Vitamins and mineral medication for life after bariatric surgery

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What is this information about?

This information is about the vitamin and mineral supplements that you must take for the rest of your life because you have had bariatric surgery (a weight reduction operation). 

It explains: 

• where you will get your supplements 
• what could happen to you if you do not take your supplements 
• why you have a higher chance of not getting enough nourishment (being malnourished) if you have had bariatric surgery and do not take your supplements 
• which blood tests you need to have each year to check that you are getting the nourishment you need 
• which supplements are right for people who have had bariatric surgery to take 
• when and how you should take your supplements. 

Why have I been given this information?

You have been given this information because you have had bariatric surgery. People who have had bariatric surgery do not get all vitamins and minerals that they need to stay well-nourished and healthy from their food. This can lead to them having poor health.  

Following the advice in this information will help you to stay well-nourished and healthy after your operation. 

Must I take vitamin and mineral supplements for the rest of my life after I have had bariatric surgery?

Yes. You must take vitamin and mineral supplements for life so that you get the nutrition you need to stay as healthy as possible.  

Where will I get the supplements that I need?

When you leave hospital after your surgery, we will give you enough supplements to take for 28 days. 

After this you must buy your own from a pharmacy or shop. The cost of buying your supplements is likely to be around 30 pence a day. 

What health problems might I get if I do not take my supplements?

Not taking your supplements can lead to you having various health conditions. Some of these are serious. Malnutrition due to a lack of vitamins and minerals can cause: 

• anaemia. This is a condition where you have a lower-than-normal number of healthy red blood cells, meaning your blood cannot carry enough oxygen to your body’s tissues, leading to tiredness, weakness, and shortness of breath.  
• poor bone health such as weak or brittle bones (osteoporosis) 
• ulcers 
• fatigue (tiredness) 
• poor, slow, wound healing 
• muscle weakness 
• problems with your sight 
• infertility 
• brain and nerve (neurological) problems. These include pins and needles (a prickling, burning, or tingling sensation), confusion, numbness and Wernicke encephalopathy. This is a serious condition with symptoms of confusion, eye movement problems, and poor balance or coordination. 

Why am I at risk of not getting enough vitamins and minerals from what I eat and drink after I have had bariatric surgery?

You are at risk of not getting enough vitamins and minerals because: 

• you are eating less food 
• your body does not take in (absorb) so many nutrients from what you do eat (you have malabsorption). 
• your body makes less stomach acid, so your food is not broken down in the same way as before your surgery. This means your body gets less nutrients from it. 
• you have less stores of vitamins and minerals built up in your body. 

What blood tests will I need to have to check my health and vitamin and mineral levels?

You will need to have a blood test every year to check: 

• your full blood count. This shows the numbers, sizes, and shapes of your red blood cells (these carry oxygen), white blood cells (these fight infection), and platelets (these help your blood to clot).  
• your urea and electrolytes. This show how well your kidneys are working, your body’s fluid balance, and the levels of essential minerals. 
• how well your liver is working (liver function test) 
• your blood levels of vitamins and minerals: 
  • iron 
  • folate 
  • calcium 
  • vitamin D 

Your blood test results may show that you need extra supplements or further blood tests.  

Which supplements must I take?

You must take all of the vitamins and minerals shown below unless your doctors or bariatric surgery team advise otherwise. 

List of suitable products  

V = Vegetarian VG = Vegan

When should I take my supplements?

We suggest that you follow this schedule if it seems ok for you. If you do not take your tablets at these times, do make sure that you take all the tablets that you need to every day. 

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. 

How should I take my supplements?

• Take your supplements with food, not on an empty stomach. 
• Do not take your supplements with tea or coffee 
• Take calcium and iron supplements at least 2 hours apart. Do not take them at the same time. 

What else do I need to know about taking supplements?

• You must take your supplements even if you think you are eating a healthy diet. 
• Talk with your bariatric surgery team before taking any other extra supplements such as omega 3, cod liver oil, or hair, skin or nail supplements. They can advise you on whether you may benefit from taking them and if they are right for you.  
• If you become pregnant, visit our website for up-to-date advice https://www.uhsussex.nhs.uk/services/bariatric/.

What is the “Fit for Me” supplement?

‘Fit for Me’ is a supplement designed for people who have had bariatric surgery. It contains all the vitamins and minerals that you need. It is available to buy online from https://fitforme.com/en-gb/ . It costs less than £1 per day. 

Who can I contact if I need further information or support after I have read this information?