'''Supplements after these procedures are permanent, and the amounts depend on which operation you had.''' Everything below is quoted from the published nutritional guideline for these patients (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Loopa builds your schedule from it, and your care team can replace any line.
'''Written by nutrient, never by brand.''' What matters is what is in a product, not whose name is on it. Take these figures to a pharmacist or your dietitian and they can tell you what covers them.
== The daily list ==
'''A bariatric-formulated multivitamin with iron''' is the base everything else sits on.
'''Thiamin (vitamin B1).''' "All post-WLS patients should take at least 12 mg thiamin daily", and preferably 50 mg from a B-complex or multivitamin once or twice daily (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Vitamin B12.''' By mouth (disintegrating tablet, sublingual or liquid), 350–500 mcg daily. By injection, 1,000 mcg monthly, if that is the route your prescriber uses (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Folate.''' 400–800 mcg a day from your multivitamin; 800–1,000 mcg a day for women of childbearing age (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Iron.''' At least 18 mg for people at low risk. '''At least 45–60 mg of elemental iron''' for menstruating women and after bypass, sleeve or duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Calcium citrate.''' 1,200–1,500 mg a day after a band, sleeve or Roux-en-Y bypass; '''1,800–2,400 mg a day after a duodenal switch''' (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Given in divided doses. Calcium citrate can be taken with or without food.
'''Vitamin D3.''' 3,000 IU daily until your blood level of 25(OH)D is above 30 ng/mL (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Your prescriber sets the target and any adjustment.
'''Vitamin A.''' 5,000 IU after a band; 5,000–10,000 IU after a bypass or sleeve; 10,000 IU after a duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Vitamin K.''' 90–120 mcg after a band, bypass or sleeve; 300 mcg after a duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Vitamin E.''' 15 mg a day (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Zinc.''' 8–11 mg after a sleeve or band; 8–22 mg after a bypass; 16–22 mg after a duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
'''Copper.''' 1 mg after a sleeve or band; 2 mg after a bypass or duodenal switch. About 1 mg of copper for every 8–15 mg of elemental zinc (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
== The one timing rule that matters ==
'''Iron and calcium are taken apart.''' Oral iron "should be taken in divided doses separately from calcium supplements, acid-reducing medications, and foods high in phytates or polyphenols" (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]).
Loopa knows this one. If you schedule iron and calcium within two hours of each other, it tells you and offers a time that clears it. It never moves a time you set.
== What Loopa does not decide ==
How many doses you split a divided one into, and what amount is right for you. The guideline says "in divided doses" and stops there; so do we. Your care team fills that in.
== Related ==
- [[long-term-follow-up-and-labs|Long-term follow-up and labs]]
- [[bariatric-surgery-explained|Bariatric surgery explained]]
- [[nausea-constipation-gas-and-hair|Nausea, constipation, gas and hair shedding]]
== Where this comes from ==
Everything on this page is drawn from published clinical guidelines and peer-reviewed research, cited above. The full list, with a link to every original, is at [https://loopahealth.app/sources/ loopahealth.app/sources]. '''Loopa does not give medical advice.''' It does not decide whether a procedure is right for you, does not recommend one over another, and never sets a dose. Your care team does all three, and where they give you an instruction, theirs is the one to follow.
'''Supplements after these procedures are permanent, and the amounts depend on which operation you had.''' Everything below is quoted from the published nutritional guideline for these patients (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Loopa builds your schedule from it, and your care team can replace any line. '''Written by nutrient, never by brand.''' What matters is what is in a product, not whose name is on it. Take these figures to a pharmacist or your dietitian and they can tell you what covers them. == The daily list == '''A bariatric-formulated multivitamin with iron''' is the base everything else sits on. '''Thiamin (vitamin B1).''' "All post-WLS patients should take at least 12 mg thiamin daily", and preferably 50 mg from a B-complex or multivitamin once or twice daily (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Vitamin B12.''' By mouth (disintegrating tablet, sublingual or liquid), 350–500 mcg daily. By injection, 1,000 mcg monthly, if that is the route your prescriber uses (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Folate.''' 400–800 mcg a day from your multivitamin; 800–1,000 mcg a day for women of childbearing age (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Iron.''' At least 18 mg for people at low risk. '''At least 45–60 mg of elemental iron''' for menstruating women and after bypass, sleeve or duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Calcium citrate.''' 1,200–1,500 mg a day after a band, sleeve or Roux-en-Y bypass; '''1,800–2,400 mg a day after a duodenal switch''' (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Given in divided doses. Calcium citrate can be taken with or without food. '''Vitamin D3.''' 3,000 IU daily until your blood level of 25(OH)D is above 30 ng/mL (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Your prescriber sets the target and any adjustment. '''Vitamin A.''' 5,000 IU after a band; 5,000–10,000 IU after a bypass or sleeve; 10,000 IU after a duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Vitamin K.''' 90–120 mcg after a band, bypass or sleeve; 300 mcg after a duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Vitamin E.''' 15 mg a day (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Zinc.''' 8–11 mg after a sleeve or band; 8–22 mg after a bypass; 16–22 mg after a duodenal switch (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). '''Copper.''' 1 mg after a sleeve or band; 2 mg after a bypass or duodenal switch. About 1 mg of copper for every 8–15 mg of elemental zinc (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). == The one timing rule that matters == '''Iron and calcium are taken apart.''' Oral iron "should be taken in divided doses separately from calcium supplements, acid-reducing medications, and foods high in phytates or polyphenols" (Parrott J et al., ''Surgery for Obesity and Related Diseases'', 2017 · [https://doi.org/10.1016/j.soard.2016.12.018 doi:10.1016/j.soard.2016.12.018]). Loopa knows this one. If you schedule iron and calcium within two hours of each other, it tells you and offers a time that clears it. It never moves a time you set. == What Loopa does not decide == How many doses you split a divided one into, and what amount is right for you. The guideline says "in divided doses" and stops there; so do we. Your care team fills that in. == Related == * [[long-term-follow-up-and-labs|Long-term follow-up and labs]] * [[bariatric-surgery-explained|Bariatric surgery explained]] * [[nausea-constipation-gas-and-hair|Nausea, constipation, gas and hair shedding]] == Where this comes from == Everything on this page is drawn from published clinical guidelines and peer-reviewed research, cited above. The full list, with a link to every original, is at [https://loopahealth.app/sources/ loopahealth.app/sources]. '''Loopa does not give medical advice.''' It does not decide whether a procedure is right for you, does not recommend one over another, and never sets a dose. Your care team does all three, and where they give you an instruction, theirs is the one to follow.
