Vitamins and minerals for life after bariatric surgery

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Introduction

You must take vitamin and mineral supplements for life after bariatric surgery.

What happens if I do not take them?

Malnutrition is a serious complication of bariatric surgery. If you do not take your supplements you risk the following:
• Anaemia.
• Poor bone health and osteoporosis.
• Ulcers.
• Fatigue.
• Poor immune system.
• Poor wound healing.
• Muscle weakness.
• Vision disturbances.
• Infertility.
• Neurological symptoms: pins and needles, confusion, numbness, Wernicke encephalopathy.

Why am I at risk?

You are at risk of vitamin and mineral deficiencies after surgery due to:
• Eating less food.
• Malabsorption.
• Decreased gastric acid.
• Depletion of vitamin and mineral stores.

Essential supplements

The hospital will provide you with 28 days worth of supplements to take home after your surgery. After this you must buy your own. This will cost you less than £1 per day.

There are lots of different types of supplements available, but not all are suitable to meet your needs after bariatric surgery. Please only buy the specific supplements which are recommended in this leaflet.

If you are unsure if you are taking the correct vitamin and mineral supplements, bring them along to your next appointment to discuss with your bariatric team.

Vitamin B12 Injections VG

These are injections that will be supplied and administered by your GP every 3 months. You will be responsible for booking these appointments with your GP practice.

Blood tests

You need a blood test every year. The blood test checks full blood count, urea & electrolytes, liver function test, iron studies, folate, Vitamin B12 (unless having regular injections), calcium, Vitamin D, selenium, copper and zinc. You might need extra supplements and extra blood tests depending on your results.

List of suitable products to buy

You must take all of these every day unless advised differently by your doctors or bariatric team. See below for the suggested times to take your supplements.
V = Vegetarian VG = Vegan

Suggested times to take your supplements

Breakfast: Multivitamin and mineral calcium and vitamin D3.

Lunch: iron.

Tea: multivitamin and mineral *

Bedtime: Iron **

And: B12 injection every 3 months from GP.

Multi vitamin and mineral

Forceval capsules, 1 a day OR Holland & Barrett ABC-Z, 1 twice a day V OR Sanatogen A-Z, 1 twice a day V OR Tesco A-Z, 1 twice a day V OR Lloyds pharmacy A-Z, 1 twice a day OR Waitrose A-Z, 1 twice a day V OR Asda WellbeingA-Z, 1 twice a day V OR Sainsbury’s Health, 1 twice a day OR Viridian Essential Vegan, 1 twice a day VG OR Boots Vegan A-Z, 1 twice a day VG

Calcium

A tablet containing 500mg per day. If your diet is low in calcium, you may require a higher dose, this will be discussed with your dietitian.

Vitamin D

A tablet containing 2000-4000IU (50-100μg) per day.

Iron

Ferrous fumarate 210mg from behind the pharmacy counter. Take 1 daily OR twice daily if you have periods.

Important information about supplements

• Do not take with tea or coffee.
• You need to take supplements even if you are eating a healthy diet.
• Do not take calcium and iron at the same time. Take them at least 2 hours apart.
• Take calcium with food.
• If you keep forgetting to take your supplements try setting phone reminders or link it with something you do every day, like brushing your teeth.
• Chewable multivitamin and mineral tablets that you purchase in the shop are not suitable.
• Do not take extra vitamin and mineral supplements without discussing with your bariatric team e.g. omega 3, cod liver oil, hair, skin, or nail supplements.
• If you become pregnant contact the bariatric team. You will need to swap your multivitamin and mineral to a pregnancy specific brand, and you may also need a prescription of folic acid.

Baricol® Complete

Is a specialist bariatric supplement which contains all of the vitamins and minerals that you need (in two or three doses per day). This is available in different forms: chewable, tablets, effervescent and powder. It is available to purchase online from baricol.com