Why might B12 deficiency anemia occur after bariatric surgery?

What causes B12 deficiency after gastric bypass?

Gastric bypass patients don’t fully digest or absorb vitamin B12 from protein foods, which puts them at high risk of deficiency. The amount of stomach acid produced in the new stomach pouch is significantly low. Stomach acid is needed to release vitamin B12 from protein foods.

Does vitamin B12 deficiency appear immediately after bariatric surgery?

Although the body’s cobalamin storage is substantial (about 2,000 mcg) and daily needs low (2 mcg/day), the deficiency is common two to nine years after bariatric surgery. Vitamin B12 deficiency, though not always symptomatic, usually presents as macrocytic anemia and neurologic disease.

Why do I need B12 injections after bariatric surgery?

Copper deficiency can also present with sign and symptoms of subacute combined degeneration of spinal cord and therefore 3 monthly vitamin B12 injections are safest for bariatric surgery patients to maintain vitamin B12 levels, which help in early diagnosis and management of copper deficiency.

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Why is protein malnutrition a common problem in patients with bariatric surgery?

Its etiology is multifactorial—patients often have postoperative intolerance to protein-rich foods and protein digestion is impaired by reduced mixing with pancreatic enzymes, which results both from mechanical factors and, as in our patient, exocrine pancreatic insufficiency.

What is pernicious anemia caused by?

A lack of vitamin B12 (vitamin B12 deficiency) causes the signs and symptoms of pernicious anemia. Without enough vitamin B12, your body can’t make enough healthy red blood cells, which causes anemia.

Can gastric bypass cause pernicious anemia?

Pernicious anemia can also occur after gastric bypass surgery.

How does gastric surgery cause malabsorption?

This bypass results in mild fat and protein malabsorption due to a slight delay in mixing of food with bile and pancreatic enzymes. One impact on digestion affected by this type of surgery is reduction in the absorption of calcium, iron, and B-complex vitamins.

What nutrients are deficient after bariatric surgery?

According to the most recent reviews, bariatric surgery patients are commonly at risk for deficiencies of water-soluble vitamins B12, B1, folate and C; fat-soluble vitamins A, D, E and K; and the minerals iron, zinc, selenium, calcium, magnesium and copper.

Can gastric sleeve cause malabsorption?

The chance of nutrient deficiency is also less likely with the gastric sleeve surgery than with gastric bypass surgery because there is no malabsorption.

What is malabsorption after gastric bypass?

Another type of bariatric surgery is called controlled malabsorption. This surgery makes it impossible for your body to break down and absorb food in a normal way. If your healthcare provider recommends this type of surgery, you may have a surgery called biliopancreatic diversion with a duodenal switch (BPD-DS).

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How much B12 should I take after gastric sleeve surgery?

At least 500 mcg per day of Vitamin B12 (cobalamin or methylcobalamin). B-12 that dissolves (melts in your mouth) or chewable tablets are the most common choice for vitamin B-12 supplementation.

What vitamin is often poorly absorbed in patients who have had bariatric surgery?

An early experienced symptom of vitamin deficiency after gastric bypass surgery is usually neurological related to inadequate absorption of vitamin B1 (thiamine). Thiamine is not stored in the body for very long, so we need a constant supply of it.