title: The gastric sleeve: losing weight as fast as micronutrients?
abstract: BACKGROUND
  Recently, the laparoscopic sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched.
  
  
  METHODS
  From January 2005 to October 2008, 60 patients underwent LSG. All patients were instructed to take daily vitamin supplements. Patients were tested for micronutrient deficiencies 6 and 12 months after surgery.
  
  
  RESULTS
  Anemia was diagnosed in 14 (26%) patients. Iron, folic acid, and vitamin B12 deficiency was found in 23 (43%), eight (15%), and five (9%) patients, respectively. Vitamin D and albumin deficiency was diagnosed in 21 (39%) and eight (15%) patients. Hypervitaminosis A, B1, and B6 were diagnosed in 26 (48%), 17 (31%), and 13 (30%) patients, respectively.
  
  
  CONCLUSIONS
  Due to inadequate intake and uptake of micronutrients, patients who underwent LSG are at serious risk for developing micronutrient deficiencies. Moreover, some vitamins seem to increase to chronic elevated levels with possible complications in the long-term. Multivitamins and calcium tablets should be regarded only as a minimum and supplements especially for iron, vitamin B12, vitamin D, and calcium should be added to this regimen based on regular blood testing.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. eaarts@alysis.nl
authors.forename: Edo O
authors.initials: EO
authors.lastname: Aarts
authors.forename: Ignace M C
authors.initials: IM
authors.lastname: Janssen
authors.forename: Frits J
authors.initials: FJ
authors.lastname: Berends
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003677:Deficiency Diseases / Q000209:etiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000172:deficiency*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D015431:Weight Loss; D055815:Young Adult
chemical_list: D018977:Micronutrients