Vitamins and bypass versus vertical sleeve

I was just reading a post about taking so many vitamins and vitamin deficiency and thought of this.

In gastric bypass surgery, they bypass your duodenum and a large part of your small intestine.  These are both very important for vitamin and mineral absorption.  Because of this and drastic decrease of food intake, vitamin deficiencies are very common.

In vertical sleeve surgery, none of your intestines are bypassed.  In fact, all of them remain fully intact and are still fully used in digestion/absorption.

Doesn't it make sense that, because vitamin deficiency is very common,  this surgery would be more ideal for better health in the long run?

Less invasive, better nutrient and mineral absorption from the food and whatever vitamins we may need to take, if any.  It's likely that we would still need to take vitamins, but probably not as many.

This really got me thinking.  What do you think?

One will have to supplement with any weight loss surgery. Regardless of the rerouting of intestines and malabsorption of nutrients, simply due to the small amounts of food any WLS patient has the ability to ingest puts one at risk of a vitamin deficiency. Add into the mix an individual's own body make-up and ability to use nutrients efficiently,

Does this make VSG more "ideal"? For some perhaps. But one certainly cannot say what is "ideal" for everyone simply based on having to take vitamins. We all have to take vitamins to maintain good health.

I highly recommend doing some research on this, and other weight loss surgery related topics, with the ASMBS (American Society of Metabolic and Bariatric Surgery). Here is a link to a 2013 document updating their original 2008 document: http://asmbs.org/resources/clinical-practice-guidelines-for- the-perioperative-nutritional-metabolic-and-nonsurgical-supp ort-of-the-bariatric-surgery-patient

Specifically Table 6. You will note that the vitamin requirements for RNY (they label it RYGB) and VSG (they label it LSG) are remarkably similar.

I have a VSG and you have to take the same amount of vitamins as people who have had a RNY and we also can also have vitamin deficiencies which I have had off and on.

RNY for heavy weights is (generally, IMHO) better. The small pouch coupled with malabsorption helps lose weight faster and more effectively. You only have about a year-18 months before your honeymoon phase is done, and having a 2 fold weight loss tool, for me, was the best. 

That the sleeve is less invasive is a common myth.  Although there are fewer cuts, there is a much longer staple line and leaks can be much more devastating than with bypass.  Also having your old stomach removed is a down side, as there is nothing left to go back to with extreme complications, whereas a bypass can be "undone" if necessary.  Add to that the more modest results and lesser durability of sleeve, and I don't ever see it being truly preferred to bypass.  Nutritional risk can easily be tempered with education and proper follow-up.

Agree with those who said "the right surgery for the right patient" though, but how to answer that question is always a challenge :)

When you undertake WLS you promise to be diligent with vitamins regardless of surgery type.  I had the VSG and am religious about my vitamins.  I may not have to take quite as many as other surgery types but it is still a commitment and an expense that must be planned for. 

I had a vsg 6 months ago and have vit A deficiency and vit D deficiency....all my vits are jacked up...on the same not though I started at 376 lbs and am down 146...no matter what the surgery, you gotta work it!   I love my sleeve though and would never change it if I could.

Thanks for the info and comments everyone.  It definitely made me think.  I don't mind taking my vits at all.  My neighbour just had a bypass on Jan 19th and she needs to break up hers into smaller pieces with a pill crusher.  I can imagine with the size of some, passing through the opening will be difficult.

I had discussed this briefly with the dietician and he mentioned that bypassing the duodenum and some small intestine can and very often does create problems.  But because of the small amounts of food eaten, vitamin deficiency is very common with both surgeries.  I'm sure you can imagine my question when viewing how food is digested.  I am definitely goingto check out that article that Karen mentioned.

I'm just going to be happy to have whatever surgery they give me and I will take my vits.