Annual blood tests after sleeve gastrectomy: Why, when & what!

I want you to ask yourself a simple question…. When was the last time you had blood tests done since your sleeve? If it’s been more than a year you need to read on. And if you’ve had yours done recently, then read on anyway to make sure you’ve had the right things tested!

You might remember your surgeon, bariatrician or dietitian saying that you should visit regularly after a sleeve gastrectomy. They also probably mentioned that you should have blood tests done regularly as well. I know sometimes life gets busy, or you think you are well and so there is no need, but there is a reason we ask you to come back! More than checking your weight, and whether you’re “succeeding” or “failing” – these visits are a way to check for any potential long-term side effects of the surgery and to make sure you are getting the most out of your sleeve.

Your annual visit is a chance for you to get in touch with your team, ask any questions you have, raise concerns and to get the support you need throughout the process. Your team can give advice if you need it or just encourage you in the fact that you’re doing all the right things and cheer you on if all is going well!

As part of the annual visit, blood tests are a simple way for your team to compare your results year-on-year and look for any unfavourable trends and intervene quickly. As a dietitian, I would rather identify a potential nutrient deficiency before it happens and get on top of it rather than waiting for the deficiency to develop to the point you get symptoms.

The American Society of Metabolic and Bariatric Surgery (ASMBS) guidelines that we use for the nutritional management of weight loss surgery patients provides a list of what labs need to be checked before and after bariatric surgery. Below I’ve listed the measures suggested for the long-term annual appointments. Bear in mind though, there is some variation between medical teams, as well as health care systems and therefore some tests they won’t order unless physical symptoms of a deficiency are present due to cost. There are also extra tests not listed below that may be done in case of suspected deficiency for a clear diagnosis.

*Calcium deficiency is difficult to test, and serum calcium is not a good measure of bone stores. A DEXA or BMD scan should be completed every 2 years to look for reduction in bone mineral density.

**Vitamin E, Vitamin K, Zinc, and copper are only required when there are physical symptoms of deficiency.