A Supplement Guide After Gastric Sleeve Surgery

A Supplement Guide After Gastric Sleeve Surgery

After weight loss surgery, you want to feel as good as possible, for as long as possible. To succeed, you need to take supplements of vitamins and minerals every day for the rest of your life.

Even if you eat good and nutritious food, it’s not enough because the uptake is worse than before. About 85% of the stomach is removed during a gastric sleeve operation. The feelings of hunger decrease sharply after the weight loss surgery because the hunger hormones are largely present in the stomach. The reason why you need to take supplements of vitamins and minerals after a gastric sleeve is that, in addition to eating less food, you have a limited amount of hydrochloric acid in the stomach which is needed for the activation of vitamins and minerals.

The biggest challenge is to take your vitamins even though you feel better than ever. If you fail to comply with your vitamin and mineral guidelines, serious illness can result from it. It takes many years to develop deficiency symptoms, so many are lulled into a false sense of security and think they don’t need to take their essential bariatric vitamins. This can in the long run lead to osteoporosis, memory problems, nerve damage, and fatigue. Some symptoms get better when you start taking your vitamins again, while others are irreversible.

To prevent this, below we share a small supplement guide after your gastric sleeve surgery.


After a weight-loss surgical procedure, the uptake of iron decreases partly because of the anatomy changes and partly due to changed eating habits. Iron needs to be converted in the stomach to be absorbed and requires the presence of hydrochloric acid for optimal absorption. This affects both gastric sleeve and gastric bypass surgery as well as both men and women. Most patients need 45-60 mg of iron per day after surgery.


B12 is a vitamin that’s dependent on hydrochloric acid and the protein Intrinsic factor (IF) to be absorbed by the body. As we said, after a gastric sleeve operation, you have less hydrochloric acid and a poorer supply of the protein IF as these are found in the stomach, therefore the body’s ability to absorb vitamin B12 is affected.

The amount of B12 from the diet also decreases when the portions are smaller. By consuming large amounts of B12 via dietary supplements, the vitamin is absorbed in the usual way but also via passive diffusion in the intestine. At least 500 mcg of vitamin B12 is recommended per day.

Vitamin D

Source: Unsplash

Vitamin D is absorbed in the part of the intestine that is removed during a gastric sleeve. Vitamin D is necessary to be able to absorb calcium and phosphate from food. This vitamin also prevents the body from breaking down the skeleton, which it otherwise does in order to maintain normal calcium and phosphate levels in the blood.

Guidelines from the ES and the AACE/TOS/ASBMS recommend high vitamin D doses following this type of surgery, ranging from 3,000 IU daily to 50,000 IU 1-3 times weekly, and increasing to 50,000 IU 1-3 times daily if there’s severe malabsorption.


Source: Unsplash

Thiamin or vitamin B1 is important for the body’s metabolism of carbohydrates so that nerves and muscles function properly. The amount of thiamin from the diet decreases because the portions are smaller after a weight-loss operation. If thiamin deficiency occurs, it usually occurs in the first few weeks after gastric sleeve surgery. And you want to avoid a long-standing lack of thiamin as it can lead to permanent brain damage. Following your gastric sleeve surgery, you must discuss with your healthcare practitioner how much thiamin you’re required to take.

Folic Acid

It’s impossible to speak about folic acid without mentioning folate as well. It’s like two sides of the same coin or simply said two different forms of the same B vitamin. You get folate through foods such as dark green leafy vegetables, beans, fruit, and berries, while folic acid is actually an artificially produced folate.

As the uptake of folate and folic acid deteriorates after gastric sleeve surgery, it’s vital for patients to make sure they get it. Folic acid and folate are essential for cell division to function normally, the structure of amino acids, otherwise known as the body’s building blocks, and consequently the formation of red blood cells. If, for instance, you’re consuming a multivitamin, make sure it contains at least 400 mcg of folic acid.

Final Thoughts

To ensure proper nutrition following gastric sleeve surgery, doctors advise patients to take the right vitamins and minerals. To maximize absorption of micronutrients after surgery, make sure to follow the abovementioned supplement mini-guide and you’ll find the key to staying healthy and strong.

Katherine Baldwin

Katherine is just getting her start as a journalist. She attended a technical school while still in high school where she learned a variety of skills, from photography to nutrition. Her enthusiasm for both natural and human sciences is real so she particularly enjoys covering topics on medicine and the environment.

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