Guidelines on vitamin and mineral supplementation after gastric bypass and sleeve gastrectomy

Guidelines on vitamin and mineral supplementation after gastric bypass and sleeve gastrectomy

Latest guidelines on vitamin & mineral supplementation after Gastric Bypass and Sleeve Gastrectomy
(British Obesity and Metabolic Surgery Society April 2020) Updated May 2021

When you start the pre-surgery liver shrinkage diet, we would recommend that you take a chewable multivitamin & mineral supplement. Examples include Centrum Fruity Chewables or Superdrug A-Z Chewable Multivitamins and Minerals. Please take 2 per day.

Continue these for a month or so after surgery until you can manage tablets easily, and then change to one of the over the counter multivitamins & minerals listed below.

You can have prescribable or over the counter supplements but please follow the guidance above. These brands of Multivitamin & mineral supplements contain all of the vitamins and minerals you need in the correct proportions. Other vitamin & mineral supplements may not provide everything you need. If you are unsure or have any queries, please contact the team on 01905 733965.

Questions and answers

Q Do I have to buy my own supplements after surgery?
A When you come into hospital you will be supplied with the following-

• Dispersible or chewable calcium and Vitamin D(Calci-D) 1 tablet once per day
• Iron Syrup (Fersamal) 5mL twice per day.

You will need to see your GP when your stocks are running low to request more supplements

You will need to buy your multivitamin & mineral supplements as your GP will not prescribe these. (Your GP will prescribe your iron and calcium and Vitamin D supplements and Vitamin B12 injections). You will need Vitamin B 12 injections every 3 months at your GP surgery.

Q What if I don’t like the taste of my vitamins and minerals?
A If you struggle with the taste of supplements, you can ask your GP about different preparations or you could try over the counter versions.

Q How often should I have my bloods tested?
A Before surgery, and 3, 6, and 12 months after surgery and every year for the rest of your life. Bloods may be checked more frequently if there are any concerns.

Q Where should I have my bloods tested?
A Your GP may arrange to test your bloods at the surgery, or you can arrange to have them taken as Worcestershire Royal Hospital, Alexandra Hospital, Kidderminster Treatment Centre or Princess of Wales Hospital if the bariatric team have requested them.

Q Which routine bloods tests do I need?
A U&E (Urea and electrolytes), Liver function tests (LFT’s), Full Blood Count (FBC), Ferritin (iron stores), Folate, Vitamin B12, Calcium, Vitamin D, and Parathyroid Hormone (PTH) at 3, 6 and 12 months after surgery and annually thereafter. Zinc and Copper levels should be checked 1 year after surgery and annually. Selenium levels also need to be checked 1 year after your surgery and annually if you have had a Roux-en-Y gastric bypass. We would also monitor your HbA1c (long term blood sugar control) if you had diabetes before surgery. We will write to your GP to let them know so there is no need to worry.

Q Do you test anything else?
A We may test additional nutrients depending on your symptoms, or check things more frequently if you have lower levels.

Q How long do I need to take my supplements for?
A It is important that you take your supplements daily for the rest of your life and have Vitamin B12 injections every 3 months for life.

Q When should I take my supplements?
A It is important to take your supplements as directed by your Doctor or Pharmacist.

Updated November 2022

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

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Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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