What does fact checked mean?
At Healthfully, we strive to deliver objective content that is accurate and up-to-date. Our team periodically reviews articles in order to ensure content quality. The sources cited below consist of evidence from peer-reviewed journals, prominent medical organizations, academic associations, and government data.
- Pubmed Health: Ferritin
- Pubmed Health: Ferritin
- National Institutes of Health’s Office of Dietary Supplements: Dietary Supplement Fact Sheet: Iron
The information contained on this site is for informational purposes only, and should not be used as a substitute for the advice of a professional health care provider. Please check with the appropriate physician regarding health questions and concerns. Although we strive to deliver accurate and up-to-date information, no guarantee to that effect is made.
What Iron Supplements Can Gastric Bypass Patients Take?
A major complication after gastric bypass surgery is malnutrition caused by the smaller quantity of food consumed and the decreased ability to digest and absorb certain nutrients. It is recommended that individuals who have had gastric bypass take vitamin and mineral supplements every day for life to prevent malnutrition. Iron is one of the minerals affected by the surgery.
Iron Absorption
A study published in the "American Journal of Clinical Nutrition" in 2009 found that gastric bypass surgery reduces both iron absorption and iron status. Researchers followed 51 patients for 18 months after surgery. Iron absorption from both supplements and food at 6 months decreased to between 32.7 and 40.3 percent of the initial values, with little change by 18 months. Thirty-eight percent of subjects were anemic at 18 months compared with 1.5 percent initially.
- A study published in the "American Journal of Clinical Nutrition" in 2009 found that gastric bypass surgery reduces both iron absorption and iron status.
- Iron absorption from both supplements and food at 6 months decreased to between 32.7 and 40.3 percent of the initial values, with little change by 18 months.
Iron Status
How to Take Iron Supplements Before Surgery
Learn More
The serum ferritin level is directly related to the iron stores in the body and is a common test for anemia. Normal levels range between 12 to 150 ng/mL for women and 12 to 300 ng/mL for men. According to the National Institutes of Health, signs of low iron levels include feeling tired and weak; decreased performance; difficulty maintaining body temperature; decreased immune function; an inflamed tongue; and pica, a craving for non-nutritive substances such as ice, dirt and clay.
Supplements
Most physicians recommend taking an iron supplement after gastric bypass surgery in addition to the iron available in a multivitamin after solid food can be consumed. Ferrous fumarate and ferrous gluconate are available over the counter and are the most absorbable forms of iron, according to the West Penn Allegheny Health System 2. Iron and calcium supplements should be taken at least two hours apart. Vitamin C helps the body absorb iron, so iron should be taken with vitamin C supplements or foods that contain vitamin C, such as fruits and vegetables. Ask your doctor about recommended brands and amounts that are right for you. Supplements specifically formulated for bariatric patients are available.
- Most physicians recommend taking an iron supplement after gastric bypass surgery in addition to the iron available in a multivitamin after solid food can be consumed.
- Vitamin C helps the body absorb iron, so iron should be taken with vitamin C supplements or foods that contain vitamin C, such as fruits and vegetables.
Potential Side Effects
How Long Does Iron Stay in Your System?
Learn More
Large doses of iron can cause:
- gastrointestinal upset
- including nausea
- vomiting
- constipation
- diarrhea
- abdominal distress
Take iron with meals to increase absorption and prevent stomach upset. You may also find it beneficial to take the prescribed dose in two to three equally spaced doses because the Office of Dietary Supplements reports the amount of iron absorbed actually decreases with larger doses.
Related Articles
References
- National Institutes of Health’s Office of Dietary Supplements: Dietary Supplement Fact Sheet: Iron
- West Penn Allegheny Health System: Bariatric Surgery Dietary Guidelines
- Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–174.
- National Heart, Lung, and Blood Institute. Iron-Deficiency Anemia.
- Vaucher P, Druais PL, Waldvogel S, Favrat B. Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. CMAJ. 2012;184(11):1247-54. doi:10.1503/cmaj.110950
- Stugiewicz M, Tkaczyszyn M, Kasztura M, Banasiak W, Ponikowski P, Jankowska EA. The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications. Eur J Heart Fail. 2016;18(7):762-73. doi:10.1002/ejhf.467
- Cherayil BJ. The role of iron in the immune response to bacterial infection. Immunol Res. 2011;50(1):1–9. doi:10.1007/s12026-010-8199-1
- Jáuregui-lobera I. Iron deficiency and cognitive functions. Neuropsychiatr Dis Treat. 2014;10:2087-95. doi:10.2147/NDT.S72491
- Cleveland Clinic. How to Tell If You Have Iron Deficiency Anemia. Updated October 30, 2017.
- Murat S, Ali U, Serdal K, et al. Assessment of subjective sleep quality in iron deficiency anaemia. Afr Health Sci. 2015;15(2):621–627. doi:10.4314/ahs.v15i2.40
- Dosman CF, Brian JA, Drmic IE, et al. Children with autism: effect of iron supplementation on sleep and ferritin. Pediatr Neurol. 2007;36(3):152-8. doi:10.1016/j.pediatrneurol.2006.11.004
- Office of Dietary Supplements. Iron Fact Sheet for Health Professionals. Updated October 16, 2019.
Writer Bio
Based in Chapel Hill, N.C., Debra McKenzie has been writing since 2001. Her work has appeared in journals, including "JADA" and "Obesity Research," and in the textbook "Nutrition in the Prevention and Treatment of Disease." She holds a Master of Science in nutrition from University of Vermont and completed her dietetic internship at Meredith College.