Happily (and Healthfully) Ever After

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses minerals, vitamins and supplements you should take after weight-loss surgery.

After bariatric surgery it is essential to take multivitamins and mineral supplements to make sure these important dietary micronutrients are in adequate supply to maintain good health during weight loss.

During a conversation with a patient, a newlywed who recently returned from her honeymoon, I was pleasantly surprised to learn she brought her vitamins to her wedding and took them during the reception! That’s one organized bride who added "Take your supplements" to her wedding day  to do list. Success after weight-loss surgery requires this type of commitment to developing positive diet and lifestyle habits to ensure healthy weight loss!

To review the latest vitamin and mineral requirements after gastric bypass and sleeve gastrectomy, refer to the list below. These recommendations are from the American Association of Clinical Endocrinologists, the Obesity Society, and American Society of Metabolic and Bariatric Surgery's 2013 Clinical Practice Guidelines.

Multivitamin and Mineral Supplement

• Purchase a high potency vitamin containing 100 percent of daily value for at least 2/3 of the nutrients listed
• Dose: Two (2) multivitamins/day.
• Chewable multivitamin are recommended for the first two to three months after surgery. Do not use a “gummy–type” vitamin they usually do not have a complete array of the required nutrients.

Calcium Citrate Supplement (with Vitamin D)

• Purchase a supplement containing calcium citrate. This form of calcium is better absorbed after gastric bypass or sleeve gastrectomy surgery.
• Dose: 1200 to 1500 mg of calcium/day.
• Do not take more than 600 mg of calcium at a time.
• Pay attention to the serving size on the label. For calcium supplements the serving size maybe two pills instead of one.
• If you take iron supplements, do not take calcium and iron together; separate them by at least two hours.

Additional Vitamin D Supplement

• Total Dose: 3000 International Units/day.
• Add up the vitamin D in your two (2) multivitamins and in all of your calcium supplements. If the total amount of vitamin D is less than 3000 International Units - an additional vitamin D tablet is needed to bring your daily total to 3000 International Units.

Vitamin B-12

• Either a daily sublingual B-12 tablet OR a monthly B-12 shot is needed.
• The daily sublingual or “under-the-tongue” tablets or liquid should have at least 500 micrograms of vitamin B-12 per dose.
• A primary care physician can administer a monthly B-12 shot.

While some individuals find it challenging to comply with the daily post- surgery vitamin and mineral protocol making supplements a part of your daily routine, like the bride above, results in healthy weight loss (and hopefully happily ever after lifestyle!)

Lose Weight at Penn Medicine

Penn can help you lose weight. Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.