Nutritional deficiencies and hypervitaminosis 5 years after a Sleeve Gastrectomy: the need for tailored supplementation

The Sleeve Gastrectomy (SG) has become the most frequently performed bariatric procedure worldwide. Patients undergoing an SG are at risk for developing micronutrient deficiencies in the short term after surgery, due to limited oral intake, food intolerances and malabsorption. To assess their long-term nutritional status, a retrospective study was conducted collecting data of the nutritional status of 1793 SG patients over a 5-year follow-up period.

Deficiencies and excess levels of micronutrients

Prior to surgery, deficiencies were observed for vitamin D, vitamin B12, iron and ferritin, and these deficiencies still prevailed 5 years after surgery, accompanied by deteriorated anemia. In contrast, excess levels of micronutrients (B1, B2, B6) were observed 1 year after operation, but gradually declined to normal levels, with only vitamin B6 still being in excess after 5 years.

After 5 years % deficient % excess
Iron 40 5
Ferritin 50 5
Vitamin D 38
Vitamin B1 3
Vitamin B6 23
Vitamin B12 15 8

Tailored supplementation is required

The data shown in this study demonstrate that levels of multivitamins and minerals are continuously changing in the years after an SG. This emphasizes the need for a regular nutritional screening and subsequent adequate supplementation, not only for the short term, but also for the longer term after surgery.

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Al-Mutawa A., Al-Sabah S., Kojo Anderson A., Al-Mutawa M. (2018) Evaluation of nutritional status post laparoscopic sleeve gastrectomy – 5-year outcomes. Al-Mutawa, A et all, Obesity Surgery (2018) 28: 1473-1483.

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