Guest Blog By: Dr. Lillian Craggs-Dino, DHA, RDN, LDN, CLT In the complex system that keeps our bodies running, micronutrients are like secret superheroes. They may not get much attention, but they're incredibly important for our health and how we feel. Vitamins and minerals are essential for our bodies to work correctly, helping with everything from keeping our cells strong to maintaining our genes. But we often only realize how important they are once we face a deficiency, which can seriously impact energy, mood, organ functioning, and more. In this blog, we look into why it's important to watch out for low levels of essential nutrients after bariatric surgery. We also offer a bariatric dosage guide for select nutrients to help you steer clear of common deficiencies and maintain good health.* Understanding Micronutrients Micronutrients are essential vitamins and minerals required to keep our bodies functioning and developing. Micronutrient deficiencies can lead to severe, life-altering conditions. Take vitamin B12, for instance. It helps in making healthy blood cells, nerves, and DNA in our bodies. If you don't get enough B12, you might end up with vitamin B12 deficiency disorders that lead to chronic health conditions. So, it's crucial to make sure you get the right amount of B12 through diet, and supplements when needed, to stay healthy and prevent these conditions.* Importance of Micronutrients in Bariatric Surgery Metabolic and bariatric surgery increases the risk of vitamin and mineral deficiencies due to various factors, including: Changes in your digestive anatomy Eating smaller portions and decreased food variety Food intolerances This is why bariatric programs teach the significance of micronutrients, the right doses, and ways to improve tolerance. They also suggest getting regular lab tests to track levels and adjust supplements and doses if necessary. Post-Surgery Vitamins and Minerals One of the greatest responsibilities post-surgery is to take your vitamin and mineral supplements regularly and never suddenly stop. It’s also essential to communicate with your bariatric team to ensure your lab results are within normal range. Even if you eat a balanced diet with a variety of foods, it's important to remember that not all nutrients may be absorbed or used properly because of the changes from metabolic and bariatric surgery. That's why a higher amount of vitamins and minerals from supplements are recommended to maintain your health.* Bariatric Vitamins: Recommendations and Deficiencies Check out Table 1 below for the suggested minimum amounts and types of vitamins and minerals to take after metabolic and bariatric surgery. Remember, it's crucial to consult your specific bariatric program or dietitian for personalized nutritional needs, follow-up, and monitoring. Table 1 also shows possible problems that can happen if you don't get enough micronutrients. The aim is to avoid these problems altogether. If you're thinking about taking other micronutrients not mentioned, it's essential to talk to your bariatric team to make sure they're safe and right for you. Table 1: American Society for Metabolic and Bariatric Surgery (ASMBS) Micronutrient Recommendations and Associated Deficiencies1 Micronutrient Recommended Starting Dosage (Based on Bariatric Procedure) Condition Associated With Deficiency Calcium (calcium citrate is preferred or calcium carbonate with food) 1,200-1,500mg (sleeve gastrectomy and gastric bypass) 1,800mg (biliopancreatic diversion with duodenal switch (BPD/DS) or single anastomosis duodenal switch (SADI)) Osteoporosis and bone disorders Vitamin D (as vitamin D3—cholecalciferol) 3,000 IU (75mcg) Osteoporosis, immune function impacted Vitamin B12 350-500mcg (dissolvable, daily) or 1,000mcg (injection monthly) Impact on central nervous system and blood cell functions Vitamin B1 or thiamin (found in B complex supplement) 50-100mg Brain function impacted Iron 45-60mg Iron deficiency anemia Multivitamin/multimineral Adult dosage, preferably a bariatric multivitamin Specific deficiency conditions related to the micronutrient Summary It's really important to grasp why micronutrients matter, especially after metabolic and bariatric surgery. By following the suggested doses and keeping an eye on your nutrient levels, you may prevent deficiencies and the health problems that come with them.* Reference 1. Parrott J et al. Micronutrients. 2017;13:727-741. *These statements have not been evaluated by the Food & Drug Administration (FDA). These products are not intended to diagnose, treat, cure, or prevent any disease. This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your bariatric surgeon or another qualified healthcare provider with any questions in regard to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.