Iron and Vitamin D/Calcium Deficiency after Gastric Bypass: Mechanisms Involved and Strategies to Improve Oral Supplement Disposition

2019 ◽  
Vol 20 (3) ◽  
pp. 244-252 ◽  
Author(s):  
Aisling Mangan ◽  
Carel W. Le Roux ◽  
Nana Gletsu Miller ◽  
Neil G. Docherty
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Treatment Strategies ◽  
Health Benefit ◽  
Calcium Deficiency ◽  
Vitamin D Supplementation ◽  
Absorption Capacity ◽  
Nutritional Deficiencies ◽  
Oral Supplement ◽  
Iron And Calcium

Background:Nutritional deficiencies are common following Roux-en-Y Gastric Bypass (RYGB). Aetiology is diverse; including non-compliance, altered diet, unresolved preoperative deficiency and differential degrees of post-operative malabsorption occurring as function of length of bypassed intestine. Iron and calcium/vitamin D deficiency occur in up to 50% of patients following RYGB. Currently, treatment strategies recommend the prescription of oral supplements for those who become deficient. Meanwhile, debate exists regarding the absorption capacity of these post-operatively and their efficacy in treating deficiency.Objective:To examine the disposition of oral iron and calcium/vitamin D supplementation following RYGB. Methods: A literature review was carried out using PubMed and Embase. Data from the key interventional studies investigating iron and calcium/vitamin D oral supplement absorption and efficacy following RYGB was summarized.Results:Absorption of both iron and vitamin D/calcium is adversely affected following RYGB. Distribution and metabolism may be altered by the predominance of paracellular absorption pathways which promote unregulated influx into the circulatory system. Overall, studies indicate that current supplementation strategies are efficacious to a degree in treating deficiency following RYGB, generally restoration of optimal status is not achieved.Conclusion:Oral supplement disposition is altered following RYGB. As a result, patients are required to take regimens of oral supplementation indefinitely. The dosage which confers optimum health benefit while avoiding potential toxicity and tolerability issues remains unknown. Novel preparations with improved disposition could help limit the extent of post-RYGB nutritional deficiencies.

scholarly journals VITAMIN D DEFICIENCY AND PARATOHOMMONIUM INCREASE IN LATE POSTOPERATIVE GASTRIC BYPASS IN ROUX-EN-Y

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Daniela Vicinansa MÔNACO-FERREIRA ◽  
Vânia Aparecida LEANDRO-MERHI ◽  
Nilton César ARANHA ◽  
Andre BRANDALISE ◽  
Nelson Ary BRANDALISE
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Calcium Metabolism ◽  
Calcium Deficiency ◽  
Ionized Calcium ◽  
Nutritional Deficiencies ◽  
Biochemical Tests

ABSTRACT Background : Roux-en-Y gastric bypass patients can experience changes in calcium metabolism and hyperparathyroidism secondary to vitamin D deficiency. Aim : To evaluate nutritional deficiencies related to the calcium metabolism of patients undergoing gastric bypass with a 10-year follow-up. Method : This is a longitudinal retrospective study of patients submitted to Roux-en-Y gastric bypass at a multidisciplinary clinic located in the Brazilian southeast region. The study investigated the results of the following biochemical tests: serum calcium, ionized calcium, vitamin D, and parathormone (PTH). The generalized estimating equations (GEE) determined the nutritional deficiencies using a significance level of 5%. Results : Among the patients who finished the study (120 months), 82.86% (n=29) had vitamin D deficiency, and 41.94% (n=13) had high PTH. Postoperative time had a significant effect on PTH (p=0.0059). The percentages of patients with vitamin D, serum calcium, and ionized calcium deficiencies did not change significantly over time. Conclusion : One of the outcomes was vitamin D deficiency associated with secondary hyperparathyroidism. These findings reaffirm the importance of monitoring the bone metabolism of patients submitted to Roux-en-Y gastric bypass. HEADINGS: Calcium deficiency. Vitamin D deficiency. Secondary hyperparathyroidism.

scholarly journals Osteoporosis in Patients with Chronic Kidney Diseases: A Systemic Review

2020 ◽  
Vol 21 (18) ◽  
pp. 6846 ◽  
Author(s):  
Chia-Yu Hsu ◽  
Li-Ru Chen ◽  
Kuo-Hu Chen
Keyword(s):  
Vitamin D ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Renal Osteodystrophy ◽  
Bone Structure ◽  
Kidney Diseases ◽  
Treatment Strategies ◽  
Vitamin D Supplementation ◽  
Systemic Review ◽  
Lifestyle Modifications

Chronic kidney disease (CKD) is associated with the development of mineral bone disorder (MBD), osteoporosis, and fragility fractures. Among CKD patients, adynamic bone disease or low bone turnover is the most common type of renal osteodystrophy. The consequences of CKD-MBD include increased fracture risk, greater morbidity, and mortality. Thus, the goal is to prevent the occurrences of fractures by means of alleviating CKD-induced MBD and treating subsequent osteoporosis. Changes in mineral and humoral metabolism as well as bone structure develop early in the course of CKD. CKD-MBD includes abnormalities of calcium, phosphorus, PTH, and/or vitamin D; abnormalities in bone turnover, mineralization, volume, linear growth, or strength; and/or vascular or other soft tissue calcification. In patients with CKD-MBD, using either DXA or FRAX to screen fracture risk should be considered. Biomarkers such as bALP and iPTH may assist to assess bone turnover. Before initiating an antiresorptive or anabolic agent to treat osteoporosis in CKD patients, lifestyle modifications, such as exercise, calcium, and vitamin D supplementation, smoking cessation, and avoidance of excessive alcohol intake are important. Managing hyperphosphatemia and SHPT are also crucial. Understanding the complex pathogenesis of CKD-MBD is crucial in improving one’s short- and long-term outcomes. Treatment strategies for CKD-associated osteoporosis should be patient-centered to determine the type of renal osteodystrophy. This review focuses on the mechanism, evaluation and management of patients with CKD-MBD. However, further studies are needed to explore more details regarding the underlying pathophysiology and to assess the safety and efficacy of agents for treating CKD-MBD.

Calcium and Vitamin D Supplementation after Gastric Bypass Should Be Individualized to Improve or Avoid Hyperparathyroidism

2010 ◽  
Vol 20 (6) ◽  
pp. 738-743 ◽  
Author(s):  
Lilliam Flores ◽  
M. Jesús Martínez Osaba ◽  
Alba Andreu ◽  
Violeta Moizé ◽  
Lucía Rodríguez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Vitamin D Supplementation

Correlation between vitamin D levels and hard-to-heal wounds: a systematic review

2020 ◽  
Vol 29 (Sup7) ◽  
pp. S24-S30 ◽  
Author(s):  
Karen Smith ◽  
Susan Hewlings
Keyword(s):  
Vitamin D ◽  
Financial Burden ◽  
Vitamin D Supplementation ◽  
Nutritional Deficiencies ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Venous Ulcers ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D ◽  
The Relationship

Objective: Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. Method: PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. Results: A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Conclusion: Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.

scholarly journals A Review on Vitamin D Deficiency Treatment in Pediatric Patients

2013 ◽  
Vol 18 (4) ◽  
pp. 277-291 ◽  
Author(s):  
Ji Yeon Lee ◽  
Tsz-Yin So ◽  
Jennifer Thackray
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Pediatric Patients ◽  
Calcium Absorption ◽  
Pediatric Population ◽  
Vitamin D Supplementation ◽  
The Body ◽  
Nutritional Deficiencies ◽  
Bone Demineralization ◽  
Symptomatic Hypocalcemia

Vitamin D is essential for calcium absorption and for maintaining bone health in the pediatric population. Vitamin D deficiency may develop from nutritional deficiencies, malabsorption, enzyme-inducing medications, and many other etiologies. It may present as hypocalcemia before bone demineralization at periods of increased growth velocity (infancy and adolescence) because the increased calcium demand of the body cannot be met. In children, inadequate concentrations of vitamin D may cause rickets and/or symptomatic hypocalcemia, such as seizures or tetany. In this review, we will discuss the pharmacology behind vitamin D supplementation, laboratory assessments of vitamin D status, current literature concerning vitamin D supplementation, and various supplementation options for the treatment of vitamin D deficiency in the pediatric population.

scholarly journals IMPACT OF VITAMIN D AND CALCIUM DEFICIENCY IN THE BONES OF PATIENTS UNDERGOING BARIATRIC SURGERY: A SYSTEMATIC REVIEW

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 120-123 ◽  
Author(s):  
Jefry Alberto Vargas CABRAL ◽  
Gabriela Pereira de SOUZA ◽  
Juliana de Almeida NASCIMENTO ◽  
Luis Fernando SIMONETI ◽  
Carolina MARCHESE ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Vitamin D ◽  
Bone Fractures ◽  
Calcium Deficiency ◽  
Nutritional Deficiencies ◽  
Increased Risk ◽  
Fat Soluble Vitamins ◽  
And Control ◽  
The Impact

ABSTRACT Introduction: Bariatric surgery is considered the most effective tool in the control and treatment of severe obesity, but patients undergoing this procedure are at increased risk of developing nutritional deficiencies by limiting the intake and absorption of many nutrients. Objective: To assess the impact of vitamin D deficiency and calcium in bone in patients after gastric bypass in Roux-en-Y, pointing directly at the type of administration, doses and effects after surgery. Method: Was conducted a systematic review with articles related to the topic of the last 10 years searched in PubMed (US National Library of Medicine National Institutes of Health, Medline, Lilacs, Scielo and Cochrane using the headings "bariatric surgery", "bone", "obesity", "vitamin D '', "calcium" AND "absorption". Exclusion criteria to research on animals, smokers, pregnant women and patient treated with bisphosphonates. Results: Five articles were included in this review. All refer that bariatric surgery can lead to nutritional deficiencies and poor absorption of fats and fat-soluble vitamins and other micronutrients such as calcium. Conclusion: Patients submitted to RYGB should make use of multivitamins and minerals especially vitamin D and calcium to prevent bone fractures. Monitoring, treatment and control of risk factors are essential to prevent complications after this operation.

Correlation between vitamin D levels and hard-to-heal wounds: a systematic review

2021 ◽  
Vol 30 (Sup6) ◽  
pp. S4-S10
Author(s):  
Karen Smith ◽  
Susan Hewlings
Keyword(s):  
Vitamin D ◽  
Financial Burden ◽  
Vitamin D Supplementation ◽  
Nutritional Deficiencies ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Venous Ulcers ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D ◽  
The Relationship

Objective: Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. Method: PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. Results: A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Conclusion: Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.

scholarly journals High dose vitamin D supplementation does not rescue bone loss following Roux-en-Y gastric bypass in female rats

Bone ◽  
2019 ◽  
Vol 127 ◽  
pp. 172-180 ◽  
Author(s):  
Aidi Niu ◽  
Thomas O. Carpenter ◽  
Jayleen M. Grams ◽  
Shahab Bozorgmehri ◽  
Steven M. Tommasini ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Bone Loss ◽  
Vitamin D Supplementation ◽  
Female Rats ◽  
High Dose ◽  
High Dose Vitamin

Vitamin D supplementation in pregnancy, lactation and infancy: why is it fundamental?

2020 ◽  
Vol 28 (5) ◽  
pp. 315-322
Author(s):  
Suma Uday ◽  
Jessica Bowie ◽  
Wolfgang Högler
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Calcium Absorption ◽  
Calcium Deficiency ◽  
Vitamin D Supplementation ◽  
Food Sources ◽  
Dietary Calcium Intake ◽  
Stunted Growth ◽  
Fortified Food ◽  
Bone Mineralisation

Vitamin D is mainly made in the skin following exposure to sunlight but can also be taken in via specific natural or fortified food sources. It is essential for intestinal calcium absorption and thereby bone mineralisation. Deficiency in vitamin D, or low dietary calcium intake, therefore results in defective bone mineralisation causing osteomalacia in children and adults and rickets in growing children. The leading causes of rickets and osteomalacia worldwide are solar vitamin D deficiency and/or nutritional calcium deficiency. Long-standing severe vitamin D deficiency can lead to craniotabes, large fontanelle, leg bowing, stunted growth and obstructed labour. The deficient state in the infant is almost always acquired from the mother. Therefore, robust antenatal and infant vitamin D supplementation programmes are obligatory to prevent complications. Conversely, lack of programme monitoring and conflicting recommendations can lead to confusion among healthcare professionals and poor uptake in the population. Factors shown to improve adherence to supplementation include universal supplementation of breast- and bottle-fed infants, monitoring supplementation at antenatal/postnatal healthcare visits, providing information to families at discharge from the neonatal unit and financial family support.

2299 INCREASING DOSES OF VITAMIN D SUPPLEMENTATION ARE ASSOCIATED WITH DECREASED RISK OF NEPHROLITHIASIS IN POST GASTRIC BYPASS SURGERY

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Patrick Scheffler ◽  
Mark Dunn ◽  
Nicolas V. Christou ◽  
Ross E. Andersen ◽  
Sero Andonian
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Vitamin D Supplementation
Sign in / Sign up

Export Citation Format

Share Document