Your Post-Surgical Vitamin Regimen

Bariatric surgery is weight loss surgery performed on obese or severely overweight individuals. Weight loss surgery patients need to take vitamins and supplements for the rest of their lives, but the types and amounts of supplements vary depending on the bariatric surgery procedure performed and the individual.

Procedures such as gastric bypass, sleeve gastrectomy, and lap band decrease the stomach size to reduce the amount of food eaten.  As a result of restricted food intake, your bariatric surgeon and registered dietitian will recommend you take 3 vitamin/mineral supplements for the rest of your life in order to ensure adequate intake of nutrients.  Patients who have had gastric bypass surgery or sleeve gastrectomy procedure may need additional supplements because surgery can cause nutrient malabsorption.  Our dietitians recommend the following vitamins after bariatric surgery.

* Multivitamin – You will be advised to take a multivitamin in the chewable form.  It cannot be a gummy, because they do not contain iron.  It needs to be a complete multivitamin that contains 100% of you daily iron needs (18mg).   You will need to take 2 per day, unless otherwise specified.  Below is a list of the multivitamins that we recommend taking.

• Flintstone Complete or generic equivalent.  NO GUMMIES
• ProCare (procarenow.com)-only need to take ONE CHEWABLE per day
• OPURITY™ by Unjury® (www.OPURITY.com) – only need to take ONE CHEWABLE per day
• Bariatric Advantage® (www.bariatricadvantage.com)-must take iron supplement in addition to this vitamin
• Prenatal chewable (requires a prescription)
• Celebrate Bariatric Supplements (www.celebratevitamins.com)

* Vitamin B-12 – A Vitamin B-12 supplements is advised after your weight loss surgery.  It can be taken in liquid, tongue dissolving, nasal spray or injectable forms. Vitamin B-12 helps produce red blood cells and prevents anemia.  Choose from below:

• Nasal spray (requires a prescription):   Nascobal: 1 spray in 1 nostril once a week (www.nascobal.com)
• Sublingual: 500 mcg/1 x day (If it has 1,000 mcg, can do every other day). Do NOT purchase 2,500 mcg!
• Shot: 1,000 mcg/1 x month

* Calcium Citrate with Vitamin D:  1200 mg/day (1500 mg/day postmenopausal women and adolescents).  Make sure you take “CITRATE” not carbonate! The body cannot absorb all 1200-1500 mg at once so you must break up into smaller doses (400-600mg doses).  Both vitamin D and calcium help to build strong bones and prevent bone loss.   Vitamin D helps your body better absorb calcium.  Choose from below:

• Citracal® with vitamin D or generic equivalent-4 pills/day (take 2 pills with lunch, take 2 pills with dinner) Band patients must crush!
• Citracal® with vitamin D Petites or generic equivalent-6 pills/day (take 3 pills with lunch, take 3 pills with dinner.
• Bariatric Advantage® Calcium with vitamin D chewable-3 lozenges/day OR 5 chewy bites/day (www.bariatricadvantage.com)
• OPURITY™ by Unjury® Calcium Citrate Plus chewable- 4/day (www.opurity.com)
• Celebrate Bariatric Supplements Calcium with Vitamin D chewable-3/day (www.celebratevitamins.com)

Because calcium supplement absorption can be impacted by ingesting iron, calcium and iron supplements should be taken at least two hours apart.  You should wait 2-3 hours between taking multivitamin and calcium supplement because the iron from the multivitamin and calcium will compete for absorption!

Common additional supplementation includes Vitamin D and Iron.  Vitamin D is a challenge for the body to absorb through food, and even more so for patients who have had certain bariatric surgery procedures. Therefore, a vitamin D supplement is often needed after weight loss surgery.  If you become low on iron after bariatric surgery, you may feel weak and fatigued. If recommended by your weight loss surgeon, taking iron supplements can help prevent anemia and build your body’s red blood cells.

We will monitor your lab work at your six month follow-up, one year follow-up and annually after that in order to see if additional or less supplementation is needed.