Vitamin B12 is essential for every cell within your body. Your body uses B12 to break down foods for energy, to maintain the nervous system and to create red blood cells and DNA. Your body does not create B12, so you must consume the vitamin in foods such as milk products, meat, fish and poultry. Gastric bypass is a surgical procedure used to treat those with morbid obesity. People who undergo a gastric bypass can often end up vitamin-deficient.
Gastric Bypass Procedure
A gastric bypass procedure is major surgery conducted under general anesthesia. During the procedure, the surgeon will make an incision through the abdomen. The surgeon will first use staples to divide the stomach into a small upper section about the size of a walnut, called the pouch. This pouch will collect the food eaten. The surgeon then attaches a part of the small intestine, called the jejunum, to a hole created in the pouch. The jejunum is farther down in the intestine, allowing food to bypass the lower part of the stomach and the first part of the intestine so the body absorbs fewer calories, according to the National Institutes of Health.
B12 Absorption
Vitamin B12 is absorbed through the small intestine, but the process of absorption begins in the stomach. The stomach's parietal cells create a substance known as intrinsic factor, which attaches to B12 to ready it for absorption in the first section of the small intestine. When the body no longer creates the proper amount of intrinsic factor or if the food does not enter the first part of the large intestine for absorption, this can lead to many vitamin deficiencies, including B12.
Vitamin B12 Deficiency
People who undergo gastric bypass often suffer from B12 and iron deficiencies because of surgery. A B12 deficiency can cause a lack of red blood cells, leading to pale skin, shortness of breath and fatigue. A lack of B12 can also lead to nerve damage, causing numbness and tingling of the extremities, a lack of coordination and confusion, according to the University of Maryland Medical Center.
Treatment
If your physician suspects a B12 deficiency, he will often prescribe B12 injections, because the injections will go directly into the bloodstream without having to be absorbed through the intestines. The National Institutes of Health says if the deficiency is severe, you may need to take weekly injections for the first two weeks. Physicians will taper off injections to monthly doses. Over time, if your physician feels you no longer need the injections, you may switch to oral or under-the-tongue B12 supplements.
Consideration
If you experience symptoms of a B12 deficiency after a gastric bypass, discuss this with your physician as soon as possible. The University of Maryland Medical Center says if B12 treatment does not begin within six months of onset of symptoms, nerve damage can often be permanent.
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