The Roux-en-Y weight loss surgery (WLS) procedure can restrict and prevent absorption of calories and nutrients. The limited size of the gastric pouch restricts calories, and the hence, the amount of nutritious foods that you can consume. In addition, calories and nutrients may not be optimally absorbed because of the surgical bypass of the secretory digestive portion of the stomach and a good portion of the absorptive surface of the small intestine. As a result, all WLS patients must commit to taking vitamin and mineral supplements for the rest of their lives to ensure they get adequate nutrition. If you are considering WLS, you should begin taking a multivitamin and calcium supplement several months prior to surgery to correct any possible nutrient inadequacies and to attain optimal nutrition status for surgery. These supplements will need to be continued after surgery. Patients having the Roux-en-Y surgery will need to take three supplements for the rest of their lives after the procedure. Your health care team may prescribe additional supplements based on your individual needs.

WLS patients will need to take:

• A multivitamin with minerals
  
• A calcium supplement
  
• A B12 supplement

Multivitamin with Minerals

A multivitamin can cover all of your nutritional bases. This is especially important after surgery when your diet is extremely limited in both quantity and variety. Choose a high potency multivitamin (containing iron, zinc and folic acid) at the level of 100 to 200 percent of the RDI. Choose a chewable or liquid multivitamin for the first six weeks after your surgery. Then, if desired, you may resume taking your usual tablet or capsule multivitamin. Over-the-counter multivitamins or specialized multivitamins for WLS surgery patients are both acceptable.

Calcium

A calcium deficiency may cause bone loss, resulting in osteoporosis, osteomalacia or metabolic bone disease. These conditions usually take several months or years to develop. Therefore, it is important to remain vigilant in your supplementation regimen. A calcium supplement is required due to a combination of inadequate intake and changes in absorption. Since the environment of the new stomach pouch is less acidic than that of the stomach before surgery, we encourage you to take calcium citrate for optimal absorption in a low-acid environment. Vitamin D and magnesium are corresponding nutrients that assist in the absorption and utilization of calcium. Choose a chewable or liquid calcium supplement for the first six weeks following surgery, and then you may progress to a tablet form if desired.

B12

Vitamin B12 is necessary for proper nerve impulse transmission. A low B12 level can result in anemia and permanent neurological damage. B12 depends on the presence of intrinsic factor ─ a chemical is produced in the bypassed region of the stomach – to be released from the animal protein in the foods we eat. Therefore, WLS can limit its availability to assist in the absorption of B12. B12 may be taken sublingually (under the tongue) or by injection. You should start your B12 supplement within one month after having surgery.

Tips For Taking Supplements

• Because they compete for absorption, take calcium and iron (found in multivitamins) at least four hours apart. You can take your multivitamin at breakfast and dinner and your calcium at lunch and bedtime snack.
  
• Do not take more than 600 mg of calcium at a time. Take your calcium two or three times over the course of the day.
  
• Do not take vitamins on an empty stomach because they may cause nausea.
  
  
  Back to top