Best Bariatric Vitamins

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BEST BARIATRIC VITAMINS

By Dr. HMT

Bariatric vitamins” are specialized dietary supplements designed specifically for individuals who have undergone bariatric surgery.

What is Bariatric Surgery?

Bariatric surgery” is a weight loss surgery for individuals who are severely overweight and have been unsuccessful in losing weight through conventional methods such as diet and exercise. This surgery alters the digestive system to reduce the amount of food a person can consume or absorb. 

Examples of bariatric surgeries include gastric bypass, gastric banding, and sleeve gastrectomy. 

Why Bariatric Vitamins are Important after Surgery

Bariatric surgery alters the anatomy of the digestive system, which not only restricts food intake but also impairs nutrient absorption. In other words, there is a high risk of developing nutritional deficiencies even when eating a very healthy diet.

Therefore, BARIATRIC VITAMINS are MANDATORY for anyone undergoing bariatric surgery in order to address any potential gaps in their nutritional status.

Are Bariatric Vitamins Different From Regular Vitamins?

Absolutely.

The American Society for Metabolic and Bariatric Surgery (ASMBS) offers guidelines for the precise quantities of micronutrients necessary for individuals who undergo bariatric surgery. These recommendations aim to prevent deficiencies and achieve optimal patient outcomes.

  • Bariatric vitamins are specifically formulated to meet the nutritional needs of these patients, providing them with essential vitamins in the right doses.
  • On the other hand, regular vitamins which are designed for the general population, can not provide adequate nutrients in post-bariatric surgery patients.
  • Moreover, bariatric-specific pills are better absorbed and cause less irritation to your stomach and intestines.

What Vitamins Are Typically Recommended After Weight Loss Surgery?

According to ASMBS NUTRITIONAL GUIDELINES, post surgery bariatric vitamins include vitamin B1, B12, folate, vitamin A, D, E and K.

I am sharing my supplement recommendations to prevent micronutrient deficiencies below, but first, let’s explore how serious the deficiencies are.

  1. Vitamin B1 (Thiamine)

Thiamine is critical for the metabolism of carbohydrates which are used as a major energy source to power all the functions of the body particularly, of brain and heart.

Thiamine is absorbed in the duodenum, which is bypassed in the new route of the GI tract. According to research, 27% of patients who underwent bariatric surgeries experience B1 deficiency. 

Thiamin deficiency can cause heart failure and neurological issues that could be permanent if not treated quickly. 

  1. Vitamin B12

Vitamin B12 is an important nutrient that the body needs to keep the nerve and blood cells healthy. Moreover, it also assists in making DNA, the genetic material in all cells.

Vitamin B12 deficiency is more common in gastric bypass rather than sleeve gastrectomy. This is because to be absorbed, vitamin B12 needs to come into contact with a thing called “Intrinsic Factor” in the stomach. In the case of a bypass, the portion of the stomach responsible for making the intrinsic factor is bypassed.

B12 deficiency can cause anemia, breathlessness, palpitations, nerve problems like tingling and numbness, and tongue inflammation. More severe form can result in reduced production of all blood cells and permanent nerve damage.

  1. Folate

Like B12, folate is needed for DNA synthesis, red blood cell production, and normal development and functioning of the nervous system.

Studies have shown that post bariatric surgery patients who are not taking folic acid supplements and those who underwent sleeve gastrectomy tend to be at greater risk for folate deficiency.

Folate deficiency can cause anemia, and peripheral neuropathy (weakness and numbness in the hands and feet). Low folate levels in pregnant women can cause fetal brain and spinal cord malformations.

  1. Vitamin A

Vitamin A is a fat-soluble vitamin that supports healthy vision, immune function, and wound healing.  

A large portion of the small intestine where vitamin A is absorbed, is bypassed during bariatric surgery. Moreover, inadequate absorption of dietary fat also impairs absorption of this fat-soluble vitamin in post-surgery.

Vitamin A deficiency will present with dry hair, hyperkeratosis (skin thickening), xerophthalmia (dryness of eye), night blindness, and immune impairment.

Among different forms of vitamin A, ASMBS recommends retinol derivatives as opposed to beta carotene because the former are better absorbed.

  1. Vitamin D

Vitamin D is another fat soluble vitamin needed for strong bones and teeth, as it helps your body absorb calcium.

Vitamin D deficiency has been reported to occur in 50-80% of bariatric patients. This is due to bypassing the part of the bowel where it is absorbed.

The deficiency can lead to osteomalacia (soft bones), osteoporosis and increased risk of fractures.

The good news is that routine supplementation was found to significantly reduce post-surgical prevalence of vitamin D deficiency.

  1. Vitamin E

Vitamin E functions as an antioxidant and plays an important role in immunity and neurological health. 

Vitamin E deficiency is most prevalent in patients who undergo malabsorptive procedures like gastric bypass.

Vitamin E deficiency can cause weakened immunity, hemolytic anemia, and neuromuscular damage that results in loss of sensation and body movement control, muscle weakness, and vision problems.  

  1. Vitamin K

The final member of fat soluble vitamins, Vitamin K, is an essential nutrient in the blood clotting process.

Although vitamin K deficiency is less common, it does occur in the long term. In a study in which patients were followed up for 42 months, vitamin K deficiency was seen in 60% of the patients.

Signs and symptoms of vitamin K deficiency include delayed blood clotting, bruising, bleeding from nose and gums, and prolonged excessive bleeding in severe cases.

Daily Maintenance Recommendations According to ASMBS

ThiamineAt least 12 mg/day. Risk patients ( rapid weight loss, protracted vomiting, alcoholics, encephalopathy, heart failure) may need up to 50-100 mg/day.
Folic acid400-800 mcg/day800-1000 mcg/day for female,child bearing age
Vitamin B12350-1000 mcg/day orally
Vitamin A5,000-10,000 IU/day
Vitamin D3,000 IU/day
Vitamin E15 mg/day
Vitamin K90-120 mcg/day

Our Recommendation for Best Bariatric Vitamins 

Bariatric vitamins are available in various forms, including chewables, capsules, tablets, liquids, gummies, patches, and more. My suggestion is to begin with a chewable bariatric multivitamin because the stomach’s ability to process and absorb nutrients diminishes following surgery. And these chewable bariatric multivitamins are also better digested and absorbed.

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The bottom line

Vitamin deficiencies are frequently seen in patients following bariatric surgery, which can lead to significant health issues if not addressed. It is crucial to consistently stay in touch with your bariatric care team after the surgery to ensure that your vitamin levels remain optimal. Additionally, taking the recommended supplements will aid in preventing deficiencies after the procedure.