July 2021
Jacqui Lewis - BHSc Nutritional and Dietetic Medicine

Increase Your Intake with Iron, Vitamin B12 & Calcium After WLS

What do we know about the benefits of bariatric surgery?
First, there's a lot of significant research indicating some incredible, life-saving benefits that gastric sleeve and bypass surgery offer, such as eliminating type 2 diabetes and reducing the risk of cardiovascular events such as stroke and heart attack. In addition, an overall increase in life expectancy is behind the increase in weight loss surgery procedures occurring every year.

With all these benefits, I bet you're wondering, is there a catch!? I have always run by the adage - if it's too good to be true, it probably is. Well... Let us reassure you, there is not necessarily a catch, and neither are the benefits of bariatric procedures - it’s too good to be true. However, your bariatric team will likely outline that the surgery is a tool that comes with specific responsibilities

Therefore, daily supplementation with comprehensive weight loss surgery specific multivitamins is advised for life.

It's no secret that the amount of food you can consume overall is heavily reduced by restriction.
The other implication of WLS is Malabsorption, which is the changes to your digestive system to reduce the amount of energy absorbed from your food for improving weight loss.
However, it will also interfere with the absorption of certain nutrients for the rest of your life.
Enter the need for supplements with high enough levels of key nutrients to keep you from becoming malnourished.
We all know the goal of having WLS in the first place is to improve your health, so regular supplementation will prevent other health issues from developing and sending you a curved ball along your journey.

What are the key nutritional deficiencies seen after surgery, and why do they happen?

IRON, VITAMIN B12 AND CALCIUM absorption are the leading players affected for life after your WLS. In addition, gastric bypass patients may expect impacts on fat-soluble vitamins A, D, E, and K. 

This is why regular blood testing is also a part of the deal for life to keep an eye on so you can avert any troubles early.

Woman Suffering from Headache - BN Healthy

Are you feeling Flat, Foggy and Forgetful with Fitful Sleep?

Iron deficiency is widespread - and found in up to 1/3 of patients within the first year. 

You'll know about this if you have it because you will feel flat and forgetful. You might even sleep poorly, and you will often find yourself out of breath without much effort. 

The problem arises because iron needs ample acid to be absorbed, and the surgery lowers your levels of acid so that some iron will make its way through unabsorbed.

By consuming vitamin C with Iron Bisglycinate simultaneously, you can improve your iron absorption with ease and gentler on the digestive system.
Daily recommendations for iron supplementation for WLS patients are between 45-60mg for maintenance and much higher doses for catching up once you have hit the lower end of the healthy range. Iron infusion is used for a fast track catch-up; your doctor will work out whether you qualify.

Think Once, Think Twice, Think Vitamin B12

A good friend of iron is Vitamin B12, which is also heavily affected, and deficiency in B12 is also extremely common at the 2-3 year mark once its stores are depleted. 

B12 can present when the daily 350-500mcg is not upheld regularly enough. 

Before surgery, we only need about 3mcg of B12 each day to keep us well. 

 Still, due to the change in the way we absorb our B12 after surgery, bariatric patients need a whopping 350-500mcg every day to just get the 3mcg we need - this is a prime example of malabsorption. B12 helps our DNA to stay healthy, our blood to form well and protects our nervous system. So signs of deficiency include brain fog, pins and needles, overall fatigue as well as anaemia - you see, B12, B6, and iron are a team!

The Knee Bone’s Connected To The Thigh Bone

Let’s not forget to explore the mineral is crucial for keeping our heart beating, muscles contracting, and our bones nice and strong

You guessed it - CALCIUM is on the list, and daily supplementation of between 1300-1500mg is recommended every day.

Check with your professional team to work out your personal needs.

Calcium is very tightly regulated, as it plays a role in maintaining heart rhythm and contraction. So, any shortfall in this mineral will be made up of bone stores and can lead to problems with bone density if not spotted early. It’s not only good for our bones; calcium is a crucial nutrient needed for weight loss too! The research also indicates that the type of calcium in your WLS supplements is vital. Calcium citrate is best as it is less reliant on acid for absorption than calcium carbonate. 

Ideally, food is always the first port of call for good health. A varied diet full of colour, protein, and fruit and veg is a big part of the equation. In addition, the prevention of nutrient deficiencies and their impact on your quality of life after your surgery will be heavily linked to your efforts to take a bariatric supplement every day.

Here is an excellent article on WLS and Nutrient Loss if you're keen to know more: read here.

Jacqui Lewis
BHSc Nutritional and Dietetic Medicine

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