Anemia after Bariatric Surgery

The phrase ‘what you put in is what you get out’ is often used to assess different situations of everyday life.  The same can be said about the amount and type of vitamin supplementation taken before and mainly after weight loss surgery.  While it is known that there need to be lifetime changes in diet and exercise habits after WLS, the importance of vitamin supplementation is not as rigorously expressed.  With lower than required daily vitamin supplementation, health related conditions such as anemia has been seen within the bariatric community.

The truth about Anemia

Anemia after Bariatric surgery or in general is a medical condition in which the levels of healthy red blood cells are lower than normal while the size and the shape may also be affected. This can lead to changes in the oxygen supply because the red blood cells bring oxygen to the organs.

We often hear that anemia is caused by low Iron levels, but it is not ‘just an iron deficiency’.  The truth is, anemia can also be caused by a chronic deficiency in Vitamin B12 or FolIc Acid.

Iron Deficiency Anemia

Our bodies maintain a natural process that allows us to store iron for future use.  An iron deficiency is when the iron levels are consistently low and the stored iron has been depleted because the body is not getting enough iron from food or iron supplements.  After WLS, less iron is usually absorbed from food sources and the levels need to be maintained by iron supplementation.  Studies have shown that iron deficiency anemia after WLS is more common in women who have become pregnant or have heavy menstrual bleeding.

Some symptoms of iron deficiency anemia include fatigue, a pale appearance, spoon nails (koilonychia), and abnormal cravings such as chewing on ice, chalk or even dirt.

Vitamin B12 & Folic Acid Deficiency Anemia

After gastric bypass or other weight loss surgery, the most common cause of anemia has been attributed to an iron deficiency.  Even so, adequate supplementation of Vitamin B12 and folic acid also play an important role in preventing anemia.  Vitamin B12 helps to make DNA, and works closely with folic acid for the production of normal size and shape of the red blood cells.  If Vitamin B12 levels are consistently lower than needed, this can lead to symptoms such as shortness of breath, memory loss, weakness and nervous system problem such as feeling numbness and tingling.

It is important to maintain a close relationship with your Doctor and Nutritionist to have the necessary tests completed and determine the amounts of Folic acid, Vitamin B12 and Iron supplements that is right for you.

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