People who have had a total gastrectomy, and sometimes a subtotal gastrectomy, cannot absorb vitamin B12 from food or oral supplements. As a result, they may be unable to make enough red blood cells, which carry oxygen around the body. This can lead to a condition known as pernicious anaemia. The most common early symptom of anaemia is tiredness. Your skin will look pale and you may also feel breathless, get headaches, have a racing heart and lose your appetite. You will need regular vitamin B12 injections.

A gastrectomy may also reduce your ability to absorb iron, causing iron deficiency anaemia. You may need iron supplements.

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Tips for managing anaemia

  • Talk to your doctor if you have symptoms of anaemia.
  • Find out what kind of anaemia you have and how it can be treated.
  • Rest when you need to and don’t overexert yourself.
  • Limit tea and coffee, as these can prevent iron absorption.
  • Ask your GP or dietitian if you need vitamin B12 injections, iron or other supplements, and whether certain foods can help.
  • Eat foods rich in iron and B vitamins, such as meat, eggs and softened dark green leafy vegetables.
  • Eat foods high in vitamin C (e.g. red or orange fruits and vegetables) in the same meal as iron-rich foods. Vitamin C helps the body absorb iron.
  • If you smoke, talk to your GP about quitting, call Quitline on 13 7848, or visit Tobacco can worsen your symptoms.

This information was last reviewed in September 2017
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