One of the reasons I’ve devoted my career exclusively to gastric sleeve surgery is that it leaves as much as your natural anatomy intact as possible. Gastric sleeve doesn’t involve rerouting your intestines, for example, so patients rarely have any malabsorption issues. But sleeve patients can still benefit from supplements, which boost nutrients you may be missing from your new diet.
The first month
You’ll be feeling great soon after surgery, but your sleeve heals on its own timetable. Since you can’t eat solid food for the first several weeks, you certainly can’t swallow a big horse pill.
I recommend that my patients begin taking a multi-vitamin in liquid, chewable, or gummy form about a week after surgery. (I don’t want you to bombard your new sleeve with too many medications during that first week.) This is also the only time I recommend drinking liquid nutritional supplements. When your sleeve is still swollen, you may not be able to take in enough calories to ensure an adequate energy level, let alone sufficient nutrients, so nutritional supplement drinks and protein shakes can be handy in the near-term.
The first year
In almost every case, patients lose the most weight in the eight to twelve months after gastric sleeve surgery. That’s why it’s especially important to get extra vitamins and minerals in supplement form during this stage. I advise patients to wait at least three months post-op before they attempt to swallow a multi-vitamin. But if you prefer to continue with liquid, chewable, or gummy forms of vitamins indefinitely, I’m fine with that.
In addition to multi-vitamins, I recommend:
• Vitamin B12, a deficiency of which can cause anemia, as well as serious neurological problems. B12 deficiency is rare but has sometimes been reported with restrictive surgeries such as the gastric sleeve.
• Calcium/vitamin D complex, which is important in preventing osteoporosis in sleeve patients.
• Iron for women of childbearing age and/or those who have anemia.
• Folic acid in a dose of 400 mcg a day for women of childbearing age.
Please note that your multi-vitamin may have adequate amounts of B12, calcium, iron, and folic acid. But it’s important to check the label carefully—and we’ll provide you with detailed information about what to look for.
The long run
No one wants to take more pills or supplements than they need to, but a multi-vitamin is simply a good insurance policy. I take one every day, and I don’t even have a gastric sleeve! Don’t get me wrong; I advocate for getting a broad range of vitamins and minerals from your food. Adding a daily multi-vitamin ensures you’re completely covered, though. Is it an absolute must? No. But there’s just no reason not to. If a daily pill is becoming a hassle, there are so many forms to choose from today that you’re sure to find one that feels more like a treat than an annoyance. The same is true of calcium and some other nutrients, by the way. Caramel, berry, chocolate…the flavors are kind of like a daily dessert.
Other Dos and Don’ts
DO make sure to space your supplements out during the day if you’re taking more than one. Even after your sleeve has healed, piling them on top of each other can cause irritation or stomach upset. It’s just easier on your stomach if you space them out by 30 to 45 minutes.
DON’T worry about supplementing electrolytes. Electrolytes are absorbed in the intestines, and again, since gastric sleeve doesn’t involve your intestines, you won’t lose any absorption of electrolytes after surgery.
Rest assured that the Endobariatric staff spends a great deal of time educating our patients about vitamins and supplements. And if you have questions about supplements at any time, we’re always here to answer questions, remember if you have another doubt don’t hesitate to send us a message to our webpage.
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“Changing lives…one sleeve at a time”.