After gastric bypass surgery, patients are at risk for various nutrient deficiencies due to reduced food intake and malabsorption. Therefore, lifelong supplementation is essential to prevent these deficiencies. Here are the recommended supplements:
1. Multivitamin with Minerals
- Recommendation: A high-potency multivitamin with minerals should be taken twice daily. The multivitamin should include at least 18 mg of iron, 400 mcg of folic acid, and should contain selenium and zinc.
2. Calcium
- Type: Calcium citrate is preferred due to its better absorption compared to calcium carbonate in the absence of stomach acid.
- Dosage: 1200-1500 mg per day, divided into 2-3 doses as the body cannot absorb more than 500-600 mg at a time.
3. Vitamin D
- Dosage: 3000 IU to 6000 IU daily to maintain optimal levels. This can be taken separately or in combination with calcium.
4. Vitamin B12
- Type: Sublingual tablets or injections, as absorption from the gastrointestinal tract is often impaired.
- Dosage: 500-1000 mcg daily or 1000 mcg injections monthly.
5. Iron
- Dosage: 45-60 mg of elemental iron daily. This is particularly important for menstruating women and individuals with a history of anemia.
- Form: Ferrous sulfate, ferrous fumarate, or ferrous gluconate. Vitamin C (500 mg) can be taken with iron to enhance absorption.
6. Folic Acid
- Dosage: 400-800 mcg daily, often included in the multivitamin.
7. Other B Vitamins
- Complex: Ensure adequate intake of other B vitamins through a B-complex supplement or a high-potency multivitamin.
8. Fat-Soluble Vitamins (A, E, K)
- Dosage: May be needed in patients with significant malabsorption. Doses should be individualized based on laboratory monitoring.
9. Additional Supplements
- Zinc: 8-11 mg per day.
- Copper: 1-2 mg per day.
- Selenium: 55-70 mcg per day.
Monitoring and Adjustments
- Regular follow-ups with healthcare providers for blood tests to monitor levels of these nutrients and adjust dosages accordingly.
- Individual requirements may vary based on specific medical conditions, the type of bariatric surgery performed, and the presence of any deficiencies identified through lab tests.
Sources
- American Society for Metabolic and Bariatric Surgery (ASMBS) Guidelines
- Cleveland Clinic
- Mayo Clinic
By following these guidelines, post-gastric bypass patients can help ensure they receive the necessary nutrients to maintain their health and prevent deficiencies.