Vitaminas y Minerales

Injectable Vitamin D for Bariatric Patients Unresponsive to Oral Supplementation

Abstract

Ara Keshishian, Terhas Asfiha Weldeslase and Miguel Rosado

Introduction: With an increasing incidence of obesity and weight loss surgery, there is an increased awareness of vitamin D deficiency and its metabolic sequala. The conventional treatment for vitamin D deficiency is not adequate for a subset of bariatric patients, both pre-and postoperatively. Compounded injectable vitamin D is an alternative for most people who do not respond adequately to oral Vitamin D supplements after bariatric surgery.

Method: Those patients diagnosed with vitamin D deficiency were all prescribed oral supplementations and levels rechecked in three and six months and yearly after that. Our recommendations included Vitamin D injections to those patients who had either not responded or further worsened their vitamin D levels. Repeat levels of vitamin D of both those on injection and oral supplements were rechecked. We did not include those Patients with preexisting Primary hyperparathyroidism or hypercalcemia. Their work up included medical, nutritional, and psychological evaluations, also to complete metabolic panel. At the time of the operation, all patients were older than 18 years old and younger than 67.

Results: Between February 2011 and June 2019, 147 patients were recommended vitamin D injections since oral supplements failed to improve the serum levels. There was a significant improvement in the Serum level for those patients who received Vitamin D compared to those who continued on higher dose oral supplements.

Conclusion: Compounded Vitamin D injections should be considered a treatment option for patients who do not respond to oral supplementations following weight loss surgery.