Optimization of Vitamin Suppletion After Roux-En-Y Gastric Bypass Surgery Can Lower Postoperative Deficiencies A Randomized Controlled Trial

Iron, vitamin B12, and folic acid deficiencies are among the most common deficiencies occurring after laparoscopic Roux-en-Y gastric bypass (LRYGB). The present study evaluates the effectiveness of a specially designed multivitamin supplement (WLS Forte, Fit-ForMe, Rotterdam, the Netherlands) specifically developed for LRYGB patients. A triple-blind, randomized, 12-month study was conducted comparing WLS forte with a standard multivitamin supplement (sMVS) containing approximately 100% of the recommended daily allowance (RDA) for iron, vitamin B12, and folic acid. WLS Forte contains vitamin B12 14000% RDA, iron 500% RDA, and folic acid 300% RDA. In total, 148 patients (74 in each group) underwent a LRYGB procedure. Baseline characteristics were similar for both groups. Per protocol analysis demonstrated that sMVS treatment was associated with a decline in ferritin (-24.4 +/- 70.1mg/L) and vitamin B12 (-45.9 +/- 150.3 pmol/L) over 12 months, whereas in WLS Forte patients, ferritin remained stable (+3.2 +/- 93.2 mu g/L) and vitamin B12 increased significantly (+55.1 +/- 144.2 pmol/L). The number of patients developing ferritin or vitamin B12 deficiency was significantly lower with WLS Forte compared with sMVS (P<0.05). Iron deficiency (ID) was reduced by 88% after WLS Forte compared with sMVS. Adverse events related to supplement use did not occur. An optimized multivitamin supplement is safe and reduces the development of iron and vitamin B12 deficiencies after LRYGB.