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A 39-year-old female asked:

how to absorb more iron after having roux-n-y gastric bypass surgery since iron is absorbed in the beginning of your small intestines, which is bypassed after roux-n-y gastric bypass, where else can it be absorbed enough to keep your iron level up

3 doctor answers5 doctors weighed in
Dr. John Fung
Dr. John Fung answered
General Surgery 39 years experience
As : As you correctly states, the duodenum is the most efficient site for absorption of iron, and after roux-en-y gastric bypass, iron absorption and levels decrease. In women who are menstruating, iron deficiency can be seen in up to 50% of them. In men, iron deficiency occurs in 20%. Nevertheless, the remaining small intestine is able to absorb some iron if formulated in an appropriate manner, occasionally infusions of iron are required when severe iron deficiency occurs. The current recommendations are 40-60 mg/d of iron (as ferrous fumarate or gluconate 320 mg twice a day) with vitamin c (which increase iron absorption) for prevention. Your levels of iron should be monitored regularly after surgery.
Dr. Leon Katz
Dr. Leon Katz answered
Bariatrics 29 years experience
Generally : Generally the malabsorption seen after a roux-en-y lasts for about 18 months and eventually diminishes, so iron absorption will likely improve at around that time. If you simply can't get adequate iron, make sure your doctor looks at your ferritin level and not just hemoglobin level. You may indeed benefit from iron infusion or if you happen to be a premenopausal women with a heavy period, you may benefit from discussing birth control pills to help diminish the degree of bleeding that occurs each month with your menstrual cycle.
Dr. Brian Mirza
Bariatrics 29 years experience
Iron : Iron deficiency can be a problem following gastric bypass surgery, because iron is partially absorbed in the duodenum. The duodenum is bypassed along with the stomach. Iron deficiency can be a particular problem for women who lose blood (and thus iron) with their menses. It is recommended that all gastric bypass patients eat foods that are high in iron, and that iron and hemoglobin levels be checked once or twice a year. Daily iron supplement such as ferrous sulfate , carbonyl, or fumarate at a dose apropriate for their condition and calculated by treating phycisian. Iron absorption seems to be enhanced by adequate vitamin c intake.( and there are many available iron/ vitamin c combo products available. Seperating iron supplement from coffe, tea, calcium and multivitamins by 3 hours also helps inhancing iron absorption. Iron containing foods include: •meat, fish, and poultry •shellfish, especially oysters •dried beans and peas •leafy vegetables such as spinach and broccoli •dried fruits such as figs, raisins, apricots, and dates.

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Last updated Oct 3, 2016

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