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Nutrient Considerations
TOP 10 TAKEAWAY MESSAGES:
Bariatric Surgery Nutrient Considerations
1. While biliopancreatic diversion with duodenal switch may result
in the greatest amount of weight loss, it is a procedure that
has a high rate of multiple post-procedure vitamin and mineral
deficiencies.
2. Common vitamin and mineral deficiencies after gastric bypass
and sleeve gastrectomy include deficiencies of vitamins B1
(thiamine), B9 (folate), B12 (cyanocobalamin), and D, as well as
deficiencies of the minerals iron and calcium (gastric bypass);
other vitamin and mineral deficiencies are more rarely reported.
3. Lower levels of vitamin D are often found pre-operatively in
patients with obesity.
4. High-quality bariatric-specific multivitamins are routinely
recommended after bariatric procedures, with supplements
often containing higher amounts of vitamin B12, iron, vitamin C
(to assist with iron absorption), vitamin D, and calcium.
5. Vitamin B1 (thiamine) deficiency can cause "dry" beriberi (e.g.,
Wernicke-Korsakoff encephalopathy) and "wet" beriberi (e.g.,
high cardiac output heart failure).
6. Vitamin B9 (folate) deficiency can cause megaloblastic anemia.
7. Vitamin B12 (cyanocobalamin) deficiency can cause
megaloblastic anemia and nervous system disorders.
8. Vitamin D deficiency can cause osteopenia, secondary
hyperparathyroidism, and hypocalcemia.
9. Calcium deficiency can cause osteopenia, secondary
hyperparathyroidism, and hypocalcemia.
10. Iron deficiency can cause microcytic anemia.
