To gamble with your skeleton

To gamble with your skeleton
August 23, 2017 Carl-Magnus Broden
osteporos vid lågt vitaminintag efter gastric bypass

In the previous blog entry we discussed keeping up the daily routines. One of the challenges is to take your vitamin supplements every day -even though you are feeling great no matter if you do or not. Vitamin compliance has been studied in 293 Swedish patients (Karefylakis et al, Obesity Surgery 2014) that had undergone gastric bypass surgery on average 11 years earlier. The question was how many of the patients were still taking their vitamin supplements as intended? And in case they did not, how did this affect their own bodies?

These patients had been put on a traditional combination of prescription-free multivitamin, plus vitamin B12 and calcium/vitamin D via prescription (nowadays there are modern all-in-one options, see for example Baricol Complete. No matter which vitamin supplement setup used, the challenge remains the same: to take vitamins daily, year in and year out, in spite of feeling better than ever. The results were depressing. Only one in five (21,5%) were taking their multivitamins and one in twenty (5,1%) were taking their calcium’/vitamin D!

How did their bodies cope with this? Well, a total of 69% suffered from ”secondary hyperparathyreoidism”. What is this then? In simple words: the body prioritizes a strict calcium level in the blood at all times (since it is vital for cell function, etc.). If the body does not receive enough calcium from the small intestine, the calcium level in blood will have a risk of dropping. The body senses this through its parathyreoid glands, positioned next to the thyroid gland on the anterior side of the throat. The hormone PTH is then released, which keeps the blood calcium levels up by using calcium from the body’s own depot. Which depot is that? Well -your skeleton. If you constantly eat too little calcium, the parathyreoid glands will always be extra active and produce PTH -you have now developed secondary hyperparathyreoidism.

In plain text, this means that the body daily eats a little bit of its skeleton to keep up the calcium levels. In the long term, this is of course not good at all. It leads to increased risk of osteoporosis and fractures, ranging from a broken hip to a collapsed vertebra of the spine. So all of you who have already, or are planning to undergo obesity surgery the strong recommendation is: take your vitamins and do your annual blood tests! Do not gamble with your skeleton.

 

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