Vitamin B12 - Hodges Weight Loss and Advanced Surgery

Updated 9/12
[email protected]
M Cameron
Hodges, MD
problems, however all women should begin
calcium supplementation in their late 30s. Gastric
sleeve patients have more normal calcium
absorption and are not as susceptible. We
generally recommend 1500 mg of calcium citrate
with Vitamin D daily for gastric bypass and 1000
mg daily with Vitamin D for gastric sleeve patients.
Vitamin B12
Vitamin replacement after weight loss
surgery.
!
Weight loss surgery causes significant
changes to your normal gastric anatomy and
therefore does predispose you to certain vitamin
deficiencies. These can be easily prevented by
taking appropriate supplements. A typical
regular multivitamin will not be sufficient. I don’t
start vitamin supplementation until one month
postoperatively. During the 1st month the flavor of
a multivitamin can be a little bit nauseating but
seems to be tolerated well by approximately 30
days after surgery.
Recommendation for general
multivitamin
!
I generally recommend a bariatric type
multivitamin which usually contains approximately
150% RDA of most of the B vitamins. This can
be obtained through many pharmacies or you can
order these at www.vitalady.com. There are
several flavors you can choose from that all meet
the minimum requirements. One pill per day
would be the typical dose. Cost varies between
$3-7 per month.
Calcium Supplementation
!
Calcium absorption occurs mostly in the
duodenum which is the 1st portion of the intestines
after the stomach. Gastric bypass patients are
much more susceptible to calcium absorption
!
Surgically altering the
stomach with either a gastric
bypass or a sleeve gastrectomy
does inhibit your ability to absorb
vitamin B12. There are 2
options for supplementation. One
would be to use sublingual pills
1000 mg daily or a prescription
nasal spray (nascobal) once per
week. Cost varies from $12-$15
for sublingual pills and $25 for
the nasal spray per month.
Iron Supplementation
!
Like calcium iron is
also absorbed in the 1st
portion of the intestines
making iron deficiency more
common with gastric bypass
than sleeve gastrectomy.
The best form of iron to use
for supplementation is
Ferrous Fumarate. This
can generally be obtained
through a pharmacy or at
the vitalady website. Dose
varies depending on the
brand between 66 and 110 µg daily with the
minimum requirement of 50 µg daily. cost should
be about $7 per month
Summary of Supplementation
1 Bariatric multivitamin one daily
2 Calcium citrate with vitamin D 1000 to 1500 mg
daily.
3 Vitamin B12 sublingual or nasal spray as above
4 Iron as ferrous fumarate 66 to 110 µg daily