How to Avoid Vitamin and Mineral Deficiencies After Gastric Bypass Surgery
Gastric bypass surgery is a type of weight loss surgery that reduces the size of your stomach and bypasses part of your small intestine. This can help you lose excess weight and improve your health, but it also comes with some risks and challenges. One of the most common issues after gastric bypass surgery is vitamin and mineral deficiencies, which can lead to serious complications such as anemia, osteoporosis, nerve damage, and more. In this blog post, we will explain why vitamin and mineral deficiencies occur after gastric bypass surgery, how to avoid them, and what are the advisable amounts of supplements you need to take.
Why do vitamin and mineral deficiencies occur after gastric bypass surgery?
There are two main reasons why vitamin and mineral deficiencies occur after gastric bypass surgery:
Reduced food intake: After gastric bypass surgery, your stomach can only hold a small amount of food, which means you will eat less and consume fewer calories and nutrients. You will also need to follow a specific diet that is high in protein and low in fat, sugar, and fiber, which may limit your intake of certain vitamins and minerals.
Malabsorption: After gastric bypass surgery, food bypasses part of your small intestine, which is where most of the absorption of vitamins and minerals takes place. This means that even if you eat enough food, you may not absorb enough nutrients from it. Some of the vitamins and minerals that are most affected by malabsorption are iron, calcium, vitamin B12, vitamin D, and zinc.
How to avoid vitamin and mineral deficiencies after gastric bypass surgery?
The best way to avoid vitamin and mineral deficiencies after gastric bypass surgery is to follow the dietary and supplement recommendations of your bariatric team. Here are some general guidelines:
- Eat a balanced and varied diet that includes lean protein, low-fat dairy, fruits, vegetables, and whole grains. Avoid foods that are high in fat, sugar, and calories, such as fried foods, sweets, pastries, and alcohol. Chew your food well and eat slowly to avoid nausea, vomiting, and dumping syndrome.
- Drink plenty of fluids, at least 1.5-2 liters per day, to stay hydrated and prevent kidney stones. Avoid carbonated drinks, as they can cause gas and bloating. Drink fluids between meals, not with meals, to avoid overfilling your stomach and diluting your digestive juices.
- Take a complete multivitamin and mineral supplement every day, as prescribed by your doctor. This will help you meet your daily requirements of vitamins and minerals that you may not get enough of from your diet. Choose a supplement that is designed for bariatric patients, as it will have higher doses and better absorption than regular supplements. Do not take gummy vitamins or vitamin skin patches, as they are not effective for bariatric patients.
- Take additional supplements of specific vitamins and minerals, as prescribed by your doctor. Depending on your blood tests and the type of gastric bypass surgery you had, you may need extra supplements of iron, calcium, vitamin D, vitamin B12, zinc, copper, or others. Follow the instructions of your doctor on how much, when, and how to take these supplements. For example, you may need to take iron and calcium at different times of the day, as they can interfere with each other’s absorption. You may also need to take vitamin B12 as an injection, as it may not be absorbed well from oral supplements.
- Have regular blood tests to monitor your vitamin and mineral levels, as well as other indicators of your health, such as hemoglobin, liver function, and bone density. Your doctor will advise you on how often and what tests you need to have. If you have any symptoms of vitamin and mineral deficiencies, such as fatigue, weakness, hair loss, brittle nails, tingling sensations, bone pain, or mood changes, contact your doctor as soon as possible.
What are the advisable amounts of supplements after gastric bypass surgery?
The advisable amounts of supplements after gastric bypass surgery may vary depending on your individual needs, the type of surgery you had, and the results of your blood tests. However, here are some general recommendations from the American Society for Metabolic and Bariatric Surgery (ASMBS)
- A complete multivitamin and mineral supplement that contains at least 200% of the daily value (DV) of most vitamins and minerals, except for iron, calcium, and vitamin D. Take one or two tablets per day, as directed by your doctor.
- An iron supplement that provides 45-60 mg of elemental iron per day, preferably in the form of ferrous fumarate, ferrous sulfate, or ferrous gluconate. Take it with vitamin C (50-100 mg) to enhance absorption. Do not take it with calcium, as it can reduce absorption. Take it at least two hours before or after your multivitamin and mineral supplement.
- A calcium and vitamin D supplement that provides 1200-1500 mg of elemental calcium and 3000 IU of vitamin D per day, preferably in the form of calcium citrate, which is better absorbed than calcium carbonate. Take it in divided doses of 500-600 mg at a time, with meals or snacks. Do not take it with iron, as it can reduce absorption. Take it at least two hours before or after your multivitamin and mineral supplement.
- A vitamin B12 supplement that provides 1000 mcg of cyanocobalamin or methylcobalamin per day, preferably in the form of a sublingual tablet, a nasal spray, or an injection. Oral tablets may not be absorbed well after gastric bypass surgery, so check with your doctor before taking them.
- A zinc supplement that provides 8-22 mg of elemental zinc per day, preferably in the form of zinc citrate, zinc gluconate, or zinc sulfate. Take it with food to avoid stomach upset. Do not take it with iron or calcium, as it can reduce absorption. Take it at least two hours before or after your multivitamin and mineral supplement.
- A copper supplement that provides 2 mg of elemental copper per day, preferably in the form of copper gluconate or copper sulfate. Take it with food to avoid stomach upset. Do not take it with zinc, as it can reduce absorption. Take it at least two hours before or after your multivitamin and mineral supplement.
These are only general recommendations, and you may need more or less of certain supplements depending on your individual situation. Always consult your doctor before taking any supplements, and follow their instructions carefully. Remember that supplements are not a substitute for a healthy diet, and they can have side effects and interactions with other medications. Do not take more than the recommended doses, and do not take any supplements that are not prescribed or approved by your doctor.
Conclusion
Vitamin and mineral deficiencies are common and serious complications after gastric bypass surgery, but they can be prevented and treated with proper dietary and supplement management. By following the advice of your bariatric team, eating a balanced and varied diet, drinking enough fluids, taking your prescribed supplements, and having regular blood tests, you can avoid vitamin and mineral deficiencies and enjoy the benefits of your weight loss surgery. If you have any questions or concerns about your nutrition after gastric bypass surgery, do not hesitate to contact your doctor or dietitian. They are there to help you achieve your health goals and improve your quality of life.