Vitamin D and Calcium Deficiency After Weight Loss Surgery
Vitamin D and calcium are very interrelated because they both work together in maintaining the calcium levels in the bloodstream and are very important in the maintenance and production of strong healthy bones. Vitamin D is a fat-soluble vitamin, and it is found in milk and eggs and some fish and some liver. Calcium is present in virtually all dairy products and calcium deficiency is common after gastric bypass surgery and it is more common, we believe, among women than it is among men. Calcium and vitamin D are being studied actively all the time because they are so important for bone metabolism and it is believed that the very common problem of osteoporosis or thinning of the bones is related to the deficiencies of calcium and vitamin D. Vitamin D deficiency does result from any sort of malabsorptive procedure, such as a biliopancreatic diversion, more with the jejunoileal bypass, less so with gastric bypass, but it is still somewhat possible, and the duodenal switch type procedures as well.
Deficiencies of calcium or vitamin D lead to breakdown of the bone deposits and weakening of the bones in general. The symptoms of vitamin D and calcium deficiency are typically fatigue and pain in the joints and bones, muscle aches, and over time will lead to the progression of osteoporosis. Osteoporosis is bad because it will lead to a greater increase in the risk of fractures. Most people are familiar with osteoporosis when we think of elderly people, especially elderly women falling and suffering a broken hip or a broken leg which is a very serious problem. When weight loss surgery very first became more popular, it was not recognized that vitamin D and calcium were likely to be deficient and it was really an under reported and under recognized problem until recently. Now I think we realize that calcium and vitamin D both should be supplemented and monitored after gastric bypass surgery, and even more so after biliopancreatic diversion or more malabsorptive type procedures.
Vitamin D needs to be converted to an active form with exposure to sunlight to the skin, so interestingly, the healthier we feel and the healthier we are and the more active we are outside in the sunshine, then the healthier our bones tend to be. So something in there that our mothers probably taught us about being outside and active and getting a little sunshine was really true in preventing osteoporosis and vitamin D and calcium deficiency. We recommend that everybody supplement calcium and vitamin D with 1200 mg of calcium daily and the vitamin D supplement of around 8 mcg. There are several commercial pharmaceutical grade vitamin and mineral supplements that have this combination or they can be supplemented separately. We have gradually added lines of vitamins and minerals to our own programs to specifically supplement patients who have undergone weight loss surgery.