Iron deficiency after sleeve gastrectomy: an integrative review
DOI:
https://doi.org/10.36557/2674-8169.2026v8n3p1173-1189Keywords:
Iron lack; Obesity surgery; Adults; Vertical gastrectomy; Anemia; postoperative; micronutrients.Abstract
Iron deficiency is a common complication following sleeve gastrectomy, resulting from reduced intake of iron-rich foods and decreased gastric acid secretion, which favors the development of iron-deficiency anemia, especially in women of reproductive age. Obesity, in turn, is a chronic, multifactorial metabolic disorder. In Brazil, more than half of the population is overweight, a condition that negatively affects health, quality of life, and social acceptance. Bariatric surgery is an effective option for obesity treatment and comorbidity reduction, but it can lead to significant nutritional deficiencies, requiring proper monitoring and management to prevent and treat these conditions. Objective: To analyze the specialized literature on iron deficiency following sleeve gastrectomy. Methods: An integrative review based on clinical trials and systematic reviews published in the last five years was conducted using the Cochrane Library, Google Scholar, PubMed, SciELO, and Web of Science databases in English, Spanish, and Portuguese. Results: A total of 79 studies were identified, and after applying the inclusion criteria, 11 studies were selected: five primary studies—four quantitative and one qualitative—and six secondary studies. Improvement in iron levels was observed up to six months post-surgery, with increased serum iron in groups adhering to supplementation. Nevertheless, iron deficiency remained present, requiring individualized supplementation. Anemia was reported in 50% of cases, predominantly in women of reproductive age. Iron deficiency increased with longer postoperative periods and was associated with low micronutrient intake, anatomical changes, and reduced gastric acidity.Conclusion: Sleeve gastrectomy is safe and effective but carries a risk of iron deficiency, iron-deficiency anemia, and low ferritin levels. Although adherence to supplementation was limited, it was important, and nutritional and multidisciplinary follow-up prevented or minimized complications, particularly in women of reproductive age.
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Copyright (c) 2026 Amanda Rafaelly do Nascimento Bezerra, Edigleide Maria Figueroa Barreto , Giselia de Santana Muniz, Catarine Santos da Silva, Niuhelen Sara da Silva, Maria Goretti Pessoa de Araújo Burgos
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