Introduction to nutrient intake
Bariatric surgery can dramatically alter your body’s ability to absorb vitamins, minerals and other nutrients. Additionally, the small portions of food you’ll be eating provide far less of these compounds than before surgery. Vitamin and mineral deficiencies can have serious medical implications.
That’s why it’s essential to take your prescribed nutritional supplements daily for the rest of your life. Your health care team will prescribe supplements suitable to your needs.
As your follow-up progresses, your health care team will conduct regular blood tests to check for nutritional deficiencies. The following are some of the most common deficiencies. If you neglect to take your supplements, you will be at a higher risk of developing some of the resulting symptoms.
- Iron
This is one of the most common deficiencies. Iron is found in red meat and in small amounts in other foods, such as eggs, beans, nuts, apricots, beetroot and spinach. Women regularly lose iron during menstruation. Your health care team will probably prescribe 80-120 mg of iron per day.
Symptoms of iron deficiency include:
- Fatigue
- Irritability
- Anaemia – blood tests can detect early warning signs by measuring the body’s iron store levels (ferritin concentration)
Severe iron deficiency and anaemia causes, defects to develop in the structure and function of the tongue, nails, mouth and stomach. The skin may appear pale, and the inside of the lower eyelids may appear pink instead of red. Fingernails become thin and flat, and eventually spoon-shaped. The tongue may burn and/or appear red, smooth and waxy. Extreme cases of untreated anaemia can result in heart failure.
- Vitamin B1 (Thiamine)
Vitamin B1 is a very important nutrient after bariatric surgery. Its role is to promote the oxidative metabolism of glucose –that is the body’s ability to use carbohydrates as energy.
A deficiency of vitamin B1 can appear in connection with severe vomiting or when glucose is perfused, leading to a shortage of glucose in the nervous system. Under these circumstances, the neurological symptoms may be severe. If vomiting persists for more than 12 hours, call your health care team.
- Vitamin D
Vitamin D deficiency is very common before surgery and often increases after any type of bariatric surgery. Vitamin D is important for bone health and is increasingly recognised as responsible for muscle malfunction. Lack of vitamin D may lead to decreased bone density (osteopenia and osteoporosis) and sometimes fractures. Other consequences of vitamin D deficiency include muscle weakness and fatigue, leading to falls among the elderly.
- Vitamin B12 (Cobalamin)
A severe vitamin B12 deficiency can cause neurological disorders ranging from cognitive impairment and depression to incontinence and nerve damage. The damage caused by vitamin B12 deficiency cannot always be reversed by taking additional B12 supplements. It is important to regularly monitor B12 in the blood and to prevent deficiencies.
Symptoms of vitamin B12 deficiency include numbness, tingling and burning in the feet as well as stiffness and general weakness in the legs. Anaemia is common, and early signs can be detected with blood tests. It may take 5 or 6 years for deficiency symptoms to appear after natural sources of the vitamin are restricted.
- Calcium
Calcium is essential for the proper functioning of many organs. The most significant consequence of calcium deficiency is its impact on bone health (osteoporosis, reduction of bone density and sometimes bone fractures). About 1000-1500 mg of calcium are required every day.
Tetany – This condition is caused by extremely low levels of calcium in the blood, increasing the irritability of nerve fibres and nerve centres and resulting in muscle spasms such as leg cramps.
- Vitamin B9 (Folic acid)
Folic acid is important for red blood cell formation and healthy cell growth and function. During early pregnancy, folic acid is critical for reducing the risk of birth defects in the brain and spine. The recommended daily amount for adults is 400 mcg. Adult women who are planning a pregnancy or are pregnant should take 400 to 800 mcg of folic acid a day.
The symptoms of folic acid deficiency are often subtle. They include:
- Fatigue
- Grey hair
- Mouth sores
- Tongue swelling
- Growth problems
- Magnesium
Magnesium is a mineral that helps:
- Maintain normal nerve and muscle function
- Support a healthy immune system
- Keep the heartbeat steady
- Bones remain strong
- Regulate blood glucose levels and aid in protein synthesis
Magnesium deficiency causes noticeable negative symptoms including muscle aches or spasms, poor digestion, anxiety, and trouble sleeping.
You will need to have your vitamin and mineral levels checked periodically. If in doubt about your nutrient requirements, deficiency symptoms or blood tests, don’t hesitate to contact your health care team.