From the Guidelines
For patients with Roux-en-Y gastric bypass (RYGB) and mildly low zinc levels, I recommend supplementation with 15 mg of elemental zinc daily, as suggested by the British Obesity and Metabolic Surgery Society guidelines 1. This dose may be contained within a multivitamin and mineral supplement. It is essential to monitor zinc levels regularly, at least annually, to ensure that the supplementation is effective and to adjust the dose as needed 1. Additionally, it is crucial to maintain a ratio of 8- to 15-mg zinc to 1-mg copper to avoid zinc-induced copper deficiency 1. RYGB patients are particularly susceptible to zinc deficiency due to the malabsorptive effects of the surgery, which bypasses the duodenum and proximal jejunum where zinc is primarily absorbed. Adequate zinc is essential for wound healing, immune function, taste perception, and protein synthesis, making supplementation particularly important in this population. It is also important to note that zinc supplements should be taken at least 2 hours apart from iron supplements or calcium-containing products to minimize interference with zinc absorption. Regular monitoring of zinc levels will help to determine the effectiveness of the supplementation and the need for any adjustments to the dose or frequency of supplementation 1.
From the FDA Drug Label
The recommended adult dose is 50 mg as zinc three times daily Since 25 mg t.i.d. is also an effective dose in children 10 years of age or older or in women who are pregnant, it may be advisable to use a dose of zinc to 25 mg three times a day, as long as the patient is compliant with therapy.
For a patient with RYGB (Roux-en-Y gastric bypass) and mildly low zinc levels, the dose of zinc supplement is 25-50 mg three times a day. It is advisable to start with a lower dose of 25 mg three times a day and monitor the patient's response to therapy. If necessary, the dose can be increased to 50 mg three times a day 2.
From the Research
Zinc Supplementation for Patients with RYGB and Mildly Low Levels
- The ideal amount of zinc supplementation for patients with Roux-en-Y gastric bypass (RYGB) and mildly low levels is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, it is noted that zinc deficiency is common after RYGB, with 55.55% of patients demonstrating zinc deficiency preoperatively and 61.11% postoperatively 6.
- The study also found that protein intake after 6 months of surgery was below the recommended intake for 88.88% of the patients, which may contribute to zinc deficiency 6.
- Another study found that women who had undergone RYGB were at risk for inadequate zinc intake, and that the nutrient intake of these women was similar to that of non-operated women, with the exception of reduced intake of iron, zinc, and vitamins B1 and B12 4.
- There is no specific recommendation for zinc supplementation in the provided studies, but it is suggested that patients with RYGB should be monitored for nutritional deficiencies, including zinc, and that multivitamin and mineral supplements may be necessary to prevent or treat these deficiencies 3, 4, 6.