Micronutrient deficiencies and malnutrition are known complications after bariatric surgery, or weight-loss surgery. Depending on the type of surgery, these complications can be due to a restriction in the quantity and even type of food that can be eaten or a decreased ability to digest and absorb certain nutrients. Taking supplements of important vitamins will stave off deficiencies as well as adverse health conditions. Consult your doctor for more information regarding what supplements to take.
Multivitamins
Many bariatric patients take a chewable multivitamin supplement twice a day with meals immediately following surgery. Chewable tablets are the most easily absorbed and are less likely to cause heartburn and ulcers after surgery. As your diet progresses and you can tolerate solid foods, you may switch to a non-chewable. However, multivitamins alone may not meet your specific nutritional needs, and other supplementation may be necessary.
Vitamin B-12
After bariatric surgery, it is common that you will no longer be able to digest and absorb sufficient amounts of vitamin B-12. You can supplement B-12 through a monthly injection, a weekly nasal spray or sublingual lozenges or drops. A typical amount is 500 mcg per day. Vitamin B-12 will boost your metabolism and help with weight loss.
Other B Vitamins
Thiamin, or vitamin B-1, deficiency may occur after bariatric surgery due to restriction of food intake, vomiting and reduced acid production. Ensure that your multivitamin contains adequate amounts of thiamin. Folate is known to prevent anemia, which is common after surgery. Most multivitamins contain 400 to 800 mcg of folate.
Vitamin D
In addition to the amounts of vitamin D in your multivitamin and calcium supplement, your doctor may recommend taking extra vitamin D. According to a study done by Jason M. Johnson and colleagues in the May 2006 issue of the "Annals of Surgery," gastric bypass results in long-term vitamin D deficiency. Recommendations are individualized based on blood levels, so get tested to see where you stand. You may take up to 2000 IU per day.
Calcium
Because a small amount of calcium is usually in multivitamins, it is recommended to take an additional chewable calcium tablet or liquid in the amount of 1000 to 1500 mg each day after surgery. Take one dose, or about 500 to 600 mg, twice a day with meals to enhance absorption. Different forms, such as calcium carbonate and calcium citrate, vary in their absorption. Citrate is most efficiently absorbed after gastric bypass surgery.
Iron
Following surgery, many people also take one iron supplement daily, as iron-deficiency anemia is common after weight-loss surgery. The most absorbable forms are ferrous fumarate, ferrous sulfate or ferrous gluconate. If symptoms of nausea and/or constipation develop from the iron supplementation, try taking it every other day. Vitamin C will aid absorption, whereas calcium will inhibit it, so avoid taking iron and calcium supplements together.
References
- Bariatric Surgery at the West Penn Allegheny Health System: Vitamin/Mineral Supplementation After Bariatric Surgery
- Consumer Guide to Bariatric Surgery; Post-Bariatric Surgery Supplement Savvy; Denise Mann; January 2010
- "Annals of Surgery"; The Long-term Effects of Gastric Bypass on Vitamin D Metabolism; Jason M. Johnson, et al.; May 2006
- "Current Opinion in Clinical Nutrition and Metabolic Care"; Nutrient Deficiencies Secondary to Bariatric Surgery; Jacqueline I. Alvarez-Leite; 2004
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