The goal of bariatric surgery is to help patients achieve their weight loss goals and address health concerns that may be hindering their quality of life. There are a lot of factors that determine which bariatric surgery is right for each patient, like their medical history, their needs and goals, and the amount of fat that needs to be removed from the body. To know which procedure is right for you, your doctor will go over your specific case and perform an in-person examination in order to create a treatment plan to address your needs. Once it’s established, they’ll go over it with you so that you’re prepared, both mentally and physically, for what your body is about to go through during and after the surgery.
This means talking about the possible complications during or after the surgery, as well as what you should expect on your recovery period. Your doctor will give you a set of instructions that you have to follow, such as improving your eating habits, taking on physical activity, and removing harmful habits from your daily life. However, there are some postoperative situations that may arise even if your surgery was successful and for this article we will talk about one of them. Deficiency in vitamin b12 is very common for bariatric patients who have already recovered from their surgery and here we’ll explain why that happens and how to solve it.
At LIMARP®, our multidisciplinary medical team, led by Dr. Liza María Pompa González, has all the resources to help you have a successful recovery and to aid you in any capacity pertaining to diet and exercise. A deficiency in vitamin b12 is common and it’s important to identify the symptoms in order to treat it in a safe and efficient way.
For this article, we will talk about why bariatric patients, especially those who are recovering from a gastric bypass, need vitamin b12 supplementation even after they’ve recovered.
The Gastric Bypass and Vitamin B12
Gastric bypass surgery[1], also known as Roux-en-Y, is a technique that consists in making the stomach smaller by dividing into two sections with surgical staples; the top, smaller section is called a pouch and it’s where the food will go. The pouch only holds a certain amount of food, which will allow you to eat less. Then, your surgeon will connect part of your small intestine to the pouch so that the food that you eat goes directly from one to another. This means that your body will absorb less calories.
So, what’s the link between the gastric bypass and vitamin b12 deficiency?
According to one study[1], there’s a metabolic reason why bariatric patients, especially those who’ve had a duodenal switch or gastric bypass, lack vitamin b12. Their explanation goes like this: B12 is broken down in the stomach, meaning that it’s separated from the protein it was in previously. Intrinsic factor, which is a protein released in the stomach, is combined with the B12. The study goes on to say that “this binding occurs in the duodenum and absorption occurs in the ileum. However, when the intestinal tract is bypassed or modified as it is with the gastric bypass or duodenal switch, there is less surface area for this process to occur”.
Symptoms of Vitamin B12 Deficiency
Just because it’s common for bariatric patients to suffer from vitamin b12 deficiency, doesn’t mean that it’s going to be a given for every single case. There are many reasons why patients may lack vitamin B12, such as limited intake in their diet, malabsorption, some medical conditions, or the use of B12-depleting medications[3]. However, we’d like to present some of the symptoms that you may experience if you have a deficiency. Keep in mind that as a bariatric patient in recovery, these symptoms may also apply to that same postoperative process or to other conditions that may have developed after the surgery.
- Fatigue
Tiredness is expected for bariatric patients when they’re in their recovery process, but extreme fatigue may signal a b12 deficiency. This is because “having inadequate B12 levels can decrease normal red blood cell production, which can impair oxygen delivery”[4].
- Abnormal Skin Tone
Anemia related to B12 deficiency can make the skin pale due to a lack of healthy red blood cells in the body and bariatric patients are also at risk of developing jaundice, which makes your skin and the whites of your eyes take on a yellowish color.
- Depressive Symptoms
B12 is essential to the proper functioning of your central nervous system and a deficiency in this nutrient can impact your mental health. Bariatric patients with this deficiency are at a greater risk of developing depression[5].
Other symptoms include: Gastrointestinal issues, difficulty concentrating, pain and inflammation in the mouth, paresthesia in hands and feet, among others. There are several treatments for these symptoms and you have to get tested in order to know how to overcome your b12 deficiency. Some options may include oral supplements or injections.
Contact Us to Learn More
If you’re a bariatric patient and are struggling with a vitamin b12 deficiency, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.
References
- [1] “Gastric bypass surgery”. https://medlineplus.gov/ency/article/007199.htm. (Accessed September 20, 2022).
- [2] “Understanding Vitamin B12 Deficiencies after Bariatric Surgery”. https://www.vipsurg.com/blog/understanding-vitamin-b12-deficiencies-after-bariatric-surgery/. (Accessed September 20, 2022).
- [3] Ankar A, Kumar A. Vitamin B12 Deficiency. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441923/
- [4] Tardy AL, Pouteau E, Marquez D, Yilmaz C, Scholey A. Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence. Nutrients. 2020 Jan 16;12(1):228. doi: 10.3390/nu12010228. PMID: 31963141; PMCID: PMC7019700.
- [5] Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232. PMID: 31527485; PMCID: PMC6770181.