Common Nutritional Deficiencies After Bariatric Surgery

In a practice that has treated thousands of bariatric patients, we have seen it all. However, one of the most problematic complications we see after bariatric surgery is when patients don’t stay abreast of their nutritional requirements. Patients lose weight because of a significantly restricted caloric intake, meaning they will consume fewer vitamins and minerals. Some vitamins and minerals are more affected than others. As such, we work with our patients to create a supplementation plan based on the procedure performed and the results of their blood panels taken periodically after surgery.

Vitamin supplementation is probably the easiest part of the postoperative bariatric life because it requires nothing more than remembering to take supplements. However, sadly, we see a few patients every year who have not complied and may experience significant and sometimes permanent side effects from their nutritional deficiency. So, which vitamins and minerals do we commonly prescribe for patients after bariatric surgery? Before we delve into that, we must mention that a multivitamin is always a part of a patient’s postoperative diet, regardless of the procedure performed. These multivitamins lay a foundation of supplementation to ensure that every patient receives at least the most essential nutritional requirements. Beyond that, common supplements include:

Vitamin B12

Because intrinsic factor in the stomach is compromised after virtually any bariatric procedure, vitamin B12 is not metabolized similarly and is a widespread deficiency. Patients often take Vitamin B12 supplements daily by mouth. However, some patients choose to receive, or need, B12 injections. Vitamin B12 is critical for proper nervous system functioning and can cause significant problems if a patient is deficient for an extended period.

Vitamin D

Vitamin D is also crucial to a patient’s postoperative lifestyle. Mind you, most Americans, not just bariatric patients, do not get enough vitamin D daily. This is typically absorbed through the sun, but in the modern day, life often doesn’t give us the sun exposure needed to keep levels where they should be. Most patients will, therefore, supplement with a vitamin D3 pill.

Calcium

Calcium is the building block of bone strength and works with vitamin D. Without vitamin D, calcium cannot be adequately absorbed. Most patients can enjoy their calcium as a delicious- tasting chew, while others prefer a swallowable pill. No matter what form of calcium is taken, patients must prioritize their intake to ensure continued health.

Iron

Anemia from iron deficiency can also occur after bariatric surgery. Anemia can reduce red blood cells’ oxygen content and cause significant fatigue. Iron deficiency is more common in women than men and can be easily rectified with supplementation. Patients should follow their iron supplementation regimen closely, as iron supplements are toxic at high levels. We will also supplement your diet based on blood test results. This is why we require you to follow up per your post-op packet. If you move out of town and can no longer see us, you must speak to your new primary care physician and medical team to ensure you keep up with your blood work and supplementation needs. It is also important to remember that your body changes over time, and your supplementation needs will change, too. These regular and periodic checkups can help you optimize your supplement intake for ideal health.

Non-Essential, Supplements

You may have heard of the benefits of several other optional supplements for which you may not have a deficiency. Supplements like omega 3s, fatty acids, fish oil, magnesium, turmeric, and more may all have proven or unproven benefits. Speaking to your medical team about these supplements is vital to understand if they may be right for you. It is also critical that you remember that the FDA does not regulate supplements, and their purity and potency are not guaranteed. To reduce the likelihood of problems with your supplements, be sure to choose well-established companies, preferably those that have had their products tested by reputable third-party labs and who focus on bariatric patients.

The Bottom Line

Supplementation is critical to a successful post-operative bariatric life. One way to ensure that your levels are appropriate is to visit us per your postoperative scheduled visits, where we will perform diagnostic testing to ensure you are on the right track. In the meantime, if you have any questions about your postop operative supplementation regimen, we encourage you to call us to get and stay on track.