Why Are Vitamins So Important After Bariatric Surgery?

by Anthony Benjamin on Oct 12, 2022

Why Are Vitamins So Important After Bariatric Surgery?

Why Are Vitamins So Important After Bariatric Surgery?

After bariatric surgeryThere is an obesity epidemic continuing to expand in the western world. This increase in obesity has also increased the number of individuals opting to undergo bariatric surgery. Studies have shown dietary deficiencies in obese patients before and after bariatric surgery. Thus, it is paramount that we understand the impact of these dietary deficiencies on bariatric patients.

Keep reading to learn why vitamins are so important after bariatric surgery.

Post-Bariatric Surgery

After surgery, bariatric patients are at an increased risk of developing nutritional deficiencies for several reasons:

  • Vomiting
  • Decreased food intake
  • Food intolerance
  • Reduction of gastric secretions
  • Bypass of absorption surface areas

In the first year following surgery, it is recommended that patients’ nutritional statuses are monitored every three months. In the second year post-surgery, it is recommended to be monitored every six months, and then every six to 12 months starting in the third year. The goal is to identify nutritional deficits early to reduce the risks associated with specific dietary deficiencies.

Depending on the weight loss surgery you have, what you need in a multivitamin is going to be different. There are several essential nutrients that we will address in this blog post. These include:


  • Iron
  • Vitamin D
  • Calcium
  • Vitamin B12
  • Folate
  • Vitamins A, E, and K
  • Zinc
  • Copper


Doctors have commonly reported iron deficiencies following bariatric surgery, with reports ranging from 20% to 49% of the bariatric community experiencing an iron deficiency.

One study found a net reduction of almost 50% in the total meat consumed daily by bariatric patients following surgery. This confirmed that red meat contributes to your overall iron absorption and that some bariatric patients have a low tolerance to red meat after surgery.

A second reason bariatric patients may experience iron deficiency is that almost every bariatric surgery reduces gastric capacity and ultimately hydrochloric acid production and volume. Hydrochloric acid is needed to convert Fe3+ into the more absorbable Fe2+ ion. Without this conversion, you’re limiting iron release from the structural proteins.

The third reason one may experience iron deficiency after surgery is that the bariatric procedure reduces the total absorption surface area. This concept is pretty straightforward. The less absorption surface area there is, the fewer nutrients you will absorb. Usually, 70-80% of your stomach is removed, and a small pouch is what is left, making the absorption of nutrients difficult.

The fourth and final reason you may be iron deficient after surgery is that you were also deficient before surgery. It’s been recorded that peri-operative iron deficiency anemia occurs in about nine to 16 percent of bariatric patients, which may account for a post-operative deficiency. You must monitor this condition, as it is associated with increased postoperative morbidity and mortality and decreased quality of life.

To avoid iron deficiencies, lifelong monitoring is required. In some cases, appropriate supplementation with iron and vitamin C (to enhance absorption) is not enough. Some patients may need intravenous doses of iron gluconate.

More attention and caution should also be administered to specific populations, like young, fertile women and patients with a previous history of peptic ulcer disease.

Vitamin D & Calcium

Vitamin D has two essential functions:

  1. Optimize bone mineralization
  2. Maintain calcium homeostasis

Prolonged vitamin D deficiency can lead to osteopenia, osteoporosis, and hypocalcemia.

It’s estimated that over 50% of post-operative patients develop low vitamin D levels, and 25-50% develop hypocalcemia. Due to this risk, lifelong supplementation is highly recommended. (You should consume more vitamin D than is available in a multivitamin).

Vitamin B12 & Folate

Vitamin B12 and folate are typically evaluated together as either deficiency can lead to macrocytic anemia. Many doctors recommend daily oral supplementation.

Vitamin B12 keeps your body’s blood and nerve cells healthy. If you are deficient, you may experience tingling and numbness in your fingers and toes or feel tired and confused.

Folate is needed for red blood cell formation, growth, and function. It is vital for women who may become pregnant because it plays a crucial role in fetal development. Deficiency will often present as weakness, fatigue, irritability, headache, and shortness of breath.

Vitamins A, E & K

Vitamin A is involved in vision, reproduction, immunity, and cellular communication. Deficiency can present as xerophthalmia, which dries out the eyes and can lead to night blindness if not treated.

Vitamin E’s primary role in the human body is to act as an antioxidant, fighting off free radicals that damage cells. It also enhances immune function and prevents blood clots from forming in the heart. Signs of deficiency include:

  • Retinopathy – damage to the retina
  • Peripheral neuropathy – damage to the peripheral nerves, like the hands and feet, causing weakness and pain
  • Ataxia – loss of control of body movements
  • Decreased immune function

Vitamin K helps make various proteins needed for clotting and the construction of bones. Deficiency is rare but may occur due to malabsorption. The most common signs of deficiency include:

  • Prolonged prothrombin time (a longer time for blood to clot; can be measured at the doctor’s office)
  • Bleeding
  • Hemorrhaging
  • Osteopenia or osteoporosis

Associated Malabsorption After Duodenal Switch Surgery

It’s worth noting that the fat-soluble vitamins A, D, E, and K are mostly dissolved in dietary fat before being absorbed by the body. Duodenal Switch (DS) patients don’t absorb as much dietary fat, which leads to associated malabsorption of these vitamins.

That’s specifically why ProCare Health formulated the DS / SADI Once Daily Bariatric Multivitamin Capsule!


Zinc is involved in cell growth, DNA synthesis, and building proteins. It also plays a vital role in reproduction, immune function, and wound repair. Zinc deficiency is considered rare but is most commonly found in people with digestive disorders or those who have undergone gastrointestinal surgery. Deficiency can cause:

  • Loss of taste or smell
  • Poor appetite
  • Impaired immune function
  • Hair loss
  • Difficulty concentrating
  • Depressed mood
  • Delayed wound healing
  • Diarrhea


Copper is used to make energy, connective tissues, and blood vessels and supports a healthy immune and nervous system. Most copper within the human body is found in the liver, brain, heart, kidneys, and skeletal muscle. Both too much and too little copper can affect how the brain works, as impairments have been linked to Menkes, Wilson’s, and Alzheimer’s disease. Deficiencies are rare but can cause:

  • Anemia
  • Low body temperature
  • Bone fractures
  • Osteoporosis
  • Loss of hair and skin pigmentation
  • Thyroid issues
  • An increased risk of infection

High zinc (over 150 mg/daily) and vitamin C (over 1,500 mg/daily) intake may induce copper deficiency by competing with copper for absorption in the intestine.

ProCare Health

At ProCare Health, we offer a premium selection of bariatric-approved vitamins and supplements to ensure that you receive everything you need to stay healthy.

Some of our essential products include:

We care about your health journey and want you to be successful. The only way to do that is to ensure you receive the correct nutrients for your body to function correctly.

Visit our website today at to learn more about ProCare Health. We can’t wait to help you!