Mrs X is a 52 year old female who had a Roux-en-Y Gastric bypass 18 months ago. During this time she has lost 10.5 stone and her BMI has dropped from 47.5 to 27. She is extremely pleased with the results however complains of excessive fatigue. Her GP took some blood samples and sent them off to test for iron deficiency. She is currently taking a multivitamin, calcium, iron and folic acid supplementation, despite this she has very low ferritin levels and is anaemic.
Background to mineral deficiencies post Roux-en-Y gastric bypass
The prevalence of vitamin and mineral deficiencies including iron varies depending on the type of bariatric surgery that has been performed, with minimal deficiencies in those with a gastric band and more common deficiencies in those with gastric by pass1. Due to Mrs X having a Roux-en-Y gastric bypass this is what this …show more content…
This is based on a study with a very small number of patients (n = 30). The majority of patients were women (25) which may skew the results due to a higher percentage of the normal female population being anaemic than men. The methodology of how anaemia is measured and using what reference ranges is not referred to which present a problem in how to apply these results to a wider population.
Cable8 in 2011 used a must larger study population (n=1009), but follow up was relatively poor at only 720 after 1 year. It showed anaemia had a prevalence of 36% at 12 months and the follow up at 2 years had dropped to 35.4% and therefore would highly likely to not be a fair estimation of prevalence due to other factors that encourage this population to maintain contact with the study clinicians. This is relevant to Mrs X as she was still seeking medical assistance after 18 months post surgery due to the anaemia related symptoms she was