What Vitamins Do You Have to Take After Gastric Bypass

Individuals who undergo gastric sleeve or bypass surgery have reduced ability to absorb vitamins and electrolytes which places them at higher risk of developing nutritional and vitamin deficiencies (especially gastric bypass patients). These deficiencies include, but are not limited to, vitamin A, B, C, D, E, K, folate, calcium, iron, zinc and magnesium.

It is recommended that you BEGIN TAKING VITAMINS AS SOON AS YOU START THE PRE-OP DIET and get into a habit of taking them daily FOR THE REST OF YOUR LIFE.

Stop taking vitamins 3 days before surgery, when you start your liquid diet stage, since taking vitamins on an empty stomach or without solid food may cause nausea.

Resume taking vitamins after surgery as soon as you are able to tolerate pills (it is fine to wait 1 or even 2 weeks before you resume vitamins after surgery to allow your stomach to heal, or you may use liquid vitamin forms or a pill crusher).

You will need to purchase the following vitamins:

• Multivitamins (ideally with Iron and B12)
• Iron (if not included in the multivitamins)
• B-Complex (with B1)
• Calcium Citrate with D3
• Magnesium Citrate (is often combined with Calcium Citrate and D3)
• Omega 3
• Probiotics

Note! It is not required to purchase specifically bariatric vitamins (Calcium Citrate, Vitamin B Complex and Probiotics do not need to be a bariatric brand; though they are often better tasting and are higher quality products). You can choose any brand as long as you reach the recommended doses of each vitamin. Keep in mind that standard over the counter (OTC) vitamin brands are formulated to meet the nutritional needs of the general population. As a bariatric patient, your body requires a much higher level of 13 micronutrients that OTC brands will not meet; this is why we recommend using bariatric formulated brands when available.

Below you will find recommendations for each vitamin, brand and dosage.

NO GUMMIE VITAMINS OF ANY KIND AFTER SURGERY!

Dosage:
Bariatric formulated Multivitamin with iron & Vitamin B12: 1 serving daily (each brand has different serving sizes, read the label carefully, one serving may require 1, 2, or 3 pills or capsules per day.)

Non-bariatric multivitamins: 2 serving sizes daily (200 % Recommended Daily Allowance (RDA))

We recommend capsule presentation, as chewable tablets are often reported by our patients as unpalatable.

Important! If you choose a non-bariatric formulated multivitamin, be sure to either choose multivitamin complex that includes iron, or take iron separately.

Iron (100 % RDA) use one the following types:

• Ferrous Sulfate 325 mg/day (some brands may say 65 mg of elemental iron, it is equivalent to 325 mg of ferrous sulfate)
• Ferrous Gluconate 325 mg / day
• Elemental Iron 18-27 mg /day

Note! Always allow at least 2 hours between Calcium Citrate and Iron (or multivitamins that include iron) for better absorption. If ferrous sulfate has unacceptable side effects (nausea or stomach pain), ferrous gluconate is a possible alternative for patients who cannot tolerate ferrous sulfate. Be aware that iron intake will cause dark stools, it is normal.

Note! All bariatric formulated multivitamins include the recommended dosage of vitamin B12. If your non-bariatric multivitamin brand does not include B12 or the dosage is low, be sure to take it separately as B12 or part of B-Complex. See the recommended daily dosage below:

Vitamin B12 (Cobalamin) use one of the options:

• 500 – 1000 mcg per day (ideally sublingual dissolvable pills or liquid form)
• 1000 mcg twice a month by injection (only if necessary)

Your lab values will be high when taking this amount of B vitamins. We expect this high lab value; taking the B complex helps prevent a deficiency. We will adjust your intake based on your post-op lab work that is recommended 3, 6, 12, and 24 months post-op.

B-vitamins can be taken on an empty stomach, all others should be taken with a meal.

Dosage:
Calcium Citrate 1500-2000 mg/day – Vitamin D3 800-2000 UI /day

Divide this into 2-3 servings per day to reach the daily recommended dosage and for better absorption.

Choose a brand that contains Calcium Citrate and vitamin D3. Avoid Calcium Carbonate or Calcium Caltrate.
Remember: separate the multivitamin with iron from calcium citrate by 2+ hours for maximum absorption.

If possible, give preference to Calcium brand that contains Magnesium, otherwise take Magnesium separately.

Magnesium Citrate Dosage: 400 – 500 mg per day

We recommend that you start taking Omega 3 (fish oil) during your pre-op diet and resume as soon as you can tolerate it after surgery, preferably 2- or 3-months post-op. Give preference to brands that source fish oil from non-farmed wild species. If you are allergic to fish, use capsules with flaxseed oil, also a great source of Omega 3.

Omega-3 Dosage: 2000 mg per day (with meal).

After weight loss surgery, the balance between "good" and "bad" bacteria may become altered. This is due to disruption of your GI tract, as well as the use of antibiotics after surgery to help prevent infection. While antibiotics can help keep harmful bacteria under control, they can also wipe out the good bacteria in your body. The number and type of intestinal bacteria is regulated by both intestinal motility and gastric acid secretion, which are both altered with the weight loss surgery (WLS). Probiotics will also help vitamin B12 absorption and will help decrease intestinal inflammation and other types of discomfort that often follow WLS.

There are many over the counter probiotics available, most of them contain only one strain of bacteria. Probiotics with at least 5 billion colony forming units (CFUs) per dose that contain at least seven strains of probiotics appear to be the most effective. Probiotics are most effective when taken with meals (unless the label states otherwise). Probiotics come in many forms, including pills, powders, liquids, capsules, and chewable tablets.

*3^rd Calcium intake is recommended for bypass patients only or women after menopause after either gastric sleeve or bypass.

*Extra iron (additionally to multivitamins with iron) only if needed after having lab work done to confirm iron deficiency.

Note! You may take vitamins throughout the day at your convenience (make your own schedule), as long as you do not take Calcium and iron (or multivitamins that contain iron) at the same time.

What Vitamins Do You Have to Take After Gastric Bypass

Source: https://www.golightbariatrics.com/vitamins-pre-and-post-op/

Share this post