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Regarding severe bone loss after RNY



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Here is a link to the position paper of the American Society for Metabolic and Bariatric Surgery. https://asmbs.org/resources/metabolic-bone-changes-after-bariatric-surgery

The conclusions were:

Conclusion

  1. Obesity appears to be independently associated with Vitamin and mineral deficiencies involved in bone homeostasis affected by race and potentially affected by gender. These pre-existing Vitamin and mineral deficienciesmay compound postoperative absorption of bone homeostatic micronutrients depending on the type of weight loss surgery and degree of weight loss. Patients preparing for bariatric surgery should be screened for the presence of Vitamin D deficiency and hyperparathyroidism with treatment initiated.
  2. Cross sectional, retrospective, and prospective studies do not conclusively support any increased incidence of osteoporosis or increased fracture risk after bariatric surgery. Accuracy of current methods of assessing BMD (DXA) in patients who have extreme obesity as well as after extreme weight loss should be evaluated with further research. The use of one third distal forearm to measure BMD can be considered in situations of extreme weight that exceeds the limits of conventional DXA tables as well as in cases of secondary hyperparathyroidism related to malabsorption of Vitamin D and Calcium.
  3. The degree of bone turnover and BMD loss after bariatric surgery is related to the type of procedure performed, the amount and rate of weight loss, and the degree of malabsorption of other micronutrients and Protein. Long-term follow-up monitoring and supplementation should be provided according the type of procedure and the individual patient’s risk for bone loss.

Edited by Airstream88

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How much Calcium and Vitamin D do folks post sleeve take each day?


Sent from my iPhone using the BariatricPal App

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This is what you call an unreliable source. She has a degree in divinity and in massage therapy. She isn't even qualified to speak on this stuff. Look for peer reviewed sources written by scholars with nutrition and medicine credentials. This article is worthless.

Also it's laughable that the article mentions her being a member of the American Medical Writers association as if it credentials her -- anyone can become a member. Best of all, the website where this article is posted is selling  Calcium supplements! The author is trying to sell you a product. This is exactly why peer-reviewed scholarly sources are where we need to get our information when making decisions on our health.

The one good thing about this link is that the bottom has a list of articles from which the author claims she got her info (even though she doesn't properly cite them) and the articles themselves provide some insight (but not enough to be extremely worried -- maybe enough to be diligently adherent with Vitamin supplementation recommendations).

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Ps I take 4 Flintstones complete and 2 500mg Bariatric Advantage Chewy Bites (Strawberry) and Nascobal B12 nasal spray weekly. But I had RNY (this is the RNY forum).

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I was just told by my surgeon's nurse that they have a new policy for post surgical use of PPIs (proton pump inhibitors or what people may call antacids). Studies have shown that prolonged use of PPIs like omeprazole and pantoprazole can cause bone loss. So now instead of taking a PPI for one year post surgery we are to wean off the drug at 3 months postop. I'm trying to wean right now.


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I was just told by my surgeon's nurse that they have a new policy for post surgical use of PPIs (proton pump inhibitors or what people may call antacids). Studies have shown that prolonged use of PPIs like omeprazole and pantoprazole can cause bone loss. So now instead of taking a PPI for one year post surgery we are to wean off the drug at 3 months postop. I'm trying to wean right now.




I'm on pantoprazole. I'm having RNY next month but my doc didn't say anything about stopping it. They said I would keep on it. Is this something I should be overly concerned about? I'm 53. Osteoarthritis runs in my family.


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Well the concern is more about osteoporosis. The surgeons at Duke keep up with the most innovative treatment practices available and this seems to be the latest on use of PPIs and bone loss. If you want to research the concerns and request to stop the drug after 3 months that could be an option? Your surgeon could easily find this info for him or her self. I was really worried because I have been VERY dependent on PPIs for years prior to surgery, but I'm doing just fine without any now. I definitely wouldn't be worried enough to not have the surgery by a long shot. Good luck!

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