Which nutrient deficiency is described as a risk after gastric bypass surgery and is also one of the classic five deficiencies?

Which nutrient deficiency is described as a risk after gastric bypass surgery and is also one of the classic five deficiencies?

• A. Copper
• B. Calcium
• C. Iron
• D. Folate

Answer: (A)

Gastric bypass alters the gut in a way that reduces the absorption of several minerals, including copper. Copper absorption mainly occurs in the stomach and proximal small intestine, so bypassing these regions and the resulting changes in gastric chemistry lessen its uptake. Additionally, zinc supplementation, which is commonly used after bariatric surgery, can further impair copper absorption by inducing metallothionein in enterocytes that traps copper. Copper is essential for enzymes involved in iron metabolism (such as ceruloplasmin), connective tissue formation, and nervous system function. Deficiency can lead to anemia that may mimic iron deficiency but doesn’t respond to iron therapy, along with neutropenia and neuropathy. Because these absorption patterns and clinical risks have long been recognized in the post-gastric bypass population, copper is described as one of the classic deficiencies seen after this surgery.

Gastric bypass alters the gut in a way that reduces the absorption of several minerals, including copper. Copper absorption mainly occurs in the stomach and proximal small intestine, so bypassing these regions and the resulting changes in gastric chemistry lessen its uptake. Additionally, zinc supplementation, which is commonly used after bariatric surgery, can further impair copper absorption by inducing metallothionein in enterocytes that traps copper.

Copper is essential for enzymes involved in iron metabolism (such as ceruloplasmin), connective tissue formation, and nervous system function. Deficiency can lead to anemia that may mimic iron deficiency but doesn’t respond to iron therapy, along with neutropenia and neuropathy. Because these absorption patterns and clinical risks have long been recognized in the post-gastric bypass population, copper is described as one of the classic deficiencies seen after this surgery.