Core Supplement Set
Multivitamin with iron and trace minerals (usually two daily)
Calcium citrate 1200–1500 mg/day split into doses
Vitamin D 3000 IU/day, adjusted by serum level
Vitamin B12 — oral, sublingual, or intramuscular per protocol
Iron — additional dosing for menstruating patients or after bypass
Why Bypass Needs More
Roux-en-Y and mini-gastric bypass bypass part of the duodenum and proximal jejunum, reducing absorption of iron, calcium, B12, and fat-soluble vitamins. Sleeve patients have lower but still real risk.
Laboratory Monitoring
Standard follow-up labs at 3, 6, 12 months and annually thereafter — including CBC, iron studies, B12, folate, 25-OH vitamin D, calcium, PTH, and selected trace elements.
When to Adjust
Symptoms such as fatigue, hair shedding, paresthesia, or bone pain warrant additional testing rather than self-adjustment of doses. Decisions about replacement should be guided by the bariatric team.
References
- ASMBS Integrated Health Nutritional Guidelines
- Mechanick JI et al., 2019 Perioperative Nutrition Update
The results of any surgical or interventional procedure may vary from person to person. It is recommended that you obtain detailed advice from your physician before the procedure.
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