6 Signs to Identify Iron Deficiency After Gastric Bypass

Iron Deficiency and Gastric Bypass.

Gastric Bypass and Iron Deficiency

As with any major surgery, gastric bypass is not without risks and side effects. Many Gastric Bypass (Bariatric) patients (about 50%) experience Iron Deficiency which is often connected to anemia. These 6 Signs could signal an Iron Deficiency after Gastric Bypass:

  1. Extreme Fatigue and Exhaustion
  2. Frequent Infections
  3. Pale Skin
  4. Swollen Tongue
  5. Pica
  6. Hair Loss

A 1998 study found that women were more than two times more likely than men to have an Iron Deficiency after Gastric Bypass surgery. In fact, Iron Deficiency can occur in more than half of women who are past menopause when they have this surgery.

When you have bariatric surgery, you will feel full sooner, meaning you’ll eat less, but it also affects how food is processed and the amount of nutrients including vitamins and minerals that your body absorbs.

Why Does This Happen?

The deficiency is caused by internal changes that are made in the body during surgery. During a gastric bypass procedure the small intestine (duodenum) is bypassed which is where we absorb Iron and other nutrients. The acids from our stomach take the Iron from the food we ingest and make it easier to absorb. Post-surgery, the stomach is smaller thus reducing the amount of acid it produces which in turn decreases iron absorption.

Check out this video to get a deeper perspective:

Another factor sometimes overlooked in bariatric patients is food intolerance. Specifically, many patients develop an aversion to red meat which is a significant source of iron. One study found that approximately forty percent of the gastric bypass subjects under review vomited after eating meat. (1) Another researcher discovered that half of his gastric bypass patients had a chronic distaste for meat following surgery. (2)

Iron comes in two forms: heme iron from animal sources and non-heme iron from plant sources. Heme iron is more readily absorbed by the blood cells. Therefore, eating animal proteins is your best source of iron from food. Fortified cereals, and dark leafy greens are also good non-heme choices. (3)

6 Signs to Identify Iron Deficiency After Gastric Bypass

Iron is important for the health of your hair, skin, and nails. It also helps make hemoglobin. This is the substance inside red blood cells that carries oxygen throughout your body. When you are anemic because of an Iron Deficiency, you may have these 6 signs:

1. Extreme Fatigue and Exhaustion: Fatigue is one of the most common signs of iron deficiency because it means your body is having trouble carrying the oxygen to your cells, so it’s affecting your energy levels.  When we lack iron in our bloodstream we often feel weak, unable to focus or extremely sluggish. However, fatigue can also be the sign of many other conditions, so be sure to have your doctor check your iron levels.

2. Frequent Infections: Low levels of iron can make someone more susceptible to infections since iron is critical to a healthy immune system. Red blood cells help to transport oxygen to the spleen, which is where we can fight off infections. The lymph nodes also consist of infection fighting white blood cells and red blood cells are responsible for carrying oxygen to them. When someone has an iron deficiency, the white blood cells aren’t being produced as well, and they’re not as strong because they’re not getting enough oxygen, making that person more susceptible to infections.

3. Pale Skin: The healthy, rosy glow our skin often has is the result of hemoglobin, so low levels may cause the skin to become pale. When there is not enough iron in our red blood cells, they become lighter and smaller and in turn, our skin becomes lighter. This may be easier to detect in people with lighter complexions, but no matter what your skin tone, if the area inside your bottom eyelid is lighter than normal, this may be a sign of iron deficiency.

4. Swollen Tongue: Soreness, swelling or abrasions on the tongue can be a sign of iron deficiency as well as cracks on the side of the mouth.

5. Pica: When people with severely depleted iron stores crave non-food items such as ice or dirt, this could be a clear sign of deficiency. However, giving in to your cravings and eating these substances could be harmful, as it may lead to the ingestion of harmful toxins and substances, as well as interfere with the absorption of other essential nutrients.

6. Hair Loss: This is common when it comes to anemia. If the hair follicles aren’t exposed to enough oxygen they may begin to fall out. This issue will not be resolved until the anemia has been reversed. If you notice your hair loss is excessive and it is not growing back, this may be a sign of iron deficiency.

Iron deficiency is one of the most common and most commonly overlooked micronutrient deficiency after bariatric surgery. When patients have only vague symptoms, or laboratory test results do not show absolute iron-deficiency anemia, it is often missed. Thus, it is critical that doctors order tests and interpret lab results carefully, so they can appropriately screen, diagnose, and treat iron deficiency after bariatric surgery. 

The routine laboratory tests to assess for iron deficiency should include complete blood count, ferritin, iron concentration, and total iron binding capacity that is used to calculate transferrin saturation. (4)

Consider Transdermal Supplementation

Iron supplementation can be a tricky business for those who are at risk of an iron deficiency. The standard 18 mg multivitamin may not be enough to prevent anemia if you have had this type of surgery and you will need to supplement if your iron is low post-surgery.

However, oral supplements can cause complications for many patients so  it’s best to take these supplements transdermally. PatchMD Iron Plus Topical Patches are an ideal choice for a transdermal and ultra bioavailable iron supplement alternative.

Click Here to Learn More About Patch MD Iron Plus Patches!

These patches are perfect for Bariatric Patients! Click here to see them on our website.


Thank you for taking the time to read 6 Signs to Identify Iron Deficiency After Gastric Bypass.

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