Bariatric Surgery and Vitamin D - many studies

Created April 2023

1 year after Bariatric Surgery (RYGB)

74 lbs lost if >30 ng of Vitamin D

48 lbs lost if <30 ng of Vitamin D

Note: Might not have needed surgery if weight loss plan + weekly 50,000 IU of Vitamin D

18+ Vitamin D Life pages have BARIATRIC in the title

This list is automatically updated

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Many Bariatric Surgeries reduce absorption of vitamins and minerals - including Vitamin D

Vitamin D both before and after Bariatric Surgery - up to 50,000 IU 3 times per week - 2017

Obesity and Bariatric Surgery: Ultimate Need for Vitamin D Supplementation

Biomed Pharmacol J 2017;10(3). https://dx.doi.org/10.13005/bpj/1220

Saeed Ali Alsareii1, Abdulhadi Mohamed Elbashir1 and Mohammed Helmy Faris Shalayel2

Obesity and morbid obesity comprise mounting serious health problems reaching epidemic ratios in many countries. The cause of low levels of serum 25-hydroxyvitamin D in obese individuals remains obscure although increasing number of the postulations including vitamin D sequestration in fat tissues, rendering it less bioavailable for transformation into calcitriol, and diminished sun exposure. Bariatric surgery is one of the most efficacious long-term weight reduction procedures. Patients who are submitted to bariatric surgery are at increased risk of vitamin D insufficiency (VDI) and deficiency (VDD) that are potentially correlated with skeletal and non-skeletal pathology. Nevertheless, there is no assent considering the favorable management for these events. The severity of vitamin D deficiency due to bariatric surgery is obviously linked to the modality of bariatric procedures implemented, weight loss rate, and the intensity of malabsorption of other micro- and macro-nutrients.

According to the Clinical Practice Guidelines (CPGs) on vitamin D supplementation in bariatric surgery, high doses of vitamin D supplementations, ranging from 3,000 IU daily to 50,000 IU 1 – 3 times weekly are strongly recommended. Nevertheless, they do not fulfill criteria for applicability. Patients programmed for bariatric surgery should be motivated to follow continuous physical activity, appropriate dietary habits, and vitamin D supplementations pre- and post-operatively.

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Most people need >2,000 IU of vitamin D before and after Bariatric Surgery - meta-analysis Sept 2023

Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis

Rev Endocr Metab Disord. 2023 Sep 4. doi: 10.1007/s11154-023-09831-3

Andrea Giustina 1, Luigi di Filippo 2, Antonio Facciorusso 3, Robert A Adler 4, Neil Binkley 5, Jens Bollerslev 6, Roger Bouillon 7, Felipe F Casanueva 8, Giulia Martina Cavestro 9, Marlene Chakhtoura 10, Caterina Conte 11, Lorenzo M Donini 12, Peter R Ebeling 13, Angelo Fassio 14, Stefano Frara 2, Claudia Gagnon 15, Giovanni Latella 16, Claudio Marcocci 17, Jeffrey I Mechanick 18, Salvatore Minisola 19, René Rizzoli 20, Ferruccio Santini 21, Joseph L Shaker 22, Christopher Sempos 23, Fabio Massimo Ulivieri 2, Jyrki K Virtanen 24, Nicola Napoli 25 26, Anne L Schafer 27, John P Bilezikian 28

Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management.

Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL.

After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily).

Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. Regardless of the type of procedure, high-dose supplementation is recommended in patients after bariatric surgery.

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Note: Best to have Vitamin D loading dose before or after any surgery

A Loading dose will provide benefit in weeks instead of 5+ months

Probably also need Gut-Friendly Vitamin D as there is poor gut absorption after bariatric surgery

The Effect of Vitamin D Adequacy on Thyroid Hormones and Inflammatory Markers after Bariatric Surgery - 2023

Hormones and Inflammatory Markers after Bariatric Surgery. Metabolites 2023,13, 603. https://doi.org/10.3390/ metabo13050603

Roberta França h2, Adryana Cordeiro [email protected], Silvia Elaine Pereira 2,:3, Carlos José Saboya 3 and Andrea Ramalho 2,4

Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-598, Brazil
Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
Multidisciplinary Center of Bariatric and Metabolic Surgery Carlos Saboya, Rio de Janeiro 22280-020, Brazil
Department of Social Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil

Vitamin D status affects the clinical and corporal outcomes of postoperative patients who undergo a Roux-en-Y gastric bypass (RYGB). The aim of this study was to evaluate the effect of adequate vitamin D serum concentrations on thyroid hormones, body weight, blood cell count, and inflammation after an RYGB. A prospective observational study was conducted with eighty-eight patients from whom we collected blood samples before and 6 months after surgery to evaluate their levels of 25-hydroxyvitamin D 25(OH)D, thyroid hormones, and their blood cell count. Their body weight, body mass index (BMI), total weight loss, and excess weight loss were also evaluated 6 and 12 months after surgery. After 6 months, 58% of the patients achieved an adequate vitamin D nutritional status. Patients in the adequate group showed a decrease in the concentration of thyroid-stimulating hormone (TSH) (3.01 vs. 2.22 pUI/mL, p = 0.017) with lower concentrations than the inadequate group at 6 months (2.22 vs. 2.84 pUI/mL, p = 0.020). Six months after surgery, the group with vitamin D adequacy showed a significantly lower BMI compared with the inadequate group at 12 months (31.51 vs. 35.04 kg/m2, p = 0.018). An adequate vitamin D nutritional status seems to favor a significant improvement in one's thyroid hormone levels, immune inflammatory profile, and weight loss performance after an RYGB.

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