Vitamin deficiency?

[green*eyed*girl 170]

So, one of my main reason for choosing the sleeve over the bypass is that I do not have to be concerned about malabsorption issues and I will less likely develop Vitamin deficiency. Right? Or am I mistaken? I have found this article, and I am shocked, I mean those are pretty bad numbers!

"Over 5 years of follow-up, 77.9% of patients developed Vitamin D deficiency, 41.2% had Iron deficiency, 39.7% had zinc deficiency, 39.7% had a Vitamin B12 deficiency, 25% had a folic acid deficiency, and 10.3% developed anemia.

These deficiencies occurred "despite routine supplementation, in a higher rate than we had expected," the researchers wrote."

http://www.medpagetoday.com/Endocrinology/Obesity/40490

[elfnow 277]

Remember that Sleeve hasn't been around very long, maybe 6 years. There aren't long-term studies about it yet - this is one of the few.

There's probably a lot of people who take Iron with their Calcium, which blocks the absorption of Iron. Reduced Vitamin D? GO OUTSIDE. Get some sun on your bare skin and don't wear sunscreen.

I don't know about zinc, but B12 and Folate can be taken separately and 400 mcg of folate really isn't enough. (I happen to take 2mg folic acid per day with my antidepressant, 5x "recommended").

Taking Vitamins is hard. Taking Vitamins on an empty stomach is REALLY HARD (and nauseating!) and not recommended for half the vitamins but is recommended for others... and taking iron separate from Calcium is hard to do in a Multivitamin.... Part of the issue, I'd wager, is "routine supplementation" versus the specialized supplementation that a post-surgical individual would need.

I have no real ideas on how to resolve this (aside from hints above)... It takes trial and error and personal Vitamin regiment versus "take a one-a-day"

[green*eyed*girl 170]

Thanks elfnow. Very eye-opening! I never thought taking Vitamins are such work and complicated. I will really need to get organized as of now I'm not even strict on taking that 1 Multivitamin that I'm suppose ...

This article made me very confused...I thought stats are better 5 years out but I guess not...

[MichiganChic 3,262]

I've seen that study, too. I was anemic before surgery (for no known reason), and I take Iron every day, and my labs are normal. I don't need Calcium, and with the supplements, it was too high. I was horribly Vitamin D deficient as an obese person, now it's normal now with minimal supplementation.

I think when you have this surgery, you are making a life long commitment to taking Vitamins, and it pays to know when/how to take them. I think it's different for each of us, but we all have to take some Vitamins. I have no problems managing it now, but I did at first when I had to take calcium. It felt like a full time job, at first. Super easy, now.

[elfnow 277]

I have had a very hard time taking the multi every day, it makes me nauseous and I just think "ugh yuck."

I take:

a one-a-day multi that has Iron

A calcium citrate tablet (dissolves and absorbs without food)

A B12 supplement (I swallow it instead of dissolving it bc the taste is so annoying)

A D3 gelcap

And my 2mg folic acid, my Effexor xr, my Pepcid. It's all good...

And as far as I'm concerned "good enough for now". when I'm in more maintenance I can adjust more.

[green*eyed*girl 170]

Do we need the extra B12? I mean there is already B12 in the multivitamin... I hate the smell of it, it makes me gag

Thanks for the suggestions, I will plan my Vitamin intake very carefully.

[elfnow 277]

We do, at least for extra energy (while our bodies want to be slugs because not enough food / conserving energy)....

Good news is there are SO many b-12 formulations AND my doc said one can just swallow it vs letting it dissolve slowly... So I'd you hate the taste just swallow it instead.

At the moment I gulp all my pills at once. Iron? Calcium? F*ck it. I'm taking a Vitamin at all, for now that's enough. I always run low Iron, so taking ANY improves me.

I could barely take any Vitamins while I was pregnant, and FORGET ABOUT taking them postpartum / while breastfeeding... I was like "f this I'll just eat all the food" ... Which I did... And now, surgery.

[DairyFairy42 30]

Hi green eyed girl - stop and take a breath, then another one.

ive read ur posts and uve really thought this procedure thru so this is just something else you will look up and investigate.

I personally need to take starflower oil for hormones and zinc and magnesium for intense periods so I know my diet of the future will need to be high in these.

I know someone who had bypass and she now has B12 injections and various Vitamins and she just gets on with it and shows no sign of malnutrition.

I had a wobble a few days ago so maybe this panic is normal cause I was freaking but now I've moved on and I've stored my cocerns about gerds and put in notes for the future.

This is a great adventure and we have to do our homework but we can do this

[moonlitestarbrite 902]

i wonder how many normal (or obese) people with standard american diets are deficient in these nutrients. here's the thing about any follow up study with people who have had WLS, we are, as a group, not people who generally comply with diets, follow doctors orders or follow through with caring for ourselves. if we were, we wouldnt need this surgery. in my group, many people are not consistent with their Vitamins , or they take the cheapest kind they can. a few dont take them at all. and many still eat a diet full of processed junk and fast foods with very few fresh fruits and vegetables. out of 60ish people in the group, i think their are 3 of us who eat whole, organic diets.

so, i wouldnt base what is going to happen with me on what others do... since its about my choices, not theirs.

[elfnow 277]

That leads to the question, how many of the people in the study were deficient before the surgery and are still deficient? I think I'd have to read the actual PubMed article further to see where the gaps are...

Edited March 22, 2014 by elfnow

[Mrs. Whatsit 33]

I have not yet had surgery and am already B12 and Vit. D deficient. I give myself a B12 injection every month and take a prescription dose of Vit. D twice a week.

This study only had 68 participants. I don't think you can make any generalized statements regarding Vitamin supplementation based on 68 people. It might be valid for that one program but not for Gastric Sleeve patients in general.

[Ms skinniness 3,003]

Hi everyone, I am 3 years out and stopped taking my supplements due to feeling nauseous the last time I had taken them. Lately I have such severe dry chapped swollen lips ever. Haven't been able to heal them for over a month. SO now I'm taking my multi and vit B complex hoping that this will help.

Have anyone experienced this? I know that I have had a lot of increased anxiety too.

[BLERDgirl 6,417]

i wonder how many normal (or obese) people with standard american diets are deficient in these nutrients. here's the thing about any follow up study with people who have had WLS, we are, as a group, not people who generally comply with diets, follow doctors orders or follow through with caring for ourselves. if we were, we wouldnt need this surgery. in my group, many people are not consistent with their Vitamins , or they take the cheapest kind they can. a few dont take them at all. and many still eat a diet full of processed junk and fast foods with very few fresh fruits and vegetables. out of 60ish people in the group, i think their are 3 of us who eat whole, organic diets.

so, i wouldnt base what is going to happen with me on what others do... since its about my choices, not theirs.

Most people are Vitamin D deficient. It's more a "3rd world" issue than anything else. For the most part we work in offices and rarely get enough natural sunlight because we no longer live in hunter- gatherer societies. Unless it's at dangerously low levels I wouldn't worry about it. However, most people will be asked to take the supplements.

I've noticed recently this has become an issue with people who have had sleeve surgery. According to what I've read on American Society for Metabolic & Bariatric Surgery *Scroll down to table 5 Vitamins and supplements are necessary. However I'm learning that my doctor tends to be more on the cautious side than other people's. Personally I'm okay with that as I have a virtually carefree surgical course and post op. I will ask them when I see them next month. It may indeed be a case of the sleeve surgery being too new to truly know.

Edited November 12, 2014 by Blerdgirl