Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation

Note:   I just want to apologize to all for not posting sooner.  I’ve been studying for a test.  I will try and do better in the future – I have not forgotten you all, and I thank you for your patience.   I am also on FaceBook and Twitter now (@gerl_369)

Here is another interesting article out of Denmark that shows how nutrient deficiency progresses during the first two years after Roux-en-Y gastric bypass surgery.   Two years after surgery, 98% of patients require additional supplementation over and above the standard vitamin regime initially prescribed.

Some of the conclusions from the study show the lack of effectiveness of multi-vitamin therapy and it documents the rapidity of the onset of the deficiencies, with most deficiencies presenting at the 6th peri-operative month.   One of the more common recommendations of doctors to the gastric bypass patients is to double their multi-vitamins, but according to this study the effectiveness of that approach has not even been determined.   If one of something isn’t working, it doesn’t necessarily make sense that doubling it will.    The author’s recommendation is to develop a daily single-dose supplement and determine the most effective route of administration to encourage compliance and improve overall health outcome.

After two years, 80% of patients required additional B-12, 60% required additional calcium and iron and 45% required additional folic acid – on top of the multi-vitamin they’d been taking.   Smaller percentages were prescribed additional nutrients such as zinc, magnesium and B-vitamins.

This article is concerning in light of the finding that only about 35% of bariatric patients are compliant with their supplementation at all.    After two years, most patients are no longer under their bariatric surgeon’s care and are now being followed by their primary care practitioner who may, or may not, have significant experience with nutrient deficiency.

Bariatric patients should educate themselves on which laboratory tests are available to test for nutrient deficiencies, how indicative they are of actual tissue deficiency, what those optimum levels for their well-being should be, and associate those levels with a supplement regimen that adequately helps them maintain those levels.

One piece of information from this study that really caught my attention was the identification of the rapid onset of deficiency around the six month mark.   Most of the people that contact me regarding addiction transfer indicate that their problems did not start right after surgery, but rather during this 6-24 months post-operative period when this rapid onset of nutrient deficiency occurs.    There is still much to be studied and learned, but I for one would love it if they followed the recommendations of this paper and developed a one-shot effective supplement that was proven to be absorbable and effective.

If you have any questions, please email me at (, follow me on Twitter (@gerl_369) and FaceBook (It’s Not Addiction Transfer after Gastric Bypass Surgery)



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2 responses to “Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation

  1. Mike M.

    I’m so glad that I came across your blog. Finally, someone articulating exactly how I feel. I’m in such a desperate spot right now. I really don’t know if I will be alive three months from now. I seem to be incapable of experiencing any sense of optimism. I’m a 28 y.o. male from Canada. I had my surgery done three and a half years ago. I lost 125 lbs and have kept most of it off so far. However, almost a year after losing the weight, I began to develop a persistent sense of impending doom, social anxiety disorder, light headedness, and like you say, a sense of just not feeling “right” in my head. My alcoholism has steadily become worse. All the more troubling, is the guilt which I’m feeling for what I have put my family through. Six months ago, I hanged myself in my basement and came within minutes of my life. Thankfully, I was found in time and the paramedics were able to start my breathing again. I was committed to the psychiatric ward for almost a month with Major Depressive Disorder and alcohol induced psychosis. I’ve been to rehan, and I’ve also suffered several alcohol withdrawal seizures; losing my driver’s license as a result. Nothing seems to be working!!! Right now, I’m drinking 3-4 times a week-10+ beverages at a time. I black-out always, and my social standing in the community is beginning to take a hit. All the worse, this is the point in my life where I thought I would start prospering. I have three university degrees, never-the-less, I just can’t seem to protect myself against the cravings for alcohol no matter how hard I try to intellectualize my disease. The only time I achieve any sense of peace is when I’m drinking. I will be leaving work in the next couple of weeks and I plan on attending, for the second time, a 21 day rovery program. I would appreciate any prayers/words of wisdom that you might have to offer. Also, I’m currently being treated with B12 injections and testosterone therapy as a result of these deficiencies. I see my GP on Saturday and I plan on mentioning this site to him. I know that there is definitely a psychological component to my addiction, there was to my eating, but I’m certain there is a physiological component to all of this as well.

  2. Mike,
    I am so sorry to hear about this. I’m not sure whether my posting today about Dr. King’s study where they are at least finally coming out and saying this is not “addiction transfer”. They are finally getting off that nonsense. Little by little. But anyway, the important thing is for you to get your physical and mental health back. It seems to hit men harder and faster. Men lose weight harder and faster and this side effect does too. It seems to correlate and it could have to with how quickly you deplete your reserves. You must start your days with protein shakes (whey, rice or egg whites…whatever works), add liquid centrum (or good multi of your choice), some liquid magnesium, calcium citrate, and some liquid Omega-3’s. Split it up 4x per day. It may feel like that is all you do….drinking protein shakes and drinking vitamins…but in about two weeks you will notice a difference. There are some amino acids that can help with symptoms, but if you are on medication you should check with your doctor first.

    The other half is to get some help breaking the alcohol=pleasure=addiction pathway. I would suggest you seek help from your physician or counselor and discuss the various medications and/or behavioral therapies out there. Ask or look up Naltrexone (Sinclair method), Baclofen (not widely known about), Topiramate (moderate effectiveness).

    Good Luck to you and there is help.

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