I always bow to those who have been on the weight-loss surgery path for years – they are the pioneers and the ones who flag the problems that might occur so that we, the so-called ‘newbies’ (under 5 years!), might profit from their experiences and advice. This is why I like to read the latest blogs from Susan Maria Leach of Bariatric Eating in the US and others who are longer term post-surgery bariatrics . I read Susan’s book just after my own gastric bypass surgery and it helped me so much. Recently she has turned her attention more and more to supplementation since she sees an increasing need for weight-loss surgery patients to be aware that deficiencies do rear their heads after WLS but they can be controlled with effective action.
Vitamin D was one of her latest and she says:
91% Of Gastric Bypass Patients May Be Vitamin D Deficient!
‘Relatively little has been published in the general medical literature about the post-operative complication of bariatric surgery called metabolic bone disease. Many of us are walking around thirteen, fifteen, and twenty years post op, oblivious to what is going on inside and upcoming events.
A study conducted in 2005 noted that long term gastric bypass patients were developing bone diseases commonly observed in long term patients who had gastric resections for reasons other than obesity. The women were age 43 to 58, had gastric bypass 9 to 12 years prior and reported fatigue, muscle and joint pain for many months or years before correct diagnosis was established. All had very low or undetectable 25-hydroxyvitamin D levels.
What we don’t want to see is people 30 years out developing serious skeletal and bone problems from an operation designed to correct the comorbidities we started with.
The simplest and most effective path to make sure your body is getting the vitamin D it needs is to have your doctor check your vitamin D level. Most bariatric screening does not include testing for 25-hydroxyvitamin D (or 25-OH-D) levels. Never assume it is included; request if it is not. The longer patients were followed from their original bariatric surgery, the more prone they were to be D deficient. Recent studies show that as great as 91% of those who have had a gastric bypass are D deficient.
If you are one of this majority who is deficient, your doctor may have you take much higher doses than you are familiar with to bring your vitamin D up to a healthy level, then switch to a lower weekly dose to maintain your new higher levels.
When deficiency is detected, oral vitamin D supplementation is needed. Current evidence suggests that regular dosing with oral D3 cholecalciferol (e.g., 60,000 IU weekly) may have slight advantages over other regimens when replenishing vitamin D stores following deficiency. For long-term supplementation, smaller regular doses, such as D3 cholecalciferol 1,000 IU daily, or 10,000 IU weekly, are suitable.
With deficiencies so common after this surgery, experts recommend that your blood be tested every six months for the rest of your life to ensure that you are getting the right amount of vitamins and minerals.
But how do you know if you’re deficient? The the most reliable is of course to be tested but here are some signs that may indicate you are:
7 SIGNS THAT YOU MIGHT BE VITAMIN D DEFICIENT
Your bones ache.
Especially in winter, [vitamin D deficient] adults feel more achiness in bones and muscles and joints are a little more stiff when you get up in the morning.
You’ve got the blues.
Vitamin D seems to improve levels of the neurotransmitter serotonin which in turn could lift your spirits. In a small 1998 study, healthy people given vitamin D supplements during the winter reported greater positive feelings than people given no vitamin D.
You’re 50 or older.
The skin simply doesn’t make as much vitamin D as you get older, and the kidneys start to grow a little less productive when it comes to converting that D into the form the body puts to good use, according to the American Cancer Society. Older adults may also spend more time indoors, according to the NIH.
You’re overweight or obese.
There’s no change in vitamin D production in people carrying excess weight, but the higher concentration of body fat affects the levels of vitamin D in the blood. That’s because vitamin D is fat soluble, meaning the more body fat you have, the more it gets diluted. People who are overweight or obese may require more daily vitamin D to make up for this effect.
You have darker skin.
Studies have shown distinct demographic differences in rates of vitamin D insufficiency and deficiency. Your skin pigment is natural sunscreen. A sunscreen with 30 SPF reduces the skin’s ability to make vitamin D by a whopping 97 percent. Someone with very dark skin needs up to 10 times the amount of sun exposure than someone with a very pale complexion to make the same amount of vitamin D.
You’re a big-time head sweater.
Travel back in time a century or so and you’d find visiting doctors asking new mothers about how sweaty they found their heads. It’s no joke, says experts – it’s one of the first, classic signs of vitamin D deficiency.
You have gut trouble.
People with Crohn’s, coeliac or inflammatory bowel disease may be a greater risk for vitamin D deficiency because of the way these gastrointestinal conditions affect fat absorption. With these and other stomach issues, like those associated with weight-loss surgery – fat absorption can be lower, but that in turn lowers absorption of fat-soluble vitamins like D, according to the NIH.
So how can you get your D safely?
Sensible sun exposure is key, since D production only occurs on unprotected skin. If you know you’re likely to get a mild sunburn after 30 minutes outside without sunscreen, venture out for about 10 to 15 minutes and then put your sun protection on. Expose arms, legs, abdomen and back if you can, for maximum vitamin D production. And keep in mind depending on where you live, you may only make vitamin D for part of the year due to the angle of the sun, he says, and likely only from about 10 a.m. to 3 p.m. for the same reasons.
BUT WHAT IF YOU HAVE HAD WEIGHT-LOSS SURGERY?
Here at www.bariatriccookery.com we use supplementation as an insurance measure as well as having regular testing to ensure we’re up to the mark. The easiest way has been through taking Vit D in an oral spray form. Just one spray per day to date has done the trick (our lab tests prove it). We now offer this on the website. Check out Dlux 3000 Vitamin Oral Spray on our shopping page. It a handy size to keep in your purse or handbag, is easy to administer, easy to absorb (better than tablets) and tastes great!