controlled trial. The primary aim is to evaluate the effects of the mineralocorticoid receptor antagonist eplerenone on plasma intact PTH (iPTH) concentration in patients with pHPT. Secondary end points comprised surrogate parameters of cardiovascular health [24-h ambulatory SBP and DBP and echocardiographic parameters related to systolic/diastolic function as well as to cardiac dimensions]. We enrolled 110 study participants with pHPT, 25-hydroxyvitamin D at least 20 ng/ml and estimated glomerular filtration rate more than 50 ml/min per 1.73 m. Patients were 1 : 1 randomly assigned to receive either 25 mg eplerenone once daily (up-titration after 4 weeks to 50 mg/day) or matching placebo for a treatment period of 8 weeks.The study was completed by 97 participants [mean (SD) age: 67.5 ± 9.5 years; 78.4% women). The mean treatment effect (95% confidence interval) for iPTH was 1.0 (0.9-1.1; P = 0.777) pg/ml. Mean 24-h ambulatory SBP and DBP decreased significantly [mean change (95% confidence interval) -6.3 (-9.4 to -3.3) and -3.7 (-5.7 to -1.7) mmHg, respectively; P < 0.001]. No differences were seen in any further secondary outcomes or frequency of adverse events. In pHPT, treatment with eplerenone compared with placebo had no effect on circulating iPTH levels. Eplerenone treatment was well tolerated and safe and followed by significant decrease of ambulatory blood pressure.

Changes of anterior pituitary function in patients with central nervous system infection

Objective To investigate changes and clinical significance of serum anterior pituitary hormone levels in patients with central nervous system infection. Methods Forty-five cases suffering from central nervous system infection at the department of Neurosurgery, Henan Provincial People's Hospital were enrolled in this study. All of patients received the laboratory tests of adrenocorticotrophic hormone (ACTH), cortisol, thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), growth hormone (GH), insulin-stimulation factor-1 (IGF-1), gonadal hormone within 24 h of admission. On the third day post-infection and one month after infection curing, ACTH, cortisol, TSH, FT3, FT4, GH, IGF-1, prolactin prolactin (PRL) , follicle stimulating hormone (FSH), and luteinizing hormone (LH) were determined. Results During the acute phase, 18 patients (40.00%) showed apparent anterior pituitary hormone deficiencies, including 4 patients (8.89%) with corticotropic insufficiency, 5 patients (11.11%) with thyroid insufficiency, 7 patients (15.56%) with somatotropic deficiency [5 cases (11.11%) with low IGF-1], and 2 patients (4.44%) with low PRL [one cases (2.22%) with low FSH and LH]. On 18 cases, 16 cases (88.89%) with anterior pituitary hormone deficiencies resolved and 2 patients (4.44%) had corticotropic insufficiency one month after infection curing. Conclusion Pituitary insufficiency may occur in a considerable number of patients after acute infection. And the majority may reversible after infection recovery. Key words: Central nervous system infection; Anterior pituitary; Hormone

Sorafenib-induced changes in thyroid hormone levels in patients with hepatocellular carcinoma

Sorafenib-induced changes in thyroid hormone levels in patients with hepatocellular carcinoma

Thyroid Hormone Levels in Chronic Schizophrenic Patients: Association with Psychopathology.

Thyroid disorders are highly prevalent in patients with schizophrenia. Changes in the levels of thyroid hormones cause the occurrence of psychiatric disorders and affect the response to treatment. The aim of this study was to investigate the changes in thyroid hormone levels in patients with chronic schizophrenia, and to demonstrate any association between psychiatric symptoms and hormones. Sixty-three patients with schizophrenia and 53 controls were included in this study. The serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in patients and controls were tested by using the chemiluminescence immunoassay. Symptoms were assessed via the Positive and Negative Syndrome Scale (PANSS). The level of FT4 in the schizophrenia group was statistically significantly lower than the control group (p = 0.045). There was no significant difference between the clinical subtypes of schizophrenia and thyroid hormone levels. There was a mild negative correlation between PANSS negative subscale scores and levels of TSH (p = 0.023). These findings suggest that the subclinical hypothyroidism observed in the chronic schizophrenic patients may be associated with the treatment of neuroleptics. The possible alterations of thyroid hormones should be considered in chronic schizophrenic patients for treatment with neuroleptics.

The influence of thiazide intake on calcium and parathyroid hormone levels in patients with primary hyperparathyroidism.

The effects of thiazide medication in patients with primary hyperparathyroidism (PHPT) have so far not been elucidated. The aim of this study was to analyse the extent to which the administration of thiazides may influence biochemical parameters and therefore the diagnosis of PHPT in a large cohort of patients. The biochemical parameters of 1066 patients with PHPT were analysed, and drug history was documented. Calcium (Ca)/creatinine clearance ratio (CCCR) was calculated. The results of patients given thiazides (n = 170) and those not given thiazides (n = 896) were analysed and compared. Twenty-four-hour urinary calcium excretion (24hU), albumin-corrected serum calcium, PTH, creatinine, 1,25OH- and 25OH-vitamin D were measured, and CCCR was calculated. 24hUC a and CCCR were significantly lower in patients on thiazides (P = 0·02 and P = 0·0068, resp.), and serum creatinine was significantly higher in those subjects (P < 0·0001). Serum Ca levels only proved different in an analysis of covariance among patients younger than 60 years (P = 0·003). Nevertheless, PTH was not different in both groups (P = 0·917). According to recently published guidelines, 24hUCa measurement is necessary to give indication for surgery in asymptomatic patients and to distinguish between PHPT and familial hypocalciuric hypercalcaemia [FHH]. Thiazides significantly decrease 24hUC a , yet neither increase serum Ca nor influence PTH levels in patients with PHPT. However, discontinuing thiazides is crucial for a correct CCCR calculation to pre-operatively rule out FHH. As a consequence, the withdrawal of thiazide medication must be recommended for the diagnosis of PHPT prior to surgery.

Integrated traditional Chinese and western medicine for Menopausal syndrome: Meta-analysis of randomized controlled trials

Background: To critically assess the evidence of integrated Chinese and western medicine for treating Menopausal syndrome (MPS).Methods and Materials: A search across the Chinese Biomedical Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), VIP database (VIP), Wangfang database (Wanfang), PubMed and the Cochrane Library databases was conducted (up to October 31st, 2013) in commonly used integrated Chinese and western medicine therapies for menopausal syndrome. A number of Randomized Controlled Trials (RCTs) evaluating the therapeutic efficacy of integrated Chinese and western medicine in patients with PPS were included. The quality of the included studies was evaluated and a meta-analysis was performed using the RevMan5.0 software.Results: Twelve RCTs with 1155 patients were evaluated in this review. The results of meta-analysis showed that the therapy of using integrated Chinese and western medicine was significantly superior to that of western medicine alone towards improving the efficacy, relieving the clinical symptoms and decreasing follicle-stimulating hormone (FSH）levels (P&lt;0.05), even though the effects of two treatments were the same in regulating the levels of luteinizing hormone (LH) and estradiol (E2).Conclusion: Compared to a regular treatment with western medicine alone, the therapeutic approach that utilizes integration of Chinese with western medicine can effectively improve the clinical efficacy and serum hormone levels in patients with menopausal syndrome. However, the evidence was not very strong due to the poor quality of the included studies.Key words: Integrated Traditional Chinese and Western Medicine, Menopausal Syndrome, Meta-analysis

Effect of Quyu Huatan decoction on lipid metabolism and hormone levels of patients with polycystic ovary syndrome

To study the effect of prescription for removing blood stasis and resolving phlegm on lipid metabolism and hormone levels of patients with polycystic ovary syndrome. Totally 93 cases of patients with polycystic ovary syndrome treated in our hospital from March 2013 to July 2014 were randomly divided into control group and observation group. The observation group was treated by oral administration of Quyu Huatan decoction, while the control group was treated with metformin. The result indicated that the total effective rate of the observation group was significantly higher than that of the control group(χ²=632, P<0.05). After treatment, the score of syndrome for traditional Chinese medicine in the observation group was significantly lower than the control group(t=13.865,P<0.05). After treatment, the levels of TG, BMI, TC in the observation group were significantly lower than the control group(P<0.05), and the difference of HDL between the two groups were not significantly. After treatment, the levels of FSH, LH and T in the observation group were significantly lower than those in the control group(P<0.05). After treatment, FBG and INS in the two groups were significantly decreased(P<0.05); the FBG in the observation group was significantly lower than that in the control group(t=3.981, P<0.05), and the INS level in the observation group was significantly higher than that in the control group(t=6.472, P<0.05). In this study, we can find that the Quyu huatan decoction for removing blood stasis and resolving phlegm has a better clinical efficacy in the treatment of polycystic ovary syndrome. It not only ameliorates the secretion of variety sex hormone, but also regulates the body's metabolism of glucose and lipid, so it is worth clinical promotion and application.

Cyclic Vomiting Syndrome in Infants and Children: A Clinical Follow-Up Study

BackgroundCyclic vomiting syndrome is characterized by recurrent vomiting that is associated with increased adrenocorticotropic hormone and antidiuretic hormone levels during cyclic vomiting syndrome attacks. However, both prognosis and treatment remain unclear. We therefore evaluated the clinical features, prognosis, and effectiveness of the prophylaxis of cyclic vomiting syndrome as well as the relationship between symptoms and adrenocorticotropic hormone/antidiuretic hormone levels. MethodsWe included 31 patients with cyclic vomiting syndrome who were admitted to Teikyo University between 1996 and 2008. All patients were diagnosed with cyclic vomiting syndrome based on the criteria of the second edition of the International Headache Classification. The patients (25 of 31) were followed until 2013. ResultsThe median overall duration of the disorder was 66 (3-179) months. Follow-up was completed for 25 patients with cyclic vomiting syndrome, of whom 44% (n = 11) developed migraine. Valproic acid, valproic acid with phenobarbital, phenobarbital, and amitriptyline were effective in nine, four, three, and one patients, respectively. Abnormally high adrenocorticotropic hormone (n = 17) and antidiuretic hormone (n = 18) levels were found among the 25 patients for whom follow-up data were available. The following correlations were significant: attack duration and adrenocorticotropic hormone levels (correlation coefficient: 0.5153, P = 0.0084) and attack duration and antidiuretic hormone levels (correlation coefficient: 0.5666, P = 0.0031). Antidiuretic hormone levels in patients with bilious vomiting were higher than in those without bilious vomiting (P = 0.048). ConclusionsMost patients with cyclic vomiting syndrome recovered completely and benefited from prophylactic therapy, although half of them developed migraines.

Basal Serum Cortisol and Adrenocorticotropic Hormone Levels in Patients with Atopic Dermatitis

Background: Atopic dermatitis (AD) is an inflammatory skin disease with eczematous pruritic lesions. Topical corticosteroids are the most widely used and the mainstay of treatment for AD. There are some studies that percutaneous systemic absorption of topical steroids may occur and lead to suppression of hypothalamic-pituitaryadrenal axis (HPAA). However, almost in all of these studies, “basic” HPAA function (before application of topical steroids) was not evaluated. Aim: The aim of this study was to investigate basal serum cortisol, adrenocorticotropic hormone (ACTH), and IgE levels in patients with AD and their correlation with disease severity. Methods: Levels of basal serum cortisol, ACTH, and IgE were assessed by ELISA in 31 patients with AD and 31 control subjects. Clinical severity of AD was evaluated by the SCORAD (SCORing Atopic Dermatitis) index. Results: Data analysis showed no statistical difference for basal serum cortisol and ACTH levels between two groups. The serum IgE level was significantly higher in AD group (P=0.02). The SCORAD index was correlated with serum IgE level, but not with the basal serum cortisol level and ACTH level. Conclusions: Basal serum cortisol and ACTH levels are normal in AD patients. Serum IgE level is significantly higher in AD patients and correlated with disease severity.

THU-381 - Relation of CT Determinded Sarcopenia to Steroid Hormone Levels in Patients with Chronic Liver Disease

THU-381 - Relation of CT Determinded Sarcopenia to Steroid Hormone Levels in Patients with Chronic Liver Disease

Procedural pain does not raise plasma levels of cortisol or catecholamines in adult intensive care patients after cardiac surgery.

The gold standard for quantification of pain is a person's self-report. However, we need objective parameters for pain measurement when intensive care patients, for example, are not able to report pain themselves. An increase in pain is currently thought to coincide with an increase in stress hormones. This observational study investigated whether procedure-related pain is associated with an increase of plasma cortisol, adrenaline, and noradrenaline. In 59 patients receiving intensive care after cardiac surgery, cortisol, adrenaline, and noradrenaline plasma levels were measured immediately before and immediately after patients were turned for washing, either combined with the removal of chest tubes or not. Numeric rating scale scores were obtained before, during, and after the procedure. Unacceptably severe pain (numeric rating scale ≥ 4) was reported by seven (12%), 26 (44%), and nine (15%) patients, before, during and after the procedure, respectively. There was no statistically significant association between numeric rating scale scores and change in cortisol, adrenaline, and noradrenaline plasma levels during the procedure. Despite current convictions that pain coincides with an increase in stress hormones, procedural pain was not associated with a significant increase in plasma stress hormone levels in patients who had undergone cardiac surgery. Thus, plasma levels of cortisol, adrenaline, and noradrenaline seem unsuitable for further research on the measurement of procedural pain.

The meaning of anti-Müllerian hormone levels in patients at a high risk of poor ovarian response

Measurements of ovarian reserve play an important role in predicting the clinical results of assisted reproductive technology (ART). The ideal markers of ovarian reserve for clinical applications should have high specificity in order to determine genuine poor responders. Basal follicle-stimulating hormone levels, antral follicle count, and serum anti-Müllerian hormone (AMH) levels have been suggested as ovarian reserve tests that may fulfill this requirement, with serum AMH levels being the most promising parameter. Serum AMH levels have been suggested to be a predictor of clinical pregnancy in ART for older women, who are at a high risk for decreased ovarian response. We reviewed the prognostic significance of ovarian reserve tests for patients undergoing ART treatment, with a particular focus on the significance of serum AMH levels in patients at a high risk of poor ovarian response.

Assessment of Testosterone Hormone Level in Patients with Toxoplasmosis Attending Omdurman Military Hospital

Assessment of Testosterone Hormone Level in Patients with Toxoplasmosis Attending Omdurman Military Hospital

Presentation and Outcomes After Surgery for Primary Hyperparathyroidism During an 18‐Year Period

The objective of this study is to analyze whether the trend towards operating on patients with less severe primary hyperparathyroidism (pHPT) than earlier is reflected in a change of preoperative presentation and surgical outcome. In this longitudinal cohort study, patients with pHPT subjected to first time surgery were compared in three time periods: 1989-1994, 1995-2000, and 2001-2006 in this longitudinal cohort study. There were 404 patients. Median levels of preoperative ionized calcium were lower in 2001-2006 compared to 1989-1994; 1.45 versus 1.50 versus 1.45 mmol/L; p < 0.001. Preoperative parathyroid hormone levels in patients with parathyroid adenoma were lower in 2001-2006 than in 1989-1994; 10.0 versus 11.6 pmol/L; p 0.04. Median preoperative bone mineral density, BMD, in the whole cohort did not differ between time periods. Median pre- and postoperative glomeruli filtration rate, GFR, and 25-hydroxy-vitamin D3 remained unchanged between period 1 and period 3. Adenoma weight was lower in 2001-2006 than 1989-1994; 0.70 versus 0.50 g; p 0.04. Cure rate did not change during observation time. There was no evidence for differences in change of BMD (femoral neck) after surgery between period 2 and 3 1995-2000 and 2001-2006, 0.798 versus 0.795 g/cm(2); p 0.67. GFR did not change significantly between 1989-1994 and 2001-2006, 74 versus 77 mL/min; p 0.43. A significant change towards operating patients with smaller adenomas and lower preoperative calcium levels was evident throughout the observation period, but this did not correlate with differences in preoperative renal or skeletal function. We found no evidence for a change of postoperative renal function or skeletal function during observation time.

Malnutrition and hyperphosphatemia in dialysis patients

Abstract This study aims to document the incidence of hyperphosphatemia in dialysis patients and correlate it with malnutrition. The incidence and severity of malnutrition (low serum albumin) and hyperphosphatemia (increased serum phosphorus level) were correlated with serum calcium, serum alkaline phosphate, and serum parathyroid hormone levels in patients on dialysis. In India, approximately on an average, every 10th person has evidence of early stage of chronic kidney disease. There is high incidence of malnutrition in chronic kidney disease (CKD) patients on dialysis (stage 5D). There have been varying reports of incidence of hyperphosphatemia in dialysis patients in India. Patients on maintenance hemodialysis (MHD) also have high incidence of malnutrition. Indian patients on dialysis have been reported to have less incidence and severity of hyperphosphatemia. A total of 500 patients on MHD (122 female and 378 male patients, age range 9–89 years, and mean age 47.0 ± 15.25 years) were evaluated for hyperphosphatemia, malnutrition, and degree of renal failure. There was trend of more hyperphosphatemia in the group of patients with serum albumin level ≥3.0 g/dl, because these patients were taking adequate dietary protein intake. Patients with malnutrition (serum albumin level

Predictive value of thyroid hormone assessment in septic patients in comparison with C-reactive protein

IntroductionThyroid dysfunction is associated with mortality in critically ill patients. We investigated the predictive value of the thyroid hormone compared to CRP in septic patients. Methods80 patients were included in a prospective, randomized study done in the critical care department. ResultsFT3, FT4, and TSH levels on the fifth day were below the normal range in 61.3%, 31.2%, and 23.8% patients respectively. There was a significant decrease in the FT3 level on admission compared to the fifth day (p<0.001). By comparison of thyroid hormone levels in patients with sepsis, severe sepsis and septic shock; we found the mean level of FT3 was lower in patients with septic shock (1.3±0.4pg/ml) and severe sepsis (1.7±0.2pg/ml) as compared to patients with sepsis (2.4±1.2pg/ml). The mean FT3 level increased in survivors (2.9±1.03pg/ml) compared to non survivors (1.9±0.89pg/ml) (p<0.001). Correlation of FT3 on the 5th day to CRP (r=−0.332, p=0.039), FT3 on 5th day to IL-6 (r=−0.339, p=0.035) in non survivors. Correlation of FT3 on the 5th day to APACHE II (r=−0.359, p=0.025) and SOFA score (r=−0.427, p=0.007). ROC curves indicated that FT3 on the 5th day had the greatest power for predicting ICU mortality (sensitivity 87.2% and specificity 73.2%). CRP (sensitivity 100% and specificity 92.7%) is a better tool than IL-6 (sensitivity 92.3% and specificity 80.5%) in predicting mortality in sepsis. ConclusionFT3 levels were negatively correlated to CRP and IL-6 levels as well as APACHE II, SOFA scores. FT3 may be used as a marker of disease severity and a predictor of mortality.

Continuous Positive Airway Pressure Treatment Increases Serum Vitamin D Levels in Male Patients with Obstructive Sleep Apnea.

Recent studies report a link between obstructive sleep apnea (OSA) syndrome, low vitamin D levels, and high parathyroid hormone (PTH) concentrations. The aim of the current study is to evaluate the effect of 7-night continuous positive airway pressure (CPAP) therapy on serum vitamin D, PTH, and calcium levels in patients with severe OSA syndrome. Patients with severe OSA were enrolled into the study and compared to control subjects. Patients with OSA underwent CPAP therapy for 7 nights and were consequently divided into responders (OSA-R, mean residual AHI < 5/h) and nonresponders (OSA-nR, mean residual AHI > 5/h). Serum vitamin D, PTH, and calcium levels were measured at baseline in patients with severe OSA (apnea-hypopnea index > 30/h) and control subjects. Patients with OSA underwent a final morning blood sample after 7-night CPAP therapy. We enrolled 90 patients with OSA into the study (65 OSA-R and 25 OSA-nR) compared to 32 control subjects. At baseline, lower vitamin D and higher PTH levels were detected in the OSA group compared to controls. After 7-night CPAP therapy, male OSA-R patients showed a significant increase in vitamin D levels. Conversely, female OSA-R patients did not show the same increase in vitamin D levels. It was also observed that OSA-nR subjects did not show modifications of serum markers after nCPAP-therapy. The study demonstrates that short-term nCPAP treatment is able to promote the recovery of vitamin D homeostasis in male patients with OSA. The mediation of sexual hormones in regulating vitamin D is a possible explanation of the lack of recovery of vitamin D homeostasis in female patients with OSA as it often affects postmenopausal women.

A prospective observational study of all-cause mortality in relation to serum 25-OH vitamin D3 and parathyroid hormone levels in patients with type 2 diabetes.

BackgroundLow levels of vitamin D have been related to increased mortality and morbidity in several non-diabetic studies. We aimed to prospectively study relationships between serum 25-OH vitamin D3 (vitamin D) and of serum parathyroid hormone (PTH) to total mortality in type 2 diabetes. We also aimed to compare the levels of these potential risk-factors in patients with and without diabetes.MethodsThe main study design was prospective and observational. We used baseline data from 472 men and 245 women who participated in the “Cardiovascular Risk factors in Patients with Diabetes—a Prospective study in Primary care” study. Patients were 55–66 years old at recruitment, and an age-matched non-diabetic sample of 129 individuals constituted controls for the baseline data. Carotid-femoral pulse-wave velocity (PWV) was measured with applanation-tonometry and carotid intima-media thickness (IMT) with ultrasound. Patients with diabetes were followed for all-cause mortality using the national Swedish Cause of Death Registry.ResultsLevels of vitamin D were lower in patients with diabetes than in controls, also after correction for age and obesity, while PTH levels did not differ. Nine women and 24 men died during 6 years of median follow up of the final cohort (n = 698). Vitamin D levels were negatively related to all-cause mortality in men independently of age, PTH, HbA1c, waist circumference, 24-h systolic ambulatory-blood pressure (ABP) and serum-apoB (p = 0.049). This finding was also statistically significant when PWV and IMT were added to the analyses (p = 0.028) and was not affected statistically when medications were also included in the regression-analysis (p = 0.01). In the women with type 2 diabetes, levels of PTH were positively related with all-cause mortality in the corresponding calculations (p = 0.016 without PWV and IMT, p = 0.006 with PWV and IMT, p = 0.045 when also adding medications to the analysis), while levels of vitamin D was without statistical significance (p >0.9).ConclusionsSerum vitamin D in men and serum PTH in women give prognostic information in terms of total-mortality that are independent of regular risk factors in addition to levels of ABP, IMT and PWV.Trial registrationClinicalTrials.gov: NCT01049737

A case of severe anorexia, excessive weight loss and high peptide YY levels after sleeve gastrectomy.

SummarySleeve gastrectomy (SG) is the second most commonly performed bariatric procedure worldwide. Altered circulating gut hormones have been suggested to contribute post-operatively to appetite suppression, decreased caloric intake and weight reduction. In the present study, we report a 22-year-old woman who underwent laparoscopic SG for obesity (BMI 46 kg/m2). Post-operatively, she reported marked appetite reduction, which resulted in excessive weight loss (1-year post-SG: BMI 22 kg/m2, weight loss 52%, >99th centile of 1-year percentage of weight loss from 453 SG patients). Gastrointestinal (GI) imaging, GI physiology/motility studies and endoscopy revealed no anatomical cause for her symptoms, and psychological assessments excluded an eating disorder. Despite nutritional supplements and anti-emetics, her weight loss continued (BMI 19 kg/m2), and she required nasogastric feeding. A random gut hormone assessment revealed high plasma peptide YY (PYY) levels. She underwent a 3 h meal study following an overnight fast to assess her subjective appetite and circulating gut hormone levels. Her fasted nausea scores were high, with low hunger, and these worsened with nutrient ingestion. Compared to ten other post-SG female patients, her fasted circulating PYY and nutrient-stimulated PYY and active glucagon-like peptide 1 (GLP1) levels were markedly elevated. Octreotide treatment was associated with suppressed circulating PYY and GLP1 levels, increased appetite, increased caloric intake and weight gain (BMI 22 kg/m2 after 6 months). The present case highlights the value of measuring gut hormones in patients following bariatric surgery who present with anorexia and excessive weight loss and suggests that octreotide treatment can produce symptomatic relief and weight regain in this setting.Learning points Roux-en-Y gastric bypass and SG produce marked sustained weight reduction. However, there is a marked individual variability in this reduction, and post-operative weight loss follows a normal distribution with extremes of ‘good’ and ‘poor’ response.Profound anorexia and excessive weight loss post-SG may be associated with markedly elevated circulating fasted PYY and post-meal PYY and GLP1 levels.Octreotide treatment can produce symptomatic relief and weight regain for post-SG patients that have an extreme anorectic and weight loss response.The present case highlights the value of measuring circulating gut hormone levels in patients with post-operative anorexia and extreme weight loss.