Gastric bypass surgery can help someone who is morbidly obese lose weight -- even after other diet plans and exercise regimens have failed. People who have this procedure can have problems with vitamin deficiencies because the section of the small intestine that absorbs many of the necessary vitamins is unable to do so after the surgery. The amount of food that you can eat after a gastric bypass is also limited, reducing the opportunity to obtain vitamins through your diet. While vitamin supplements are required for all people who have a gastric bypass procedure, women have additional vitamin issues to consider after this surgery.
Multivitamins
All people who have a gastric bypass should take multivitamins every day to avoid becoming malnourished. Immediately after the surgery, you should take a chewable vitamin since you will not be able to tolerate solid foods or non-chewables yet. Once you can tolerate solid foods, you can start taking a non-chewable vitamin. Women can look for multivitamins that are specifically formulated for women.
Iron
Iron-deficiency anemia is a common problem after gastric bypass surgery because the part of the intestine that absorbs iron is bypassed during the procedure. For all women who are actively menstruating, iron deficiency can become a more significant problem; if you are pre-menopausal, you need to take iron supplement tablets in addition to your multivitamin. Iron can cause some side effects like nausea or constipation, so you may need to try different formulations like iron sulfate, iron fumarate, or iron gluconate to find one that does not upset your stomach. You also should avoid taking your iron pill at the same time as any calcium supplementation; each of these two minerals interferes with the absorption of the other.
Calcium
The mineral calcium plays a large role in the development and maintenance of strong bones. If you have had gastric bypass surgery, you are at risk for calcium deficiency and the development of osteoporosis because of the surgical changes in your digestive system. According to EisteinBariatrics.com, you should take 1,000 to 1,500 mg of calcium every day to avoid these problems. To get the best absorption, you should try to take a calcium citrate version, although calcium carbonate supplements are acceptable, too; your pharmacist can direct you to what is available. You should also space out your calcium and iron supplements to improve absorption.
Vitamin B-12
After bypass surgery, you can no longer absorb vitamin B-12 , which is important for blood cell formation. Since you cannot absorb this vitamin, you need to supplement B-12 through a form that can enter the bloodstream directly without entering the digestive tract. Different methods of B-12 supplementation include a monthly B-12 injection, a B-12 nasal spray, or B-12 tablets that dissolve under the tongue. Your physician will monitor your B-12 levels and prescribe the appropriate amount of supplementation.
Special Considerations for Pregnancy
Pregnancy complicates issues with vitamin intake after gastric bypass surgery in women. Pregnant women need extra vitamins to sustain a healthy pregnancy, so your OB-GYN will prescribe prenatal vitamins as with all other pregnant women; however, you may have to make some adjustments to ensure that your absorb the vitamins. Women may have difficulties tolerating regular prenatal vitamins after bypass surgery due to ulcer formation or indigestion, notes the San Jose Bariatric Surgery Center. You may need to take chewable or liquid prenatal vitamins; these vitamins should include folate, vitamin B-12, iron, calcium and vitamin D. Your physician will closely monitor your nutritional status as the pregnancy progresses.
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