Bariatric Surgery and Vitamin D - many studies

---

Most people need >2,000 IU of vitamin D before and after Bariatric Surgery - meta-analysis Sept 2023

Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis
Rev Endocr Metab Disord. 2023 Sep 4. doi: 10.1007/s11154-023-09831-3
Andrea Giustina 1, Luigi di Filippo 2, Antonio Facciorusso 3, Robert A Adler 4, Neil Binkley 5, Jens Bollerslev 6, Roger Bouillon 7, Felipe F Casanueva 8, Giulia Martina Cavestro 9, Marlene Chakhtoura 10, Caterina Conte 11, Lorenzo M Donini 12, Peter R Ebeling 13, Angelo Fassio 14, Stefano Frara 2, Claudia Gagnon 15, Giovanni Latella 16, Claudio Marcocci 17, Jeffrey I Mechanick 18, Salvatore Minisola 19, René Rizzoli 20, Ferruccio Santini 21, Joseph L Shaker 22, Christopher Sempos 23, Fabio Massimo Ulivieri 2, Jyrki K Virtanen 24, Nicola Napoli 25 26, Anne L Schafer 27, John P Bilezikian 28

Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management.
Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL.
After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily).
Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. Regardless of the type of procedure, high-dose supplementation is recommended in patients after bariatric surgery.
 Download the PDF from VitaminDWiki

---

Note: Should start with loading doses both before and after the surgery

A Loading dose will provide benefit in weeks instead of 5+ months
Probably also need Gut-Friendly Vitamin D as there is poor gut absorption after bariatric surgery

---

The Effect of Vitamin D Adequacy on Thyroid Hormones and Inflammatory Markers after Bariatric Surgery - 2023

Hormones and Inflammatory Markers after Bariatric Surgery. Metabolites 2023,13, 603. https://doi.org/10.3390/ metabo13050603

Roberta França h2, Adryana Cordeiro cordeiroadryana at gmail.com, Silvia Elaine Pereira 2,:3, Carlos José Saboya 3 and Andrea Ramalho 2,4

1. Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-598, Brazil
2. Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
3. Multidisciplinary Center of Bariatric and Metabolic Surgery Carlos Saboya, Rio de Janeiro 22280-020, Brazil
4. Department of Social Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil

Vitamin D status affects the clinical and corporal outcomes of postoperative patients who undergo a Roux-en-Y gastric bypass (RYGB). The aim of this study was to evaluate the effect of adequate vitamin D serum concentrations on thyroid hormones, body weight, blood cell count, and inflammation after an RYGB. A prospective observational study was conducted with eighty-eight patients from whom we collected blood samples before and 6 months after surgery to evaluate their levels of 25-hydroxyvitamin D 25(OH)D, thyroid hormones, and their blood cell count. Their body weight, body mass index (BMI), total weight loss, and excess weight loss were also evaluated 6 and 12 months after surgery. After 6 months, 58% of the patients achieved an adequate vitamin D nutritional status. Patients in the adequate group showed a decrease in the concentration of thyroid-stimulating hormone (TSH) (3.01 vs. 2.22 pUI/mL, p = 0.017) with lower concentrations than the inadequate group at 6 months (2.22 vs. 2.84 pUI/mL, p = 0.020). Six months after surgery, the group with vitamin D adequacy showed a significantly lower BMI compared with the inadequate group at 12 months (31.51 vs. 35.04 kg/m2, p = 0.018). An adequate vitamin D nutritional status seems to favor a significant improvement in one's thyroid hormone levels, immune inflammatory profile, and weight loss performance after an RYGB.
 Download the PDF from VitaminDWiki

---

Obesity is associated with low Vitamin D (and treated by D as well) – Aug 2019 has the following

Fast weight loss by Obese Adults: Summary of the data as of Sept 2019
1) 50,000 IU Vitamin D weekly for at least 6 months
   If gut problems, should use a gut-friendly form of vitamin D
2) Add calorie restriction diet and light exercise after ~2 months*
   * Vitamin D levels must be above 30ng/ml to help with weight loss
   * Start losing weight 2 months sooner if take a 50,000 IU daily for a week
3) More weight loss if also add Magnesium or cofactors
   30% Improved Vitamin D response with Magnesium - a Vitamin D Cofactor
   Note: Magnesium reduces weight loss by itself as well
   20% improved vitamin D response if also add Omega-3 a Vitamin D Cofactor
  Note: Omega-3 reduces weight loss by itself as well
4) More weight loss if also improve activation of Vitamin D Receptor
   Vitamin D Receptor activator: 0-30% improved Vitamin D response
   Obesity 1.5 X more likely if poor Vitamin D Receptor – meta-analysis Nov 2019
Update Dec 2019 - Dr. Greger plant-based eating (not diet) for both weight loss and health.
  His book does not mention Vitamin D nor Adenovirus

---

14+ VitaminDWiki pages with BARIATRIC in title

This list is automatically updated

---

VitaminDWiki – Overview Obesity and Vitamin D contains

• FACT: People who are obese have less vitamin D in their blood
• FACT: Obese need a higher dose of vitamin D to get to the same level of vit D
• FACT: When obese people lose weight the vitamin D level in their blood increases
• FACT: Adding Calcium, perhaps in the form of fortified milk, often reduces weight
• FACT: 168 trials for vitamin D intervention of obesity as of Dec 2021
• FACT: Less weight gain by senior women with > 30 ng of vitamin D
• FACT: Dieters lost additional 5 lbs if vitamin D supplementation got them above 32 ng - RCT
• FACT: Obese lost 3X more weight by adding $10 of Vitamin D
• FACT: Those with darker skins were more likely to be obese Sept 2014
• OBSERVATION: Low Vitamin D while pregnancy ==> more obese child and adult
• OBSERVATION: Many mammals had evolved to add fat and vitamin D in the autumn
  • and lose both in the Spring - unfortunately humans have forgotten to lose the fat in the Spring
• SUGGESTION: Probably need more than 4,000 IU to lose weight if very low on vitamin D due to
    risk factors such as overweight, age, dark skin, live far from equator,shut-in, etc.
• Obesity category has 409 items