Osteomalacia After Gastric Bypass Surgery

Topic: Pharmacologic Doses of Vitamin D in the Treatment of Patients with Osteomalacia After Gastric Bypass Surgery

Keywords: OSTEOMALACIA, BONE HEALTH, GASTRIC BYPASS SURGERY, OBESITY - Vitamin D

Reference: "Osteomalacia with Bone Marrow Fibrosis Due to Severe Vitamin D Depletion Following Gastrointestinal Bypass Surgery for Severe Obesity," Al-Shoha A, Qiu S, et al, Endocr Pract, 2009; 1-16. (Address: Bone & Mineral Research Laboratory, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, USA).

Summary: In a study involving 5 patients (between the ages of 39 and 60 years) who had undergone gastrointestinal bypass surgery for severe obesity, who had developed severe vitamin D depletion over the course of 17 years post-bypass and were diagnosed with osteomalacia with marrow fibrosis, who were unresponsive to "usual" therapy, experiencing symptoms of generalized bone pain and tenderness, muscle weakness, stooping posture, difficulty walking, and waddling gait due to severe proximal muscle weakness for a period of 2-5 years, treatment with pharmacologic doses of vitamin D (100,000 IU/d ergocalciferol) and calcium carbonate (1-2.5 g/d) was found to significantly improve clinical symptoms and functional status, as well as biochemical indices, BMD and bone histomorphometry. The authors point out that in this population (gastric bypass surgery patients), the clinical presentation of osteomalacia is often mistaken for arthritis, gout, osteoporosis or various other conditions. They also point out that the "usual" recommendations for treatment are grossly inadequate. They conclude, "Gastric bypass surgery predispose to severe vitamin D deficiency and osteomalacia in the absence of pharmacologic doses of vitamin D therapy. Prospective long-term studies are needed to determine the appropriate vitamin D dose required to prevent osteomalacia in such patients."

Provided by:
C. Norman Shealy, M.D., Ph.D.
Professor of Energy Medicine
President Emeritus
Holos University Graduate Seminary
www.holosuniversity.org
www.normshealy.com
www.medicalrenaissance.net

http://www.vitasearch.com/get-clp-summary/38298