Updated: Jun 2, 2020
Ever asked yourself why do I need Vitamins if I eat well? Are you entering the Bariatric vitamin life dilemma?
Even if you have balanced meals snacks every day after bariatric weight loss surgery, you’re still 'almost' guaranteed to develop vitamin and mineral deficiencies if you’re not taking daily vitamins.
It’s not IF you will develop micronutrient deficiencies, it’s typically a matter of WHEN. (In the beginning, my blood work was always spot on! However, after the first year some things popped up and needed addressing.)
There are two main reasons why we are at risk for developing vitamin and mineral deficiencies:
We no longer are able to consume large enough amounts of foods to meet your micronutrient (i.e. vitamin and mineral) needs.
Our body now absorbs and processes foods differently. (gastric bypass or duodenal switch) you’re not absorbing 100% of the nutrients in the foods that you’re eating. (sleeve gastrectomy and band) changes in nutrient processing have been documented.
For example, you may no longer have enough stomach acid in your small stomach to efficiently absorb the natural calcium found in dairy products. This is why you’ve been prescribed a special type of calcium, calcium citrate, that doesn’t require stomach acid to be absorbed. (I stopped taking these after two years and had to add them back due to this very reason.)
The signs and symptoms of vitamin and mineral deficiencies can be mild to severe. Some take only weeks to occur, while others take years to develop. While many deficiencies are reversible (anemia, or low iron), several micronutrient deficiencies are irreversible (osteoporosis, bone decay or Neurological Issues).
(My symptoms showed up years later with my energy levels first and blood work confirming very low Vitamin B & D)
How often should I be going for blood tests?
Your bariatric team will tell you how often you should have blood tests done. However, I don't see my bariatric team yearly so I have my primary and ob-gyn do my labs.
As you get older, your body needs more of some nutrients and less of others as your body changes. Some deficiencies also take a longer time to develop. (I've had many friend patients who stopped blood tests because they felt fine only to find out years later that they have multiple severe deficiencies.) Feeling good doesn’t mean everything is good.
Before feeling tired, weak, or sick, because of a nutrient deficiency, your body goes through the following stages:
You’re not getting enough of a nutrient.
Your body doesn’t have enough of the nutrient stored
You begin to have low levels of the nutrient in your body
Your organs begin to have trouble working properly
You begin feeling unwell and develop
Feeling unwell is the last step in this process
These steps can take only a few weeks for some nutrients, and up to several months for others. When you begin to feel unwell, your body has already been through weeks—or months in my case—of missing an important nutrient. Blood tests can catch these deficiencies at a much earlier stage.
I chose five different multi-vitamins listed below that I feel meet most bariatric standards. Keep in mind that everyone has their own opinion on vitamins. Some don't like chewy, some don't like chalky and some don't like pills. Each individual wants something different so I tried to name a variety.
From my many years of being a patient and research, there seems to be a standard when selecting vitamins such as:
Multivitamin with Iron - avoiding gummy. (I take without Iron because it bothers my stomach)
Calcium Citrate - do not take with vitamin
Vitamin B12 - lozenges & melts are best
Vitamin D - beneficial to take the same time as Calcium Citrate
At the time of writing this article, the below Multi-Vitamins are some great examples. I get it that vitamins are expensive and I too have to buy them as well being a patient. I tried to provide affordable options for everyone. You probably won't get all the above vitamins in a multi so keep this in mind. You will probably have to add things in addition to your multi-vitamin.
1. BariMelts: My top favorite is Barimelts because of the methylfolate and methylcobalamin. I have the MTHFR gene and must have the methylated forms.
2. ProCare Health - I like ProCare Vitamin without Iron. I cannot tolerate the Iron it is too much on my stomach. My numbers were good when I took this vitamin in the past.
3.BariatricFusion: My girlfriend has been taking these for 2 years. She and her group rant and rave about these all the time!
4. Optisource: These taste like Orange Sherbert and most enjoy the taste. Also very easy to chew.
5. Bariatric Advantage - Multi Chewy Bite: These are sweet & tart like Candy.
The bottom line:
Don't stop taking your Vitamins and get routine yearly blood tests. As always please check with your surgeon, doctor, or nutritionist on the vitamin mg's and mcg's per your blood work.