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 |
| Multivitamin | Once or twice daily over the counter multivitamins |
| Iron | Once daily 200 mg ferrous sulphate or 210mg ferrous fumarate (twice daily for mensturating females) |
| Folic acid | Supplement only if deficient |
| Vitamin B12 | 3-monthly intramuscular 1 mg hydroxocobalamin |
| Calcium and vitamin D | Continue 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 copper | Not routinely. If additional zinc needed, ratio of 8 to 15 mg per 1 mg copper must be maintained |
| Thiamine | Not 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).