Patients who have had a surgical weight loss procedure, whether the Roux en Y Gastric Bypass, Adjustable Banding, or Vertical Sleeve Gastrectomy, require close monitoring of nutritional status, physical and mental well being for the rest of our lives.
For the first year we see our Bariatric Surgeon and team, but after that we are often on our own as monitoring is passed along to our Primary Care group. Not all General Physicians are aware of the nuances of our special status and may not know we are prone to a particular set of deficiencies different from other patients. We have to be our own advocates and help our medical team take good care of us but we are ultimately responsible for our own longterm care. It's just like real life!
In our Facebook BariatricEating Support Group we have many many ice chewers who *think* they *like* chewing ice and their PCP or PA has not done a Ferritin test to check stored iron levels - it's a safe bet they are iron deficient and have no idea it can lead to heart damage and death. (they laugh about finding others who also eat Sonic crushed ice by the cupful. It's. Not. Funny.) We push post ops to have labs done and they return to tell us their Ferritin was '3' and they were given an emergency blood transfusion, with those in the '5 to 10' range having IV Iron Infusions. Proper Replenishment: Additional Iron such as Ferrochel® used in Journey Gentle Iron, 40 to 60mg daily (which is elemental equivalent to 300 to 325 non elemental Fe)
Anyone who has been around for five or more post op years knows a few who have died with neurological complications of undiagnosed thiamine/B1 deficiency - starting with numbness in fingers, unexplained 'tripping' around the house and progressing to hospice. Proper Replenishment: Taking a multi with ALL the B vitamins. Gummies and Flintstones do not have all the B's as they compromise taste. Journey vitamins that have been formulated for Bariatric needs have the B's.
Eight years after my gastric bypass, Osteomalacia or Soft Bones complicated my orthopedic surgeon's placement of screws for a leg fracture from a motorcycle accident. A serious D deficiency had turned my bones into 'a stick of cold butter' and I needed immediate supplement therapy. It took three years and change of doctors to get my D levels above 50ng/ml. Proper Replenishment: Vitamin D3, 50,000IU once weekly x 8 weeks. Journey Vitamin D Sunshine Jellies are the perfect formulation and taste fantastic.
Recommended Annual Lab Tests For Post Bariatric Patients
Highlighted tests are more important for a bariatric patient than a non-op and may not be routine for your doc, so don't be intimidated to show them this list. Other tests may be needed if you present symptoms.
- CBC - Complete Blood Count or a Comprehensive Metabolic Panel (evaluates organ function - liver, kidneys, electrolytes, protein, calcium, glucose)
- Lipid Profile (Cholesterol/Triglyceride Levels)
- Ferritin, Iron Profile
- Vitamin A
- Vitamin B1; Thiamine
- Vitamin B12; Folate
- Vitamin D, 25 OH
- iPTH - Parathyroid Hormone
- Bone Density (DEXA) at 2 years post op
- Thyroid Panel (TSH,T4) - for those with thyroid disease
Take good care of your body, its the only place you have to live! The major surgical alterations you've made to your body last forever - be smart - bariatric vitamins are important for the rest of your life.