The choice of approach to prevent iron deficiency after RYGB

Iron deficiency is very common after Roux-en-Y Gastric Bypass (RYGB). Despite the standard prescription of iron supplements post-RYGB, the optimal approach to prevent iron deficiency, or the differences in absorption rate between various supplements, have not yet been evaluated.

Iron absorption: tablet versus solution

To assess the differences in iron absorption between a full tablet form and a solution form, twenty-four female patients were included. 1 week before and 1 month after RYGB, twelve patients received a single dose of 600 mg ferrous fumarate in tablet form, and twelve patients received a single dose of 1390 mg ferrous gluconate as a solution. Serum iron levels were measured before and every hour for 9 hours after ingestion of the supplement.

RYGB does not affect absorption of solubilized iron supplementation

Before surgery, no significant difference between in absorption between the two supplements was found. Post-RYGB, however, iron absorption from ferrous fumarate tablets decreased significantly, whereas absorption from solubilized ferrous gluconate was not affected by the operation. Therefore, a solubilized supplement is preferred as the iron supplement of first choice to optimize iron supplementation after RYGB.

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Schijns, W., Ligthart, M.A.P., Berends, F.J. et al. OBES SURG (2018) 28: 1738.

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