Table 1.
Summary of global recommendations for supplements post-bariatric surgery.
| Recommendation | Comments | |
|---|---|---|
| Multivitamin and mineral supplement | 1–2 daily | Avoid retinol-based vitamin A during pregnancy and lactation; safe to continue beta-carotene |
| Calcium | 800–1500 mg daily | Calcium citrate may have better bioavailability |
| Vitamin D | 800 units daily | Higher doses may be necessary if pre-existing deficiency |
| Iron | 45–60 mg daily | 100 mg elemental iron is recommended for menstruating women |
| Vitamin B12 | 1000 micrograms orally daily or 1000 micrograms intramuscular injection 4–12 weekly | |
| Thiamine (B1) | As contained in Multivitamin or 12–50 mg daily | Additional 200–300 mg if prolonged vomiting is experienced |
| Folic Acid | As contained in Multivitamin or 400–800 microgram daily | 5 mg preconception to 12 weeks of gestation |
| Vitamin A | As contained in Multivitamin or 5000–1000 IU daily | Additional screening in BPD/DS * or if Steatorrhoea. Increased requirements in pregnancy—avoid retinol and retinyl esters. |
| Vitamin E | As contained in Multivitamin or 15 mg daily | Additional screening in BPD/DS * or if Steatorrhoea |
| Vitamin K | As contained in Multivitamin or 90–300 micrograms daily | Additional screening in BPD/DS * or if Steatorrhoea |
| Zinc | As contained in Multivitamin to meet 100–200% RDA † | Maintain Ratio of 8–15 mg Zinc per 1 mg Copper |
| Copper | As contained in Multivitamin to meet 100–200% RDA † | Maintain Ratio of 8–15 mg Zinc per 1 mg Copper |
| Selenium | As contained in Multivitamin |
Global recommendations based on published guidelines from America, the UK and Australia [30,31,32,34]. In Pregnancy, we recommend a daily oral complete multivitamin and micronutrient (avoiding retinol), calcium with vitamin D, iron and 3-monthly intramuscular Hydroxocobalamin; omeprazole is our preferred choice of proton pump inhibitor. * BPD/DS, biliopancreatic diversion/duodenal switch. † RDA, recommended dietary allowance.