Background

Vitamin C (VC) and Thiamin (T) deficiency are rare conditions in industrialized countries. Patients suffering from morbid obesity may develop Vitamin deficiencies due to poor dietary choices. VC&T deficiency may lead to severe complications following sleeve gastrectomy (SLG).

Methods

Patients being evaluated for a SLG underwent testing for VC&T levels; in addition, values of zinc, TSH, prealbumin, HbA1c, cholesterol and triglycerides were determined. Thiamine levels 8-12 were considered low, 6-8 deficient and <6 critical; Vitamin C levels of 0.3-0.4 were considered low, 0.1-0.2 deficient and <0.1 critical.

Results

Seventy-six SLG candidates (18m/58f) median aged 42.4 (range 21.9-65.5) years with pre- or peri-operative VC&T testing (2021 to 2023) were included. BMI at testing was median 44.8 (range 36.3-68.1) kg/m2. Only 37% of patient had normal T levels, 39% had low levels, 12% were deficient and 12% had critically low levels. Fifty-five % of patients had normal VC levels, 25% had low levels, 18% were deficient and 3% had critically levels. 31 patients had combined VC&T deficiencies. Patients with low Vitamin levels or deficiencies were started on high dose thiamin and/or ascorbic acid. Zinc levels were normal in 96% and TSH levels in 95%. HbA1c levels were >5.9 in 27%; 46% of patients had hyperlipidemia. Fifty-five patients underwent robotic SLG (51 had VC&T level testing prior and four within few days after SLG).

Conclusions

The high rates of VC&T deficiency in candidates for SLG are concerning and routine testing for VC&T in these individuals should be considered.