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Instead, one of the two patients reported UTIs (136)

High B12 without supplementation is a different clinical picture entirely

For some patients a single peptide is the better starting point

Table of Contents Why Gastric Sleeve Surgery Increases the Risk of B12 Deficiency Recognising the Symptoms of B12 Deficiency After Bariatric Surgery How B12 Deficiency Is Diagnosed and Monitored on the NHS Recommended B12 Supplementation Following Gastric Sleeve Surgery Dietary Sources of B12 and Their Limitations After Surgery When to Seek Medical Advice and Long-Term Nutritional Follow-Up Scientific References Frequently Asked Questions Why Gastric Sleeve Surgery Increases the Risk of B12 Deficiency Sleeve gastrectomy removes up to 80% of the stomach, reducing parietal cells and intrinsic factor production, which impairs B12 absorption alongside reduced gastric acid secretion and lower dietary intake

The remaining 3 studies, scored eight and nine, indicating high-quality studies with low risk of bias (Table 5)