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Health July 2015

Dear Pharmacist

Nutritional Consequences of Gastric Bypass

By Suzy Cohen

Gastric bypass may end up being your solution, but you may not fully grasp the long-term nutritional consequences of gastric bypass surgery. While some physicians require mandatory nutritional counseling the first year, after that it’s optional.

Shrink your stomach and you will lose weight. The idea is perpetuated in our country and complications such as hypertension, diabetes, high cholesterol and bladder concerns making it feel dire to undergo a drastic procedure such as gastric bypass. I’ve watched 12 episodes of “My 600 lb Life” on TLC channel, and I’ve empathized with every person, it’s a great show that I highly recommend you watch.

Gastric bypass may end up being your solution, but you may not fully grasp the long-term nutritional consequences of gastric bypass surgery. While some physicians require mandatory nutritional counseling the first year, after that it’s optional. The extent of their recommendations stops after a multivitamin or multimineral, probably the basic A-to-Z once-daily sort.

I’m worried you might have fallen off someone’s radar of care. I’m worried you have symptoms of nutrient depletion and will now go on to get heavily medicated. We know anemia is a big problem due to B vitamin deficiencies, and it’s fixable.

Researchers show that deficiencies in macronutrients –  proteins, fats, and carbohydrates, and micronutrients – vitamins, minerals and phytonutrients are common. A 2014 scientific review team looked at studies published on many different types of obesity surgeries conducted between January 1980 through March 2014. Major deficits were common, especially the finding of low albumin, a critical protein used to transport hormones including thyroid, electrolytes, fatty acids, and more. Deficiencies of vitamin B1 (thiamine), vitamin B12, D, iron, zinc and others were common.

These very nutrients are critical for glucose use and management, energy production and management, gene signaling and detoxification. Often the first symptoms without these nutrients are fatigue, anemia, memory loss, cognitive changes, and loss of vitality that many chalk up to stress or aging. When left to progress, you can end up with severe damage leading to gait disturbances (trouble walking), Alzheimer’s and general loss of health and function.

Now, consider the added layer of complexity when medications are prescribed! The drug mugging effect will necessitate more nutritional supplements. For example, metformin given for blood sugar can deplete B12 and CoQ10. Certain antidepressants can reduce iodine; antimicrobials will further damage your probiotic stores.

The literature consistently shows bariatric surgery patients tend to run out of B12, B1, folate, C, A, D, and K, along with the trace minerals iron, selenium, zinc, and copper. Over-the-counter multivitamin and mineral formulas cannot provide adequate amounts of some of these micronutrients. Women need preconception care and it’s critical they receive iron, B12, vitamin A, K and natural methylfolate before becoming pregnant or there could be fetal complications.

It’s easy to get mistaken for having dementia or some other psychiatric disorder when it’s just a nutrient deficiency related to bariatric surgery. What if you had a gut infection, or had Celiac and didn’t even know?

In summary, make sure this surgery is absolutely necessary before doing it, and also, find a nutritionist who can advise which protein supplements, medical foods, greens or vitamins you need.

 

A licensed pharmacist for over 22 years, Suzy Cohen shares the pros and cons of medication use as well as natural substitutions for most any of your health concerns. Visit Suzy’s website at www.dearpharmacist.com.

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