From the Guidelines
For a patient with a history of bariatric surgery and vitamin A deficiency, the recommended dosage is 10,000 IU (3000 μg) oral vitamin A daily, which can be adjusted as necessary. This recommendation is based on the British Obesity and Metabolic Surgery Society guidelines, which suggest starting with this dose, especially for patients who have undergone malabsorptive procedures such as BPD/DS 1. The patient's current level of 35 indicates a deficiency, and supplementation is necessary to prevent symptoms such as deterioration in night vision and dry eyes.
Key considerations for vitamin A supplementation in patients with bariatric surgery include:
- Starting with a daily dose of 10,000 IU (3000 μg) oral vitamin A, as recommended by the guidelines 1
- Adjusting the dose as necessary based on the patient's response and vitamin A levels
- Monitoring vitamin A levels regularly, ideally every 3-6 months until stable, then annually
- Taking supplements with food containing some fat to enhance absorption, as vitamin A is fat-soluble
- Being aware of the potential for toxicity from excessive supplementation and adjusting the dosage under medical supervision if symptoms of deficiency persist.
It is essential to note that the type of bariatric surgery performed can impact the absorption of fat-soluble vitamins, including vitamin A, and may require additional routine oral vitamin A supplementation, especially if symptoms are present 1.
From the Research
Vitamin A Dosage for Patients with Bariatric Surgery
The recommended vitamin A dosage for a patient with a history of bariatric surgery and vitamin A deficiency is not explicitly stated in the provided studies. However, the studies suggest that vitamin A deficiency is a significant post-operative complication that can lead to visual impairment and other ocular complications.
Key Findings
- Vitamin A deficiency can occur after bariatric surgery, particularly after malabsorptive procedures such as gastric bypass 2, 3.
- The deficiency can lead to visual impairment, night blindness, and other ocular complications 2, 3, 4.
- The prevalence of vitamin A deficiency can be high after bariatric surgery, with one study reporting a prevalence of 33% at 6 months post-operatively 5.
- African American patients and those with higher pre-operative body mass index (BMI) may be at increased risk of vitamin A deficiency 5.
Treatment and Prevention
- Treatment with intramuscular vitamin A replacement can lead to near complete recovery of vision in patients with vitamin A deficiency 2.
- Prompt diagnosis and treatment of vitamin A deficiency are essential to prevent irreversible blindness and other complications 3, 4.
- Patients undergoing bariatric surgery should be educated on the importance of vitamin supplementation to prevent vitamin A deficiency and other micronutrient deficiencies 3, 6.
Note: There is no specific dosage of vitamin A mentioned in the provided studies for patients with bariatric surgery and vitamin A deficiency.