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Bariatric Vitamins: Flintstones vs. Gummies vs. PatchMD vs. Chewable

Many bariatric patients question what vitamins to take and really what is the difference between bariatric specific chewable compared to gummies or a generic multi-vitamin.

It is important to understand that after any weight loss surgery; you will need to take supplements for the rest of your life. Due to your smaller pouch, lack of digestive enzymes and malabsorption, food does not digest the same way as before surgery. The nutrients and food are not absorbed as well as before surgery.

Why bariatric specific vitamins?

  • The experts in the field, “The American Society of Metabolic and Bariatric Surgeons,” recommend chewable supplements that contain at least 200% of the daily value for most of your nutrients.
  • You only absorb 50% of what you ingest.
  • The same experts recommend that you avoid children’s supplements, they are very clear that they are incomplete and you take the risk of becoming malnourished.
  • There are certain nutrients in certain forms that you will not absorb properly due to the lack of digestion. For example, vitamin B12 needs essential factor to be absorbed properly. After surgery, you no longer produce the essential element to assist B12 to be absorbed. What does this mean, your multi-vitamin with B12 is not being consumed to benefit you.
  • Calcium, most calcium comes in carbonate form; after weight loss surgery, you do not have the enzymes to break it down and absorb it properly. You need a particular form of calcium, so you more readily absorb the calcium and get the benefit.

Gummies:
It is hard to incorporate the same ingredients to gummy vitamins as it is in chewable vitamins. Experts advise to stay away from gummies for the most obvious reason; they are made with too much sugar, and the main ingredient of many is high fructose corn syrup. You will have to take several gummies to be equivalent to just one bariatric specific multi-vitamin. Some gummies when you take all that is needed after bariatric surgery, the sugar intake from the vitamins are over 30 grams of sugar. Total recommendation for sugar for the day is to have less than 25 grams per day. Seems counter-intuitive to choose a vitamin line with that much sugar especially with the main ingredient being high fructose corn syrup. It boils down to, do you want the orange or the orange colored gummy bear to nourish your body? The bottom line is that gummies just do not have enough nutrients in them for a post weight loss surgery patient. Gummies also do not provide iron which is needed for many post-op bariatric patients.

Flintstones vs. Bariatric Specific Multi-vitamins:
You will be shocked if you just compared the labels, there is absolutely no comparison. You can take my word or do the research. Even if you doubled your intake of Flintstones vitamins, you would still be lacking in many vital nutrients like your B vitamins that support energy and skin and hair growth.

PatchMD: Bariatric Multi-Vitamin Patch 
The patch vitamins bypass the digestive system to deliver the nutrients directly into the bloodstream passing through the skin. In theory, this may help bypass malabsorption. Some findings show that not all nutrients get absorbed properly leaving you deficient in some areas. What does this mean, you may have to take addition chewable vitamins on top of the patch.

Vitamins and minerals are crucial to your weight-loss success and safety after bariatric surgery. After surgery, your diet will include less food intake -- meaning there is less chance for your body to absorb these nutrients.

Which Vitamins Post-Surgery Are Needed?

- Multi-Vitamin:

  • 200% of the recommended daily value of the majority of all nutrients
  • Chewable
  • Avoid children’s supplements
  • Take with food
  • If you are taking a multi-vitamin with iron, wait two hours before taking your calcium supplement

- B-12 Sublingual:

  • 350 – 500 mg daily
  • Sublingual or under the tongue, nasal spray or injection
  • Remember food sources will not be absorbed due to the lack of intrinsic factor. 
- Calcium Citrate:
  • Daily recommendation is 1000 – 1500 mg
  • Take in the form of calcium citrate
  • Split up into 500 – 600 mg tablets throughout the day for best absorption with lunch, dinner, and snack
  • Do not take calcium supplements with iron, iron blocks the absorption of calcium
  •  Food sources: canned salmon, sardines, yogurt, Fairlife milk, cheese, white beans, Kale, Chia seeds, Firm Tofu
- Vitamin D:
  • Daily recommendation is 2,000 – 3,000 IU
  • Best to take calcium with vitamin D3 in it
  • Sources: 15 minutes daily of sunlight, salmon, sardines, tuna, egg yolks, cow’s milk, mushrooms

- Iron:

  • The daily recommendation is 18 mg. May need additional if you are anemic
  • Recommended for gastric bypass and duodenal switch surgeries
  • Take with foods high in vitamin C like strawberries, bell peppers, citrus fruit, tomatoes for best absorption
  • Do not take with calcium supplements
  • Food sources: meat, egg yolk, beans, soybeans, dark green vegetables

For weight loss surgery patients, it is best to choose a multivitamin formulated specifically for you. Choosing a cheaper generic brand may provide versions of the nutrients that are non-absorbable to you and instead of taking one vitamin you may end up taking several throughout the day to get the same benefit. Remember, your food bill drastically goes down after having surgery, trying to buy the cheapest vitamin after surgery does not set you up to be at optimal health one of the main reasons many people have surgery, to be healthy and have more energy.