Abstract | BACKGROUND: METHODS: To identify the relevant literature, a systematic review of MEDLINE was conducted from the earliest dates through September 2012 for English-language articles describing the prevention and management of vitamin B12 deficiency in patients undergoing bariatric surgery. RESULTS: Intramuscular vitamin B12 continues to be the gold standard of therapy for vitamin B12 deficiency, especially in symptomatic patients. In select patients with asymptomatic vitamin B12 deficiency after Roux-en-Y gastric bypass (RYGB), high-dose oral cyanocobalamin should be given a consideration, especially when there are concerns with the adherence to intramuscular therapy or if compliance comes into question. Unlike patients post-RYGB, those undergoing restrictive procedures such as gastric banding and sleeve gastrectomy may be maintained postoperatively on a lower-dose daily vitamin B12 supplementation. Efficacy data of nasal and sublingual routes for maintenance therapy is currently awaited. CONCLUSION: Patients undergoing bariatric surgery must be continuously educated on proper nutrition, the risk of developing significant vitamin B12 deficiency, and the role of supplements in avoiding catastrophic consequences.
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Authors | Shounak Majumder, Jose Soriano, Allan Louie Cruz, Constantin A Dasanu |
Journal | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
(Surg Obes Relat Dis)
2013 Nov-Dec
Vol. 9
Issue 6
Pg. 1013-9
ISSN: 1878-7533 [Electronic] United States |
PMID | 24091055
(Publication Type: Comparative Study, Journal Article, Review, Systematic Review)
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Copyright | Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Bariatric Surgery
(adverse effects, methods)
- Body Mass Index
- Dose-Response Relationship, Drug
- Female
- Follow-Up Studies
- Humans
- Injections, Intramuscular
- Male
- Middle Aged
- Obesity, Morbid
(diagnosis, surgery)
- Practice Guidelines as Topic
- Treatment Outcome
- Vitamin B 12
(therapeutic use)
- Vitamin B 12 Deficiency
(drug therapy, etiology, physiopathology)
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