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Nutritional guidelines

Vitamins & minerals after bariatric surgery

After weight-loss surgery there is a high risk of you becoming deficient in vital vitamins and minerals. This is because of the change in your diet and also because your body is less able to absorb vitamins and minerals due to the surgery. The vitamins and minerals that are most impacted are iron, calcium, vitamin D and vitamin B12. Not getting enough of these vitamins and minerals can have serious health implications, such as developing anaemia, nerve damage or brittle bones. In addition to this the dissolution of acidic or enteric-coated tablets is more likely to be impeded by increases in gastric pH (which is the case after Gastric bypass or Sleeve Gastrectomy procedures), as these tablets are more soluble in a lower pH environment.

Long-term follow up

Complications are associated with pre-operative and/or post-operative malnutrition or procedure-related changes in intake, absorption and drug bioavailability. The high prevalence of nutrient deficiencies after obesity surgery makes life-long nutritional monitoring and supplementation essential.

After your surgery you will be asked to attend regular follow up appointments, currently you will continue to be seen by the bariatric team for 2 years after your operation. Take a daily vitamin and mineral supplement – Baricol complete offers a convenient , and tailored alternative to prescription vitamins available in the UK and most markets in Europe. Some GP’s may refuse to write prescriptions for Vitamins and mineral therefore it is essential that you chose an appropriate nutritional supplement to support your diet after sleeve gastrectomy and gastric bypass where the absorption of vitamins and mineral is suboptimal.

Following weight-loss surgery you run an increased risk of developing a deficiency in essential vitamins and minerals, which could have serious health repercussions. These can include anaemia, nerve damage, and osteoporosis. Therefore it is important to carefully follow the dietary advice you are given after your surgery and to take vitamin and mineral supplements every day.

This is partly due to a change in diet, but also a result of the body’s ability to absorb vitamins and minerals is impaired. The latter is mainly due to the bypassing of the first section of the small intestine (as with gastric bypass surgery), but the reduced production of hydrochloric acid and the protein IF (Intrinsic factor) owing to reduced stomach size is also a significant factor.
This leads to impaired absorption of iron, vitamin B12 and calcium.

Osteoporosis – due to lack of Calcium and vitamin D, this can lead to an increased risk of fractures.

B12 Deficiency – can lead to anaemia, tiredness, tingling in fingers and toes

Iron deficiency anaemia – feeling tired, breathlessness, fatigue. Affects men and women especially after gastric bypass.

In addition to your nutritional requirements after surgery you will be given advice and support about diet and exercise.

You may find it a bit of an emotional roller coaster after surgery, emotional and psychological support may be required. Attending support group meetings can also offer additional support in the weeks, months and years after surgery.

Blood tests

It is important for you to have blood tests 6 and 12 months after your surgery to check your vitamin and mineral levels. After that, you should have a blood test at least once a year at your health centre.

Routine tests are usually run for B12, vitamin D, folic acid, iron and calcium. Tests are sometimes also run for zinc.

Measuring bone density through DXA can also be useful. Densitometry involves measuring bone mineral density (BMD) of the skeleton. The examination involves lying still on a bed and using X-ray-type technology to measure the bone density of the skeleton. The examination is completely painless. The results are presented in the form of a table showing measured bone mineral density (BMD) and its deviation from reference material in the form of a number of standard deviations.