Bariatric Surgery and Vitamin D - many studies

---

18+ VitaminDWiki pages have BARIATRIC in the title

This list is automatically updated

---

Many Bariatric Surgeries reduce absorption of vitamins and minerals - including Vitamin D

---

Vitamin D both before and after Bariatric Surgery - up to 50,000 IU 3 times per week - 2017

Obesity and Bariatric Surgery: Ultimate Need for Vitamin D Supplementation
Biomed Pharmacol J 2017;10(3). https://dx.doi.org/10.13005/bpj/1220
Saeed Ali Alsareii1, Abdulhadi Mohamed Elbashir1 and Mohammed Helmy Faris Shalayel2

Obesity and morbid obesity comprise mounting serious health problems reaching epidemic ratios in many countries. The cause of low levels of serum 25-hydroxyvitamin D in obese individuals remains obscure although increasing number of the postulations including vitamin D sequestration in fat tissues, rendering it less bioavailable for transformation into calcitriol, and diminished sun exposure. Bariatric surgery is one of the most efficacious long-term weight reduction procedures. Patients who are submitted to bariatric surgery are at increased risk of vitamin D insufficiency (VDI) and deficiency (VDD) that are potentially correlated with skeletal and non-skeletal pathology. Nevertheless, there is no assent considering the favorable management for these events. The severity of vitamin D deficiency due to bariatric surgery is obviously linked to the modality of bariatric procedures implemented, weight loss rate, and the intensity of malabsorption of other micro- and macro-nutrients.
According to the Clinical Practice Guidelines (CPGs) on vitamin D supplementation in bariatric surgery, high doses of vitamin D supplementations, ranging from 3,000 IU daily to 50,000 IU 1 – 3 times weekly are strongly recommended. Nevertheless, they do not fulfill criteria for applicability. Patients programmed for bariatric surgery should be motivated to follow continuous physical activity, appropriate dietary habits, and vitamin D supplementations pre- and post-operatively.
 PDF printed from web

---

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: Best to have Vitamin D loading dose before or after any 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

---

Risk of divorce increases 2X in the 5 years after Bariatric Surgery - Nov 2023

 Download the Bloomberg PDF from VitaminDWiki

---

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: 204 trials for vitamin D intervention of obesity as of April 2025
• 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
• SPECULATION: Low vitamin D might be one of the causes of obesity – several studies
• 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 450 items

See also: Weight loss and Vitamin D - many studies   Child Obesity and Vitamin D - many studies   Obesity, Virus, and Vitamin D - many studies
Obese need more Vitamin D

• Normal weight     Obese     (50 ng = 125 nanomole)

Click here for 2014 study

---

VitaminDWiki – People with with poor digestion need gut-friendly Vitamin D

---

Bariatic Surgery reduces the risk of some Cancers - March 2024

Bariatric Surgery and Longitudinal Cancer Risk Jan 2024
doi:10.1001/jamasurg.2023.5809 PDF is behind a paywall
Discussed at MD Edge

Decreased Breast Cancer (vs those who remained obese)

Potential biases of the study

Study can be viewed on from DeepDyve You can try their excellent system for free for a few weeks.