Vitamin Supplementation
All bariatric patients will be on lifelong vitamin supplementation to ensure levels of key vitamins remain in healthy ranges. When your anatomy is changed surgically, your ability to process food and nutrients is altered. This is how the mechanisms of weight loss surgery work. Stomach acid is reduced when the organ is downsized and, for some, portions of the small intestine where nutrients are absorbed are bypassed. While this results in excellent weight loss, the downside is decreased absorption of some key vitamins and minerals. On top of that, many patients weren’t getting the recommended nutrients before surgery and are starting the process with deficiencies. Some of the most common deficiencies include:
- Vitamin B12 – Deficiency can cause anemia, weakness and even neurological changes. You may require B12 oral supplementation or shots to stay within normal levels.
- Vitamin D – Vitamin D is essential for the body to process and use Calcium. Therefore a D deficiency can lead to poor calcium absorption and weaker, brittle bones.
- Calcium – Many patients do not get enough calcium, required for healthy bones and to avoid osteoporosis.
- Iron – Deficiency can lead to anemia, which is a lack of healthy red blood cells.
Prevention is much easier than treatment when it comes to vitamin deficiencies, so we urge patients to adhere to the recommended bariatric supplements. For some patients, that means taking several supplements each day. Fortunately, the growth in bariatric surgery has also led to many companies making bariatric specific supplements that both address common deficiencies and taste good. Early after surgery, chewable vitamins are often recommended. They are easier to take and process considering standard vitamins are often large pills. We also want to be gentle with and protect the new staple line in the stomach.
As you can see, there are direct relationships between vitamins and minerals and it is not uncommon that a single deficiency can create other deficiencies and problems. While a daily multivitamin may handle low-level deficiencies, most patients, especially early on in the post-op journey will require specific vitamin supplementation as well.
Your levels of specific vitamins and minerals will be checked routinely at follow-up visits. Don’t skip your follow-up visits or think long-term visits are unnecessary. In extreme circumstances, certain vitamin deficiencies can result in serious symptoms like nerve damage, blindness, psychosis, or heart problems. This is one of the most important reasons we want to see you for follow up.
New bariatric research sometimes leads to changes in recommended supplementation and screenings, and some vitamin deficiencies can take long periods of time to show symptoms, as the body’s stores may not be depleted immediately. Unfortunately, not all primary care providers are up to date on what bariatric recommendations may be. And your PCP may not be familiar with common issues seen in bariatric patients, so it is important you maintain a relationship with your weight loss surgery practice long into the future.
If you move away or you no longer have access to our practice, we recommend reaching out to an established bariatric practice in your new area to consult with and be sure your records are transferred for their reference.
