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Nutrient Considerations
Micronutrient Deficiency Replacement After
Bariatric Surgery: Vitamins
Vitamin/
Mineral Assessment
Replacement of Deficiency and
Maintenance
Vitamin B9
(Folate)
Red blood cell
(RBC) folate
• If daily bariatric multivitamin has 800
mcg of folic acid, then replacement
dose for deficiency is an additional 400
mcg/day supplement (total of 1200 ug/d
of folic acid until RBC folate in normal
range); maintenance dose is 800 mcg of
folic acid, as often found in many bariatric
multivitamins
B12
(Cobalamin)
Vitamin B12 • B12 def iciency: treat with 1000 mcg or
1 mg per day orally by disintegrated
tablet, sublingually, liquid, or parenteral
(IM or SQ)
• B12 is also available by nasal spray, with
dose as per manufacturer
• Once B12 in normal range,
maintenance dose 500 mcg or 1000
mcg orally, as often found in many
bariatric multivitamins, or 1000 mcg/
month IM
(cont'd)