Specialized Multivitamin Supplementation is Needed After Roux-en-Y Gastric Bypass Surgery

Abstract

Roux-en-Y gastric bypass (RYGB) leads to a restricted absorption and decreased intake of nutrients making these patients very vulnerable for the development or worsening of nutritional deficiencies. The present study evaluates the effectiveness of supplementation with a specialized Multivitamin (MVM) in comparison with a standard multivitamin. An open label, randomized, 12 month study was conducted comparing a specialized multivitamin in combination with 1000 mg Calcium, 1000 IU vitamin D and 28 mg elemental iron for premenopausal women (<45y) with a standard multivitamin supplement. Severe vitamin D deficiencies were treated in both groups with a drinkable ampule of 25.000 IU vitamin D. In total 145 patients underwent a RYGB of which 91 patients participated in the intervention group (specialized MVM) and 54 in the control group (standard MVM). The intervention group was analyzed prospectively while the standard group was analyzed retrospectively. Baseline characteristics were similar for both groups. Per protocol analysis demonstrated significant higher serum Vitamin B12 levels (p<0.001) for the intervention group. The control group even had a significant reduction of vitamin B12 concentrations over time (p<0.001). In addition, the intervention group showed higher vitamin D levels after surgery, even higher than the control group (p<0.001), although more patients received the D-cure in the control group (45% at 4 months and 26% at 7 months in comparison with 9% and 11% for the intervention group). To conclude, a specialized MVM with adjusted doses of vitamins and minerals is needed to resolve and/or prevent deficiencies after RYGB, especially vitamin B12 and vitamin D.