The first supplement you will likely take after bariatric sleeve surgery is a multivitamin [MVI]. Immediately after surgery, you may need to take chewable or liquid vitamins because you may have trouble swallowing tablets. Bariatric multivitamins are available and typically contain vitamins A, D and E. You also need Iron and Folate. In the first six months after your bariatric surgery, your physician may recommend taking two multivitamins per day (Specialized Bariatric MVI every day for a lifetime) because you will not be able to eat a significant amount of food as you stomach heals. MVI(s) must provide at least 200% RDA of iron 36 mg, folic acid 800 mcg, plus thiamine and copper. It is best if MVI also contains selenium and zinc.
While your multivitamins may contain some calcium, it may not be enough to compensate for calcium losses in your daily diet. Because you need calcium for healthy bones and teeth, you may need to take a calcium supplement that contain 1,000 to 1,500 mg of calcium. Calcium citrate is the preferred form of calcium. Your body can only absorb about 500 mg of calcium at a time, so you may wish to separate your supplements into three (3) servings over the course of your day. (Take with meals and not at the same time as the iron supplement).
Vitamin D is required to help you absorb calcium in your body. This vitamin is difficult to get in your daily diet and even more difficult following bariatric sleeve surgery. Take at least a 1,000 IU vitamin D supplement each day to ensure you get enough of this vitamin. Take 2,000 IU of Vitamin D3 per day (it may come combined with the calcium).
Vitamin B-12 is necessary for brain functioning and building red blood cells. This vitamin binds to intrinsic factor, which is secreted by the stomach, for absorption. During laparoscopic gastric bypass, the portion of the stomach responsible for making intrinsic factor is bypassed. The lack of intrinsic factor decreases the amount vitamin B-12 absorbed by the body after gastric bypass and to a lesser extent after gastric sleeve surgery as well. As such, you should take a vitamin B-12 supplement that is either liquid or dissolves on the tongue. Take at least 500 micro-grams of vitamin B-12 per day to ensure you get enough vitamin B-12 in your diet.
Iron is needed to build healthy red blood cells in your body, and a lack of it leads to fatigue and feeling weak. Taking iron supplements can upset your stomach, which is why you should choose iron supplements that contain ferrous fumarate, ferrous sulfate or ferrous supplementation. However, these supplements have to be taken with a gap of two hours in between doses. Note: Ask your dietitian about available options and required doses.