Wernicke-Korsakoff Syndrome: A Little-Known Risk of Gastric Bypass Surgery

If you have been considering having a gastric bypass done for weight loss, there is a little know risk that you should be aware of to ensure you take the proper steps to reduce the risk.  Vitamin B1 deprivation leading to Wernicke-Korsakoff Syndrome. Wernicke-Korsakoff Syndrome is a condition that may develop if your brain is deprived of vitamin B1 for several weeks. However, being aware of the condition, its symptoms, and taking appropriate precautions can substantially reduce the risk.

What is Vitamin B1?

Vitamin B1 a/k/a Thiamine is a vitamin that the human body needs but does not produce naturally.  We get vitamin B1 from many foods. It is prevalent in meats, fruits, grains, nuts, and oats.  Furthermore, your body typically stores 2-3 weeks-worth of vitamin B1 at a time.

How Does Gastric Bypass Affect Your Thiamine Intake?

When you have a gastric bypass performed, your thiamine intake can be affected in two ways.  First, the gastric bypass procedure itself reduces the size of the stomach by bypassing part of the stomach and the intestines—specifically the duodenum.  This also is where much of your body naturally absorbs vitamin B1 from foods.  Thus, the procedure itself reduces your ability to absorb vitamin B1 into the bloodstream.

Second, it is common initially after a gastric bypass for people to lose their appetite or not even be able to hold food down as their body is adjusting to its new internal configuration. Poor diet following the surgery without taking vitamin supplements may result in your body not getting enough vitamin B1.

What are the Signs and Symptoms to Watch For?

When the body does not get enough thiamine, you may experience nausea, delirium, motor nerve deficit, loss of appetite, fatigue, irritability, blurred vision, weakness in the muscles, tingling symptoms in the limbs, and shortness of breath. If this persists, it may cause permanent brain damage resulting in Wernicke’s Encephalopathy and Korsakoff Syndrome.  These two often happen together and are referred to as Wernicke-Korsakoff Syndrome. The former is characterized by visual disturbances, confusion, ataxia, and other neurological symptoms that lead to brain damage if not treated. The latter, Korsakoff Syndrome, is characterized by short and long-term memory loss, amnesia, and confabulation—making up stories subconsciously to fill in memory gaps.

Is There a Cure?

Once a person suffers brain damage as a result of vitamin B1 deficiency, the damage is often permanent and irreversible. If the signs and symptoms are caught early on, a simple B1 injection can prevent the condition from getting to the brain damage phase and the initial symptoms will clear up.  However, not all emergency room doctors are properly educated to identify the early signs. Because neurological complaints are common to many conditions and can even be “in the patient’s head,” some doctors do not always think to do a blood panel.  If you develop Wernicke-Korsakoff Syndrome due to a doctor’s failure to diagnose the symptoms following gastric bypass surgery, you should speak to a lawyer who handles Wernicke-Korsakoff Syndrome caused by medical negligence.  A doctor should always take a detailed history which would include your gastric bypass. Knowledge of this plus any one symptom of Wernicke-Korsakoff Syndrome should trigger them to do bloodwork, catch the vitamin B1 deficiency and give you an injection.

Precautions to Take When Having a Gastric Bypass

If you are planning to have gastric bypass surgery, you would be wise to discuss with your doctor whether you should start taking a good daily vitamin or supplement to make up for the reduced vitamin absorption that can be anticipated.  Some additional things you can do to reduce the risk are to make sure that you continue to eat the amount of food recommended by your doctor following the procedure.  If you are unable to keep the food down, consult your doctor at once to see if there is anything else they recommend to ensure sufficient nutrients and vitamins are still a part of your diet.  Lastly, be familiar with the signs/symptoms described above. If you notice any of them, seek immediate medical care, give a full history including the gastric bypass to the doctor, and request that a blood panel be done to check your thiamine levels.