Bariatric Surgery and Vitamin B12 Deficiency

In an effort to combat life-threatening obesity that has not been responsive to weight loss programs, diets or exercise regimens, more and more people are begining to resort to undergoing bariatric surgery, including gastric bypass, stomach stapling and lapband installation.  Bariatric surgery is also indicated for patients with serious ulcers and those with intestinal cancer.   The use of laparoscopic techniques makes bariatric surgery a lot less invasive than even 10 years ago, and it has become a much more attractive option for many people, being performed on over 200,000 patients per year in the United States.

Weight loss can be very dramatic, and with it, the risks for diabetes, cardiovascular disease and certain forms of cancer are also reduced.  In some cases though, especially those with the more aggressive forms of bariatric surgery that bypass most of the small intestine, problems can develop with the absorption of various vitamins and minerals.  These deficiencies include, but are not limited to calcium, iron, and vitamins A and B12 (cobalamin).

Vitamin B12 deficiency is especially likely because adequate vitamin B12 manufacture and absorption involves both the stomach itself, and the ileum, the lowest part of the small intestine.  The parietal cells of the stomach secrete a protein known as intrinsic factor.  This protein binds to vitamin B12 in the ileum and is absorbed together with it into the intestinal cells.  Without either intrinsic factor from the stomach or the cells of the ileum, orally consumed vitamin B12 cannot be absorbed into the bloodstream.  Vitamin B12 deficiency results in pernicious anemia, a potentially fatal disease.

For most patients who develop vitamin B12 deficiency, the most widely followed therapeutical option is to get injections of the vitamin.  Some patients can absorb sufficient amounts of the vitamin sublingually that they can avoid the injections.  Sublingual supplements are not swallowed but held under the tongue, in contact with the mucous tissue and its rich blood supply.  Both cyanocobalamin and methylcobalamin supplements can be used sublingually.  If limited absorption through the oral route is still possible, supplementation with liquid vitamin B12 is also an option.  Transdermal vitamin B12 patches represent a newer alternative.

While some people may need to revert to surgical measures to help them lose weight, once they have healed and resume their day-to-day life, it is important that they not revert back to bad habits. Following one of the many practical programs designed for weight loss can be the best way to lose weight and keep it off, even after bariatric surgery.  As the weight begins to drop, it is also important to find some type of physical activity to help firm and tone as well as provide the necessary health benefits exercise can provide.

There are many great exercise regimens that can help you increase your weight loss as well as strengthen, tone and tighten your entire body. One very effective workout involves the use of a rebounder or mini trampoline, this type of weight bearing exercise is low-impact and extremely easy on joints, yet provides an amazing weight bearing benefit. A mini trampoline is also one of the most effective methods for cellulite reduction.

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