Why do I need specialized “bariatric” vitamins?
You have a different gastrointestinal (GI) tract after bariatric surgery, including sleeve gastrectomy, gastric bypass, duodenal switch, or any of the less common variations of these such as the mini gastric bypass.
Let’s first start with the stomach. In both the gastric bypass and sleeve gastrectomy, the size of the stomach is reduced considerably. This means that there is much less stomach acid in the stomach than before your operation or than is in a “normal” size stomach. The amount of stomach acid that is produced is dependent on the cells inside the stomach tissue. So, when there’s less stomach tissue, there’s less stomach acid.
Stomach acid is a key part of the breakdown and absorption of nutrients from both vitamins and food. The acid chemically breaks down protein to extract the important amino acids, and it is responsible for breaking down iron into a chemical structure that the cells in the body can use. A factor within the stomach acid called intrinsic factor is needed to bind to vitamin B12 for cellular uptake and use. Minerals such as calcium, magnesium, and zinc and iron are dependent upon stomach acid for breakdown as well.
In situations of decreased stomach acid, whether from the anatomy of bariatric surgery, the chronic use of acid reducing medications like Prilosec or Pepcid, advancing age, (which reduces stomach acid production) chronic high stress levels, a stomach infection called H-Pylori, or perhaps a combination of these risk factors, vitamin breakdown and absorption is impaired.
This means that not only do you need to supplement with these specific vitamins, but you need them in special forms. They must be chelated (bound to) an amino acid or in an already acidic form in order for it to be broken down and absorbed in a less acidic stomach environment. Most over the counter vitamins that you buy at the local drugstore or big box stores are cheaply formulated and are NOT chelated to amino acids, are NOT in acidic forms (because these cost more to make) and are made with fillers and binders (because this makes it cheaper to make) and these too, impair absorption.
Calcium needs to be in “citrate form” rather than the more commonly available “carbonate” form.
Iron needs to be in “ferrous fumerate” form (in combination with vitamin C) rather than the more commonly available “ferrous sulfate” form.
Magnesium and zinc need to be in a chelated form (glycinate, citrate, malate, taurate) rather than oxide form.
Vitamin B12 needs to be given at high doses if taken orally in order to make up for the decreased absorption and/or taken in a route that bypasses the GI tract absorption issues such as in sublingual or injection form.
With any bariatric procedure in which a part of the intestines are bypassed, this causes malabsorption to certain vitamins and minerals. The duodenum is bypassed in gastric bypass and duodenal switch. Since food and supplements will no longer be going through that part of intestines, vitamins and minerals that are absorbed there will need to be supplemented, and supplemented at specific levels, not just the standard “RDA” levels found in over the counter vitamins.
Building Blocks adheres to the nutritional and supplement guidelines from the American Society for Metabolic and Bariatric Surgery in formulating their supplements. These guidelines were published after studying decades of data of hundreds of thousands of post bariatric surgical patients and are the most scientifically validated guidelines available. These guidelines looked at each procedure separately and what deficiencies were most prevalent and at what rates and what form and dose of supplementation prevented these deficiencies. This is the basis for the formulation of our vitamins. We used the vast knowledge of the leading biochemist is the field of obesity and bariatric surgery in developing the product, along with the best guidelines to date in order to deliver a program to our customers that aim to keep your levels adequate and your health and vitality above “normal” and better than “fine!”
The goal for yourself should be optimal health and functioning. Committing to a product that you are confident that meets you needs is the first step to this, followed by annual bloodwork to evaluate the FULL vitamin and mineral spectrum for which you are at risk for developing deficiencies. Since we are all different people with different medical issues and histories, genetic risk factors, medications, diets, stress levels, and toxin exposures, we will have varying degrees of risk for vitamin and mineral deficiencies over time. The importance of testing rather than guessing cannot be understated. We are confident in our supplement lines’ ability to keep the majority of bariatric patients free of the devastating consequences of vitamin and mineral deficiencies. We have 20 years of experience and over 20,000 customers that tell us that.
Link to ASMBS guidelines for annual laboratory testing
Link to ASMBS guidelines for vitamin and mineral supplementation