IRON DEFICIENCY AND ANAEMIA AFTER WLS

Iron deficiency is reported to affect up to 48% of Bariatric Surgery patients within the first 12 months after their procedure. The effects of iron deficiency are seen in Gastric Sleeve patients as well as those who have undergone Gastric Bypass surgery.

The effects of iron deficiency anemia present as fatigue, memory loss or brain fog, muscle aches, and pains, disrupted sleep, shortness of breath, and perhaps dizziness or fainting. Iron deficiency can present before surgery due to the malabsorptive effect of morbid obesity or simply lack of iron-rich foods in the diet. Nutritional deficiencies present for many reasons, before and after surgery, and ensuring that your nutritional levels in your blood test reports are the best they can be before surgery is key.
After surgery, Iron supplements may be required alongside your Bariatric Multivitamin to boost iron levels if you start your journey at the lower end of the range.

After surgery, iron absorption is affected for life by the removal of the acid needed to assist in the absorption of iron, so close monitoring of your bloods is important to watch that your levels are not quietly diminishing in the background. Prevention of deficiency is key - because playing catch up is expensive, time-consuming and generally avoidable..

The American Society of Metabolic Surgeons determined that gastric sleeve and bypass patients require up to 60mg iron supplementation daily. This is important for menstruating women and those who have heavy periods may need even more. Iron dosage should be determined by your practitioner and will be based on your blood test results.

Vitamin B deficiency will also impede the body's ability to store and use iron, as this.group of vitamins are synergistic and need to be present for iron to do its job.
Vitamin C is a key to iron absorption also, and taking vitamin C or eating foods rich in vitamin C with iron supplements is recommended.
After sleeve gastrectomy or bypass, the treatment for chronic or advanced iron deficiency anaemia may be treated with an iron infusion, performed at your doctor's surgery. This will generally increase iron levels to acceptable levels, but is not recommended as a regular solution to deficiencies - prevention is better than regular infusions as high levels of iron can be a lot for the body to manage on a regular basis.

Can gastric sleeve cause anaemia?
Yes, After Gastric Sleeve, due to lower levels of stomach acid, iron absorption is significantly reduced and supplemental iron should be taken daily for life, based on blood test results.

How much iron do I need after a gastric sleeve?
ASBMS recommendation is 60mg of supplemental iron daily - but your practitioner will advise on your specific needs.
Your Bariatric Multi is formulated to MAINTAIN the current level of iron - so if there is a deficiency, additional iron will need to be added if there is deficiency present.

What vitamins should I take after gastric sleeve?
After any form of weight loss surgery, a specific Bariatric Formulation is required, due to the increased needs for certain nutrients brought about by the surgery, and the limits on food intake.
A general Multivitamin does not have enough of these specific nutrients to meet your needs - it may look like a cheaper option, but the catch-up and doctors visits will soon negate any savings you made if deficiency sets in.

WHAT CAUSES IRON DEFICIENCY?

1. Gastric Bypass and Gastric Sleeve surgery results in decreased stomach acid production.
This affects the absorption of iron for life.

2. Changing tastes and restriction after surgery can reduce intake of iron rich foods.

3. Forgetting to take your bariatric vitamins daily.

HOW MUCH IRON IS REQUIRED AFTER WLS?

For menstruating women, the recommendation is 50 to 100 mg of iron per day.
For post-menopausal women and men 18 to 27 mg/day.
Eating iron-rich foods with vitamin C increases your absorption of iron.

WHICH FOODS WILL INCREASE MY IRON INTAKE?

Foods high in iron include beef, chicken, turkey, eggs, dried lentils, peas, beans, fish, liver, peanut butter, soybeans, iron-fortified cereals and breads, raisins, prunes and apricots. High vitamin C foods include citrus, kiwi, strawberries, broccoli, sweet potatoes, mango and pineapple.

WHAT DOES IRON DEFICIENCY FEEL LIKE?

  • Symptoms of low iron or anaemia include,
  • fatigue,
  • shortness of breath,
  • irritability, sleeplessness
  • headaches and
  • poor memory.

As anaemia gets worse:

  • brittle nails,
  • spoon-shaped nails,
  • hair loss,
  • light-headedness when standing up,
  • pale skin colour,
  • shortness of breath,
  • heart palpitations,
  • sore/swollen tongue.

WHAT CAN BE DONE?

Additional daily iron supplementation is recommended (ASMBS 2016)
Once your iron is low after WLS, food alone will not be enough.
Extra iron will be needed daily and for some 3/6 months.

The recommended dose to treat diagnosed iron deficiency is 180 to 220mg of iron per day taken in divided doses) plus 250 mg vitamin C. Iron levels should be rechecked in two months.

In gastric bypass patients, the bypass of the first part of the small bowel (duodenum) decreases absorption of iron, as the duodenum is the most efficient part of the small bowel for iron absorption. Ideally, iron should be taken on an empty stomach if tolerated.

Coffee, tea, calcium, bran products, cocoa, and nuts can impair the absorption of iron.

Tips for getting more iron in the diet

The best way to add iron to the diet is to eat more foods that are rich in iron. However, the following strategies can maximize your iron intak. after Weight Loss Surgery of any kind refraining from drinking tea or coffee with meals (separated by about 2 hours) refraining from eating foods rich in calcium with those rich in iron eating iron-rich foods alongside those rich in vitamin C cooking with a cast-iron skillet cooking foods for shorter periods.

Iron from Meat V Iron from Vegetarian Sources: Heme iron is derived from animal sources, and nonheme is vegetarian, Heme sources of iron are more bioavailable and are better absorbed by the body. Nonheme sources aren't as bioavailable. It's actually dependent on some vitamin C, which helps to convert the nonheme iron into a more bioavailable form

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BN Iron Contains 24mg iron which aids healthy red blood cell production and supports blood cell health.
After WLS iron absorption is forever affected due to low acid in the stomach which is required for the absorption of iron. Taking supplemental Iron after your Bariatric Surgery helps maintain iron levels which are important for the transport of oxygen in the body and synthesis of neurotransmitters, and supports energy levels and
healthy immune system function.
BN iron is helpful when iron levels are low after Gastric Sleeve or Bypass surgery.
 
Each tablet contains
Ferrous fumarate 76.85mg
Equivalent to Iron 24mg
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