10 Day Habit Refresh
Day Ten: Vitamins
Click below to listen to the audio recording of this blog or continue reading!
Three questions we’ll answer about each habit in this series
In this series I will answer three questions about each of the habits:
What benefit does this habit bring a post-op patient?
How might the lack of this habit effect a post-op patient?
How can you best build up this habit in the post-op daily life?
What benefit does taking vitamins bring a post-op patient?
Vitamins are just too important to leave off the list if you are doing a habit refresh!
I realize vitamins can be boring, monotonous, maybe gross and sometimes expensive.
Today’s final post is meant to highlight the benefits of staying on track with vitamins and encourage you to keep after finding your best vitamin routine. If you’re doing well, keep it up! And keep your annual visits with your surgeon so you can get your bariatric lab work.
If you are struggling to find the right routine for you, keep fighting for it.
Here is a link to a blog that reviews what vitamins are recommended after surgery provided by the American Society of Metabolic and Bariatric Surgery. This is a blog that talks about bariatric specific labs.
What is the benefit of taking bariatric vitamins as recommended?
Staying on top of vitamin supplements after surgery is all about prevention.
It can be very easy to miss how important vitamins are, because you don’t necessarily see or even feel the benefits.
If someone has an expectation that taking vitamins will increase their energy, well not necessarily. If your labs are in a normal range, your supplements will help you stay in a normal range. You may not notice feeling any differently because you’re hopefully staying put where you need to be.
If someone, however, was deficient (or low) in a vitamin like B12 and then start taking additional B12 they may notice the difference. They went from below normal into a normal range.
You might remember from earlier in the blog series, vitamins and minerals are micronutrients. After bariatric surgery two things happen:
Your portions are smaller so you are eating less nutrition in food
Anatomy change means how vitamins are absorbed changes
For these two reasons, supplementing is recommended. The word supplement is just that. It’s added in to help.
Ideally good nutrition is still coming in from food but vitamin supplements will help your body to get enough to absorb what it needs.
How the surgeries differ
We could dig more deeply into the anatomy changes of each surgery and what that means for vitamin and mineral absorption, but I will instead highlight some of the reasons vitamin recommendations differ.
While Gastric Sleeve and Gastric Bypass will have similar recommendations, a Duodenal Switch and SIPS would differ some. If someone is a menstruating female their iron needs would differ. If someone had a history of low iron, they would have different needs as well.
Again, you can click here for a blog that includes images of what you need based on those factors.
My main point here is that research and recommendations on vitamins and minerals after surgery are not meant to be taken lightly.
(Quick Side Bar in the audio version regarding why bariatric programs differ yet they do not on vitamins)
It may not be that the benefit feels very strong that a patient has the habit of taking bariatric vitamins, but the benefit is that they will prevent needing to go through the experience of deficiencies.
How might the lack of vitamins effect a post-op patient?
Vitamin deficiencies are not fun.
They are costly, they cause a wide array of symptoms and they can be really serious.
I will never forget my experience with the most deficient patient I have ever seen. Her tongue was so swollen from a B12 deficiency and she was dangerously low in B1 (thiamine) which caused her a lot of confusion.
Now in this particular instance, the patient was also struggling with alcohol abuse. She may or may not have been taking vitamins (probably not) but the alcohol further inhibited the absorption of nutrition. (I will say that patient fully recovered from the deficiencies and the alcoholism! But this is a good moment to link to a blog on transfer addiction.)
That is an extreme case but the image hit me very hard what a big deal vitamins are in the body.
For less intense vitamin deficiencies, patients might need to pay for more expensive prescriptions or even have an iron transfusion (which is not without risk).
Often in the bariatric world we have a focus on protein deficiency. While it can happen, it is actually not as common as one might think. Instead, we see more dehydration, low iron and low Vitamin D. Other deficiencies happen as well, I just make that point that we may be spending more time focusing on protein but not enough on water and vitamin supplements.
How can you best build this habit in the post-op life?
Vitamins are definitely tricky.
When I was working in bariatric clinics I always enjoyed the first 80% of the visit as we talked about food and lifestyle but then we’d get towards the end and I would have to ask about vitamins.
Kind of boring for everyone.
In a perfect world if we can hone in on the right vitamins and the right routine for you and then you don’t have to talk much about it anymore because you’re just doing it!
If you’re having a hard time with vitamins, the first question would be: what is giving you a hard time?
Is it remembering?
We need to tune into your daily habits and see where we can pair vitamins with something you already do everyday.
Is it the vitamin itself?
Is it the taste, texture, how it settles on your stomach? We need to pinpoint what the barrier is and see what other products on the market might help.
I realize there is guilt with spending money on vitamins and not taking them. Many bariatric vitamin companies will offer sample packs so it’s worth seeing if another option can work for you.
You can always keep what you have and make note of the expiration date. Maybe you can get back to it. Otherwise make peace with it and find something else that can work long-term for you. It will probably be less expensive in the long run compared to dealing with a deficiency.
One final piece of advice is to keep a copy of your labs and review them year by year. This helps you see if something is trending down. Sometimes vitamins are within normal limits and don’t trigger a low reading but when you look at it compared to a year ago, it’s had a big drop.
Better to catch it then and add in supplements before it does go low and is a harder fight to bring back up.
Does it have to be bariatric specific vitamins?
This is a common question. For several years now, it has been more cost effective to buy bariatric specific vitamins.
They contain what you need with these products. This means you have to take less items in the day and don’t need to buy additional items.
A Centrum or One-a-Day vitamin will not have everything the ASMBS recommends for a bariatric surgery patient. By the time you add more iron, B12, vitamin D and calcium you’d have spent more money in the long run.
The companies I like include Celebrate Vitamins, BariMelts and Bariatric Advantage.
Here is a link to the Bariatric Food Coach “store” on the Celebrate Website. Use the code CENTRAL10 to save 10% off your oder. It does show a sample pack on that page!
If you don’t have a dietitian you’re working with to go over vitamins, I highly recommend one. Be sure and have your annual bariatric labs checked each year. If you are no longer connected with your bariatric clinic, check out this blog that includes a printable list of what to have your Primary Care Doctor have checked in your lab work.