Weight loss surgery patients should continue to take daily bariatric formulated multivitamins and calcium
Two studies this week raised gnawing worries about the safety of vitamin supplements and a host of questions. Are multivitamins and calcium supplements really necessary after bariatric surgery? Are a healthy diet and an active lifestyle enough to maintain health after bariatric surgery? Are the multivitamins that I am taking safe and effective?
This week, a study of nearly 40,000 older women found a slightly higher risk of death among those taking dietary supplements, including multivitamins, folate, iron and copper. It was just an observational study, though, not a rigorous test. Another study found that men taking high doses of vitamin E — 400 units a day — for five years had a slightly increased risk of prostate cancer.
The take home message though is that these vitamin and mineral studies looked at people who did not have bariatric surgery. Obviously, the best way to get vitamins is to eat foods that naturally contain them. A variety of foods can provide more than just vitamins and minerals, but also fiber and protein that are essential to a healthy diet. Surprisingly though, persons who suffer from clinically severe obesity, or morbid obesity, show a pattern of low micronutrient levels compared to normal-weight adults. A body mass index above 35 is associated with deficiencies of Vitamin A, E, C, D, B12, selenium, folate, carotenoids, iron and zinc and carotenoids. Thus, Dr. Tim Ehrlich, Medical Director of Bariatric and Metabolic Surgery at Griffin Hospital, recommends that all patients who consider weight loss surgery take a bariatric formulated multivitamin daily to boost up vitamin and mineral levels back to normal.
Special considerations regarding micronutrient deficiencies after bariatric surgery
There are several reasons why daily bariatric multivitamins and minerals are a necessity after bariatric surgery:
• The Lap-Band limits food volume and what patients eat (patient choice or food intolerances)
• The Sleeve Gastrectomy limits food volume, changes how food is digested and limits what patients eat (patient choice or food intolerances)
• The Gastric Bypass limits food volume, changes how food is digested, creates some malabsorption and limits what patients eat (patient choice or food intolerances).
When patients do not take daily bariatric multivitamins, nutrient deficiencies can be seen with any weight loss surgery. The most common preventable deficiencies are:
• Lap-Band: Vitamins B1, B6, B12, C, A, D, folate, iron and calcium
• Sleeve Gastrectomy: Vitamins B12, A, D, folate, iron, zinc and calcium
• Gastric Bypass: Vitamins B1, B6, B12, A, D, folate, iron, selenium, magnesium, zinc and calcium
One thing is certain: A multivitamin from the drugstore does not fit the needs of the bariatric patient. We recommend specific bariatric formulated multivitamins and calcium citrate to ensure optimal absorption of micronutrients. Vitamin and mineral levels should be tested every 6 months during the rapid weight loss phase and yearly thereafter. Please contact Dr. Tim Ehrlich to make your follow-up appointment and arrange for this important blood test. We welcome you to meet with Griffin Hospital’s bariatric dietitian Hillary Freedman, RD, to ensure that you are taking the proper supplements for optimal health. For your convenience, appointments with Hillary can be arranged at the new office of Ehrlich Bariatrics in Shelton, Connecticut.
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