NUTRITIONAL DEFICIENCY FOR RNYers INEVITABLE?

Does everyone with RNY eventually develop some sort of nutritional deficiency? I fear that because I am so young [just turned 20] that if I do have this procedure, I will one day have a nutritional deficiency, possibly multiple or major ones. If a person takes their vitamins and protein intake religiously and has their blood work annually, is the possibility of developing a deficiency still there?

 

I had the DS which has more malabsorbtion then the RNY...and the answer is no...it's not a definte.  You get annual blood work done to detect where you need tweeking...and to change your regmine a bit if it's not working for you....that is NORMAL..but not to be freaked out about it.  Long term definciences cause issues....not ones that have been around for a few months.   Get on a good suppliment regime (I recommend reading vitalady.com and finding out what she suggests....she's been around a long time and has a pretty good regime).   You can only do what you know...and sometimes you just don't know enough in the beginning.......like I didn't know I should take iron in the beginning....so I didn't.  My labs looked good up until 4 months ago when my Red blood cell count dropped and I became slightly anemic......added iron and 2 months later I'm back in the normal range.  But this is why I get tested eveyr 6 months or so (and if something is out of wack every 2 months until it's fixed).  Can anyone say you won't have a deficiency...no....but can you avoid having them long term...you bet. Scott

Thank you Scott, your reply was very helpful to me. I think I would be so paranoid that I’d want blood work every 3 months for the rest of my life, but I probably couldn’t afford that! Do you take pills to prevent mineral deficiency? Is there even such a thing and if so, is that as just as likely as vitamin deficiency? I'm starting to feel much MUCH more comfortable with the idea of surgery.

 

I believe for the most part you can avoid serious deficiencies if you really watch your labs and take your vitamins.  My opinion is that there are so many surgeons that just don't really understand the post-op life of their patients and supplementing.......I see everyday patients that don't take iron UNTIL they are crashing and burning, B-12 is a big one that many don't take properly because surgeons say take it once a week, etc.; heck B-12 is a water soluable vitamin and you'll excrete what you don't need so why take a change (sublingual or injections are what we need).   My best suggestion is get copies of all your labs, beginning with your pre-op and track them, when you see something dropping the supplement....so many doctors are comfortable with "it's within the lab range", ok fine put as a post-op being in range and it falling is an indication that something needs to be done. I agree with Scott, Michelle (vitalady) has been there and is continuously researching information on post-op life.....she can offer some very good insight on what you should monitor, supplement and help you prevent the deficiencies......will you develop a deficiency possibly, know one can be sure they won't but if you are diligent about taking your supplements and getting your labs done and be PRO-ACTIVE about it then you can avoid allot of deficiencies we see. The one thing I see happening is "we" (post-ops) start feeling normal and get lax on taking what WE know we need to take, me included.......so staying active on OH or other support groups and seeing what others experience is a wake up call to take care of yourself.

I do not think the nutritional deficiencies are inevitable.  I think with vigilance to getting your blood work done, taking your vitamins and protein intake that you can keep things in good shape. I'm almost 3 years post-op and my husband will be 4 years post-op and so far so good on our labs.  We had them run every 3 months the first year post-op (per our doctors requirements) and then every 6 months thereafter.  We've had to have adjustments made in areas like Vitamin A (him), Vitamin D (both of us), selenium (me), B12 (both of us), iron (both of us), calcium (both of us).  We had a decent program at our hospital for supplementation and got more information than many folks that I've seen post which is a good thing. Have you considered the lap band?  Some folks do as well as RNY with the lap band.  It wouldn't have the nutritional issues that an RNY or DS would have. Good luck! Kathy

BTW, wanted to add - that I think it's GREAT that you are asking this and doing your research.  It is good to know what type of commitment that you have to make. Also, I should say I'm not far from you perhaps and I've heard very good things about your surgeon.   Kathy

You've gotten great advice.  On these issues, vitalady (Michelle Curran) *rocks* and I get a lot of my supplements from her website. Running the labwork and making adjustments is really not a big deal.  It's a good idea to be proactive and get copies of your own labwork.  Then learn to look for trends from one test to the next.  The whole point of this labwork (every six months is all I do now too) is to identify deficiencies before they happen.  If you see your levels for a particular vitamin dropping even within the normal range, you can up your supplements for that and catch it before you bottom out, see?  That's how bloodwork is helpful -- not only to identify problems but to stop problems from happening in the first place.  Watch those movements within the normal ranges.  Also, figure out what part of that normal range is good for you, because some of the "normal" ranges are huge and what's okey-dokey with the lab isn't okey-dokey with me ****ep my B-12 levels in the high-normal range b/c I feel better at that level).  Regular labwork  keeps you honest with your vitamins.  I often wonder if  "normal" people wouldn't benefit from more detailed labwork now and then, as we WLS post-ops aren't the only people who might feel a bit better with proper supplements. Suzy C.

Most people I know do fine if they take their vitamins. My doctor says to take 2 vitamins a day (one in the morning and one at night), 2 calciums, and a sublingual B-12 at least 3 times a week. I think when we get into trouble is after some time passes, we get complacent and think we don't need them anymore.

Good questions. Think long and hard before going through with the surgery. I've had 2 surgeries to repair problems caused by the original gastric bypass and have dealt with anemia and thyroid problems since the surgery. I have tried to do a complete  vitamin regimen, spend time every week setting up all my supplements, etc. It is nice to  be thin, but I suspect I may have shortened my life expectancy! I am grateful for the weight loss but you are so young...think long and hard. Torrie

I had my original RNY 1-4-01.  I did great for 3 years.  And than it's been nothing but downhill since requiring 15 more surgeries.  My RNY was totally reversed in 2005 because I was not absorbing vitamins, or medicines.  I got down to 89 lbs.   Now they have fattened me up with tube feedings over the years so I am a size 12 now up from a 0. I took my vitamins, ate 120 grams of protein per day, and even over 80 ounces of water everyday.  Oh, and had my levels checked every 3 hours. I didn't eat anything that I was not allowed to.  So, I didnt eat any sugar.  I tried all the bariatric vitamins like with Vitamist, Vita4life, Real Meals Vitamins and Vista Vitamins.  I even worked for all these companies for a little of while. It's not how many vitamins you can swallow in a daily basis, it's the surgery itself.  The further a person gets out, the more problems they see with absorption. I am on 3 of my medicines via IV (port a cath in my chest).  I am very vitamin deficient right now because even trying to swallow them, I either puke them up, or, because I have very little of my small bowel left, they don't absorb. Good luck to you.  Please stay on top of your blood levels.  You always need to have them check your B1 (thiamine).  Doctors here in the US don't check that level.  I found out the hard way.  I can barely walk because of this deficiency. I am a Christian.  But, I pray to God now adays to take me home to be with him, or get me on TV to tell the "real story" after gastric bypass.  Not the sugar coated version that the doctors put out there for them to get rich off of.  I have buried 4 friends so far. My email is [email protected]