Most common vitamin deficiencies after bariatric surgery

One of the most common complications after bariatric surgery is vitamin deficiencies.  These deficiencies are mostly due to reduced food intake, inability to absorb the necessary nutrients due to bariatric surgery and noncompliance with vitamin supplementation. Patients are encouraged to keep their routine follow-up appointments in hopes of catching any possible deficiencies before symptoms arise. The most common vitamin deficiencies after bariatric surgery are vitamin D, vitamin B1, vitamin B12, folate and iron. Part of the Prisma Health bariatric program’s plan is to provide nutritional, and vitamin education in order to allow individuals to take charge of their own health.

The body creates vitamin D when the skin is exposed to the sun and helps the body absorb calcium as nutrients pass through the intestines. Vitamin D and calcium work together to maintain bone health therefore, a deficiency in one causes a deficiency in the other. Vitamin D is also necessary for muscle health and to maintain a healthy immune system. Most individuals with vitamin deficiencies have no symptoms but with a long history this deficiency, one can experience bone pain, bone fractures, muscle weakness, and low calcium levels due to the inability of a person’s intestine to absorb these nutrients.

Vitamin B1, also known as thiamine, is necessary for neurologic function such as memory, muscle function and balance. B1 is also necessary to maintain a healthy heart and for carbohydrate metabolism. Some indicators of vitamin B1 deficiency are confusion, low muscle mass, muscle weakness, fatigue, numbness or tingling of the hands or feet.

Vitamin B12 and folate, also known as folic acid, are necessary to maintain healthy red blood cells. Anemia can develop due to B12 or folate deficiency. Common symptoms of B12 and folate deficiency are fatigue, exhaustion, shortness of breath, confusion, depression, poor memory function, staggering or unsteady when walking. Folic acid is extremely important for female patients of child-bearing age to prevent neural tube defects.

Iron is an element that makes up part of the red blood cell. Therefore, iron is necessary for the health and function of red blood cells. Common symptoms of iron deficiency are increased exhaustion, shortness of breath, weakness, restless legs, and craving unusual substances such as ice, chalk, dirt or paper.

In order to avoid these deficiencies we ask for all post-bariatric surgery patients to take the recommended vitamin supplementation. As part of the Prisma Health Bariatric Surgery Department and as healthcare providers, we make sure that all of our patients have routine office visits, dietary evaluations and lab work in order to prevent or correct any of these deficiencies before they become a problem. If you have any questions regarding any of the signs or symptoms listed above, please contact our office for further evaluation.

Melisa Wiese, a certified nurse practitioner, and Christine Koop, a certified physician assistant, are with the Prisma Health Bariatric Surgery Department.

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