Boy was I surprised!

Met with the surgeon today to talk about the mesh in my abdomen. Well good news, he can do the laparoscopic surgery! Yay! So I had a whole list of other questions for him also, one of which, the iron supplement after surgery. He told me to not worry about iron. The body really can not absorb the iron so not to waste money on it. We will watch labs and if an infusion is needed then so be it. Boy was I surprised, I thought everyone had to do iron after... Anyone else's doctor say something similar?? I trust my doctor and what he thinks is appropriate, just curious. Thanks!!

My surgeon does not have us take iron unless tests show a deficiency.  He says the percentage of post-WLS patients with iron deficiency is the same as in the general population.  Since too much iron can be poisonous, he does not want us to take it without a verifiable reason.  

Not sure where your doc got that statistic, but i don't think he is correct. 

There are a lot of us who did not have problem with iron before WLS,  yet need iron infusion after RNY. 

Before RNY - my irons were ok. After RNY - i need infusions. And btw - before RNY i used to have very heavy periods, and still had no problem maintaining normal iron using food only,(not supplements). Post op RNY, not only i no longer had periods, but even with supplementation, i become deficient in iron and needed infusions app 2 years post opp RNY.  (it took 2 years for my levels to drop below normal). 

Post op RNY ~iron deficiency is very common. 

I do not doubt this.  It seems that many WLS folks do have iron problems, at least from anecdotal evidence on these boards.  Definitely, from reading here, it is something I am following in my own labs, especially because I have had iron problems before.  

I did not intend to lead  the OP astray; I wanted to respond to her question about if other surgeons besides hers do not require iron supplementation.  My surgeon explained his rationale in a presentation/class before surgery.  He and his practice/partners have been doing WLS since the late 1970's, and they have a very large database of patients that they do longitudinal research on.  The statistics from some of the studies done on this group are cited nationally, since they are some of the longest, largest studies.  (As I understand it.)

He is concerned about unnecessary iron supplementation when too much iron can be poisonous, and when his data shows that WLS patients, even over time, have anemia at a rate of about the same as that in the general population.

Of course, any study represents aggregate data.  And when dealing with our own health, the study "database" is 1:  one person, me!  Or one person: you!  There is a lot of discussion in some online health forums about studies where  n=1, advocating for us all to try things and monitor our own responses, so that we find what works for us.  

I have enormous respect for the many members of this board who have taken that n=1 approach to have long term success.  However, for the time being, I myself am not supplementing iron beyond my multivitamin, but am watching my labs carefully.

My doc said he is concerned about it upsetting the stomach and causing constipation. Lets not add anything that will upset the healing process! 

Your doc is wrong. Some iron can cause stomach upset and constipation. Other types, like carbonyl and heme iron, don't cause those issues at all.

Your doc is not correct. There are a lot of post ops who maintain healthy levels of iron with supplements. Only some of us need more than that.   And e don't know who needs iron infusion and who can maintain with supplements. 

To a variety of posters above: your doctors may be good surgeons, but they don't know crap about iron supplements. Hala already made some good points.

Very, very few WLSers have good iron without supplements. Very few. If you like those odds, keep waiting for a winning lottery ticket. It's not a matter of IF you will need iron, but a matter of how much.

Iron is stored in the body. If you don't supplement, you will likely be fine the first few times you have labs drawn, because of the reserves you MIGHT have stored. Then your iron will tank, and you'll spend every day feeling like you got hit by a bus. There is more than one lab test for iron. Pay particular attention to ferritin. That's the amount of iron you have "in the bank." That can deplete over time, until you get low enough to need an infusion. Just take your iron.

There are lots of different kinds of iron supplements. Some can upset your stomach and cause constipation. The most commonly found types of iron, ferrous sulfate and ferrous fumarate, will do this. Other types of iron, such as carbonyl iron and heme iron, will NOT. So take your iron.

There are a few postops whose bodies have trouble absorbing iron. Most of us absorb the iron in supplements just fine. So take your iron. 

If you don't supplement you can end up doing damage to yourself, and need IV iron infusions. Why go through all the expense, time, pain, and inconvenience? Just take your iron.

Don't believe people when you have labwork done and they say you are ok. Get a printed copy of your labs, every six months or a year, at most. Enter the results in a log, or spreadshee****CH THE TRENDS OVER TIME! This is perhaps more important than any single result. Your iron, or any result, may be ok right now. But if the number has dropped each time, you are headed for trouble. Maybe big, big trouble. You should be increasing that supplement. Likewise, if numbers have been rising, it may be time to cut back a little. If you watch the trends, it's harder to drop too low, or too high.

Should doctors do this for you? Yes, but they don't. They glance at today's result, and say you're fine. THIS IS YOUR HEALTH. YOU ARE RESPONSIBLE. TAKE CHARGE!

Start with the ASMBS daily recommendation of all vitamins and minerals. Have your labs done, religiously. Keep track. Learn what the numbers mean. Increase or decrease as needed. Some of us need MUCH more of certain things, others less. A complete set of labs is about 15 vials of blood. If they are taking four to seven vials, you are not getting everything you need tested.

Don't play Russian roulette with your health. Take the damn supplement.

Yes! I take Feosol with the teal label, which is carbonyl iron. No stomach trouble, labs look good, doctor says to keep taking it. YMMV, but it's good stuff.