CAN ONE HAVE VITAMIN DEFICIENCIES AFTER A SLEEVE GASTRECTOMY?
After having benefited from a sleeve procedure, according to popular opinion, the risk of developing vitamin deficiencies is rather low, at least compared to the bypass.
The purpose of this article is to refute this common belief, because, without appropriate monitoring, patients who have benefited from a sleeve CAN develop vitaminic deficiencies as much as patients who have had a bypass.
In addition, we should not minimize the fact that, approximately half of overweight patients, already present one or more deficiencies, before even having surgery.
The most common are: a deficiency in Vit D (70%, particularly in winter), in Vit B 12 (around 20%), folic acid 5 (or Vit B9 15%) and iron (around 5%). .
After the sleeve procedure, deficiencies may develop for the following reasons:
Vomiting: It can cause a reduction in Vit B1 (Thiamine). This deficiency, can in turn, have neurological consequences, in the most serious cases.
Reduced gastric acid production: this production is also linked to Vit B1; Stomach acid is necessary for the proper absorption of iron, which, in turn, is important for the synthesis of folic acid (Vit B9).
Decrease in Gastric Intrinsic Factor: most of the secretion of intrinsic factor takes place in the portion of the stomach which is removed during the sleeve procedure. As it is necessary for the absorption of Vit B12, the latter will therefore be very limited (around 5%) after surgery.
Change in food tastes: After bariatric surgery, the signals, at the molecular level, between the intestine and the brain change, leading to a change in food tastes. This is a mostly a good thing, but left unchecked, it can lead to protein, Vit B12 and Iron deficiency.
It will therefore be necessary to organize oral supplementation and regular check-ups (blood tests), after a sleeve procedure, to avoid incurring nutritional deficiencies, particularly in protein, iron, vitamin B1, B9 and B12.
♦To make an appointment with Dr. Bruto Randone, Digestive and Bariatric Surgeon, at the Clinique Internationale du Parc Monceau, 21 Rue de Chazelles, 75017 Paris, France, or at the Clinique Bizet, 23 Rue Georges Bizet, 75116 Paris, France, click on Contact