Osteoporosis and bariatric surgery

Are you not taking calcium, and has your vitamin D been low for a long time? You could be at an increased risk of developing osteoporosis.

The disease is often asymptomatic

The diseases osteopenia and osteoporosis are often asymptomatic or have few symptoms and are sometimes not discovered until the individual suffers a bone fracture and/or begins to experience pain and limitations in the musculoskeletal system. At that point, it can be difficult to reverse the progression of the disease, and individuals living with osteoporosis are at an increased risk of fracturing bones from the slightest fall or trauma.

Bariatric surgery can have an effect

Bariatric surgery can increase the likelihood of developing osteoporosis, but many other factors also have a significant impact. Most notable are factors such as genetics (around 70% is genetic), increasing age, menopause, gender (women are 3x more likely to develop the disease), and a lack of calcium and vitamin D.

In order for us to make the best use of calcium, we need to have adequate stores of vitamin D in the body. It is therefore not enough to take calcium if you lack vitamin D, and of course, not enough to take vitamin D if you lack calcium – you always need both. In addition to getting nutrients to promote bone density growth, it is also important to exercise regularly, as moderate physical load on the body and thereby the bones increases bone density.

Vitamin D is important

The risk of osteoporosis is slightly higher after gastric bypass than gastric sleeve, and part of the explanation is that the digestive tract has been altered more in bypass surgery. The absorption of both vitamin D and calcium is therefore not as it was before surgery. A reduced volume of food and food choices also have a lot to say.

To reduce the likelihood of osteopenia or osteoporosis, it is important to have vitamin D levels in the blood checked regularly after bariatric surgery. The level of calcium in the blood does not necessarily give an accurate picture of bone health. When there is a shortage of calcium in the blood, the body uses calcium from the bones to compensate for it.

Bone density scan

If osteoporosis is suspected,  a diagnosis can be obtained with a special bone density scan.

A referral from a doctor can be obtained to have bone density measured.

Sources:

Geoffroy, M., Charlot-Lambrecht, I., Chrusciel, J. et al. Impact of Bariatric Surgery on Bone Mineral Density: Observational Study of 110 Patients Followed up in a Specialised Centre for the Treatment of Obesity in France. OBES SURG 29, 1765–1772 (2019). https://doi.org/10.1007/s11695-019-03719-5

Guðlaugsdóttir , B L , Engilbertsdóttir , S , Franzson , L , Gislason , H G & Gunnarsdóttir , I (2021) , ‘ Vitamin D status before and after bariatric surgery at Landspítali ‘ , Læknablaðið , vol. 107 , no. 3 , pp. 137-143 . https://doi.org/10.17992/lbl.2021.03.627