#66 Experiencing Brain Fog after Bariatric Surgery?


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By Dr. Susan Mitchell, registered dietitian nutritionist, Dr. Susan Mitchell, and Registered dietitian nutritionist. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

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Has someone told you to take vitamin B-12 for brain fog after bariatric surgery? B-12 helps to keep your brain healthy and even helps to prevent Alzheimer’s disease as you age.

Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 66. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.

I want to give a shout out to Brittany who posted in the FB group: I love your podcasts! Brittany I love you right back for taking time to say so and share with the group.

If you want to join us in the facebook group, please do. It’s an active group where you can find answers and support day-to-day or just vent if you need to. There’s a lot to deal with after surgery, right? On facebook, search groups for bariatric surgery success with dietitian dr susan mitchell and ask to join. Click for the direct link.

Has someone told you to take vitamin B-12 for brain fog after bariatric surgery?

First let’s take a broad look at the brain, then vitamin B-12 and it’s tie to your brain and finally bring it home to bariatric surgery. Your brain has a lot of demands. It needs both calories and nutrients or vitamins and minerals. Don’t miss this fact. The brain uses 20% of your calories. Did you have any idea it was that high? B-vitamins, folate, zinc and other vitamins and minerals all join in to keep the brain healthy. A deficiency of these can cause depression type symptoms, poor memory, problems with attention, learning, fatigue, mood and appetite or what just feels like brain fog or brain impairment. This is one of the big reasons that follow up lab work after your surgery is so very important. If you listen to some of my other podcasts, you know I talk about many vitamins and minerals working together as a team. B-vitamins, folate, zinc and other vitamins and minerals such as thiamin all work like an effective basketball team in your brain. Deficiencies in these or even too few carbs can all cause brain fog but today the focus is on your brain and B-12 also known as cobalamin.

A B-12 deficiency after weight loss surgery is very common but did you know that B-12 deficiency increases with age too? This happens for a couple of reasons. Often as you get older, you tend to eat less, which decreases the amount of B12 in your diet. Also up to 1/3 of people who are 50+ don’t absorb B-12 from their food because they don’t produce enough stomach acid. This is the same thing happening after bariatric surgery but for a different reason. You have surgical changes which affect absorption. Less B12 is released in the stomach as much of the stomach is bypassed or removed.

Add age to the picture and a low vitamin B-12 blood level is tied to what feels like brain fog or brain impairment and could also be tied to dementia including Alzheimer’s disease.

Maybe you’ve heard the word homocysteine. A high homocysteine level is not something you want. It’s an amino acid in the blood and elevated levels have been linked to dementia, heart disease, stroke. The good news is that homocysteine can be lowered with the B vitamins B6, B12, and folic acid which seem to slow down the loss of brainpower.

Let’s review the science in today’s Science 101 on Vitamin B-12 specific to bariatric surgery. The absorption of B-12 can be affected due to changes in acid production and reduced availability of what’s called the intrinsic factor. This intrinsic factor helps the B-12 to be absorbed and used by the body. When it’s not there or insufficient, B-12 doesn’t get absorbed and used as it should. You could experience brain fog symptoms and feel like your coordination is off plus numbness and tingling of your arms, legs. This is a prime reason why routine screenings are so important and typically done every six months or so. These screenings help your health care provider pick up on a possible deficiency hopefully before it becomes a problem.

Two other tips to keep in mind. First, are you taking proton-pump inhibitors (PPIs) like Prilosec, Nexium or Prevacid? These meds reduce stomach acid and stomach acid is necessary to absorb B-12. Even meds such as Zantac or Pepcid can increase the risk for B-12 deficiency.

Number two. Alcohol. It inhibits the absorption of B vitamins such as B12 and thiamine. Even without alcohol, you may already be struggling to get enough of these vitamins due to surgery so be aware. Go back and listen to podcast #30 on Bariatric Surgery and Alcohol Buzz for more in depth info.

As a reminder. Do you recall what foods contain B12?

B12 is found in protein foods like meat, eggs, cheese, fish, chicken, milk, and fortified breakfast cereals meaning it was added to the cereal. You want these in your diet but the amount needed is higher than typically what food can provide.

How much vitamin B-12 do you need after surgery? The dose is 250-500 micrograms (ug) a day with most suggestions in the 350-500 microgram range daily or 1000 mcg every other day. The dose depends on your surgery, your lab results and the route of administration meaning under the tongue, injection, etc. Sometimes an intramuscular injection of B12 or a nasal spray will be ordered by health care team. You can take B12 at any time or with any other supplements. It’s likely that your multi will have enough B-12 in it so check the label before you buy additional. Be sure and discuss your lab screenings with your health care team before you decide to take any extra.

PS Check out the Supplement Facts on a number of products to see what you like best. As I’ve shared before I’m a fan of and partner with ProCare Health.

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