Your body needs iron to produce hemoglobin, the protein that carries oxygen in red blood cells. Without enough iron from dietary sources, the body cannot produce enough hemoglobin, resulting in anemia. In various studies, weight loss surgeons have reported iron deficiency in 20 to 49 percent of gastric bypass patients and in up to 51 percent in female bariatric patients, according to Linda Aills, R.D., lead researcher of a study published in the September 2008 issue of "Surgery for Obesity and Related Diseases." If you have concerns about iron deficiency after gastric bypass, consult your surgeon or nutritionist for further information.
Gastric Bypass
Gastric bypass, a type of weight loss surgery procedure, helps morbidly obese patients lose significant amounts of weight by restricting intake and causing malabsoprtion. Patients who make long-term changes to their diets and exercise routines lose weight successfully and most keep it off but they must also take vitamin and mineral supplements for the rest of their lives to prevent and treat nutritional deficiencies. The most common deficiency reported is iron deficiency.
Iron Deficiency
Symptoms of iron deficiency include fatigue and weakness. Patients may also complain of pallor of the skin, shortness of breath, dizziness, loss of appetite, swollen tongue, feeling cold, hair loss, brittle nails, depression, leg cramps and headache. Iron deficiency anemia develops slowly and, if not treated promptly, can cause heart problems, difficult pregnancies and issues fighting off infections. Some patients with iron deficiency develop cravings for dirt, paper, starch or ice.
Cause
Several factors contribute to iron deficiency after gastric bypass, according to Aills. Patients eat less food because the stomach has been reduced to an egg-sized pouch and many have difficulty tolerating protein-rich food sources including red meat. The primary issue, however, involves difficulties with iron absorption. The procedure reroutes the digestive system so that food bypasses most of the stomach and the beginning of the small intestine, the primary site for iron absorption, so less iron is absorbed. A reduction in stomach acid also reduces iron absorption after gastric bypass.
Expert Viewpoint
A study of iron absorption in 51 gastric bypass patients showed that the incidence of all types of anemia increased from 1.5 percent immediately after surgery to 38.8 percent at 18 months, according to a report published in the September 2009 issue of the "American Journal of Clinical Nutrition." The investigators found that iron stores dropped significantly about 6 months after surgery and did not improve by the end of the study period even though patients received iron supplements throughout this period of time. Factors contributing to iron deficiency in gastric bypass patients include reductions in iron intake, gastric capacity and the absorptive surface area, according to the study.
References
- "Surgery for Obesity and Related Diseases 4"; ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patients; Linda Aills, R.D., et al.; September 2008
- West Penn Allegheny Health System: Vitamin/Mineral Supplements After Bariatric Surgery
- WhyWeight.com: Vitamins for Your Weight Loss Plan
- "American Journal of Hematology"; Obesity, Bariatric Surgery, and Iron Deficiency: True, True, True and Related; Aileen L. Love, M.D., et al.; May 2008
- "American Journal of Clinical Nutrition"; Iron Absorption and Iron Status Are Reduced After Roux-en-Y Gastric Bypass; Manuel Ruz, et al.; September 2009
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