I just read an interesting ASMBS article on WLS and metabolic bone changes "Metabolic bone changes after bariatric surgery" located here:

https://asmbs.org/resources/metabolic-bone-changes-after-bariatric-surgery

People should consider taking their recommended Calcium, Vitamin D and other supplements and get periodic blood tests (although blood tests may not always be conclusive; a different article I read).

As with any supplements you should consult your PCP and/or surgeon since there are medical conditions that could arise from taking larger doses and people may have other medical conditions that can be affected by these or are taking certain meds that can be affected (absorption of these supplements or their meds, etc.).

interesting that they don't recommend periodic bone scans after RNY. My surgeon said given my age, he'd recommend that. Maybe it's different with older people - or maybe he's not quite up on the research.

Anyone that is older is at a higher risk of bone density changes. Also, women are more prone to bone changes. The main take home point is: make sure to stay up on your Vitamins including calcium and Vit D, and stay in touch with your weight loss team.

I recently had my first DEXA scan the week for fat and lean mass measurement. I will have one every 4 months or so for fat and lean mass. I will be paying close attention to any changes in my bone mass.

It seems like the recommendations for RNY gastric bypass and Duodenal Switch surgery patients appear to be those that my surgeon follows.

Supplementation after gastric bypass should include calcium citrate 1,200–1,500 mg/d, which can be taken in 2–3 split doses, 4–5 hours apart for optimal absorption. Minimum Vitamin D intake of 3000 IU/d, titrate to >30 nl/mL. Calcium citrate is preferable to calcium carbonate due to better absorption in the absence or reduction of gastric acid. Supplementation after BPD and BPD/DS should include calcium of 1800–2400 mg/d and minimum Vitamin D 3000 IU/d, titrate to >30 nl/mL.

After RNY and Duodenal Switch, there are a lot of Vitamins required daily. The calcium tablets are a major inconvenience because they taste terrible (just like eating chalk), must be spaced apart throughout the day and one has to take so many of them. As a result, I had one individual in our bariatric support group meeting say they were no longer going to take Calciums. I even cut mine back a little. But when I had my annual blood tests, they found I was on the low side and recommended that I take more Calcium. THEY GOT ME. I WAS CAUGHT. So I went back to their required dosage rates. I guess the main point is that after these types of surgery, the requirement to take supplements span for the rest of our lives - PERIOD, NO EXCEPTIONS.

I have to increase my calcium ugh....will try to get liquid calcium.I must say,this is a good article.I also need to increase my vitamin D.Thanks for posting it.Very helpful.

My Bariatric team had me get a bone density scan as a baseline and intends to repeat periodically to watch for bone complications.

Interesting. I tested low on D for a decade before WLS even with supplementation. 4 years post sleeve and D has been in the good range p, and yes I still supplement.