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We are here to help you! Knowledge is the key to success during your WLS journey!
WHY ARE MULTIVITAMINS SO IMPORTANT AFTER SURGERY?
Supplements after surgery are vital for long term HEALTH.
Based on research of over 27,000 WLS patients
Bariatric surgery has a profound effect on many aspects of your life – including the way your body absorbs nutrients.
Many nutrients are unable to behave in the same way as they did prior to surgery.
Supplementation with specialty vitamins and minerals will protect you from long term deficiency, which will show up as poor health, and lower quality of life.
BARIATRIC SUPPLEMENTS are unlike general multivitamins, made with more of the specific vitamins that are affected after WLS.
Bariatric Vitamins will cover your increased needs better than other brands that are made for general use.
There are 4 key areas in which nutrient deficiency can cause problems.
1. BONE DENSITY (Calcium, Vitamin D, Magnesium)
2. BLOOD, ENERGY & IMMUNE SYSTEM (Iron, B1, B3, B5, B6, B12, Folate)
3. NERVOUS SYSTEM (Thiamin, B1, B3, B5, B6, B12, Folate)
4. MUSCLE TISSUE (Complete Protein)
1. BONE DENSITY
Up to 90% of patients are Vitamin D deficient to begin. Surgery then impacts absorption of Calcium and Vitamin D increasing the risk of problems, such as osteoporosis.
Many patients are dairy free after surgery.
So supplementing calcium needs to be consistent to save your bones.
(recommended Calcium 1500 – 2400mg/day)
2. BLOOD & IMMUNE SYSTEM HEALTH
Anaemia affects up to 47% of patients in the first year.
This has huge effects on health.
Energy, concentration and immune system are all affected by iron deficiency.
Signs you are low can be:
Lack of focus, depression, forgetfulness, fatigue, sore / restless legs.
Daily iron supplement is recommended for all patients (ASMBS, 2017).
(recommended Iron 18 – 27mg/day)
3. NERVOUS SYSTEM & BRAIN HEALTH
Vitamin deficiency can show up as general fatigue, weakness, pins and needles, burning feet, brain fog, cravings.
B12 is a major contributor to these sensations, but many others may be included B1, B12, D, E, and folate.
Nutrients are like a team – they all work together to keep us functioning well.
(recommended B12 300 – 500 mcg/day).
4. PROTECTING LEAN MUSCLE TISSUE
Losing weight is of course the desired result of your surgery…
But not eating enough calories and a lack of protein can lead to losing muscle not fat.
A diet high in protein is recommended for life after surgery. It helps to prevent hair loss, hormone problems, and keeps the skin and immune system healthy.
(recommended Protein 60 – 80g/day).
Iron deficiency and ANAEMIA after Weight Loss Surgery
Iron is a relatively common deficiency after weight loss surgery.
Studies have shown that 20 to 49 % of gastric bypass patients develop iron deficiency/ anaemia within 12 months
WHAT CAUSES IRON DEFICIENCY?
Gastric Bypass and Gastric Sleeve surgery results in decreased stomach acid production.
This affects the absorption of iron for life.
Changing tastes and restriction after surgery can reduce intake of iron rich foods.
Forgetting to take your bariatric vitamins daily.
HOW MUCH IRON IS REQUIRED AFTER WLS?
For menstruating women, the recommendation is 50 to 100 mg of iron per day.
For post-menopausal women and men 18 to 27 mg/day.
Eating iron-rich foods with vitamin C increases your absorption of iron.
WHICH FOODS WILL INCREASE MY IRON INTAKE?
Foods high in iron include beef, chicken, turkey, eggs, dried lentils, peas, beans, fish, liver, peanut butter, soybeans, iron-fortified cereals and breads, raisins, prunes and apricots. High vitamin C foods include citrus, kiwi, strawberries, broccoli, sweet potatoes, mango and pineapple.
WHAT DOES IRON DEFICIENCY FEEL LIKE?
Symptoms of low iron or anaemia include:
fatigue,
shortness of breath,
irritability, sleeplessness
headaches and
poor memory.
As anaemia gets worse:
brittle nails,
spoon-shaped nails,
hair loss,
light-headedness when standing up,
pale skin colour,
shortness of breath,
heart palpitations,
sore/swollen tongue.
WHAT CAN BE DONE?
Additional daily iron supplementation is recommended (ASMBS 2016)
Once your iron is low after WLS, food alone will not be enough.
Extra iron will be needed daily and for some 3/6 months.
The recommended dose to treat diagnosed iron deficiency is 180 to 220mg of iron per day (taken in divided doses) plus 250 mg vitamin C.
Iron levels should be rechecked in two months.
HAIRLOSS IN BARIATRIC COMMUNITY
Hair loss is a cause of concern for WLS patients.
Hair loss can arise after surgery due to the lower intake and reduced absorption of:
protein, iron, biotin, zinc, vitamin B 12, and healthy fats.
Supplements are required in order to help prevent hair loss. A specific bariatric nutrient formula can help prevent or help to stop it continuing.
After WLS, accelerated hair loss may be associated with:
inconsistent use of bariatric specific multi vitamin formula
or inadequate diet or limited range of foods
Hair Loss occurs between the 3rd-6th month after surgery and can last 6-12 months.
In the early stages, this may reverse on its own and is generally related to the shock of surgery and rapid weight loss.
If hair loss persists more than 6 months, it is most likely related to nutritional deficiency. Hair will always be recovered given correct conditions, as the hair follicle is not damaged, but healthy habits are very important for life after surgery!
KEY NUTRIENTS RELATED TO HAIR LOSS
PROTEIN
Deficiency is related to hair loss. Under chewing food, low stomach acid, vomiting, food aversions, alcohol consumption all impact protein levels.
Minimum recommended protein intake is 60-80g / day.
IRON
is the nutrient most related to hair loss – 65mg elemental iron 2x/day is recommended.
ZINC
Encourages growth and development of hair. In cases of hair loss,
15mg / day is recommended.
HEALTHY FATS
15ml of flaxseed oil is recommended in patients suffering hair loss, 2 tbsp. olive oil also showed improvements.
BIOTIN (VIT B7)
A lack can cause loss of hair colour and hair thinning.
VITAMIN B12
Deficiency may affect the colour+texture of hair, and can be reversed with B12 supplementation. 350/500mcg per day orally is the recommendation for maintenance of B12 levels and prevention of hair loss.
FOCUS ON IMPROVED HAIR QUALITY
Patients who present with hair loss six months’ post-surgery could benefit from following these recommendation daily:
Intake 80g of protein for women and 100g for men (with sufficient amounts of L-lysine, 1.5 to 2g/day) add 15 mL of flaxseed oil, 2.5g of biotin
2 bn multi capsules/tablets with minerals
350 to 500g/day of B12 (BN Multi has 500 mcg/dose)
65mg of elemental iron twice daily.
SLEEP HYGIENE AND SLEEP PROMOTION
‘Sleep hygiene’ means habits that help you have a good night’s sleep.
• Common sleeping problems (such as insomnia) are often caused by bad habits reinforced over
years or even decades.
• If you have tried and failed to improve your sleep, you may like to consider professional help.
‘Sleep hygiene’ means habits that help you to have a good night’s sleep. Common sleeping problems (such as insomnia) are often caused by bad habits reinforced over years or even decades. You can dramatically improve your sleep quality by making a few minor adjustments to lifestyle and attitude.
Obey your body clock
The body’s alternating sleep-wake cycle is controlled by an internal ‘clock’ within the brain. Most bodily processes (such as temperature and brain states) are synchronised to this 24-hour physiological clock. Getting a good sleep means working with your body clock, not against it. Suggestions include:
Get up at the same time every day. Soon this strict routine will help to ‘set’ your body clock and you’ll find yourself getting sleepy at about the same time every night.
• Don’t ignore tiredness. Go to bed when your body tells you it’s ready.
• Don’t go to bed if you don’t feel tired. You will only reinforce bad habits such as lying awake.
• Get enough early morning sunshine. Exposure to light during early waking hours helps to set your body clock.
• Avoid blue lit screens for at least half an hour before sleep – charge your device outside of the bedroom
• Darken the room as much as possible – to eliminate any unwanted light. Use lamps and dim lighting in the evening as preparation for sleep.
Improve your sleeping environment
Good sleep is more likely if your bedroom feels restful and comfortable. Suggestions include:
• Invest in a mattress that is neither too hard nor too soft.
• Make sure the room is at the right temperature.
• Ensure the room is dark enough.
• If you can’t control noise (such as barking dogs or loud neighbours), buy a pair of earplugs.
• Use your bedroom only for sleeping and intimacy. If you treat your bed like a second lounge room – for watching television or talking to friends on the phone, for example – your mind will associate your bedroom with activity.
Avoid drugs
Some people resort to medications or ‘social drugs’ in the mistaken belief that sleep will be more likely. Common pitfalls include:
Cigarettes – many smokers claim that cigarettes help them relax, yet nicotine is a stimulant. The side effects, including accelerated heart rate and increased blood pressure, are likely to keep you awake for longer.
Alcohol – alcohol is a depressant drug, which means it slows the workings of the nervous system. Drinking before bed may help you doze off but, since alcohol disturbs the rhythm of sleep patterns, you won’t feel refreshed in the morning. Other drawbacks include waking frequently to go to the toilet and hangovers.
Sleeping pills – drawbacks include daytime sleepiness, failure to address the causes of sleeping problems, and the ‘rebound’ effect – after a stint of using sleeping pills, falling asleep without them tends to be even harder. These drugs should only be used as a temporary last resort and under strict medical advice.
Relax your mind
Insomnia is often caused by worrying.
Suggestions include:
• If you are a chronic bedtime worrier, try scheduling a half hour of ‘worry time’ well before bed.
Once you retire, remind yourself that you’ve already done your worrying for the day.
• Try relaxation exercises. You could consciously relax every part of your body, starting with yourtoes and working up to your scalp. Or you could think of a restful scene, concentrate on the
rhythmic rise and fall of your breathing, or focus on a mantra (repeating a word or phrase constantly).
• Try the Calm App or Smiling Mind app as an introduction to meditation and mindfulness, use this before sleep or if you wake during the night to re-establish sleep
General suggestions
Other lifestyle adjustments that may help improve your sleep include:
• Exercise every day, but not close to bedtime and try not to overheat yourself – your body needs time to wind down.
• Try herbal teas such as Chamomile and Lavender at least one hour before sleep is planned
• Try not to engage in mentally stimulating activities close to bedtime. Use the last hour or so before sleep to relax your mind.
• Don’t take afternoon naps.
• Avoid caffeinated drinks (like tea, coffee, cola or chocolate) close to bedtime. Instead, have a warm, milky drink, since milk contains a sleep-enhancing amino acid.
• Take a warm bath add a cup of Epsom salts and perhaps lavender essential oil for muscle relaxation
• Turn your alarm clock to the wall. Watching the minutes tick by is a sure way to keep yourself awake.
• If you can’t fall asleep within a reasonable amount of time, get out of bed and do something else for half an hour or so, such as reading a book.
• If you have tried and failed to improve your sleep, you may like to consider professional help.
See your doctor for information and referral.
Where to get help
Your doctor
Sleep disorder clinic
Things to remember
‘Sleep hygiene’ means habits that help you have a good night’s sleep.
• Common sleeping problems (such as insomnia) are often caused by bad habits reinforced over years or even decades.
• If you have tried and failed to improve your sleep, you may like to consider professional help.
NUTRIENTS THAT HELP WITH SLEEP
Amino acids/protein rich diet helps with building healthy neurotransmitters that help regulate sleep. Specifically, tryptophan – present in dairy foods.
Salmon. This oily fish is also a source of omega-3 fatty acids, which are important for health. …
Lima beans chickpeas, black beans, split peas
Poultry. Poultry includes chicken, turkey, and goose. …
Eggs. Some ways of cooking and preparing eggs are more healthful than others
Spinach Seeds Milk. Soy products
B Group – specially B6 Sunflower seeds, spinach, flaxseed
Sour cherry juice for Melatonin production
Omega 3
Magnesium – reduce nervous tension and relax tight muscles. Magnesium is a co-factor in up to 300 different reactions in the body.
FOODS TO AVOID
Iron deficiency interrupts sleep and makes sleeping through the night nearly impossible.
Restless legs are thought to be related to Iron, Magnesium and Vitamin E as well as Calcium
Proper nutrition is key to good sleep – good sleep is key to health and wellness.
