Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery

[Escape_Pod 358]

WE can develop due to thiamine deficiency. I'm particularly interested in this topic because my 1-year labs came back showing very low thiamine levels, despite faithful Multivitamin supplementation, so I've added a B complex to my routine. I know others on the boards have also seen this development. Unfortunately, the full text of the study requires a subscription or article purchase, but you may be able to obtain through a local library. Just for the record, I did not experience persistent vomiting (or, actually, any vomiting at all) - noted as a major determinant here.

Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery: A Systematic Review of Literature Data

Abstract

The use of weight loss surgery is progressively increasing, and in recent years, restrictive bariatric surgery procedures have been more often used. Although thought to be associated with a lower incidence of post-operative side effects than malabsorpitive surgery, some cases of micronutrients deficiency have been reported because of an acquired thiamine deficiency; in this clinical setting, some cases of Wernicke encephalopathy (WE) have been described. Major determinants and predictors of this major neurological complication are currently unknown. The aim of this systematic review was to analyse literature data in order to address this issue. The main result of our systematic review was that persistent vomiting is the major determinant of WE in patients undergoing restrictive weight loss surgery. In addition, early thiamine supplementation can rapidly improve the clinical conditions, avoiding permanent deficiencies. On the other hand, given the wide variability of clinical and demographic characteristics, definite prognostic factors of WE occurrence and of clinical outcome cannot be identified. In conclusion, although our results are suggestive, further ad hoc prospective studies evaluating changes in micronutrients levels according to different types of surgery are needed. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

[swimbikerun 1,045]

That's true. I've seen medical research that has mentioned deficiencies even with those who take their Vitamins.< /p>

[palomarules 45]

My story is long and complicated, so I won't go through all of it. For background information, I was sleeved 2 1/2 years ago after a disastrous experience with the gastric band . I reached my target weight within a year and have been pleased with my results. Admittedly I have been lax with my multi Vitamins because of my slow esophagus, but most days took a Multivitamin and additional Iron. In any case, I began to have problems with balance, exhaustion, tremors, headaches, heavy legs, shooting pains in my legs and arms, tingling sensations, hearing loss, occasionally slurred speech and numbness in my extremities. I was sent for an MRI because the doctor thought that it could be MS. The MRI showed lesions on my brain, but the neurologist said that I did not meet the criteria for MS. He sId that I must be suffering from depression or stress. Well, I didn't feel depressed or stressed about anything other than the symptoms that I was experiencing. No one asked for a blood test or about my WLS, and I'd not considered that WLS or nutritional deficiencies could cause neurological symptoms like the ones I have been experiencing. Absolutely all of my symptoms including the brain lesions were caused by inadequate doses of nutritional supplements. It is a cautionary tale and one that more people need to know about.

I noticed that not many people commented on this post, but a lot more should be shared about the neurological symptoms that WLS can provoke.

[swimbikerun 1,045]

@@Escape_Pod Do you have the original citation? I could probably get it, but not sure where it is from. Is it this? Eur Eat Disord Rev. 2014 Jul;22(4):223-9. doi: 10.1002/erv.2292. Epub 2014 Apr 25

[swimbikerun 1,045]

@@Escape_Pod Never mind I have the citation and I'm pretty sure I can get to the full article. It would be tomorrow though.

[swimbikerun 1,045]

@@Escape_Pod I got the full article if you are interested.

[swimbikerun 1,045]

I have several more that I sent in to be put in my records, but there are multiple references to nutritional issues and neurological issues. Its there, its just the doctors don't look for it and also think that because the "labs" are "ok", then everything is fine. Not everyone is a computer and some people may have higher levels than others.

It is for this reason, that doctors do not use the labs together with symptoms/signs, that we have the incredible amount of delayed and missed diagnoses.