No gummy vitamins after gastric bypass surgery is a common problem. This article will help explain why not taking your vitamins after bariatric surgery is important and how to get some vitamins into your body following surgery.
Vitamins are an essential dietary supplement. It allows us to stay healthy and prevent diseases. However, not taking vitamins after bariatric surgery may lead to some serious consequences that you should know about.
vitamins for after bariatric surgery
Vitamins are essential in a healthy diet. After bariatric surgery, there is a very high risk of vitamin deficiency due to the changes in your diet. The next time your doctor recommends taking vitamins after gastric bypass, don’t forget to add them to your post-surgery regimen.
Taking vitamins is essential for good health after bariatric surgery, but that’s not the only reason. Many patients who start the BBL program will struggle to take sufficient vitamins because of increased difficulty in swallowing and digestion. Over time, their bodies become used to the smaller amount of nutrients needed for a balanced diet, causing an overall decrease in their vitamin intake. Even worse, some patients may have been advised by their doctor not to take any supplements in order to avoid possible reactions while they’re undergoing surgery.
consequences of not taking vitamins after gastric bypass
Vitamin deficiencies after gastric bypass surgery aren’t that uncommon and can be a big problem. But there are many solutions, which you should know about before and after your procedure.
You’ve done all the hard work and shed what you couldn’t fit into your new, slimmer body. Now it’s time to reap the benefits of your weight loss surgery. After losing over 100 pounds, you are likely making efforts to live a healthier lifestyle towards a healthier life. This includes avoiding junk food and eating more nutritious foods, exercising more often, breathing in more oxygen and moving at a slower pace. But what happens when you aren’t getting enough vitamins and nutrients? What if your body isn’t strong enough to fight off all of those germs? What if you don’t get enough energy because of this too?
why no gummy vitamins after bariatric surgery
When your body is missing critical vitamins and minerals it can alter your mood, affect focus and energy levels, as well as cause deficiency-related diseases. Obtaining enough of the necessary vitamins and nutrients the body needs is hard enough for an average person, and is challenging for bariatric surgery patients.
WHY DO BARIATRIC SURGERY PATIENTS HAVE TO TAKE VITAMINS?
Bariatric surgery changes the size of the stomach causing individuals to eat less, and since some techniques alter the digestive system, nutrients from foods that are ingested cannot thoroughly be absorbed. This decrease in absorption means that many vitamins, minerals, and micronutrients critically needed by the body are not being captured.
How Does Gastric Bypass Work?
How does gastric bypass work?
WHAT HAPPENS IF YOU DON’T TAKE VITAMINS AFTER GASTRIC SLEEVE OR OTHER WEIGHT LOSS SURGERY?
The main objective of bariatric surgery is to improve one’s health, which will require proper nutrition. Proper nutrition involves providing the body with the nutrients it needs to function properly. Some can be obtained through meals, and others will have to be supplemented.
Usually, the doctor or weight loss clinic will monitor your nutrient levels as well as set up a schedule and dosage lineup of vitamins and supplements for you to take. Your vitamin regime must be taken seriously and strictly followed to avoid malnutrition and deficiency-related complications.
WHAT IS THE MOST IMPORTANT NUTRIENT AFTER BARIATRIC SURGERY?
There are three very important components in proper nutrition after bariatric surgery:
Macronutrients are proteins, carbs, and fats that will be tracked using daily goals or limits.
Micronutrients: this is a big word that means vitamins and minerals, but unlike proteins, carbs, and fat, your body only needs a small amount of vitamins and minerals. Macro is a prefix that means “large” and micro is a prefix that means “small”. Do not be confused, however, thinking that because the body only needs a SMALL amount, those micronutrients are unimportant because a deficiency can cause BIG problems.
Water: after weight loss surgery, it is very important you remain hydrated because dehydration is the reason bariatric surgery patients most often re-enter the hospital. You will be tracking your daily liquid intake to ensure you are getting the recommended amount. Most bariatric doctors recommend carrying around a 64-oz container of water and sipping on it throughout the day, except for 30 minutes before and after meals.
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WHAT VITAMINS & MICRONUTRIENTS ARE DEFICIENT AFTER BARIATRIC SURGERY?
The short answer to this is your body may become deficient in any vitamin or nutrient that you do not provide through a supplement after bariatric surgery. Let’s look at what vitamins and minerals you need to keep your body healthy as this will provide you a benchmark of what to look for when choosing supplements.
VITAMINS B FOR BARIATRIC PATIENTS
Vitamin B1 (or thiamin) helps turn food into energy and aids in growing healthy hair, skin, and the health of your liver. A thiamin deficiency will cause fatigue, fitful sleep, irritability, and abdominal discomfort.
Vitamin B12 is instrumental in the creation of new red blood cells and helps keep the nervous system functioning properly. B12 deficiencies can be asymptomatic but eventually lead to overall weakness, lightheadedness, the feeling of pins and needles, heart palpitations, vision changes, and more.
MICRONUTRIENTS FOR BARIATRIC PATIENTS
Iron is essential for our growth and development and is used to make hemoglobin which is a protein found in red blood cells. This protein transports oxygen from the lungs to all parts of the body. Iron is used by our bodies to manufacture certain hormones and has a plethora of other important functions.
In the United States, a deficiency in iron is an astonishingly common condition within the general public and more so among patients who have had bariatric surgery. An iron deficiency can begin with dizziness, general fatigue, feeling light-headed, a rapid heart rate or palpitations, brittle nails, and more. A chronic deficiency in iron will eventually lead to anemia which can cause even more severe complications and possibly even death.
Calcium and Vitamin D can both be derived from dairy products. A calcium deficiency can cause memory loss, confusion, muscle spasms or numbness, and tingling. A good source of Vitamin D is 15 (safe) minutes in the sun each day. Vitamin D helps keep our bones strong and healthy and increases the absorption rate of vitamin C. Vitamin D deficiency signs can cause muscle weakness and bone pain.
VIDEO: BENEFITS OF B12 INJECTIONS
LIST OF ESSENTIALS FOR BARIATRIC PATIENTS
Usually, bariatric surgery patients start with chewable tablets and then if tolerated, move to orally taken supplements. Special bariatric multivitamins help cut down on the number of pills you have to take. The vitamins you take should contain at least:
18mg of iron;
400 mcg of folic acid;
3,000 IU of vitamin D;
2mg of copper;
12 mg of thiamin;
200% for most, if not all, of the vitamins and minerals listed on the label of the daily recommended dose;
500 mcg per day of vitamin B12 (cobalamin or methylcobalamin). B-12 that dissolves in the mouth and chewable tablets are the most commonly used;
1500 mg per day calcium citrate. Normally taken in 500 mg doses 3 times a day. Calcium needs to be taken separately from iron because it inhibits iron absorption. It is recommended you take these two supplements at least two hours apart;
18 mg per day of iron. Taking iron in tandem with vitamin c helps the absorption rate. Take at least 2 hours apart from calcium supplement.
WHICH MULTIVITAMIN IS BEST FOR BARIATRIC PATIENTS?
Vitamin supplements are needed by bariatric patients for the rest of their lives to ensure that their bodies are getting the 24+ micronutrients required to function properly. Some micronutrients are needed in only trace amounts and others such as B vitamins or minerals, such as calcium, are required in larger dosages.
Multivitamins are available today that are made specifically for bariatric patients and specially formulated to contain proper dosages of most key elements to minimize the number of supplements needed every day. It is recommended that you choose one that follows guidelines recommended by the American Society for Metabolic and Bariatric Surgery (ASMBS).
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DO I HAVE TO TAKE VITAMINS FOREVER AFTER WEIGHT LOSS SURGERY?
After bariatric surgery, part of your daily routine for the rest of your life will be ensuring you consume your micronutrients. The doctor or nutritionist will work with you to determine the dosages you require and will make recommendations on how you can best obtain them.
Bariatric patients are fortunate today to have a wide range of products to choose from that offer solutions to many challenges facing weight loss surgery patients. Supplements are available in pill form, chewable form, drinkable form, and patch form. Using a combination of these can help patients reach their daily recommended dosages.
Weight-loss surgery can start you on the path to a healthier, longer and more fulfilling life. It is not a cure for obesity but rather a tool to help you lose weight. Long-term 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 and maintain your goals.
Medications
After bariatric surgery, your daily regimen will include short- and long-term medications. These include:
Omeprazole, which reduces the risk of developing ulcers in the digestive tract. Expect to take this medication for six months after surgery or indefinitely, as directed by your bariatric surgery team.
Ursodiol, which reduces the risk of developing gallstones during the postsurgical period of rapid weight loss. Expect to take it for six months after surgery. This medication is not needed for patients who don’t have a gallbladder.
The ProCare Health bariatric multivitamin, which has added iron plus all other necessary supplementation for patients who’ve had bariatric surgery. Expect to take this medication indefinitely to prevent vitamin and mineral deficiencies.
The Celebrate brand calcium supplement, which includes vitamins that enhance calcium absorption. This is taken indefinitely after surgery.
Capsule, chewable and liquid medications can be taken immediately after surgery, but tablet medications need to be broken up or crushed for the first three months. This prevents medications from getting stuck in the digestive tract or not being fully absorbed. Extended-release medications cannot be broken up, so our pharmacist will recommend alternatives prior to surgery.
After surgery, resume taking your usual medicines for other conditions, unless our pharmacist advised otherwise. We recommend checking in with your primary care provider and other specialists regularly after surgery, as rapid weight loss can necessitate frequent adjustments to medications, such as those for high blood pressure and diabetes.
After surgery, you should avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve). NSAIDs increase the risk of stomach ulcers. Patients who had gastric bypass surgery should avoid these medications indefinitely. If you had a sleeve gastrectomy procedure, you might be able to resume taking these medications after the sleeve heals (about three months after surgery), but consult your bariatric surgery team first.
Vitamin and mineral supplements
To prevent nutrient deficiencies, bariatric surgery patients need to take the following vitamin and mineral supplements daily:
Multivitamins – After surgery, taking a daily bariatric-specific multivitamin helps compensate for nutritional deficits. Bariatric-specific multivitamins include high doses of all necessary micronutrients, simplifying your postsurgical supplement regimen. The ProCare Health bariatric multivitamin can be purchased online without a prescription.
Calcium – We recommend taking 1,000 to 1,500 milligrams of calcium daily to prevent calcium deficiency and bone loss. Calcium citrate is the preferred form. To enhance absorption, reach the daily total by taking two or three divided doses over the course of the day. For example, take a 500-mg chewable or capsule supplement two or three times a day.
Vitamin D3 – This is in both the multivitamin and calcium supplement we recommend after surgery. The ProCare Health bariatric multivitamin has 3,000 international units (IU) of vitamin D3, and the Celebrate calcium supplement includes 500 IU per chew or capsule. You are therefore getting about 4,000 IU of vitamin D3 daily.
Birth control and pregnancy
We advise women of childbearing years to use an effective birth control option, such as an intrauterine device (IUD), for the first 12 to 18 months following bariatric surgery. During this time, the rapid weight loss and inability to consume normal food quantities impact a patient’s nutritional status. The physical demands of a pregnancy in the first year after surgery can compromise fetal health and result in birth defects. For the safety of patients and babies, we strongly recommend waiting at least 12 months before starting a pregnancy.
Returning to work
Many patients return to work two to four weeks after surgery, with no activity restrictions. It typically takes five to six weeks for your presurgery energy levels to return.
Diet
To prevent nutritional deficiencies and preserve muscle tissue, dietary guidelines seek to provide balanced meals while limiting calories. Each patient tolerates foods differently, so keep this in mind when considering suggestions.
Your daily caloric intake should be between 500 and 700 calories for at least the first 12 months after surgery, not exceeding 1,000 calories a day. Follow a well-designed dietary regimen that is high in protein and vegetables and low in carbohydrates and sugars. Your goal should be to get at least 60 to 80 grams of protein per day. High-protein foods include eggs, meats, seafood (including tuna and other fish), poultry, tofu and other soy products, milk, cottage cheese and Greek yogurt. It may take six to eight weeks after surgery before you are routinely reaching the protein goal.
Keys to success include keeping a daily record of portions and calories as well as following up with a dietitian regularly.
Here are some tips:
Eat slowly, take small bites, and chew thoroughly.
Avoid rice, bread, raw vegetables, fresh fruits, and meats that aren’t easy to chew, such as pork and steak. Ground meats may be easier to tolerate.
Eat balanced meals with small portions. In the initial period after surgery, you may only be able to tolerate one to two tablespoons of food at a time.
Avoid the use of drinking straws, carbonated beverages, chewing gum and ice. They can introduce excess air into your surgically created pouch and cause discomfort.
Avoid sugar, sugary foods and beverages, and fruit juices.
Over time, increase the variety of foods in your diet. Foods that are poorly tolerated initially – such as red meats, chicken, bread, and high-fiber fruits and vegetables – will become easier over time. Staying hydrated is important: Drink 1.5 to 2 liters of fluids daily, unless restricted by a medical condition.
Alcoholic beverages will have a stronger effect than previously and should be avoided. Talk with your bariatric surgery team before consuming alcohol.
Refer to the “Dietary Guidelines After Bariatric Surgery” for additional recommendations.
Exercise
Aim to exercise 30 to 45 minutes a day, performing an aerobic activity (“cardio”) three to five times a week. We recommend starting out by walking five minutes in the morning and five minutes in the afternoon. Steadily increase these intervals by five minutes, as tolerated, until you’re walking at least 15 minutes twice a day. After that, you can add variety to your plan, such as with light jogging, swimming or using a stationary bike.
Anytime you seem to reach a plateau, revise your regimen by trying new activities, adding more strenuous exercises or increasing the duration of activities. Alternating between walking and jogging in two- to five-minute intervals can help you break through a plateau and burn fat. For more of a challenge, try alternating between jogging and sprinting. Resistance training builds muscle and burns calories. This helps with maintaining weight loss since muscle tissue uses more calories at rest than does body fat. Start these workouts using light weights, such as two to five pounds, and do three sets of 10 repetitions for each exercise. As you feel your strength increasing, use more weight.
Lifestyle
You made a big decision to undergo major surgery to help yourself achieve weight loss and a healthy body mass index (BMI). Now you must commit to a new way of life. Our hope is that the practices you establish early after surgery, such as calorie counting and regular exercise, become lifelong habits.
We suggest thinking of each day as a reflection of a new attitude that you’re important and your health matters. Be proud of every day that you maintain this commitment to yourself. A key to success is engaging in activities, behaviors and groups that remind you of your health goals and support your new lifestyle, so stay involved in your hobbies, favorite activities and social groups. Regularly attend your local weight-loss or bariatric support group.
Support groups
The UCSF Bariatric Surgery Program offers a free support group for preoperative and postoperative patients. Support groups provide participants with the opportunity to share and discuss their challenges and triumphs with people who understand. What’s more, your chances of maintaining a healthy weight improve when you have a network of people who provide encouragement and help you stay on track. For more information, visit our Bariatric Surgery Support Group page. Since the onset of the COVID-19 pandemic, our support group has been meeting virtually via Zoom. Join our email list to receive the monthly Zoom invitation.
Long-term follow-up
After surgery, your blood will be checked regularly to ensure your micronutrient levels are staying in the normal ranges. Blood work will be done three, six and 12 months after surgery, then annually thereafter. The tests include:
Complete blood count (which can reveal anemia, among other problems)
Comprehensive metabolic panel (which gives information related to kidney and liver function)
Lipid panel (which measures cholesterol and other fats)
Hemoglobin A1c (a test for diabetes)
Vitamins: Iron, ferritin, B12, D, A, folate, thiamine, copper, zinc and selenium