Vitamin B12 Deficiencies After Weight Loss Surgery
Vitamin B12 is a water-soluble vitamin that can be of risk of becoming deficient after a weight loss surgical procedure. Vitamin B12 is called cyanocobalamin, but it’s a lot easier to say B12.
Vitamin B12 is an important vitamin that plays a role in a number of aspects of metabolisms. Deficiencies in vitamin B12 usually affect the nervous system. This means it can cause symptoms such as tingling or numbness in the hands or feet, or in more severe cases, deficiencies of B12 can result in problems with faulty balance and unsteady walking. Some people can even have confusion or generalized weakness or depression.
Though other vitamins can become deficient after a bariatric procedure, B12 deficiency is the most common vitamin deficiency after gastric bypass surgery, iron being the most common mineral deficiency after gastric bypass surgery. B12 deficiency is common enough that almost every author and every bariatric center has recognized that the vitamin must be supplemented on a routine basis. At our center, we give patients a choice of either a monthly intramuscular injection which is usually 1000 to 3000 micrograms or international units per injection, or since nowadays there are formulations that can be taken sublingually, that is an option that we offer patients. People can take a sublingual vitamin B12 every day and that is something that should be done for a lifetime. Without supplementing B12, people with gastric bypass surgery will experience deficiencies in a high percentage of cases. It is believed that the lack of exposure of the foods that contain B12 to the stomach acid in the bypassed portion of the stomach leads to a decreased absorption of the B12. So, of all the potential vitamins and minerals to be aware of, iron and B12 clearly are at the top of the list for anyone who has had gastric bypass surgery and they really must, in my opinion, both be supplemented regularly and I would say for a lifetime after gastric bypass.
It is probably not necessary to specifically supplement B12 for people who have had a Lap-Band operation because again they really have not created the introduction of any new impairment or rearrangement of the stomach and intestinal system and we wouldn’t really expect there to be a big reduction in B12 absorption from the foods that people are eating. Sometimes after Lap-Band surgery, people have dramatically changed their diet and are taking in much less foods of specific kinds and for that reason we recommend that everybody take a general chewable or liquid form of multivitamin after Lap-Band surgery. But again, I would not expect B12 in particular to become deficient.