ASMBS Supplementation Guidelines

Below is an overview of the supplementation guidelines that I recieved from Duke Metabolic and Weight Loss Surgery. They have distilled the information that appears in the document above into this easy to read form.

Daily Multivitamin

- chewable of liquid for the first 3 wks following surgery

- must contain 400mcg Folate, 18 mg Iron, and 15mg Zinc

- Gastric bypass and Biliopancreatic diversion patients need to take 2 multivitamins everyday

- LapBand only need 1 multivitamin daily

Calcium Citrate

- Chewable or Petite version until 3 months post op

- LapBand patients need 1500mg daily*

- RNY patients need 1500 to 2000mg daily*

- DS patients need 1800 - 2400mg daily*

* Limit calcium dosage to 400 to 600mgs every 4 hours to ensure effective absorptionand do not take within 2 hours of iron supplimentation, this will usually mean taking your multivitamin 2 hours before or after your calcium.

Additional Iron (for women who have had RNY or DS and are menstruating or have a history of anemia)

- Add 18 - 27mgs of elemental iron per day for a total dose of 50 to 100mgs, including iron in your multivitamin.*

- liquid forms of ferrous fumarate, ferrous sulfate and ferrous gluconate are the best absorbed forms of iron.

* You may want to add an over the counter stool softener such as Colace when starting an iron supplementation regimen to reduce problems with constipation when taking iron. 

Vitamin B12

- RNY patients should either take a sublingual 350mg B12 or obtain a monthly injection from their PCP. 

Vitamins A, D, E & K

- DS patients need 1 ADEK tablet daily

Here is a link to the supplementation guidelines from the American Society of Metabolic and Bariatric Surgeons (ASMBS) which are the governing body of bariatric surgeons. You will find a table that provides the information on page 7 as well as the details of what you need and why you need it. You may want to check these recommendations against your current regimen to be sure that it is complete and up to date. If you find that your regimen is incomplete, you may want to contact your surgeon to discuss modifying your supplementation regimen. This recommendation address all bariatric surgeries.