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Dr. Andrew Rynne

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What causes low lymphocytes after gastric bypass surgery?

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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

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Posted on Mon, 3 Apr 2017 in Liver and Gall Bladder
Question: Seven years ago I had gastric bypass, RNY in 2010. Prior to my surgery, my complete white count averaged a consistent 8.6 and my lymphocytes were always well within the normal range. Almost immediately my complete white count dropped and my lymphocytes have trended low since, never to return to normal. It has been a struggle to keep my body balanced. I have had several iron infusions, recently of intjectafer. I was also anemic prior to the surgery and have a current diagnosis of pernicious anemia. I have had to ask to have my other metals tested and as I suspected, am zinc deficient, severely vitamin D deficient and bottoming out on b12. My Dr. suggested that I work on my vitamin D levels, but stated that she wasn't concerned about my zinc deficiency (keep in mind, I will only continue to trend downward as I malabsorb). I'm very concerned about the advice t io essentially ignore a zinc deficiency when healthy lymphocyte and neutrophil levels are very influenced seems that I'm continuing to make myself vulnerable to cancer. Zinc supplements also make me very, very ill. I'm not sure where to start correcting these problems and quickly. Do you advise to ignore zinc? I was also told that it is not believed that my low lymphocytes are not related to a zinc deficiency?
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Answered by Dr. Shafi Ullah Khan 4 hours later
Brief Answer:
Supportive care

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. Leukocytes can vary from 4 thousand to 11 thousand normally and its all normal as far as the count is in this limit. With roux en y procedure done, shortening of bowel and gastric bypass for sure causes malabsorption and the treatment is mostly supportive. Any over the counter multi vitamin intake will be enough as it contains all essential ingredients. Also i would suggest consulting a dietitian and nutritionist for a complete balanced diet plan that covers all macro and micro nutrients. If zinc supplements bother you, you may take the supplements in middle of a meal with adequate fluids it will help reduce the discomfort. Also foods rich in zinc will help like spinach, beef, shrimps, kidney beans, flaxseeds, pumpkin seeds, oysters, watermelon seeds, garlic, lima beans, peanuts, egg yolks, turkey, salmon, lobster, pork , dark chocolate, chickpeas, beef liver, brown rice etc. So if you see zinc is almost in any diet you take. So no worries and ignore was likely meant by your doctor in this way.

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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