What Vitamins after Bariatric Surgery?

Steph Wagner MS, RDN

April 6, 2018

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What Vitamins after Bariatric Surgery does a Patient Need…

 

and for how long?

(Vitamins after Bariatric Surgery for each operation, Updated March 2021)

 

 


 

Common Vitamin Questions after Bariatric Surgery

Are you wondering about vitamins after bariatric surgery? Or how long you need to take them?

These are common questions I answer as a bariatric dietitian. Below is a video with a few answers but be sure to keep scrolling for the image of what vitamins you may need based on your surgery, gender, age and past history. *Note this is based on the ASMBS 2019 White-paper and is not meant to be medical advice. Be sure to have your annual labs and visits with your bariatric team.

Vitamins are HARD! My biggest encouragement is to keep trying. Work with a bariatric dietitian for new ideas or ways to hit your vitamin needs in the way that best works for you.

If you don’t have a bariatric dietitian you are currently working with, you are welcome to email me and I can help find someone licensed in your state.

 

 

 

Vitamin Recommendations after each bariatric surgery, gender and other key factors

 

Click on the image for a larger view of the information!

 

You can also click here for the PDF format which is best for printing

what vitamins after bariatric surgery? vitamin recommendations duodenal switch DS or single anastomosis duodenal switch SIPS SAD for male or post menopause female with history of anemia vitamins after bariatric surgery recommendations for duodenal switch DS or single anastomosis duodenal switch SIPS SADI for post menopause females vitamins after bariatric surgery recommendations for duodenal switch DS or single anastomosis duodenal switch SIPS SADI for pre menopause females vitamin recommendations for duodenal switch DS or single anastomosis duodenal switch SIPS SADI males vitamin recommendations for Gastric Band pre-menopause female vitamin recommendations for Gastric Band post-menopause female or male with history of anemia vitamin recommendations for Gastric Band male vitamin recommendations for Gastric Bypass post menopause female vitamin recommendations for Gastric Bypass pre menopause female vitamin recommendations for Gastric Bypass male or post menopause female with history of anemia vitamin recommendations for Gastric Bypass male vitamin recommendations for Gastric sleeve post menopause female vitamin recommendations for Gastric sleeve pre-menopause female vitamin recommendations for Gastric Sleeve male or post menopause female with history of anemia vitamin recommendations for Gastric sleeve male

 

Common bariatric vitamin questions:

 

How long do I need to take bariatric vitamins?

Answer: For the duration of your life :) Once you’ve had the anatomy altering surgery such as Gastric Sleeve, Gastric Bypass or Duodenal Switch your vitamins needs will always be the same.

You will not grow out of needing to supplement your diet with vitamin therapy.

Wondering about lab work after bariatric surgery? Here is a post on ‘What Lab Work is Needed after Bariatric Surgery’

What about if I haven’t been taking vitamins but my labs are always fine?

I wouldn’t get too comfortable! Lab values will come back normal, normal normal and then drop.

In fact, many doctors and nurses will glance at your labs to see if they are in the normal level but won’t always pay attention to if things are trending DOWNWARD.

I recommend asking for a copy of your labs and watching the trends yourself. It’s much better to catch that a lab value is heading downward instead of waiting for it to drop to a level that your doctor or nurse will address it.

 

What is the easiest and most cost effective way to get the vitamins I need?

I recommend sticking with bariatric specific vitamins because you don’t have to take as many vitamins in the end. These vitamins have been formulated for surgery patients so the iron is high enough, the B12, the vitamin D and so on. This keeps you from needing to take lots of others which is easier and cheaper!

My recommendations for bariatric vitamins:

Celebrate Vitamins

Celebrate Vitamins – Save 10% with this affiliate link to the Bariatric Food Coach Store on the Celebrate website

Multi-Complete 60

Calcium Citrate Soft Chew

After Gastric Sleeve or Gastric Bypass a patient could take one of the Multi-Complete 60 and three Calcium Citrate Soft Chews a day and meet all of the ASMBS guidelines. Calcium needs to be space out one at a time, two hours apart.

 

BariMelts Vitamins

Melt in your mouth vitamins that dissolve in less than 2 minutes with good flavor. Read my full review here (includes a 20% off shopping link- affiliate).

Multivitamin

Calcium Citrate

Iron

After Gastric Sleeve or Gastric Bypass some patients could take two of the Multivitamin and four Calcium Citrate and meet all of the ASMBS guidelines. Patients who need additional iron would add the BariMelts iron. Calcium needs to be space out two at a time, two hours apart from iron containing vitamins.

Save 20% off BariMelts Vitamins with this link!

 

Bariatric Advantage

Click here for their website (affiliate link)

Ultra Multi with Iron

Calcium Citrate Chews

Chocolate Raspberry Iron Chew – when patients don’t tolerate iron…this one tends to work the best! 

Why can’t I take one pill?

The biggest reason is that you cannot take calcium and iron together as they compete against each other to get absorbed. They are not team players.

Most bariatric vitamins will now contain iron (be sure to purchase the one that contains the correct amount of iron based on the photos above). Calcium is the one that will need to be taken separately.

The ASMBS recommends Calcium Citrate in no more than 500 mg at one time (that is all that is absorbed at once). For Gastric Band, Sleeve and Bypass you will need 1200-1500 mg each day. This means you’ll likely take 500 mg three times a day (2 hours apart from each other).

If you had a DS or SIPS/SADI operation you will need 1800-2400 mg of calcium citrate a day which means four times a day. You can count calcium in your foods to get to this range as well.


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17 thoughts on “What Vitamins after Bariatric Surgery?”

  1. Steph –
    I am just starting with a new doctor who is not familiar with Bariatric Surgeries and Patients. Is there a place I can go to get a printout of what I should be taking and what she should be doing for my local care? I would like to present her with all of this information so that if any issue arise, we can address them according to medical standards for me.

    Leanne

  2. Is it a concern with vitamin D intake more than recommended, since the Calcium contains vitamin D as well? One would take in a total of 4500 IU? How soon can one transition to a capsule form? Thank you!

  3. @kizz not a problem for the calcium to have vitamin D! In fact, vitamin D helps absorb your calcium which is why they contain the D. Best to verify with your surgeon when to transition to capsules – I’ve had doctors approve taking it right away and others that wait a couple weeks. Great question!

  4. IS it a good idea to get started with this regimine about 15d prior to surgery? I already do b12, vit D, folic acid, and multi vitamin

  5. @Lisa Consult with your surgery center but many patients do start the routine in advance to get used to the schedule and typically no concern with supplementing in advance. Sounds like you are ahead of the game with the vitamins you are already taking! Best wishes in your upcoming surgery – and beyond!

  6. Hi Steph,

    I was wondering if you have ever heard of ProCare Health Bariatric Multivitamins and what your thoughts were on them? They advertise as only having to take one tablet to meet ASMBS guidelines plus 2 calcium chews. I was just wondering because they are significantly cheaper than Bariatric Advantage, Celebrate, Bariatric Fusion and Optisource. The cost is $16.98 for a 30 day supply.
    Thank you,
    Jamie

  7. @Jamie I hesitate some to think the pouch can absorb everything in one pill however you could try that routine and keep a watchful eye on your lab work. When your surgeon runs labs, always ask for a copy and then the next time compare all the levels. Even if something is normal range, look for anything dipping significantly from the time before. If you have labs and everything is in normal range and there are no significant changes to your levels then you can feel good about the routine. Everyone’s body absorbs differently too so you may do well with this and someone else may see dips. Just good to keep a watchful eye!

  8. I have a question about bariaric patients taking algae calcium instead of calcium citrate. I have read it is better absorbed by the body because it is plant-based and not from rock.

  9. @MHish I am not familiar with aglae calcium! I will continue my education on the absorption but unfortunately there is nothing published related to bariatric surgery, so I don’t have any official recommendations to share!

  10. Hi Stephanie,
    I am a post sleeve patient. My hair has thinned tremendously since surgery. I am taking Bariatric Advantage vitamins and Biotin. Do you have any suggestions?

  11. @sp It can depend on how long it has been since surgery. If it’s within one year it is more of a stress related hair loss and vitamins unfortunately won’t prevent that. The hair does grow back and the biotin will help hair to be healthy but not necessarily change the loss. If it has been more than a year since surgery I would keep up with routine lab work and look at iron and zinc in particular. Here is a blog post about hair loss after surgery! https://www.bariatricfoodcoach.com/hair-loss-weight-loss-surgery/

  12. I am not supportive of them. My bariatric dietitian colleagues have reported their patient lab values go down when someone uses the patches for their vitamin needs.

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