[29M] Experiencing nausea and lethargy post-gastric bypass with substance use

Patient Description

A 29-year-old male presents with nausea and lethargy as the most bothersome symptoms, occurring many times a day for the past 3 to 4 weeks. Each episode of nausea lasts a few minutes, and no relief has been found. Additional symptoms include vomiting, occasional moderate chills without specific triggers, lightheadedness, constipation, and pale skin. The patient underwent gastric bypass surgery approximately a year ago and has since neglected vitamin supplementation. There is a history of frequent methamphetamine use, cannabis smoking, and gabapentin abuse post-surgery. The gradual onset of symptoms suggests a potential link to nutritional deficiencies or substance use.

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Arora's Assessment

What might be happening

Based on the symptoms you've described and your recent history, there are a few potential explanations for what you might be experiencing:

  1. Nutritional Deficiencies: After gastric bypass surgery, it's crucial to maintain a proper intake of vitamins and minerals, as the surgery can affect nutrient absorption. Neglecting vitamins can lead to deficiencies, which might explain symptoms like nausea, lethargy, pale skin, and faintness. Common deficiencies include vitamin B12, iron, calcium, and vitamin D. Testing for these deficiencies and addressing them with supplements could be necessary.

  2. Substance Use Effects: The use of methamphetamine, cannabis, and gabapentin can have various effects on your body. Methamphetamine, in particular, can cause symptoms like nausea, lethargy, and pale skin due to its impact on your cardiovascular system and metabolism. Cannabis and gabapentin can also contribute to lethargy and gastrointestinal symptoms.

  3. Dehydration or Electrolyte Imbalance: Vomiting and constipation can lead to dehydration and an imbalance in electrolytes, which might cause symptoms like lethargy, faintness, and chills. Ensuring adequate hydration and possibly using oral rehydration solutions could help.

What you can do

Nutritional Deficiencies:

  • Consider scheduling an appointment with your healthcare provider to discuss your symptoms and the possibility of nutritional deficiencies. They may recommend blood tests to check your vitamin and mineral levels.
  • Start taking a high-quality multivitamin specifically designed for post-bariatric surgery patients, as these are formulated to meet your unique nutritional needs.

Substance Use:

  • It may be beneficial to seek support for substance use. Consider reaching out to a healthcare professional or support group to discuss your use of methamphetamine, cannabis, and gabapentin.
  • Reducing or eliminating the use of these substances could help alleviate some of your symptoms.

Dehydration or Electrolyte Imbalance:

  • Ensure you are drinking enough fluids throughout the day. Aim for water and electrolyte-rich drinks, especially if you're experiencing vomiting.
  • Monitor your symptoms and consider keeping a journal using MDandMe to track your progress and share insights with your healthcare provider.

What you should look out for

Given the complexity of your symptoms and history, it's important to seek medical care to address these issues comprehensively. Reasons to seek more urgent care include:

  • Persistent or worsening nausea and vomiting
  • Severe lethargy or fainting episodes
  • Signs of severe dehydration, such as dry mouth, extreme thirst, or reduced urination
  • Any new or concerning symptoms

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago


People Also Ask


What are the common nutritional deficiencies after gastric bypass surgery?

Common nutritional deficiencies after gastric bypass surgery include vitamin B12, iron, calcium, and vitamin D. These deficiencies occur because the surgery alters the digestive system, affecting nutrient absorption.


How can substance use affect symptoms like nausea and lethargy?

Substance use, such as methamphetamine, cannabis, and gabapentin, can exacerbate symptoms like nausea and lethargy. Methamphetamine can impact cardiovascular health and metabolism, while cannabis and gabapentin can contribute to lethargy and gastrointestinal issues.


What are the signs of dehydration or electrolyte imbalance?

Signs of dehydration or electrolyte imbalance include dry mouth, extreme thirst, reduced urination, lethargy, faintness, and chills. These symptoms can result from vomiting and constipation.


Why is it important to take vitamins after gastric bypass surgery?

Taking vitamins after gastric bypass surgery is crucial because the surgery changes how your body absorbs nutrients. Without proper supplementation, you risk developing deficiencies that can lead to various health issues.


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