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February 25th, 2011
08:24 AM ET

What vitamins, supplements should I take after weight-loss surgery?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Friday, it's Dr. Melina Jampolis, a physician nutrition specialist.

Asked by Paulina Thomas of Jacksonville

What vitamins and supplements are recommended for people who have had weight loss surgery? And how much?
Expert answer

Hi Paulina. This is a very good question, but I can't give you any specific recommendations without knowing what type of surgery you had and without knowing more about you specifically.

According to my colleague, weight-loss surgeon Dr. John Rabkin, any type of weight-loss surgery will initially require some supplementation due to the restricted amount of food you can eat post-operatively. When you eat less food, you also take in less vitamins, minerals, and protein, leading to the need for short- and/or long-term supplementation. This is particularly important for optimal healing post-operatively and for long-term health. In addition, he notes that, many (if not most) patients have vitamin and/or mineral deficiencies at baseline (before surgery) as these deficiencies are quite common in the general population.

Rabkin goes on to explain that many procedures including gastric bypass, duodenal switch, and biliopancreatic diversion require supplementation of the fat-soluble vitamins (A,D, E, & K) and minerals (calcium, iron, zinc, occ. copper, trace minerals). These operations remove portions of the gut where these nutrients are absorbed, so you may need to take higher amounts to ensure that you get an adequate dose. In addition, you may need to take the fat-soluble vitamins in a "dry" form to improve absorption, which means that they dissolve in water instead of fat, since the procedures decrease fat absorption. Gastric banding and sleeve procedures do not remove areas in the gut where nutrient absorption takes place, so they often require less supplementation long term and have less risk of deficiencies.

The doses of vitamins, minerals and protein vary considerably between individuals, so it is important that you work closely with your weight-loss surgeon and primary care physician after the surgery to determine the right amount for you. These surgeries are not a quick fix and do have side effects, so it is critical to find a weight-loss surgeon who provides long-term care. A good place to start would be in choosing a center certified as a Center of Excellence in Bariatric Surgery by the American Society for Metabolic and Bariatric Surgery. In addition, Rabkin notes that patients who join patient support groups do better long term, so if your surgeon does not offer a support group, seek one out in your community.


soundoff (20 Responses)
  1. Vera

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    February 25, 2011 at 13:36 | Report abuse | Reply
  2. J

    very good article and response. It is very much a personalized need. Every body reacts differently and will malabsorb different vitamins. Most experts suggest that you pull full panel bloodwork to test for vitamin and mineral levels every 6-12 months for the rest of your life after WLS and to adjust your vitamin supplementation in response. It's also important to note that certain vitamin and mineral levels considered "normal" in a normal-gutted person are actually quite low for those who have been re-routed. B12 for one, might be normal in the 300's or 400's for a normal person but post-WLS folks should try to get it closer to the 900's or low 1000's,

    February 25, 2011 at 14:58 | Report abuse | Reply
  3. Bill the Cat

    Look into Bariatric Eating.com. Susan Maria Leach is the founder and has helped my wife tremendously.

    February 25, 2011 at 15:10 | Report abuse | Reply
  4. paceperformance

    Organic Multivitamins such as Earthbar's Vita-K supplements have lots of good vitamins rolled up into one, and don't hurt your stomach as much as ones loaded with too much calcium.

    February 25, 2011 at 15:45 | Report abuse | Reply
  5. Pam

    The ASMBS has a set of guidelines for bariatric patients and post-op nutrition and supplementation. (http://www.asbs.org/Newsite07/resources/bgs_final.pdf) Look at the chart on page 7 to view the base supplementation patients should start with based on their surgery type. This is the BASE supplement recommendation, which means you start with this set of vitamins but as you start getting labwork done at regular times after surgery you will adjust these supplements based on what your lab results dictate and what your individual body needs might be. Labs should be drawn every 3 to 6 months after any bariatric surgery to keep a close eye on deficiencies or malnourishment problems. (My WLS journey: http://www.PamTremble.Blogspot.com)

    February 25, 2011 at 16:50 | Report abuse | Reply
  6. charles s

    "The doses of vitamins, minerals and protein vary considerably between individuals, so it is important that you work closely with your weight-loss surgeon and primary care physician after the surgery to determine the right amount for you."

    A surgeon and a primary care doctor are going to advise you on vitamins? I have never had a doctor tell me to take any vitamin. The closest that a doctor ever mentioned a vitamin was when I told him that I was taking niacin and he agreed that it was good for the heart. Go here http://doctoryourself.com/ and you decide what you need for yourself.

    February 25, 2011 at 17:09 | Report abuse | Reply
    • Drinker

      After weight loss surgery (depending on the type) you malabsorb some vitamins and minerals and need to have your blood levels checked. In that capacity your doctor is going to know what supplements you need. Weight loss surgery is not the same thing as a doctor maybe telling you or not telling you to take a multivitamin, you could die if you do not supplement properly.

      February 25, 2011 at 17:27 | Report abuse |
  7. abby

    I take vitamins specifically designed for gastric bypass patients. Check on line for various products and then ASK your doctor.

    February 25, 2011 at 18:10 | Report abuse | Reply
  8. liz10

    Best to ask the surgeon who did procedure which vitamins to take. As stated in article, banding and sleeve will need different from bypass. My husband had the banding done, and he found vitamins in Walgreens which are ok for him. He had surgery on day before Thanksgiving, and so far has lost 60 lbs. Remember, protein is important too.

    February 25, 2011 at 18:49 | Report abuse | Reply
  9. Jocelyn Gallant

    Why is the Anesthesia Death Rates is still high in the United States today.

    Salem, NH

    February 26, 2011 at 00:09 | Report abuse | Reply
  10. Jocelyn Gallant

    What will the future of surgery will be tomorrow? It is safer to be awake during surgery?

    Salem, NH

    February 26, 2011 at 00:10 | Report abuse | Reply
  11. Bill

    I lost a lot of weight using this:
    http://b410fb6-4r9p0rck7drp2cru0x.hop.clickbank.net/

    March 1, 2011 at 17:50 | Report abuse | Reply
  12. JW

    I just found out I'm very deficient in Vitamin D. In the last 14 months I have had 4 miscarriages after having 4 healthy pregnancys. Is there any correlation between vitamin D and miscarriages?

    March 10, 2011 at 18:03 | Report abuse | Reply
  13. weerah

    Organic multi vitamins are the best source of getting energy and health.

    June 21, 2011 at 10:29 | Report abuse | Reply
  14. allen ethan

    very good post. thanks for sharing. while searching on this topic i found another informative website on this. wanted to share that with you all

    http://www.healthysolutionsweb.com/vitamin-manufacturer/

    June 29, 2011 at 06:30 | Report abuse | Reply
  15. Simon S

    For individuals who's been through a weight loss surgery, vitamin supplements is really needed since there is high risk of vitamin defeciencies after the surgery. And the best person who can give you a good gastric bypass advice is you doctor and surgeon since they are the ones who knows your health condition. There is a very useful site I happen to know for those who need information about weight loss surgeries. - http://gastricbypassadvice.com

    July 5, 2011 at 08:27 | Report abuse | Reply
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  17. Marc Williams

    This book contains all essential and vital facts figures and self help plans that may make pounds reduction endeavours pay rich dividends for all time to come You will find special sections on calorie charts physical exercise regimens and specially crafted lowcalorie recipes.

    October 30, 2013 at 07:44 | Report abuse | Reply
  18. Victor smith

    The doses of vitamins,minerals and proteins differ from people to people so it is important that you work closely with your weight-loss surgeon and primary care physician after the surgery to determine the right amount of Vitamins Benefit
    for you. These surgeries are not a quick fix and do have side effects, so it is critical to find a weight-loss surgeon who provides long-term care.

    April 26, 2014 at 05:22 | Report abuse | Reply
  19. jessiejohnson071

    Great post....thanks for posting this blog. After my bariatric surgery i was suffered from b12 panecia due to deficiency in vitamin b12 one year ago. Hence doctor recommended me to take bariatric vitamins and supplements once in a week. I cured within six months after having this.

    June 26, 2014 at 11:25 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.