Check those Symptoms!


Check those Symptoms – Do You Have a Vitamin Deficiency?

Prevent nutrient deficiencies after surgery by meeting protein goals, eating a variety of healthy foods, taking vitamin and mineral supplements and having labs monitored every 3 months for the first year after surgery and then annually. Contact your nutritionist or surgeon with questions.

Nutrient Function in Adults Deficiency Source
Vitamin A Necessary for normal vision, reproduction, is an antioxidant Night blindness, dry eyes, dry skin, dry hair, itching (pruritus), sterility, increased infections, gastroenteritis Liver, fatty fish, carrots, alfalfa, tomatoes, apricots, multi vitamin
Thiamine (Vitamin B-1) Needed to convert blood sugar into glucose and to breakdown carbohydrates, proteins and fats Headache, nausea, fatigue, irritability, depression, abdominal discomfort, mental confusion, anorexia, muscle weakness, swelling, rapid heart rate, Beriberi: swelling, tingling, or burning sensation in the hands and feet, confusion, trouble breathing, uncontrolled eye movements


Whole grains, organ meat, yeast, multi vitamin (missing from gummy vitamins)
Riboflavin (Vitamin B-2) Needed for the production of energy Dry or inflamed throat, dermatitis, anemia, fatigue, digestive problems, cracks and sores around the corners of the mouth, swollen magenta-colored tongue, eye fatigue, sensitivity to light Meats, eggs, dairy, vegetables, multi vitamin (missing from gummy vitamins)
Niacin (Vitamin B-3) Needed for metabolism Dermatitis, diarrhea, dementia (pellagra) Meat, liver, yeast, multi vitamin
Vitamin B-5 (Pantothenic Acid) Functions in the breakdown of fats, carbohydrates and proteins Deficiency is not common: fatigue,




stomach pains,


burning feet,

upper respiratory infections


Found in a wide variety of foods, multi vitamin
Vitamin B-6 (Pyridoxine) Needed for metabolism Changes in mood, such as irritability, anxiety and depression; confusion; muscle pains; low energy; worsening symptoms of anemia Seeds, grains, milk, eggs, green leafy vegetables, liver, multi vitamin
Folic Acid (Vitamin B-9) Necessary for normal cell division Anemia (megaloblastic) Poor growth, tongue inflammation, gingivitis, loss of appetite, shortness of breath, diarrhea, irritability,forgetfulness.


Meat, liver, eggs, leafy vegetables, multi vitamin
Biotin Needed in the metabolism of protein, fats and carbohydrates Hair loss (alopecia), a scaly red rash around the eyes, nose, mouth, and genital area, cracking in the corners of the mouth (cheilitis), swollen and painful magenta colored tongue (glossitis), dry eyes, fatigue, insomnia, depression Bacteria in the intestines produce biotin, eggs, meat, nuts, milk, grains, multi vitamin
Vitamin B-12 (Cyanocobalamin) Needed for DNA synthesis, protein metabolism, proper nerve function Anemia (pernicious): weakness, tiredness, lightheadedness, heart palpitations, shortness of breath, pale skin; a smooth tongue, constipation, diarrhea, loss of appetite, nerve problems: numbness or tingling, muscle weakness, and problems walking;

vision loss, mental problems: depression, memory loss, or behavioral changes


Animal sources like meat, milk, eggs After weight loss surgery vitamin B-12 isn’t absorbed well in the digestive system and sublingual (under the tongue) supplements or injections may be needed
Vitamin C (Ascorbic Acid) Needed for wound healing, improves immune function Tiredness, weakness, muscle and joint pains, easy bruising, spots that look like tiny, red-blue bruises on your skin, dry skin, splitting hair, swelling and discoloration of your gums, sudden and unexpected bleeding from your gums, nosebleeds, poor healing of wounds, problems fighting infections, joint pains, changes in your bones, tooth loss


Found in citrus fruits, berries, melon, tomatoes, green peppers and cabbage
Vitamin D Maintains healthy levels of calcium and phosphorus in the body. Rickets (a disease in which the bone tissue doesn’t properly mineralize, leading to soft bones and skeletal deformities), osteoporosis,  increased risk of death: from heart disease, cognitive impairment in older adults, and cancer


Fish, fish liver oils, and egg yolks — and in fortified dairy and grain products.
Vitamin E Important antioxidant, essential for fat metabolism, reproduction Lipid metabolism disorders, anemia (hemolytic), infertility, increased risk of heart disease or cancer, muscle weakness, loss of muscle mass, abnormal eye movements, vision problems, unsteady walking, long-term deficiency may also cause liver and kidney problems


Vegetable oils, seeds, nuts, fruits and vegetables
Vitamin K Key role in blood clotting and bone health Deficiencies are rare but could result in excessive bleeding or osteoporosis Produced by bacteria in the gut, beef liver, green tea, turnip greens, broccoli, kale, spinach, cabbage, asparagus, and dark green lettuce

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Scrambled Egg Cup

egg in cup b

Scrambled Egg Cup

2 Eggs
2 tbsp. skim milk
2 tbsp. Cheddar cheese, shredded
Salt and pepper, as desired

Coat a 12-oz. microwave-safe coffee mug with cooking spray. Add eggs and milk and mix until blended. Stir in cheese.

Microwave on high for 45 seconds; stir. Microwave until eggs are set, 30 to 45 seconds longer. Season with salt and pepper to taste. Makes 1 serving.

Nutrition information per serving: 215 calories, 17 grams protein, 15 grams fat, 2 grams carbohydrate, 244 mg sodium.

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Pumpkin Muffins

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Pumpkin Muffins

1 cup pumpkin puree
3 cups almond flour
1/3 cup unflavored whey protein powder
2 tsp baking powder
1/2 tsp baking soda
1/2 tsp salt
1 ½ tsp cinnamon
1/2 tsp ginger
1/4 tsp cloves
1/4 cup butter, softened
1/2 cup Swerve Sweetener or other erythritol
3 large eggs
1/2 tsp vanilla extract
1/3 cup skim milk

Preheat oven to 325F and line 15 muffin tins with paper liners.

In a medium bowl, whisk together the almond flour, protein powder, baking powder, baking soda, salt and spices.

In a large bowl, beat butter with sweetener until well combined. Beat in pumpkin puree, eggs and vanilla extract. Add in dry mixture and milk. Mix well.

Fill each muffin cup 2/3 full. Bake 23 minutes or until tops are set and edges are just browned. Let cool in pan 15 minutes. Makes 15 servings.

Nutrition information per serving: 183 calories, 8 grams protein, 16 grams fat, 15 grams carbohydrate (8 grams sugar alcohol, 3 grams fiber), 167 mg sodium.


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Common Deficiencies – Multi Vitamins

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Multivitamin and Mineral Supplements

Vitamins and minerals are nutrients needed in very small amounts for good health.  Your body requires the same amount of each vitamin and mineral as it did before the surgery, but because you are eating so much less food and there may be decreased absorption, supplementation is needed. Chewable or liquid supplements are recommended for the first period after surgery and are a good long-term option. If you choose to switch to a pill form, be sure that it is smaller than an “M&M” in diameter. Taking complete multi vitamin and mineral supplements for life is recommended.

Individuals may have different needs for specific nutrients or preferences in the type of supplements they choose.  For those reasons, we do not recommend a specific brand or supplement over another. Choose the type of supplement that meets your needs and preferences using the information below to make an informed decision.

  • Keep in mind that more isn’t always better—some vitamins and minerals are toxic in large amounts.
  • Use caution when using herbal supplements. There is very little regulation on these substances. Avoid “weight loss formulas” which may include stimulants or ingredients whose effectiveness has not been proven.
  • Natural and synthetic vitamins are virtually identical.
  • Look for the USP (United States Pharmacopoeia) mark on the bottle. The manufacturer pays for this testing. This means that the listed ingredients are indeed in the supplement and that the supplement will dissolve. It does not guarantee safety.
  • % Daily Values means the same thing as % USRDA (US Recommended Daily Allowance). Labels use them interchangeably. This is the FDA’s advice on how much of the vitamin or mineral to shoot for each day.
  • Check the expiration date on the bottom of the bottle.
  • Store brands are usually just as good as national brands.
  • Supplements can be called “High Potency” if at least 2/3 of its nutrients have 100% or more of the Daily Value (DV).
  • “Advanced,” “Complete,” or “Maximum” formulas can mean anything.

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Common Deficiencies – Calcium

calcium b


We often hear about calcium’s role in keeping our bones and teeth strong, but calcium has some other very important functions. Our bodies maintain a very tight range of calcium in the blood so that it is available for the maintenance of a regular heartbeat, transmission of nerve impulses and blood clotting.  Recommendations after weight loss surgery are 1500 mg of calcium from a combination of food/beverage and supplement sources. Hypertension, osteoporosis, and metabolic bone disease can result from a deficiency.

Calcium is absorbed in the first section of the small intestine, the section bypassed with gastric bypass surgery. This can reduce the amount of calcium that is absorbed so it is important to insure an adequate intake from dietary or supplement sources.

If you’re not able to consistently obtain adequate calcium intake from your diet, supplementation is important. Common calcium supplements are calcium citrate or calcium carbonate. Either form can be an effective supplement, but there are some differences to consider.

  • Calcium carbonate supplements are smaller in size and less expensive. Absorption is enhanced when taken with food.
  • Calcium citrate is well absorbed in a non-acid environment, as occurs after gastric bypass and gastric sleeve surgeries, and can be taken with or without food. Pill size will be larger although chewable supplements are available.

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