The human body, as the complex and perfect machine that it is, needs all its “gears” to be in place and well-oiled to function properly. But what would happen if one piece were to be missing? Most likely, the machine’s components would fail, generating a chain reaction that could cause successive damage, ultimately disabling the machine.
Vitamin B12 is that piece, as it is an essential element in various processes in the body. For example, vitamin B12 is involved in the production of red blood cells—responsible for transporting oxygen throughout the body—in keeping nerve cells healthy—ensuring that signals travel efficiently throughout the body—in the conversion of food into energy—contributing to better cardiovascular health, and even in the DNA production, supporting the growth and repair of cells.
Such is the importance of vitamin B12 in the body’s performance that a deficiency could lead to serious health problems.
Bariatric Surgery and Vitamin B12: Why is Vitamin B12 prescribed to Bariatric Patients That Underwent Gastric Bypass Surgery?
Understanding the relation between bariatric surgery and vitamin B12 absorption is crucial, especially if you are considering getting Gastric Bypass Surgery. Here’s why…
The main goal of a gastric bypass surgery–or any other bariatric surgery–is to support the patient’s weight loss and address other health issues that may be affecting their quality of life. There are multiple factors that help determine the type of bariatric surgery a person needs, such as their medical history, their health goals and needs, or the amount of weight they need to lose. For this, you should seek the help of a bariatric Doctor, who, after evaluating your case in depth, will advise you on the bariatric surgery you are a candidate for, and will design a post-surgery treatment plan adapted to your needs, helping you avoid a possible vitamin B12 deficiency.
But, why is a bariatric surgery patient, especially those who got a gastric bypass surgery, more likely to suffer from vitamin B12 deficiency? This is the reason behind…
Vitamin B12 Deficiency in Bariatric Surgery Patients
A Gastric Bypass is a type of Bariatric Surgery that reduces the size of the stomach by dividing it into two sections. The smaller section, called the “gastric pouch”, cand hold only a limited amount of food, reducing the patient’s food intake. Subsequently, the bariatric surgeon will connect the gastric pouch to a specific part of the small intestine, so that the food passes directly into it. Thus, reducing the absorption of calories.
Even though a bariatric surgery such as the gastric bypass surgery is highly effective for weight loss and the improvement of comorbidities, there are some adverse post-surgery situations that may arise, even if the gastric bypass surgery was successful. Vitamin B12 deficiency is one of those.
Due to the nature of gastric bypass surgery–the intestinal tract is modified or “diverted”–, less space is left in the stomach for calorie absorption, but also for the absorption of nutrients like vitamin B12. Therefore, although gastric bypass surgery is beneficial for weight loss, it also can cause vitamin B12 deficiency.
This is the reason why bariatric surgery patients who underwent gastric bypass surgery are more susceptible to developing a vitamin B12 deficiency. Studies show that around 68% of people who underwent a bariatric surgery such as gastric bypass reported a vitamin B12 deficiency.
However, although gastric bypass surgery–or any other bariatric surgery where the digestive process is modified–makes you more susceptible to a vitamin B12 deficiency, it is not the only thing that can cause it.
Other people may be at risk of developing vitamin B12 deficiency, besides bariatric surgery patients, such as:
- People with vegan or vegetarian diets, since B12 can be found in products of animal origin like eggs, meat, fish and dairy.
- People with conditions that complicate the vitamin B12 absorption, such as Crohn’s disease.
- Older adults, as vitamin B12 absorption becomes more difficult as we age, leading to a deficiency.
Symptoms of Vitamin B12 Deficiency in Gastric Bypass Surgery Patients
While it is true that a bariatric patient, especially gastric bypass patients, are more likely to suffer from B12 deficiency, it does not mean it will occur in 100% of the cases. As we mentioned earlier, a poor diet, malabsorption problems, some medications or medical conditions can also cause a vitamin B12 deficiency.
Learning to identify early symptoms of B12 deficiency related to bariatric surgery can help address them accurately and appropriately.
Some of the B12 deficiency symptoms are:
- Fatigue: feeling tired while recovering from a bariatric surgery such as gastric bypass surgery is completely normal and even expected, but experiencing fatigue might be a symptom of vitamin B12 deficiency.
- Pale or yellowish skin: B12 deficiency can cause anemia, the main sign of which is pale or yellowish skin. If you underwent gastric bypass surgery or other bariatric surgery, and exhibit this symptom, consult a bariatric doctor immediately.
- Depression: vitamin B12 also plays a key role in the central nervous system, therefore, it can influence the bariatric patient’s mental health. Thus, a person who got a bariatric surgery such as gastric bypass surgery, and developed a B12 deficiency, can suffer from depression symptoms.
Other B12 deficiency symptoms related to bariatric surgery and gastric bypass surgery can be: gastrointestinal disorders, difficulty to focus, memory problems, mouth swelling and tingling sensation in hands and feet.
We must emphasize that, if left untreated, vitamin B12 deficiency can escalate into long-term health problems.
Bariatric Surgery and Vitamin B12: How Long After The Gastric Bypass Surgery a deficiency manifests?
The answer is simple: it depends on the patient’s reserves of the vitamin, and the type of diet they are on after the gastric bypass or any other bariatric surgery.
For this reason, it is very important to choose a professional and certified medical team that specializes in bariatric surgery such as gastric bypass surgery. Only they can dictate the ideal post-surgery treatment, food plan and new healthy habits that a patient must follow to prevent a B12 deficiency after gastric bypass surgery.
Even though a B12-rich diet is recommended in almost all of the cases, you must consider that a person who underwent gastric bypass surgery–or any other bariatric surgery in which the intestinal tract was modified–is not be able to absorb this nutrient anymore, meaning vitamin B12 supplementation will be mandatory.
Treatment Options for Bariatric Patients with B12 Deficiency
Although supplementing is mandatory for gastric bypass surgery patients, and it can also be for other bariatric surgery patients, it is critical to attend to regular check-ups with a bariatric doctor to determine the right treatment plan for you. Among the alternatives to prevent vitamin B12 deficiency are: oral supplements, B12 injections, and sublingual pills. Let’s talk about all of them…
- Oral supplements: taking pills may work for some, but for bariatric surgery patients, especially those with a gastric bypass, it may not be the best option due to the fact that their stomach lost its capacity to absorb vitamin B12, which may lead to a deficiency.
- B12 injections: as this option delivers the nutrient directly into the bloodstream bypassing the area of the stomach unable to absorb it, it may be a good option for bariatric surgery patients who underwent gastric bypass to prevent a vitamin B12 deficiency.
- Sublingual pills: since these pills never reach the stomach but dissolve in the mouth, it can also be a good option for bariatric surgery patients seeking to avoid vitamin B12 deficiency after their gastric bypass.
It is crucial to point out that only a Bariatric Doctor can indicate the proper treatment to prevent a vitamin B12 deficiency after a gastric bypass surgery. A patient must not self-medicate under any circumstances.
Supplementation After Bariatric Surgery: How Long Should a Gastric Bypass Patient Take Vitamin B12 to Avoid a Deficiency?
After a bariatric surgery like the gastric bypass, the digestive tract changes forever, unless the patient reverses their gastric bypass surgery–an unlikely scenario–. Therefore, the patient’s stomach will not be able to absorb the B12 again, no matter how much time has passed since the surgery. With that in mind, we could say that B12 supplementation for bariatric patients must be for life. Otherwise, the risk of a deficiency is high, and it can cause serious health problems in the long-term.
After a gastric bypass or any other bariatric surgery, it is essential to receive regular check-ups by your bariatric doctor to monitor your vitamin B12 levels and treat any deficiency if detected.
Habits That Can Aggravate B12 Deficiency in Bariatric Patients After Surgery
A gastric bypass surgery or any other bariatric procedure is just the first step in a patient’s weight loss journey. To achieve a significant improvement, both physically and in their quality of life, the process must be complemented with new healthy habits, like a well-balanced eating plan, physical conditioning routines, psychological therapy, among others.
However, as healthy habits can prevent a vitamin B12 deficiency, unhealthy ones can aggravate it, such as:
- Smoking: smoking damages the stomach cells and difficult vitamin B12 absorption, which for a bariatric surgery patient is already reduced.
- Drinking alcohol: drinking can also affect the body’s capacity to absorb B12, which can lead to a deficiency for gastric bypass surgery patients.
- Lack of follow-up care: not receiving periodic check-ups from your bariatric doctor can prevent you from detecting a vitamin B12 deficiency. Follow-up care after a gastric bypass or any other bariatric procedure is a must.
Vitamin B12 deficiency is very common, and identifying its symptoms promptly makes all the difference. At LIMARP, our multidisciplinary team of experts, led by the renowned Dr. Liza María Pompa, provides you with all you need to avoid a vitamin B12 deficiency after bariatric surgery. Also, we will support you in every aspect related to bariatric surgery, and guarantee you a successful recovery from gastric bypass surgery.
As part of our Comprehensive Bariatric Program, we offer not only bariatric procedures such as gastric bypass, but also nutritional guidance, psychological support, personalized fitness plans and long-term follow-up care.
For our bariatric patients from abroad, we provide hospital stay of 1-2 days, accommodations, and airport transfers to make your experience hassle-free.
Contact Us For More Information About Gastric Bypass Surgery
If you are considering gastric bypass, or any other bariatric procedure, and are looking for a professional, experienced, and board-certified medical team to support you, you are in the right place.
Book a consultation online or call (619) 373-0229. We will be happy to answer all the questions you may have about bariatric surgery or vitamin B12 deficiency.
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.
