Vitamin B12 Deficiency: A Complication of Gastric Bypass
 Can also be experienced with other forms of Weight Loss Surgery

 By Charlene Collins , published Jul 16, 2008 Published Content:

The benefits of the bypass clearly outweigh the risks for most people; that being said, there is a downside for some people, including myself. Thousands of Americans are severely obese. Sometimes the only hope an individual has for a normal life is to undergo a procedure such as a gastric bypass. Even though the Lap-band procedure is popular, the bypass still remains the most sought after, when diets just don't work. The benefits of the bypass clearly outweigh the risks for most people; that being said, there is a downside for some people, including myself.

For the last couple of years I have been noticing that I have been having memory loss. For the last year I was treated with the antidepressant, Welbutrin, in case my memory loss was linked to depression. I have not been depressed, but frustrated because I can't remember. I have aphasia at times where I cannot think of a word. I might be in conversation and then I can't think of the word for an object. One morning I wanted to say something about the telephone, I could see the phone in my mind, but could not find the word, so that I could say it. I am so forgetful that I went back to my doctor convinced that I had early onset Alzheimer's disease. My doctor sent me to a neurologist and ordered a lot of tests. The only alarming result was that my body has been depleted of Vitamin B-12.

The body is dependent on Vitamin B-12 and folic acid for normal red blood cell formation, repair and synthesis of DNA. B-12 is also necessary for the formation of myelin that forms the myelin sheath-the coating over the nerves of the brain and spinal cord. Normally 3 to 5 years worth of Vitamin B-12 is stored in the liver. It is synthesized in the stomach. Stomach acids react with the ingested protein foods in the stomach to isolate the B-12. Then a substance called intrinsic factor, (produced by specialized cells in the stomach lining) binds with the B-12 and then follows the digestive tract to the small intestine to be absorbed.

If you've had a gastric bypass most of the stomach is bypassed. You have a very small pouch that acts similarly to a funnel to empty ingested food into the small intestine. The part of the stomach, that makes the intrinsic factor is bypassed. The food that is ingested does not go into that part of the stomach, so Vitamin-B12 cannot be absorbed. People who have had a gastric bypass may need to get Vitamin B-12 injections at certain intervals throughout their lives, because their bodies cannot synthesize it.

The symptoms of Vitamin B-12 deficiency are subtle. People that have had a gastric bypass may slowly manifest symptoms such as dizziness, confusion, paranoia, loss of appetite, fatigue, pallor of the skin, shortness of breath, or rapid heartbeat. They may suffer from sleep disorders, change in personality, memory loss, depression and psychosis. These symptoms are not the worst outcome of Vitamin B-12 anemia, but they preclude a condition called pernicious anemia, which is fatal. Pernicious anemia depletes the body of red blood cells; if the body does not have enough red blood cells, the body is starved of oxygen. The symptoms become bothersome long before pernicious anemia sets in; this is when people will go to the doctor because they don't feel well.

It is important to gastric bypass recipients to always take a good multivitamin, because B-12 needs folic acid to be absorbed by the body. I you had a gastric bypass and you have any of the symptoms that I have mentioned in this article, please mention them to your primary care physician. For more information about Vitamin B-12 deficiency I will list my source at the bottom of this article.