Are Vitamins Really That Necessary?

By Karla Reyes, MS, RDN, LD

I know that we drill you over vitamins… Are you taking them? Which kind? Are you consistent?
But we do this with good heart (trust me, we care about you!)

The answer is: YES! Very crucial! Here’s why:

Bariatric surgery significantly alters the physiology of our digestive system, altering the way we absorb our vitamins and minerals from our food. Also, keep in mind that the amount of food changes as well, making it impossible to get all vitamins and mineral through diet itself. Therefore, vitamin supplementation is essential for life after bariatric surgery.

But what exactly are vitamins?

Multiple Prescription Pills

Vitamins and minerals are considered micronutrients. Meaning that, unlike protein, carbohydrates, and fats, they do not provide energy. Instead, they are compounds that are essential (meaning, we don’t make them, we eat them!). Vitamins and minerals are in charge of multiple functions in your body, including: converting food to energy, creating multiple enzymes and hormones, chasing free-radicals, building strong bones and teeth, creating red blood cells, formulating chemical signals, and much more!

But here’s the thing, bariatric patients require higher amounts of nutrients than a person with an intact digestive anatomy. In order to avoid any deficiencies, vitamin supplementation must be compliant to the American Society of Metabolic and Bariatric Surgery (ASMBS) nutritional guidelines.

Here are the ASMBS vitamin recommendations for sleeve gastrectomy and gastric bypass:

Nutrient Requirement Function Deficiency
Vitamin B1 (Thiamin) At least 12 mg Helps convert nutrients to energy Muscle weakness, neuropathy, memory loss, confusion, neurological damage
Vitamin B12 350-500 mcg Red blood cell formation, proper nervous system and brain function Megaloblastic anemia, numbness and tingling of extremities, lightheadedness, beef red tongue
Folate 400-800 mcg
800-1000 mcg (women of childbearing age)
Proper cell division Same as vitamin B12; changes in pigmentation or ulceration of skin, nails, or oral mucosa
Calcium 1200-1500 mg Bone and teeth structure and formation, muscle function, blood vessel contraction Leg cramping, tetany, muscle weakness, osteoporosis
Vitamin A 5000-10000 IU Proper vision and organ formation Night blindness, poor wound healing, hyperkeratinization of skin, loss of taste
Vitamin E 15 mg Immune function, antioxidant Neurologic damage, impaired balance, muscle weakness
Vitamin K 90-120 mcg Blood clotting and proper bone formation Hemorrhage, easy bruising, bleeding gums, delayed blood clotting, osteoporosis
Vitamin D At least 3000 IU Proper immune function, calcium absorption, bone growth, creates hormones Hypocalcemia, tingling, cramping, osteomalacia
Iron 45-60 mg Produces red blood cells, provides oxygen to muscles, creates hormones Fatigue, anemia, pale skin, trouble concentrating, difficulty swallowing, palpitations, spoon-shaped nails
Zinc 8-11 mg Normal growth, immune function, wound healing Rash, change in taste, increased infections, alopecia, delayed wound healing
Copper 1-2 mg Connective tissue formation, normal brain and nervous system function Anemia, hypopigmentation of hair, nails, or skin, neuropathy

The good thing is that we don’t need to take all of these separately. Bariatric-specific vitamins are specially formulated to meet the requirements of bariatric patients. Look for supplements that are ASMBS compliant with nutrient recommendations. We recommend a high-potency multivitamin with iron and calcium citrate (dosage will depend on brand and/or product).

If you have questions regarding your vitamin supplementation, please contact your bariatric surgeon or registered dietitian, we’re here to help support your every need!