Table 11

General vitamin and mineral supplementation recommendations following vertical sleeve gastrectomy (VSG), roux-en-Y gastric bypass (RYGB) and bilopancreatic diversion with duodenal switch (BPD-DS)23 24

Supplementation VSG/RYGB/BPD-DS
MultivitaminOnce or twice daily over the counter multivitamins
IronOnce daily 200 mg ferrous sulphate or 210mg ferrous fumarate (twice daily for mensturating females)
Folic acidSupplement only if deficient
Vitamin B12 3-monthly intramuscular 1 mg hydroxocobalamin
Calcium and vitamin DContinue with pre-operative maintenance dose. Likely require 800mg calcium and 20μg vitamin D (eg, Adcal D3). Many patients will liklely need additional vitamin D.
Zinc and copperNot routinely. If additional zinc needed, ratio of 8 to 15 mg per 1 mg copper must be maintained
ThiamineNot routinely. If prolonged vomiting prescribe thiamine 200–300 mg daily, vitamin B costrong 1–2 tablets and urgent referral to bariatric centre. Intravenous thiamine if symptomatic.
  • Individualised supplementation regimes may be needed for some patients or patient subgroups (e.g., pregnant women).