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Can My Gastric Bypass Surgery Lead To Dropped Hemoglobin Levels?

Posted on Thu, 20 Mar 2014

Question: Hi, my name is Sherri, I am a 46 year old female, I have had gastric bypass surgery about 10 years ago and have become severely iron deficient anemic. I have had to have two blood transfusions in the past few years, 1 being just 2 weeks ago, also I have had to have iron transfusions for several months a few years ago because my ferritin iron was so low. My doctor tells me that my body has stopped producing red blood cells and wants me to see a hematologist to have a breakdown of an anemic panel and a possible bone marrow test. I have also had two scopes done, a colonoscopy and an endoscopy both showing no bleeds, all my other blood work has come out perfect. I have no insurance. My question is, is it possible since my body doesn't absorb iron and minerals due to the gastric bypass surgery like it used to and once my iron drops so low can that cause my blood to stop producing the red blood cells? I have no other indications of any types of cancer. when my hemocrit and hemoglobin dropped that last time it was down to a 7.5 but it had been down for quite a while because I could tell by the way I had been feeling. I usually know when it goes down. Would there be any other signs or symptoms of blood or bone cancer if it was some type of cancer, like my white cells or could it just be from the gastric bypass surgery and the absorption of iron?

Answered by Dr. Vaishalee Punj (1 hour later)

Brief Answer: Yes it is a well known fact Detailed Answer: Hi Thanks for posting your query on HealthcareMagic. Yes it is a well known fact that gastric bypass surgery can cause anemia. Most of iron and minerals are absorbed in the initial parts of the small intestine. During gastric bypass, this initial part of intestine (called as duodenum) gets bypassed. The reason is that some part of stomach is resected and the remaining stomach is stitched somewhere after the duodenum. This results in malabsorption of iron and other minerals. Another reason is that intrinsic factor is produced in the stomach. It is required for the absorption of vitamin B12 in the body. This Vit B12 is required for the formation of red blood cells. Its deficiency also results in anemia called as megaloblastic anemia. Blood cancer may have similar symptoms but it will have a different picture on blood tests (drastically increased white blood cells). A diagnosis of bone cancer will be made from radiological imaging of suspected tumour and some blood tests. Unless you are diagnosed with any such condition with the help of tests, there is no point in worrying about them. You probably don't have cancer. Hope I was able to clear your doubts. Let me know if I can assist you further. Dr Vaishalee

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Vaishalee Punj (7 days later)

Thank you for your information. Is there something I can do to help boost my iron levels up and keep them from dropping so drastically. I already take iron supplements and folic acid. I eat iron rich foods.

Answered by Dr. Vaishalee Punj (12 hours later)

Brief Answer: Iron can be taken im or iv Detailed Answer: Hi again There are two options. Now nature is remodels the body's function after surgery. Now that duodenum is unable to absorb iron, lower intestines takes over the function (though partially). So you need to continue taking the oral supplements, since they may be getting absorbed in the lower intestine. You can take iron with juices to enhance absorption. You can also take iron rich non-vegetarian foods as follows: Rich source of iron: Liver, egg yolk, oyster, dry beans, dry fruits, wheat germ, yeast Medium source of iron: Meat, chicken, fish, spinach, banana, XXXXXXX Poor source of iron: Milk and its products, root vegetables The iron in the non-veg food is absorbed as such without much help from mucosal transporters. Iron should not be taken with milk, its products and alkalies like antacids. Second option is injectable form of iron. These are available as following compounds like: FERROUS SUCROSE - can be taken intravenously only FERRIC CARBOXYMALTOSE - can be taken both intravenously and intramuscularly The side effects can be like LOCAL: pain at the site of injection, skin pigmentation, sterile abscess SYSTEMIC: fever, headache, joint pain, urticaria (not common). Talk to your doctor about this option. Hope it helps. Dr Vaishalee

Above answer was peer-reviewed by : Dr. Shanthi.E