Vitamins A, D, E and K are all classified as fat soluble vitamins - since they are soluble in fat and are absorbed by the body from the intestinal tract. They follow the same path of absorption as fat and any condition interfering with the absorption of fats would result in poor absorption of these vitamins as well. This class of vitamin can be stored in the body to some extent, mostly in the liver, and because of this, short term deficiencies are less likely to manifest themselves slower than the water-soluble vitamins.
Vitamin A is a generic term for a large number of related compounds. Retinol (an alcohol) and retinal (an aldehyde) are often referred to as preformed vitamin A. Retinal can be converted by the body to retinoic acid, the form of vitamin A known to affect gene transcription . Retinol, retinal, retinoic acid, and related compounds are known as retinoids. Beta-carotene and other carotenoids that can be converted by the body into retinol are referred to as pro vitamin A carotenoids. Hundreds of different carotenoids are synthesized by plants, but only about 10 % of them are pro vitamin A carotenoids
Vitamin A plays a major role in many bodily functions Vision, Regulation of gene expression, Immunity, Growth and development, Red blood cell production, and Nutrient interactions (works with zinc and iron). In vision retinol plays a major role in night vision.
As you can see from this---Vitamin A is just one of the keys to good health for anyone---but as it pertains to those of us who have undergone WLS---it is so much more than that. Because we have difficulty tolerating fat. Well some of you do, I don't. Also I've found some interesting research about this whole fat tolerance. But that is for another post.
The thing is---because of the bypass of the upper portion of the small intestine in the RNY surgery---we don't absorb fat as easily. Hence we don't absorb fat soluble vitamins as easily---ergo we are very susceptible to Vitamin A deficiency. The main points as far as deficiency go as related to WLS have to do with the role it plays with iron and zinc as stated above. Here are 2 additional key points about this deficiency.
Vitamin A deficiency and vision
This has been shown to happen even years after WLS. Sometimes leading to BLINDNESS . Yep, that's right. You can go completely blind from not having enough absorption of Vitamin A. Check this out: Vitamin A Deficiency Related to GI Surgery Can Occur Years Later You will have to register to be able to access the info. Here are some highlights:
Intestinal surgery may result in malabsorption of vitamin A, with ocular symptoms manifesting years or even decades after surgery, especially when other comorbidities are present, ophthalmologists report.
I don't know about y'all, but that scares the begeezes out of me. The fact that even years after having this surgery I may go through this. :shudders:
Here's some more of that article:
The two male patients were treated with intramuscular injection of vitamin A, and both reported improvements in vision in both eyes within the first week . The woman refused further treatment and was lost to follow-up.
Well at least there is some hope for reversal of the symptoms. That is good to know.
Vitamin A also plays a role in the immune system. I don't know about y'all, but I don't like being sick. Hell, I don't know of too many people who actually enjoy being sick.
Vitamin A deficiency and infectious disease
This is what the RDA recommends for Vitamin A supplementation:
Now this is for NORMAL people. As someone who has had WLS, you are never NORMAL again. Your whole entire life is different. That again is something for another post. Anyway back to the topic at hand.
As far as vitamins go most people think if 1 tab is good than 2 is twice as good. That you can never get enough of a good thing. That is not always the case. There can be major problems associated with getting too much Vitamin A. But how much is too much??? First let's talk about what having too much can do to your body.
It is important to note that treatment with high doses of natural or synthetic retinoids overrides the body's own control mechanisms, and therefore carries with it risks of side effects and toxicity. Additionally, all of these compounds have been found to cause birth defects. Women who have a chance of becoming pregnant should avoid treatment with these medications. Retinoids tend to be very long acting; side effects and birth defects have been reported to occur months after discontinuing retinoid therapy.
So since our absorption of vitamin is remarkably decreased for several reasons, we really should be taking the maximum allowed without fear of toxicity. It would be safe to state, that 10,000 IU would be our recommended dose.
But where do you get Vitamin A from? Can you take it in a pill?? Can you get it from eating whole foods alone??? This is what I have found.
*One IU is equivalent to 0.3 mcg of retinol, and one mcg of retinol is equivalent to 3.33 IU of retinol.
So there you have it y'all. Everything you always wanted to know about Vitamin A. Hey it's probably more than you want to know. But you definitely NEED to know.
WLS is not a "quick fix" for obesity. It is not the "easy way out" so many seem to think it is. This is -- everything changes for the rest of your life --surgery, not to be taken lightly.
My advice to anyone who has had WLS or is thinking about it---know what is needed to maintain proper health now that we are no longer NORMAL. Eat good sound whole foods---not food products. Take your supplements religiously. Have your doc do routine blood work that includes checking your Vitamin A levels.
Hey, it is NOT standard procedure to have this test done. So don't even think you are "peachy keen" if your doc states your "labs" look great. Ask for a print out of them. Know exactly what tests they have done. Don't just blindly accept or assume this was one value they checked.
Every health consumer---not just those having WLS--- should be proactive in their own care.
Stay tuned for many more posts dealing with supplements after WLS.