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What Vitamins Should I Take After Gastric Bypass Surgery

Gastric Bypass Vitamin Schedule


Your weight loss surgeon along with their nutritionist consultant will recommend a customized gastric bypass vitamin schedule based on the results of your bloodwork. To improve compliance, your surgeon may suggest a few different options for your bariatric vitamin schedule. These may include:

  • Schedule 1: A complete gastric bypass multivitamin that includes both iron and calcium may be the simplest option to follow. Depending on your needs, you may take these chewable or liquid bariatric vitamins 4 times a day.
  • Schedule 2: This gastric bypass vitamin schedule may include bariatric multivitamin with B12 and iron . In addition, a calcium citrate dose of 1500 mg daily may be recommended in chewable tablet or pill form.
  • Schedule 3: If your surgeon determines that you need more of B12 bariatric vitamins, they may recommend a gastric bypass vitamin schedule that includes a multivitamin with iron , calcium citrate and vitamin B12 daily.
  • Schedule 4: When addition reinforcement of both B12 and iron is required, your gastric bypass vitamin schedule may include multivitamin, iron , vitamin B12 , and calcium citrate per day for best results.

Is It Ok To Skip Vitamins

MultivitaminsSkipmultivitaminvitaminsSymptoms of Vitamin B12 Deficiency

  • Weakness, tiredness, or lightheadedness.
  • Heart palpitations and shortness of breath.
  • Pale skin.
  • Constipation, diarrhea, loss of appetite, or gas.
  • Nerve problems like numbness or tingling, muscle weakness, and problems walking.
  • Vision loss.

How To Take Fish Oils

If you have had bypass surgery with grafts made from veins: take 4 grams of fish oils a day.

As an anti-inflammatory: take 30 to 40 milligrams of EPA and DHA per kilogram of your body weight a day.

For doses greater than 3 grams, you should consult your doctor because of an increased risk of bleeding.

Take fish oils with meals. Supplements may be easier to tolerate if you take them in divided doses. Try 1 gram 3 times a day instead of 3 grams in one sitting.

Dont buy cod liver oil to get your omega-3 fatty acids. It contains high amounts of vitamin A and vitamin D, both of which can be toxic in large doses.

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How Common Is The Problem Of Vitamin Deficiency After Gastric Bypass

What many dont realise, is that most patients, if not all, who undergo gastric bypass surgery will need to take vitamin supplements for the rest of their lives. Vitamin deficiency after gastric bypass is something experienced by almost 40% of all gastric bypass patients. Whether it be due to patients not adhering to the strict dietary and supplementation guidelines after surgery, or physicians not diligently checking their patients vitamin levels, the problem of vitamin deficiency after gastric bypass surgery is surprisingly very common.

How Can I Prevent Loose Skin After Bariatric Surgery

Gastric Bypass Surgery

A Balanced Diet Can Reduce Loose Skin After Weight Loss Surgery. After bariatric surgery, a balanced diet with plenty of protein can help you keep the weight off, retain lean muscle, and feel better than ever. This diet may help to some degree to minimize loose or excess skin.

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What Types Of Vitamins Do I Need

Before driving to the local Walgreens or CVS to stock up on vitamins youll need to know what type of vitamins you need. Not all vitamins are created equal.

Lets start with some guidelines of what not to take:

  • No gummy vitamins.
  • Avoid childrens vitamins which are incomplete.
  • Consider additional supplementation if you take an all-in-one multivitamin with calcium and iron.
  • Choosing a Multivitamin

    • Depending on the brand and size of the vitamin youll need to take between 1 and 4 pills, or chewable tablets daily. Read the label to find out how many are required daily.
    • It should contain at least 18mg of iron. If you choose a multivitamin without iron, youll need to take iron supplementation separately.
    • Your surgeon or dietitian should provide guidance on how much iron youll need after surgery.
  • It should contain at least 400 mcg of folic acid.
  • At least 200% of the recommended daily intake for most, if not all, of the vitamins and minerals listed on the label.
  • It contains at least 2mg of copper.
  • Should contain 12 mg of thiamin.
  • At least 3,000 IU of Vitamin D.
  • Lets take a look at the label below.

    Choosing Vitamin B12

    • At least 500 mcg per day of Vitamin B12 .
    • B-12 that dissolves or chewable tablets are the most common choice for vitamin B-12 supplementation.



    The Most Important Vitamins For Bariatric Patients

    So what are the most important vitamins for bariatric patients? Since the body processes the vitamins differently after weight loss surgery, it is important to make sure that you are adding in certain vitamins and minerals. Specifically, you need to add iron, B12, calcium and vitamin D.

    You should take a multivitamin daily. Look for one that has at least 18 mg of iron. Make sure you are getting 1500 mg of calcium a day to prevent bone density loss. To make sure you are getting the best absorption possible, split the dosage of calcium between 3 doses a day. Do not mix the calcium and iron together since iron can have an effect on calcium absorption. To make sure you are getting enough Vitamin D, you will want to take 800 to 1000 IU daily. It is best to take this in 2 doses and take them at the same time you take the calcium. You can also opt for a vitamin that is calcium and Vitamin D together. The last vitamin you want to make sure you are getting enough of is Vitamin B. You can take this as 500 mg daily or as a monthly injection.

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    Not Taking Vitamins After Gastric Sleeve

    The primary cause of post-bariatric nutritional deficiency is not taking vitamins after gastric sleeve surgery. Bariatric vitamins for gastric sleeve patients should be decided in consultation with the surgeon and a certified dietitian. Not taking vitamins after gastric sleeve as recommended by the surgeon may sometimes lead to the following illnesses.

    • Vitamin B1 deficiency can cause beriberi disease
    • Vitamin B2 deficiency can cause nerve, eye, skin problems
    • Vitamin B3 deficiency can cause pellagra disease
    • Vitamin B4 deficiency can cause hair loss and dry skin
    • Vitamin B5 deficiency can cause fatigue
    • Vitamin B6 deficiency can cause anemia, dermatitis, insomnia
    • Vitamin B12 deficiency can cause leucopenia, glossitis, nerve damage

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    How It Can Cause A Vitamin B12 Deficiency


    In the stomach, theres a paper-thin layer called the gastric mucosa. This layer releases intrinsic factor that helps the stomach to absorb vitamin B12 from food. The new stomach pouch is so small that there is a decrease in gastric acid. When food is traveling through this small section of the stomach, the gastric mucosa is unable to provide enough intrinsic factor to allow vitamin B12 to be adequately absorbed.

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    Calcium Citrate After Gastric Bypass

    To any who have had gastric bypass surgery or to those considering gastric bypass surgery, you should know that intestinal calcium absorption is effected by weight-loss surgery. Forty-eight percent of patients who have had malabsorptive bariatric surgery develop a calcium deficiency and may need calcium citrate after gastric bypass.

    Using Supplements After Gastric Bypass Surgery

    Posted in:Weight Loss BlogTags:Gastric BypassPosted on:

    surgery reduces the size of the stomach and reroutes the digestive system so that fewer nutrients are absorbed. You will need to pay very careful attention to what you consume after your surgery to make sure that you get the vitamins and minerals you need each day.

    Taking a good multivitamin daily is one of the most important things you will need to do to maintain good health after weight loss surgery. Failing to keep up with that can lead to serious complications related to vitamin deficiencies. However, a multivitamin alone will not be enough to make up for nutrients you will no longer be getting from foods.

    You should also supplement B vitamins. A B-1 deficiency can cause heart problems. It can also lead to a nervous system disorder known as beriberi. Symptoms include dizziness, nausea, vomiting and a loss of appetite. B-12 is also necessary. Many surgeons recommend that you take 500 micrograms of B-12 in a sublingual pill each day.

    Anemia is common after weight loss surgery, and an iron supplement can help stave it off. Taking your iron supplement with orange juice or with an iron supplement can help your body absorb iron more efficiently.

    Calcium helps protect bones against breakage. You should take 1200 milligrams each day. Take half of this in the morning and half at night. Do not take calcium supplements at the same time as iron, as calcium can keep iron from being absorbed properly.

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    What Is Roux En Y Gastric Bypass Malabsorption

    Gastric bypass malabsorption, or Roux en Y gastric bypass malabsorption, refers to the bodys inability to absorb vitamins and minerals from the food being consumed. While this is an important process of supporting weight loss, not absorbing the vitamins and minerals after gastric bypass surgery can also be incredibly dangerous and lead to severe deficiencies.

    During gastric bypass surgery, surgical staples are used to create a small pouch in the top part of the stomach. The pouch is then attached to the lower part of the small intestine, creating a channel for food to bypass most of the stomach and the first section of the small intestine. There are two main reasons this procedure supports weight loss:

  • The small stomach pouch can only hold so much food before feeling full
  • Less food is absorbed into the body
  • While this means that fewer calories are absorbed into the body, it also means that the section of the intestine that normally absorbs important vitamins and minerals is out of action. Absorption of the majority of the nutrients takes places in the jejunum, with a few exceptions: iron is absorbed in the duodenum, and vitamin B12 and bile salts are absorbed in the terminal ileum. During gastric bypass, the duodenum is entirely bypassed, as well as the distal stomach and proximal jejunum, contributing to potential vitamin and mineral deficiencies.

    Life After Bariatric Surgery

    Vitamins and Minerals After Bariatric Surgery

    Weight-loss surgery is not a cure for obesity, but rather a tool to help you lose weight to live a healthier, longer and more fulfilling life. Success depends on your ability to follow guidelines for diet, exercise and lifestyle changes.

    The UCSF Bariatric Surgery Center offers comprehensive follow-up care, including a support group, dietitian services and continuing education to help you achieve long-term success.

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    Follow Your Diet Carefully

    You will need to make sure you are getting enough protein, vitamins, and minerals while you are losing weight quickly. Eating mostly protein, fruits, vegetables, and whole grains will help your body get the nutrients it needs.

    Protein may be the most important of these foods early after surgery. Your body needs protein to build muscles and other body tissues, and to heal well after surgery. Low-fat protein choices include:

    • Skinless chicken.
    • Lean beef or pork.
    • Fish.
    • Whole eggs or egg whites.
    • Beans.
    • Dairy products, which includes low-fat or nonfat hard cheeses, cottage cheese, milk, and yogurt.

    After gastric bypass surgery, your body will not absorb some important vitamins and minerals. You will need to take these vitamins and minerals for the rest of your life:

    • Multivitamin with iron.
    • Vitamin B12.
    • Calcium and vitamin D. Your body can absorb only about 500 mg of calcium at a time. Divide your calcium into 2 or 3 doses during the day. Calcium must be taken in the “citrate” form.

    You may need to take other supplements also.

    You will need to have regular checkups with your provider to keep track of your weight and to make sure you are eating well. These visits are a good time to talk with your provider about any problems you are having with your diet, or about other issues related to your surgery and recovery.

    Should I Take Vitamins And Supplements After Weight Loss Surgery

    After weight loss surgery, your body may not absorb enough of certain vitamins and minerals specifically, iron, vitamin B12, calcium and vitamin D. Long-term health complications, such as anemia, can develop due to a deficiency of iron or B12 neurological complications, such as memory loss or irritability from a lack of B12 and bone and kidney disease due to changes in the way your body absorbs calcium and vitamin D.

    It is important that you take the following vitamins and supplements on a daily basis after weight loss surgery to prevent nutrient deficiencies.


    Take a chewable multivitamin daily containing a minimum of 18 mg of iron. Brands that contain this formula include Trader Joe’s, Flintstone and Centrum. Childrens chewable vitamins also can be taken in an adult dose by taking two tablets daily.


    Take 1,500 mg calcium citrate or 2,000 mg calcium carbonate daily to prevent calcium deficiency and bone disease. To enhance absorption, take the calcium supplement as three divided doses at three different times a day. Calcium citrate is the preferred form of calcium. Do not take calcium at the same time as your multivitamin with iron, since the iron may affect calcium absorption.

    Vitamin D

    Take 800 to 1,000 international units of vitamin D daily. This total amount should be taken as 400 to 500 IU twice daily with your calcium supplement. If you prefer, you can take a combination calcium-vitamin D supplement as long as it contains the proper dosages.

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    Vitamin Guidelines After Bariatric Surgery

    After bariatric surgery, you must take vitamins for the rest of your life. Serious illness can result from non-compliance with your vitamin and mineral guidelines. Mood, energy, and focus can also suffer from a lack of proper vitamins after bariatric surgery. Blood tests are required every three months for your first year after surgery and annually after that.

    In this article:

    • Why vitamins and minerals are essential after bariatric surgery.
    • What types of vitamins and minerals are required by procedure?
    • What to look for when buying vitamins and minerals.
    • Signs and symptoms of vitamin and mineral deficiencies.
    • How much you can expect to spend monthly.

    Which Vitamins Do I Really Need


    Spring 2010

    To view a PDF version of this article,

    After weight-loss surgery, one of the things that most people have to adopt as a new habit is taking vitamins every day. While there are general things that might be the same between what your doctor recommends and what another doctor recommends, some things might be different.

    When answering the question, What do I really need to take?, the first and most important answer is Take what your doctor recommends. Somewhere along the way, your bariatric surgeon, or the dietitian in the office, probably gave you a list of the vitamins you needed to take after surgery based on your procedure.

    Also, if your doctor looked at your labs, you might have been given some very specific recommendations just for you. Either way, this is where you should start. If you have not seen your bariatric surgeon in many years, it is also wise to call the office and find out what the current recommendations are knowledge about nutrition has changed a lot in recent years and they might have new recommendations that you were not given.

    Generally speaking, taking supplements after surgery is for three reasons:

    • To make sure you get adequate vitamins and minerals even though you are eating less food
    • To help prevent deficiencies that you are at greater risk for because of your procedure
    • In some cases, to treat a nutritional deficiency

    The most common types of supplements taken after surgery are multivitamins, calcium, vitamin B12 and iron.


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    Benefits Of Fish Oils

    Omega-3 fatty acids strengthen the hearts electrical system, preventing heart rhythm abnormalities. Within the artery walls, omega-3 fatty acids inhibit inflammation, which is a factor in plaque build-up. Therapeutic doses of fish oils are therefore used to prevent the re-blockage of arteries that commonly occurs after angioplasty, a procedure in which a small balloon is used to open blocked blood vessels.

    Omega-3 fatty acids are also effective general anti-inflammatories. Other preliminary evidence suggests that fish oils have many additional benefits, including prevention of graft failure after heart bypass surgery.

    Why Do I Need Vitamins After Gastric Bypass Surgery

    Gastric bypass surgery is an incredibly effective weight loss procedure regularly performed in all states of Australia. A form of bariatric surgery, gastric bypass operations are used to treat morbid and extreme cases of obesity. For those undergoing gastric bypass surgery, lifelong nutritional support is a critical factor in successfully losing weight and keeping it off.

    The nature of gastric bypass surgery means that a portion of the small intestine is bypassed, which forces the body to undergo neuroendocrine changes and absorb fewer nutrients from food consumed. While post-operative dietary requirements can often provide sufficient vitamins and minerals, most gastric bypass patients will need to supplement and take additional vitamins after surgery because of gastric bypass malabsorption.

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    What Are The Best Vitamins To Take After Bariatric Surgery Here Are Some Vitamins To Support Your Health After A Gastric Bypass Surgery

    Bariatric Multivitamin

    A bariatric multivitamin is essential to health for those who have had a bariatric procedure. Bariatric multivitamins are much different than a regular multivitamin you would find at a drug store. Bariatric multivitamins should contain higher levels of vitamins and minerals than a typical multivitamin. The American Society for Metabolic and Bariatric Surgery recommends that bariatric patients take a multivitamin with high doses of B1, B12, vitamin A, and vitamin D.3


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