Patients with extreme obesity may benefit from bariatric surgery or commonly known as weight loss surgery, which may also result in not only immediate weight loss, but also improvement of type 2 diabetes mellitus. Although this surgery like any other surgery carries certain risks, some men and women suffering morbid obesity choose to receive this surgery.
In addition to a lifetime commitment to a new lifestyle and dietary habit, patients who undergo weight loss surgery may need lifelong supplementation of multivitamins, particularly high doses of vitamin B12 to avoid vitamin deficiency, particularly cobalamin deficiency or vitamin B12 deficiency, according to a review published in Surgery for Obesity and Related Disease.
Reviewers say vitamin B12 deficiency is most commonly found in people who have received bariatric surgery and they conclude “Intramuscular vitamin B12 continues to be the gold standard of therapy for vitamin B12 deficiency, especially in symptomatic patients.”
The review was based on study reports published in MEDLINE from the earliest dates through Sept. 2012 concerning the prevention and management of vitamin B12 deficiency in those undergoing weight loss surgery.
In the review, the authors suggest that in patients who have received Roux-en-Y gastric bypass (RYGB) surgery but do not experience any post-surgery symptoms, particularly patients do not adhere to intramuscular therapy, high doses of oral cyanocobalamin should be used.
Unlike patients post-RYGB surgery, patients undergoing restrictive procedures such as gastric banding and sleeve gastrectomy may use a daily lower-dose of a vitamin B12 supplement.
It should be noted, according to the review, that efficacy of nasal and sublingual routes for maintenance of vitamin B12 has yet to be determined.
Vitamin B12 deficiency can lead to symptoms including weakness, tiredness, or light-headedness, rapid heartbeat and breathing, pale skin, sore tongue, easy bruising or bleeding, stomach upset, weight loss, diarrhea, and constipation.
Vitamin b12 plays essential roles in folate metabolism and synthesis of succiny-CoA, a citric acid cycle intermediate and preservation of DNA integrity and the myelin sheath around neurons and the synthesis of neurotransmitters. Deficiency of vitamin B12 can cause a series of health conditions including increased risk of breast cancer, cardiovascular disease, inflammation, depression, osteoporosis, and premature cognitive decline.
It is not just patients who receive bariatric surgery who need vitamin B12 supplementation. Older people and those who have problem absorbing vitamin B12 from foods, vegans definitely need vitamin B12 supplementation.