Baricol / News Archive / Why do I need so much Vitamin B12 after WLS?
Hand holding blister pack of vitamins vitamin B12 after WLS

Why do I need so much Vitamin B12 after WLS?

You’ve heard that you need to take vitamins and minerals after bariatric surgery.  Hopefully you’ve also heard that a regular old vitamin and mineral supplements just don’t cut it. This is because your body digests and absorbs certain nutrients less efficiently than before surgery. One of those most affected is Vitamin B12. Keep reading to learn about why taking Vitamin B12 after WLS is so important.

How does WLS affect B12 absorption?

Whether you’ve had a bypass and a sleeve, you need to supplement Vitamin B12. The reason for this is that the amount of both hydrochloric acid (HCl) and a protein called Intrinsic Factor (IF) are greatly reduced after both procedures.  The HCl is needed to convert B12 into a usable form. The IF is needed to activate B12 to make it absorbable. Given the lack of HCl and IF after WLS, you need a megadose of at least 350mcg of Vitamin B12 daily for your body to absorb enough to keep you healthy. 

Do I need Vitamin B12 after WLS even if my blood work is good or even high?

Most people will have normal levels of B12 in their blood even without supplementing – for about 2-4 years that is. That’s about how long the vitamin B12 stored in your liver will last.  The amount of B12 you have stored combined with taking high doses of B12 can cause higher than normal levels in your bloodwork. Because of this, some providers that may not have experience working with patients who have had WLS say to stop taking your B12 supplement. This may seem reasonable at first. However, given that many people have a hard time taking their supplements anyway, the risk of B12 deficiency after WLS far outweighs the risk of toxicity. 

What are the symptoms of Vitamin B12 deficiency? 

Symptoms of Vitamin B12 deficiency include: 

  • Lack of energy
  • Extreme tiredness
  • Pins and needles sensation  
  • Sore, red tongue
  • Mouth ulcers
  • Muscle weakness
  • Psychological problems such as confusion, memory loss, or depression 
  • Nerve damage

Vitamin B12 deficiency can be corrected, but it needs to be caught early so that the symptoms (like nerve damage) don’t become permanent. Therefore, you need to take your daily B12 (like you find in Baricol of course) and have your bloods tested at least once a year. Not sure which labs you need? We have the answer!  

Masked B12 deficiency: another reason to do your bloodwork! 

High doses of folic acid (folate) of 800mcg or more can mask a B12 deficiency. How? In a typical B12 deficiency, your blood cells are larger than normal. With excess folate, they are normal in size regardless. In addition, deficiencies in folate and B12 have the same symptoms.  That’s why it is important to have your bloodwork done (namely folate, B12, and ferritin in this case) to determine the causes of symptoms before determining a remedy.   If there were a situation where both B12 and folate here low, we always correct Vitamin B12 first since treatment with folic acid alone risks worsening the neurological symptoms.

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