Iron Deficiency After Gastric Bypass Surgery - My Bariatric Life

Patient Expert

Iron deficiency is a problem for fifty percent of those who have had gastric bypass surgery and is connected to anemia in one third of the cases. A 1998 study found that women were more than two times more likely than men to have an iron deficiency after weight loss surgery.

Women who are pregnant or having heavy menstruation are most susceptible.

Iron is a critical part of the hemoglobin that carries oxygen in red blood cells. Lack of iron will lessen the production of hemoglobin and cause anemia.

Causes of  Iron Deficiency After Gastric Bypass Surgery

Iron deficiency can occur after gastric bypass surgery because the duodenum is bypassed in the procedure. Iron is partially absorbed in the duodenum. Stomach acids draw iron from food and make it more easy to absorb. The small stomach pouch that has been created reduces the amount of acid that is produced which in turn decreases iron absorption.

Iron deficiency begins with the exhaustion of stored iron. A diagnosis can be made via blood testing. A low ferritin level in the blood signals a drain of stored iron.

Annual screening for iron deficiency and anemia should be part of the bariatric patient's post-surgery maintenance.

Meat intolerance is another factor that contributes to iron deficiency. Many patients who have had weight loss surgery 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. Another researcher discovered that a full half of his gastric bypass patients had a chronic distaste for meat following surgery.


In some instances patients develop pica, an eating disorder characterized by compulsive cravings to eat nonfood items such as ice or clay.

What Is Anemia?

Anemia is a medical condition that occurs when blood does not have enough healthy red blood cells. Red blood cells bring oxygen to organs and, if these cells also lack hemoglobin, then the body does not get enough oxygen.

There are over four different types of anemia. Iron deficiency anemia is the most common type of anemia. Symptoms of iron deficiency anemia are paleness, fatigue, and general weakness. It can develop gradually and go unnoticed for an extended time.

Other symptoms that have been reported are constipation, drowsiness, palpitations, and depression.

How Is Iron Deficiency After Gastric Bypass Surgery Addressed?

Supplements of iron are use to treat the iron deficiency that can follow weight-loss surgery. Oral supplements are prescribed most often along with vitamin C to increase absorption. Five hundred milligrams daily can be adequate.

Side effects from the high dosage of iron that is needed after gastric bypass can include nausea, heartburn, diarrhea or constipation. Should oral supplements prove ineffective then intravenous iron can be administered at a hospital. Side effects can include chills, rashes, and body aches.

Foods containing iron are organ meats, shellfish, whole grain products, leafy vegetables, and dried fruits.

Oral iron supplements that are taken after Roux-en Y gastric bypass have been found to prevent iron deficiency in women who are menstruating, although anemia still presented in instances.

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