After gastric bypass and sleeve gastrectomy:
These surgeries alter the way your body absorbs many vitamins and nutrients. It is important to take supplements the rest of your life to avoid the deficiency problems that can develop without supplementation. Most vitamins and minerals can be replaced with a good adult multivitamin. This will have the full complement of water-soluble and fat-soluble vitamins, iron, zinc, and other minerals needed. The vitamin supplement should be chewable during the first three weeks, but afterwards can be in pill form.
The second supplement needed is calcium. Calcium is absorbed in a part of the intestine that is bypassed, so it takes additional supplementation to avoid the thinning of bones and potential fractures that can occur. The preferred calcium supplement is Calcium Citrate with Vitamin D-3 and the recommended intake is 1500mg daily.
The third supplement is Vitamin B-12. This vitamin is normally absorbed from the diet after it combines with a protein called intrinsic factor. This complex is then absorbed in your lower intestine. Intrinsic factor is made in the bypassed stomach and therefore Vitamin B-12 can no longer be absorbed in the diet or in pill form. Vitamin B-12 is important to help prevent anemia and also functions in spinal cord nerve function. To prevent deficiency, supplementation must occur a different way than pill form to be absorbed. Options include daily sublingual tablets (under the tongue), nasal spray, or monthly injections.
Gastric banding does not alter the absorption of the foods you eat. However, you will be eating less. We recommend a simple multivitamin once daily and 1500 mg of calcium citrate with Vitamin D-3 for our patients who have the Lap-Band procedure.