Vitamins: Knowing the A’s thru Z’s for your Weight Loss Surgery

For anyone who has had or is planning on having weight loss surgery, vitamins are essential to your health. The American Society for Metabolic and Bariatric Surgery (ASMBS) provided recommendations in 2008 to help you make sure that you are getting the right vitamins. Here are some Do’s and Don’ts that you will want to keep in mind when picking out the vitamin that is right for you.


  • Do find a multivitamin that has 100% of at least 2/3 of the nutrients complete. So 2 out of 3 of the vitamins listed should show 100% of the daily value or higher. Keep in mind that not all the vitamins are listed. So if it is not there, they are not likely to tell you that it is missing. Here are some essentials to look for:
    • B Vitamins: thiamin, riboflavin, vitamin B12, vitamin B6, pantothenic acid, folic acid (folate)
    • Iron: at least 18 mg; some will need an additional 18-27 mg/day
    • Zinc: the Recommended Dietary Allowance  is 8 mgs/day for women and 11 mg/day for men
  • Don’t take any vitamins (or medications) that have an enteric coating or that are time-released capsules.
  • Don’t take a children’s formula. Many are incomplete for nutrients that an adult would need and are missing some important minerals such as iron.
  • Do separate your multivitamin and calcium supplements by at least 2 hours. The iron in your multivitamin and the calcium will compete for absorption.
  • Do begin taking your 1-2 multivitamins each day after you are home from your surgery.
  • Do look for sugar free, calorie free vitamins.

Vitamin B12

  • Do take a vitamin B12 supplement if you have had weight loss surgery (if you have had lap-band® surgery, most often you will not need extra vitamin B12)
  • Do look for one of the following types available based upon your preference
    • Injection – 1000 µg each month
    • Oral forms: 350-500 µg/day (*please that most of these have more than 1000 µg which has been found safe for you to use!)
      • Sublingual tablet (dissolved under the tongue)
      • Liquid drops
      • Mouth spray
      • Nasal gel/spray
  • Don’t take a pill form of vitamin B12 that you swallow as a pill. Because of stomach changes, you must take one that is absorbed through your mouth, nose or as an injection.
  • Do watch for signs of deficiencies.


  • Do look for a brand with calcium citrate and vitamin D3
  • Do get 1500-2400 mg/day (depending on which surgery you have had)
    • Band – 1500 mg
    • Gastric bypass or sleeve gastrectomy 1500-2000 mg/day
    • Duodenal Switch 1800-2400 mg/day
  • Do take only 500-600 mg at a time for best absorption.
  • Do separate your calcium and any iron-containing vitamins by at least 2 hours.
  • Do eat 2-3 high calcium foods each day, even if you are taking a supplement.
  • Do begin taking your calcium when you are drinking at least 64 ounces of water each day.
  • Do look for sugar free, calorie free calcium supplements.
  • Do watch for signs of deficiencies.

ADEK’s (duodenal switch only)

  • Do follow up with your surgeon regularly to have your levels checked.
  • Do look for a supplement with
    • Vitamin  A – 10,000 IU/day – look for sources primarily from retinol rather than beta carotene
    • Vitamin D – 2,000 IU/day – your calcium should have vitamin D in it as well!
    • Vitamin K – 300 µg/day  (micrograms) – caution if you are taking any blood thinners!
  • Do begin taking your ADEK supplements when you are home from surgery.

And last but not least…don’t let the daunting task of finding a supplement overwhelm you. What is the most important thing with supplements? To take them! To stay healthy, supplements will be needed every day for the rest of your life after you have had weight loss surgery. Seek the advice of your surgeon and dietitian if you still aren’t sure which one works best for you. We are here to help!


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