From the Guidelines
Patients who have undergone gastric bypass surgery do not typically develop hypophosphatasia (low alkaline phosphatase levels) 5 years post-operatively. While gastric bypass surgery can lead to various metabolic changes and nutritional deficiencies, low ALP levels are not a commonly reported long-term outcome. The primary concerns post-bypass include issues with calcium and vitamin D metabolism, which can lead to elevated ALP levels as the body attempts to compensate for bone mineral loss, as noted in a study on nutritional recommendations for adult bariatric surgery patients 1. Post-bypass patients should undergo regular monitoring of multiple metabolic parameters, including:
- Calcium
- Vitamin D
- Parathyroid hormone
- Alkaline phosphatase If low ALP levels are detected, this would be unusual and might indicate a separate condition unrelated to the bypass surgery itself. The metabolic changes after gastric bypass primarily relate to altered absorption in the reconfigured digestive tract, particularly affecting fat-soluble vitamins and minerals, but hypophosphatasia specifically is not a recognized complication of this procedure at the 5-year mark or beyond, according to the clinical practice guidelines published in Advances in Nutrition 1.
From the Research
Gastric Bypass and ALP Levels
- The relationship between gastric bypass surgery and Alkaline Phosphatase (ALP) levels is not directly addressed in the provided studies, but we can look at related information on nutrient absorption and bone health after gastric bypass surgery.
- Studies have shown that gastric bypass surgery can lead to malabsorption of essential nutrients, including calcium and vitamin D 2, 3, 4.
- One study found that vitamin D deficiency and elevated parathyroid hormone (PTH) levels are common after gastric bypass surgery and can progress over time 5.
- Another study found that alkaline phosphatase levels were elevated in 40.3% of patients after gastric bypass surgery and correlated with PTH levels 5.
- However, none of the studies directly address the issue of low ALP levels in patients who have undergone gastric bypass surgery 5 years after the procedure.
Bone Health and Nutrient Absorption
- Gastric bypass surgery can have negative effects on bone health, including decreased calcium absorption and increased bone turnover 2, 5.
- Studies have shown that calcium and vitamin D supplementation can help improve bone health after gastric bypass surgery, but individualized supplementation may be necessary 3, 4.
- Exercise programs have also been shown to have a positive effect on bone health and body composition after gastric bypass surgery 6.
Hypophosphatasia
- Hypophosphatasia is a rare genetic disorder characterized by low ALP levels, but it is not directly related to gastric bypass surgery.
- The studies provided do not address the issue of hypophosphatasia in patients who have undergone gastric bypass surgery.
- More research is needed to determine if gastric bypass surgery can lead to low ALP levels or hypophosphatasia in some patients 5.