Nutritional Deficiencies & Symptoms
Have you been told you’re nutrient deficient? Maybe you’ve recently undergone life-changing bariatric or weight loss surgery and need to get started on your vitamin and mineral supplementation so you don’t become deficient. Whatever the case, ProCare Health believes vitamins should enhance life, not complicate it!
If you’re curious about which vitamins you need and why, keep reading to learn the intricacies and vital nature of each of the different vitamins and minerals, how best to take them, the amazing benefits for your body, and what food sources contain them, so you can make the best eating and supplementation decisions post-Bariatric surgery.
Why Do I Need Bariatric-Specific Vitamins?
Research shows that those who choose bariatric surgery often have serious nutritional deficiencies prior to surgery due to poor lifestyle and food choices and lack of supplementation. And the risk of these deficiencies gets worse post-surgery.
Therefore, the vitamin and mineral needs and dosages for weight loss surgery patients is much higher than non-surgical consumers, since the ability to eat the quantity of food needed is diminished, and the deficiencies going into surgery are typically higher.
The delivery method for proper nutrients also changes the way they are absorbed; that’s why bariatric-specific vitamins and minerals are engineered specifically for your needs. The right supplementation is critical to a life well-lived for anyone, especially post-bariatric and other weight loss surgery patients.
Vital Nutrients & How to Get Them
To get healthy and remain healthy with the best chance of success, it is imperative to take supplements with certain vitamins and minerals that work in perfectly balanced doses.
The following is a list of recommended daily vitamins and minerals for optimal health. There are common and scientific names listed, as well as if they are fat soluble or water soluble, each vitamin’s and mineral’s purpose, what to look for in the way of deficiencies, and food sources for each.
The information contained here is to help you make informed decisions when selecting your daily vitamins, minerals, and nutrients, and guide you as you take your bariatric journey. And be sure to check with your medical professionals before starting any nutritional and supplementation program.
Vitamins & Minerals for Bariatric Surgery
The following is an overview of each vitamin and mineral. Vitamins listed as water soluble means they do not have to be absorbed in the presence of fat. Typically, these vitamins are not stored in your system beyond what you need and will be excreted through urine if there is extra, which reduces the risk of toxicity. This is most noticeable with Vitamins B and C; your urine will have a more yellow color and specific odor as you eliminate what isn’t needed in the short-term.
Fat-soluble vitamins must be taken with a meal or snack that contains fat in order to be properly absorbed. These tend to be stored in higher amounts in the body, which can lead to a slight risk of toxicity if taken in excess.
Minerals are neither water nor fat soluble and are absorbed via the small intestine. Some vitamins help minerals get absorbed better and others can stop absorption – a well-designed multivitamin will have just the right combination.
You will notice with each vitamin and mineral description, there are no recommended daily amounts (RDA) listed. This is for two reasons: 1). each complete ProCare Health bariatric-specific supplement contains at least the minimum RDA (and in some cases more) for optimal health for the general bariatric patient population, and 2). your doctor will make RDA recommendations specific to your needs based on testing.
Vitamin A, fat soluble, also known as retinol, retinal, retinoic acid, retinyl, retinyl palmitate, retinyl acetate, and carotenoids, including beta carotene.
- Required for: normal vision, gene expression, reproduction, immune function. Essential for normal growth, development, and maintenance of epithelial tissue. Helps promote normal bone development and influences normal tooth formation; functions as an antioxidant and is necessary for wound healing.
- Deficiency symptoms: acne, dry hair and skin, fatigue, growth impairment, insomnia, hyperkeratosis (thickening and roughness of skin), immune impairment, night blindness, dry eyes, weight loss.
- Food sources: orange and ripe yellow fruits, green leafy vegetables, carrots, pumpkin, squash, spinach, fish, soya milk, milk, and egg yolks.
Vitamin B12, water soluble, also known as cobalamin, cyanocobalamin, methylcobalamin.
- Required for: the biosynthesis of nucleic acids and nucleoproteins (DNA/RNA). Assists with red blood cell maturation and folate and central nervous system metabolism. Also plays a role in the metabolism of amino acids and is related to growth. This vitamin is essential to life.
- Deficiency symptoms: anemia, constipation, depression, dizziness, fatigue, intestinal disturbances, headaches, irritability, low stomach acid, mental disturbances, mouth lesions, numbness and nerve issues, spinal cord degeneration, heart palpitations.
- Food sources: meat, fish, poultry, milk and dairy products; egg yolks, liver, and kidney meats. Vegans require supplementation.
Biotin, water soluble, also known as Vitamin B-7.
- Required for: converting food to energy. It is an essential component of enzymes that are involved with carb, fat, and protein metabolism. Coenzyme carrier of carbon dioxide. May have positive effect on type 2 diabetes.
- Deficiency symptoms: skin issues such as Seborrheic dermatitis; eye inflammation, hair loss, brittle cracked fingernails, loss of muscle control, insomnia, muscle weakness, tongue swelling.
- Food sources: liver, organ meats, egg yolks, yeast, bananas. Most vegetables including cauliflower and mushrooms; strawberries, grapefruit, watermelon, peanuts, dairy.
Vitamin C, water soluble, also known as ascorbic acid, dehydroascorbic acid.
- Required for: strong immunity, wound healing, and allergic reactions. Helps increase absorption of nonheme iron. Essential in the synthesis of collagen; functions as an antioxidant and helps metabolize drugs and steroids.
- Deficiency symptoms: poor immunity, inflammation, bleeding gums, depression, easy bruising, impaired wound healing, irritability, joint pain, loose teeth, malaise, tiredness, scurvy.
- Food sources: fruit, especially citrus fruit, papaya, cantaloupe, strawberries, guava, pineapple, and kiwi; vegetables like cabbage, tomato, peppers, greens, and potatoes.
Calcium, a mineral also known as calcium citrate, calcium carbonate, calcium lactate gluconate, calcium citrate malate, calcium phosphate.
- Required for: building and maintaining bones and teeth. Essential for blood clotting and muscle, nerve, and hormone function. May help with high blood pressure and weight.
- Deficiency symptoms: brittle nails, muscle cramps, delusions, depression, insomnia, irritability, osteoporosis and soft bones, palpitations, periodontal disease, rickets, tooth decay.
- Food sources: milk and dairy foods, green leafy vegetables, soy, tofu, nuts, whey protein, and calcium fortified foods like cereal and orange juice.
Chromium, a mineral also known as chromium picolinate, chromium amino acid chelate, chromium chloride, chromium nicotinate.
- Required for: insulin sensitivity; enhances protein, lipid, and carbohydrate metabolism.
- Deficiency symptoms: anxiety, fatigue, glucose intolerance, adult-onset diabetes, impaired growth. Peripheral neuropathy (weakness, numbness, and pain usually in the hands and feet); decreased respiratory quotient which relates to what the body is using for energy (protein, carbs, or fat).
- Food sources: broccoli, green beans, tomatoes, potatoes, oats, barley, romaine lettuce, apples, egg yolks, meat, whole grains.
Copper, a mineral also known as copper citrate, copper amino acid chelate, copper glycinate, cupric oxide, copper gluconate, copper sulfate.
- Required for: the function of many enzymes and iron. May be integral part of RNA and DNA molecules; functions as an antioxidant.
- Deficiency symptoms: anemia, arterial damage, depression, diarrhea, fatigue, fragile bones, hair loss, hyperthyroidism, weakness, eye health, swelling, cardiomyopathy.
- Food sources: almonds, nuts, seeds, chickpeas, avocado, oysters and shellfish; sunflower, dark chocolate, organ meats, potatoes, dark leafy greens, prunes.
Vitamin D, fat soluble, also known as calciferol, cholecalciferol (D3), ergocalciferol (D2).
- Required for: the formation of normal bones and teeth. Promotes the absorption of calcium and phosphorus. Essential for normal growth and development. Plays a role in immunity and hormonal balance.
- Deficiency symptoms: burning sensation in mouth, diarrhea, insomnia, myopia, nervousness, softening of bones, osteoporosis, rickets, scalp sweating, fatigue, low immunity.
- Food sources: egg yolks, liver, mushrooms, fatty fish (salmon, tuna, sardines) and vitamin D-fortified milk. And though not a food source, it is most available through unfiltered sunlight!
Vitamin E, fat soluble, also known as Tocopherols, d-alpha tocopheryl, d-l-alpha tocopheryl, tocotrienols.
- Required for: healthy tissue cells; membrane antioxidant. Acts as a coenzyme and aids in neuromuscular function; helps protect red blood cells.
- Deficiency symptoms: increased heart failure risk, may interfere with vitamin K activity leading to prolonged clotting and bleeding. In anemia, not having enough suppresses the normal hematologic response to iron. Gait disturbances, poor reflexes, loss of positional and vibration sense, shortened red blood cell life.
- Food sources: vegetables (green, leafy vegetables), nuts, seeds, vegetable oils, liver, egg yolks, butter; whole grain breads, cereals, and other fortified or enriched grain products; wheat germ.
Essential fatty acids, also known as Omega-3 fatty acids, ALA, EPA, DHA.
- Required for: energy production, brain function, reproductive and hormonal function, healthy skin, hair, nails. Can decrease cardiovascular disease (CVD) risks, arrhythmia, high triglycerides, blood pressure and platelet stickiness. Play a role in insulin function, weight management, digestion, allergies, inflammation, bone health, stress.
- Deficiency symptoms: heart disease, diabetes, hypertension, immune impairment, chronic illness, liver degeneration. Infertility, poor wound healing, PMS, acne, gall stones. Dry, flaky skin, cracking/peeling skin, small bumps on back of arms.
- Food sources: Fatty cold-water fish such as krill, sardines, salmon, mackerel, tuna; walnuts, chia, flax seeds; oils from flax, seeds; fortified foods such as eggs, soy, milk.
Folate (Vitamin B9), water soluble, also known as folic acid, folinic acid, folacin.
- Required for: the biosynthesis of nucleic acids or DNA/RNA (especially important in early fetal development). Necessary for normal maturation of red blood cells.
- Deficiency symptoms: anemia, apathy, diarrhea, fatigue, headaches, insomnia, loss of appetite, neural tube defects in fetus. Paranoia, shortness of breath, sore tongue, yellow-tinged skin, mouth ulcers, vision problems, depression, irritability.
- Food sources: green leafy vegetables, legumes, wholegrain breads, and fortified or enriched grain products like cereal. Oranges, cantaloupe, beets, liver, lean beef, eggs, fish, lentils. Asparagus, broccoli, collards; yeast.
Iodine, a mineral also known as potassium iodine.
- Required for: thyroid function; important in regulation of cellular oxidation and growth.
- Deficiency symptoms: can cause cretinism, fatigue, weakness, hypothyroidism, weight gain, goiter; hair loss, dry skin, feeling cold, heartrate changes, reproductive issues.
- Food sources: iodized salt (some sea salt has iodine, some does not), dairy, seaweed/kelp, shrimp, tuna, eggs, prunes.
Iron, a mineral also known as ferric, ferrous, ferrous fumarate, ferrous sulfate, ferrous gluconate, carbonyl.
- Required for: oxygen-carrying red blood cell production; oxygen transport from lungs into the body. Increases resistance to infection; functions as part of the enzymes involved in tissue respiration.
- Deficiency symptoms (iron is the most common mineral deficiency): anemia, brittle nails, confusion, constipation, depression, dizziness, fatigue, headaches, inflamed tongue, mouth lesions, malabsorption. Irritability, unhealthy pallor (pale appearance), lethargy, inability to be physically active to desired level.
- Food sources: liver and organ meats; shellfish, spinach, broccoli, legumes, tofu, eggs, dark chocolate, fortified cereals.
Vitamin K, fat soluble, also known as phylloquinones (K1), menaquinones (K2), menadione (K3), phytonadione.
- Required for: the synthesis of blood clotting factors. Involved in bone metabolism; assists in calcium metabolism.
- Deficiency symptoms: increased bruising, slow to blood clot when cut or punctured, heavy menstruation. Possible hemolytic anemia (condition in which red blood cells are destroyed and removed from the bloodstream before they should be), jaundice (a yellowish tinge to the skin and the white part of the eye caused by elevated bilirubin levels).
- Food sources: leafy green vegetables such as spinach, kale, mustard greens, collards; broccoli, cauliflower, Brussel sprouts, egg yolks, liver, natto.
Magnesium, a mineral also known as magnesium citrate, magnesium oxide, magnesium sulfate.
- Required for: more than 300 enzyme systems that regulate biochemical reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control, blood pressure regulation, and nerve impulse transmissions. Assists with muscle contractions (heart pumping and movement of muscles).
- Deficiency symptoms: anxiety, confusion, heart attack, heart palpitations, high blood pressure, hyperactivity, insomnia, nervousness, restlessness, weakness, muscle twitching and cramps, mental disorders, asthma.
- Food sources: bananas, leafy greens, some fatty fish, seeds, nuts, legumes, tofu.
Manganese, a mineral also known as manganese sulfate, manganese amino acid chelate, manganese gluconate.
- Required for: normal brain and nerve function; involved in protein and energy metabolism. Helps with formation of connective tissue, bones, blood-clotting factors, sex hormones. Plays a role in fat and carbohydrate metabolism, calcium absorption, and blood sugar regulation.
- Deficiency symptoms: atherosclerosis, dizziness, elevated cholesterol, glucose intolerance, hearing loss, loss of muscle control, ringing in ears, infertility, bone growth impairment.
- Food sources: nuts, legumes, oatmeal, bran, leafy greens, brown rice, whole wheat bread, pineapple, acai, dark chocolate.
Molybdenum, a mineral also known as molybdenum amino acid chelate, sodium molybdate, ammonium molybdate.
- Required for: activating four essential enzymes which are biological molecules that drive chemical reactions in the body. Breaks down aldehydes (yeast, mold, fungi), which can be toxic to the body.
- Deficiency symptoms: very rare but may include changes in mental status; abnormalities of sulfur and purine metabolism.
- Food sources: almonds, cashews, peanuts, peas and lentils, kidney, lima, navy beans, soy milk, tofu, cheese, yogurt, leafy veggies, eggs, whole grains
Niacin (Vitamin B3), water soluble, also known as Niacin, niacinamide, nicotinic acid, nicotinamide riboside.
- Required for: every part of the body to function; the synthesis of glycogen and the breakdown of fatty acids. Assists with transfer of hydrogen and acts in the metabolism of carbohydrates and amino acids. Involved in tissue respiration and brain function. Flushing does not occur with niacinamide.
- Deficiency symptoms: bad breath, canker sores, confusion, depression, dermatitis, diarrhea, emotional instability, fatigue, irritability, loss of appetite, memory impairment, muscle weakness, nausea, skin eruptions and inflammation
- Food sources: meat; poultry; liver; fish; egg yolk; vegetables (mushrooms); tree nuts; wholegrain breads, cereals, and fortified or enriched grain products; legumes; milk.
Pantothenic Acid (Vitamin B5), water soluble, also known as pantothenic acid, D-calcium pantothenate.
- Required for: the synthesis and breakdown of many vital compounds; essential in intermediary metabolism of carbohydrates, protein, and fat.
- Deficiency symptoms: abdominal pains, burning feet, depression, eczema, fatigue, hair loss, immune impairment, insomnia, irritability, low blood pressure, muscle spasms, nausea, poor coordination, sleep disturbances.
- Food sources: meat, fish, poultry, liver, egg yolks, yeast, wholegrain breads, cereals, and other grain products; legumes, vegetables.
Phosphorus, a mineral also known as sodium phosphate, potassium phosphate, calcium phosphate.
- Required for: every cell in the body to function; building and maintaining bones and teeth; component of nucleic acids, phospholipids; acts as a coenzyme in energy metabolism; buffers intracellular fluid.
- Deficiency symptoms: phosphate depletion is unusual, but can affect the kidneys, nerves and muscles, skeletal system, as well as blood chemistries.
- Food sources: protein-rich foods like meats, dairy, beans, lentils, nuts, some whole grains.
Potassium, a mineral also known as potassium citrate, potassium chloride, potassium gluconate, potassium bicarbonate.
- Required for: regulating fluid balance, muscle activity (especially the heart muscle), and nerve signals. Potassium content of muscle is related to muscle mass and glycogen storage (an adequate supply of potassium must be present to form muscle). Helps reduce blood pressure, water retention; protects against stroke, osteoporosis, and kidney stones.
- Deficiency symptoms: muscle spasms, acne, constipation, depression, edema, excessive water consumption, fatigue, glucose intolerance, high cholesterol levels, insomnia, mental impairment, muscle weakness, nervousness, poor reflexes, abnormal heart rhythms.
- Food sources: bananas, apricots, dried fruits, avocado, cooked spinach and broccoli, sweet potatoes, beets, white beans.
Probiotics, live bacteria such as Lactobacillus and Bifidobacterium, measured in billions of CFUs, known as “good bacteria.”
- Required for: supporting digestive, gut, and immune health. Helpful in preventing diarrhea, reducing gastrointestinal discomfort; assists with weight loss; possibly increases B12 levels.
- Deficiency symptoms: gas, bloating, digestive discomfort, weight gain, irregular bowel movements, food allergies/sensitivities, skin issues, depression, anxiety.
- Food sources: kefir, kimchi, sauerkraut, tempeh, kombucha, miso, yogurt, natto, pickled cucumber, fermented foods.
Pyridoxine (B6), water soluble, also known as pyridoxine, pyridoxamine, pyridoxal, pyridoxol, pyridoxine HCl.
- Required for: the synthesis and breakdown of amino acids and unsaturated fatty acids from essential fatty acids; conversion of tryptophan to niacin; essential for normal growth, red blood cells, nerves, skin.
- Deficiency symptoms: reduced red blood cell volume or reduced concentration of blood hemoglobin, acne, anemia, arthritis, eye inflammation; depression, dizziness, facial oiliness, fatigue, impaired wound healing and immunity; irritability, loss of appetite, loss of hair, mouth lesions, nausea, seizures.
- Food sources: meat, liver, vegetables, tree nuts, bananas; wholegrain breads, cereals, or other grain products; legumes, potatoes, egg yolks, milk, oatmeal.
Riboflavin (Vitamin B2), is water soluble.
- Required for: growth and good health. Aids in tissue respiration and acts as transporter of hydrogen ions. Helps break down carbohydrates, proteins, and fats for energy (ATP); allows oxygen to be used by the body.
- Deficiency symptoms: tearing, burning, or itching of the eyes; cataracts, soreness and burning of the lips, mouth, or tongue; inflammation (swelling) of the corner(s) of the mouth; purple, swollen tongue, dermatitis, dizziness, hair loss. Damage to peripheral nerves that often causes weakness, numbness, and pain usually in the hands and feet. Excessive growth of blood vessels into the cornea. Sensitivity to light, sleepiness, weakness.
- Food sources: milk and dairy products, organ meats, eggs, bananas, popcorn; green beans, asparagus, meats, egg yolks, legumes, wholegrain breads, cereals, and fortified or enriched grain products.
Selenium, a mineral also known as selenium amino acid chelate, sodium selenite, L-selenomethionine.
- Required for: reproduction, thyroid gland function, DNA production, immunity; protecting the body from damage caused by free radicals and infection. Also essential in tissue respiration. Associated with fat metabolism and vitamin E; acts as an antioxidant.
- Deficiency symptoms: arthritis, growth impairment, high cholesterol levels, heart disease; increased incidence of cancer, pancreatic insufficiency, immune impairment, liver impairment, male sterility, muscle pain, fragility of red blood cells.
- Food sources: brazil nuts, yellow-fin tuna, fish, ham and pork, enriched foods, beef, turkey, chicken.
Thiamin (Vitamin B1), water soluble, also known as thiamine, thiamin, thiamin mononitrate.
- Required for: metabolism of protein, carbohydrates, and fat; essential for growth, normal appetite, digestion, and healthy nerves.
- Deficiency symptoms: indigestion, constipation, malaise, heaviness and weakness of legs, tender calf muscles, “pins and needles” and numbness in legs, increased pulse rate and palpitations. Edema, tense calf muscles, fast pulse, distended neck veins, high blood pressure, decreased urine volume.
- Food sources: pork liver, organ meats; oatmeal, brown rice, vegetables, potatoes, eggs; wheat germ, wholegrain and enriched breads, cereals, and other grain products; legumes.
Zinc, a mineral also known as zinc citrate, zinc amino acid chelate, zinc picolinate, zinc sulfate, zinc acetate.
- Required for: the breakdown carbohydrates, fats, and proteins. An important structural component of many proteins and systems in the body, including DNA. Helps body fight bacterial and viral infections and boosts immunity.
- Deficiency symptoms: decreased ability by the body to heal wounds; immune impairment, mild anemia, growth failure, skin changes, acne, amnesia, apathy, brittle nails, delayed sexual maturity, depression, diarrhea; eczema, fatigue, hair loss, high cholesterol levels, impotence, irritability, lethargy; loss of appetite and sense of taste, low stomach acid, male infertility, memory impairment, night blindness, paranoia, white spots on nails.
- Food sources: meat, shellfish, seeds, nuts, legumes; dairy, eggs, whole grains.
How to Determine What Supplements You Need
In American and British scientific studies, all adults studied had some kind deficiency in most of the vitamins and minerals listed. Without a measured, balanced nutrient plan, bariatric patients – who need more nutrients that the average person – can suffer serious health consequences, which can mean the difference between life and death.
Some symptoms of deficiencies will look like side effects associated with bariatric surgery or may be chalked up to “stress” or regular fatigue, and a physical exam may not be enough to determine what is going on. The only way to find out if you have nutritional deficiencies is through in-depth laboratory testing.
It is crucially important to stay under the care of your bariatric team or a physician who understands your post-operative needs. It is crucial that you form a plan with your team before and after surgery and have regular nutritional testing that goes far beyond the standard once-a-year routine blood work. Once you get those in-depth nutritional test results, you can create a plan, monitor your needs, and make changes as needed.
A Great Way to Get Started
While you’re undergoing testing to determine your nutritional status, our once-daily bariatric multivitamin is specifically designed to safely meet your post-surgical nutritional needs with ease.
As with all of ProCare Health’s vitamin and mineral supplements, our once-daily multi was developed in coordination with doctors, dietitians, and bariatric coordinators. We offer the most complete, affordable, compact multivitamin available with 21 nutrients, that’s the preferred size, taste, and texture. You can even decide if you want chewable or regular capsules, with or without iron and probiotics.
At ProCare Health, we consider what we do of vital importance to your health, and only provide the best
quality, accuracy, and bio-availability possible so that you get the most from every supplement you take.
ProCare Health is Here to Help
If you’ve had bariatric, adjustable band, DS switch, gastric bypass, gastric sleeve, or a mini bypass, we are here for you and make getting your critically important nutrition EASY! Be sure to reach out to us today if you have questions or need help with your order. 877-822-5808
Please note: the information contained within this article is in no way to be considered medical advice
nor is it meant to replace your medical team’s recommendations. We gain no benefit from the resources
listed here nor do we promote any of their products or services. This article’s purpose is to educate and
allow the reader to make informed decisions with the help of his or her medical team.
- US National Library of Medicine, https://www.nlm.nih.gov/
- National Institutes of Health, https://www.nih.gov/
- National Center for Complimentary and Integrative Health, https://nccih.nih.gov/health/integrative-health
- The Evolving Role of Multivitamin/Multimineral Supplement Use among Adults in the Age of Personalized Nutrition, https://www.mdpi.com/2072-6643/10/2/248
- Nutritional Status of Bariatric Surgery Candidates, https://www.mdpi.com/2072-6643/10/1/67.