How important are vitamins and minerals in my diet?

vitamins after bariatric surgeryLet’s expand on the importance of vitamins and minerals after obesity surgery. ( I am going to refer to vitamins and minerals from now on as V&M – please do not confuse it with, well…you know!).  Regardless of which bariatric surgery procedure you have had or if you have had or not yet had obesity surgery, you should be taking V&M to be healthy. These important items help  your body stay strong, they support your immune system and they help you heal after any type of physical stress (surgery, flu, allergy). There are countless discussions about the miracles of V&M. I will leave that to those who capable of finding miracles in dryer lint balls.

•The Dr Dirk website has a link to a nutrition eStore that will help you find all the V&M you need to stay healthy.

•Obesity surgery changes your body. It will change your body’s need for V&M AND it will change how they are absorbed. You will need more V&M because of the stress of surgery and exercise to come. You will need a different vitamins preparation (capsule, gel-cap, chewable tablet, gummy bear, bubble gum type) because surgery has changed how it will process the item you put in your mouth.

•First, why vitamins after all types of obesity surgery? No matter which operation you have had, your body can not longer eat the AMOUNT of food you would need to get all the V&M your body needs. Heck, even without surgery we Americans don’t get what we need from our diets. More important of surgery patients. You can not eat the amount of fruit, vegetables, salads and other stuff. Given my earlier posts, you would not want to because of the amount of calories they have. So V&M preparations stuff all you need in one convenient, easy to swallow carrier.

•Second, by changing your body’s ability (Band, Sleeve, Bypass, Switch) to process the carrier, hard tablets are no longer convenient. Hard tablets are well, hard. This needs stomach acid and a normal size stomach to break it down. Band patients complain of the tablet floating around in their pouch and making them burp V&M breath all day. Ain’t nobody got time for that! So, by taking the other formulations the body’s heat breaks down the outside cover and allows the V&M to be absorbed. Chewables and gummies allow the saliva to carry the V&M’s to where they need to go.

Dr. Dirk What do I need? I thought you would never ask!

•Multi-vitamin(or MVI) – and definitely not a One-a-Day®. These are not meant for obesity surgery patients. Any good MVI worth its money should be taken twice a day. There are varieties out there that are only for once a day. I tell my patients to take them twice a day to make sure they get all they need. What your body does not need will be eliminated when you urinate. MVI have lots of B vitamins, but alone may not be enough for what your body now needs. Some of you may notice the colorful neon productions when you go to the bathroom!

•B-complex – Not just B-12, all the B’s. B vitamins are important for skin growth, hair growth, nail growth, nerve health, bone health. A good B capsule once a day in addition to your MVI gives you what you need and then some. DO NOT BREAK OPEN A B CAPSULE unless you want to stink like dead fish for a few days.

•B 12 – Some patients and doctors torture me about B-12. It is very important, but if you take it orally, you will be fine. If you have anemia, a predisposition to anemia, known anemia, hereditary anemia, oral B-12 may not be enough. These specific patients may or will need nasal / inhaler B-12 or injections. Always check with your doctor and bariatric surgeon to be safe.

•Vitamin D – I do not agree with all the broo-ha-ha about Vitamin D nowadays. BUT, I do recommend to everyone to make sure that their MVI has vitamin D (all respectable preparations do, just check the labels to make sure). Vitamin D is important for Calcium and bone health. There are combined Calcium and Vitamin D capsules, caramel chews and fizzy drinks. No need to suffer through the chalk sized, constipating inducing plugs in your grocery store.

•Iron – Important for women who still have periods or anyone with anemia. Men tend not to need iron unless they have a medical condition that requires it. Do not take iron and vitamin C, or iron and Calcium at the same time. Iron comes in capsules, gel caps and even chewable preparations.

•Minerals – This will include Calcium, magnesium, zinc, copper, selenium, iodine and others. Most MVI include these. Because of the changes I have mentioned, it is important for your body to get these everyday. They play an important part  of supporting and strengthening your immune system. They also help in healing your body from everyday stresses. Read the labels of what you are buying to make sure it has what you need. Taking Calcium is not a substitute for daily aerobic exercise. Exercise forces your body to absorb Calcium. If you do not exercise, your body will not absorb Calcium!

•Dr. Dirk, how do I know that my V&M’s are the right ones for me?  – Excellent question. If you feel healthy, your hair is growing and you have the energy you need to do your daily activities and exercise, you are getting what you need. If you are concerned have your doctor or surgeon run a blood test to check specifically for vitamin levels. If you are fatigued, your hair is falling out, your skin is excessively dry, you have redness or irritation around the corners of your mouth, have double vision or have numbness and tingling in your toes or fingertips, talk with your surgeon or doctor right away.

Who needs what – Let me break down my recommendations for different obesity operations, but first allow me to emphasize –

• Women – Must take Iron if they still have their monthly periods or if they have a known anemia. Must take Calcium and Vitamin D, definitely after 40.

• Duodenal Switch –  patients will need Calcium, Magnesium and a Vitamin A,D,E &K combination. Dr. Dirks website has a nutrition eStore that has these. Duodenal Switch patients have very specific V&M needs. Failure to take these V&M’s will make the Switch patient miserable in the short and long term.

Lap Band – MVI, twice a day

Gastric Sleeve – MVI twice a day, B-complex once a day

Gastric Bypass – MVI twice a day, B complex once a day

•Duodenal Switch – MVI twice day, B-complex once a day, Calcium, Magnesium, Vitamin ADEK packet once a day.  Like obesity surgery, V&M’s help make you healthy and keep you healthy for the rest of your   life.