Had the surgery in 2001, but I feel so tired!

I had the surgery, I had a little bit of an infection during those first days, but it all cleared. My weight it's down dfrom 250 to 156. I'm happy about that, but i'm still taking meds for High blood pressure, and the athsma still comes around once a year. But my main concern it;s that I;m tired at all times. My appetite it;s really down. I'm going to check my blood this month, but I'm seriously thinking that because of the surgery and the reduction of the amount of food that you can eat, it's giving me this problem. I'm exausted to the point that I sit here at work and I;m almost falling asleep o the keyboard. My body feels hevy to move around. I'm taking the B12 shots twice per month. I also take all b complex vitamins, and mega vitamins daily. i try to eat protein first with all my small meals. But physically I'm ore tired now than before the surgery. Does anyone here had something similar hapend to them? Thank you my friends, God Bless, Gin@

Any chance you could be pregnant?

Gina, I had the same problem. I am a Registered nurse and work with many doctors in a busy ICU. One of them, a hemetologist, said he'd see me. Come to find out my iron was extremely low. Our liver stores iron and it stores enough to live on for about a year, if we don't absorb iron the liver loans it's stores to our body. But then when it's stroes are depleted then your in trouble....tired ALL the time and weak....exhausted. The portion of your stomach that makes acid is bypassed and the acid helps absorb iron, so you like me may be not absorbing iron now and have depleted your iron stores. Ask you MD to check TIBC panel and retic count. Also my hemeatolgist said that IM, or intramuscular iron injections don't work, they are poorly absorbed and often sit in the muscle for months, so he gives me IV iron, which requires a 3-5hr infusion in his office. Hope this helps! Mary G

HI Mary, My name is sharon first of all i also had the gastric-by pass surgery back in feb of 01. I wen from 420lbs to 155lbs. I hace been doing great until her these last 6-8 months. i have been also so very tired and having low iron an my blood pressure has been low. so my doctor prescribed me some iron supplements tablets that i have been taking for the last 6months and he has take several blood test and they all have come back low iron so he would just up my dose from 1x aday to 2x aday to 3x aday to finally i went to a encronknigoist she found that my ferrtin was a 2 an that I'm serverally anemic an so she sent me a hemotogist right away. he told me that my body is so low right now that it is critical that my red blood cell count is extremely low and so he said i need to have a full body iv infusion. I'm really scared about this and i was reading your thing and saw that you have had this done . I just wanted to know dose it hurt and dose it make you sick and do you feel better and how often do you have to have this done and anything else that you can think of that might help me feel alittle better about having this done. Ihope you get this before i have to go have it done. which is scheduled for nov 4th 04, He did tell me that it was going to take me at least 6- 8 hours to do it and that he heavly medicates his clients. He also said he hopes that my body will except it. But any ways feel free to e-mail me back at [email protected] thank you so much for your time and any help you can give me.

Gina, this article explains more in depth my previous post. It's from "Beyond Change" a wt loss surgery journal. Mary The Roles of Iron in the Body Iron is a trace element nutrient that the body uses for several discrete areas of normal health and function. The primary role of iron is in the formation of hemoglobin and myoglobin. Hemoglobin is the protein in your red blood cells that transports oxygen around the body. Myoglobin is a protein that is similar in structure to hemoglobin that is important for the storage and usage of oxygen by muscles, including the heart. Additionally, iron also plays a role in regulating the response of the body to low-oxygen conditions or hypoxia. The body also uses iron in many enzymes that are critical for metabolism. These enzymes, called cytochromes are required for the metabolism and detoxification of many natural compounds in the body as well as chemicals, drugs and environmental pollutants. DNA synthesis also requires an iron-containing enzyme, which is why iron is so important for growth, development and wound healing. Iron in food Iron is found in two primary forms in food. The form typically thought to be the best - meaning it is the form that the human body can most easily absorb and utilize - is heme iron. This is the form of iron found in animal sources such as lean red meat, dark poultry, shrimp and tuna. One question about heme iron that we do not know is whether it continues to be the best source after weight loss surgeries such as gastric bypass. Heme iron is released from foods when it is digested by proteases in the stomach, and somewhat in the small intestine. But is this going to be efficient or occur at all with very little stomach? This we do not yet know. Iron is also found in plants. These non-heme irons are typically considered to be harder to absorb because it takes extra effort by the digestive system to free them from the foods they are in. This process depends both on contact with stomach acid and with enzymes. Stomach acid contact helps to stabilize plant irons in what is called the ferrous (Fe+2) state. Ferrous iron is more readily absorbed in the small intestine than the ferric (Fe +3) form, which is not very soluble. Absorption of non-heme iron can be either further inhibited or enhanced by other substances that are ingested at the same time. Substances that inhibit the absorption of non-heme iron include tannins in tea; oxalates in green vegetables, chocolate, berries and other foods; and compounds in grains, soy protein and egg yolks. Coffee and tea when consumed with iron can reduce absorption by 40% and 60% respectively. Absorption of plant-iron can be enhanced by simultaneous ingestion of heme iron. Other substances that naturally improve absorption include vitamin C; organic acids such as citric acid, lactic acid, or malic acid; and frucooligosaccharides (FOS). Iron in supplements There are a variety of iron forms sold as nutritional supplements. Iron supplements can be challenging to those who need to take them because the nutrient when isolated is not easy to digest and can readily lead to nausea, constipation or both. This experience can be especially profound after weight loss surgery when many individuals find that their digestive systems are more sensitive. To minimize side effects, it is typically recommended to take iron with food. Additionally, if you are taking large doses of iron (above the RDA), it may be advisable to take it in divided doses. This can minimize irritation and give greater opportunity for the iron to be absorbed. Most of the iron supplements on the market are iron salts. All contain different amounts of elemental iron, so it is important to read the labels carefully. The forms also vary in how easily they are digested and absorbed. Soluble salts like iron citrate, gluconate, succinates tend to be better tolerated than the more commonly used ferrous sulfate. You may also find iron supplements that are fortified with compounds such as vitamin C that enhance absorption. Nutrient interactions If you are supplementing iron to prevent or treat a deficiency, it is important to know about the compounds in foods (discussed above) as well as other nutrients that can interfere with absorption. Vitamin A and iron appear to support each other. When Vitamin A is deficient, iron is more likely to be deficient, and iron deficiency is more readily reversed in the presence of adequate vitamin A. Copper is required for iron metabolism and, if deficient, can allow for the accumulation of iron in the liver. Additionally, iron-dependant red blood cell formation is impaired when copper is too low. Both zinc and calcium can impair the absorption of iron form the digestive system. Zinc and iron may compete for the same absorption pathway, which may be most important if one or the other is deficient. Consumed at the same time, calcium in substantial doses can decrease iron absorption by up to 62%. This interference appears to be independent of calcium form, having been demonstrated with calcium phosphorus, calcium carbonate and calcium citrate alike. While some recent studies suggest that this interaction may not significantly harm iron stores, it is important to remember that these studies are not done in either deficient individuals or in those with determined malabsorption, surgical or otherwise. Because of the potential for numerous interactions, it is probably best for the individual with known deficiency to take iron away from other minerals. Since absorption is further impaired by procedures like gastric bypass, this may be the best preventive strategy as well. Drug interactions Numerous drugs may impair the absorption of iron. A few of the more common ones include those for stomach acid or ulcer such as proton pump inhibitors, H2 antagonists and antacids; thyroid medications; some antibiotics like tetracycline; and bisphosphonates. If you are taking prescription medications, it is a good idea to ask your doctor or pharmacist if they impair nutrient absorption, and how you can best take them to minimize this effect. How do you know if you are deficient? After weight loss surgery your doctor will recommend a schedule for regular blood work that will include tests for iron status. There are many tests that are used including ferritin, iron saturation, serum iron, and red blood cell indices. But because iron deficiency can happen between tests (especially if you are out a bit from surgery and only getting tested annually, or perhaps less frequently), it is good to know what some of the signs and symptoms of deficiency are. Common signs of deficiency include easy fatigability, increased heart rate, rapid breathing - especially with exertion, muscle weakness, pale or grayish color (loss of "pinkness") - this may be especially notable around the eyes or just inside the lower eyelid where normally pink tissue may become pale. Other signs may include fragile or spooned nails, intolerance to cold, restless legs at night, and persistent diffuse hair loss (telogen effluvium). Conclusions Iron is a critical nutrient for development as well as long-term health and well-being. After weight loss surgery when there are greater challenges to maintaining proper iron status, it is important to be familiar with how iron functions in the body, sources for iron, and signs of deficiency. If you are unsure of your own iron status, or whether you are following the proper regimen, you should start by contacting the office where you had your surgery to find out your doctor's most recent recommendations for blood work and supplementation. Brody T. Nutritional Biochemistry. 2nd ed. San Diego: Academic Press; 1999. Earley CJ,et al. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology. 2000;54(8):1698-1700. Fairbanks VF. Iron in Medicine and Nutrition. In: Shils M, et al, eds. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:223-39. Groff JL, et al. Advanced Nutrition and Human Metabolism. 2nd ed. St Paul: West Publishing; 1995: 353-66. Lynch SR. Interaction of iron with other nutrients. Nutr Rev. 1997;55(4):102-10. Ohta A, Sakai K, et al. Int J Vitam Nutr Res 1999 Sep;69(5):348-55. Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002 Jul;27(5):396-404. Review. Scholz-Ahrens KE, Schaafsma G, et al. Effects of prebiotics on mineral metabolism. Am J Clin Nutr. 2001 Feb;73(2 Suppl):459S-464S. Zijp IM, Korver O, Tijburg LB. Effect of tea and other dietary factors on iron absorption. Crit Rev Food Sci Nutr. 2000 Sep;40(5):371-98. Jacqueline Jacques, ND

how are your iron levels?

I had the surgery in 2002. I am experiencing the exact same thing. I am falling asleep while driving and falling asleep while typing at work. No matter how much sleep I get I am exhausted. I went to my Primary care because it has been getting so bad and he can not figure it out. I don't know what is going on. Monica