How to Prevent Iron Deficiency After WLS
It is important to take iron supplements as prescribed by your doctor before a deficiency arises because once a patient develops iron deficiency, oral supplementation of iron may not be enough to treat it and in very severe cases, patients may even require blood transfusions. For many patients, a multivitamin contains enough iron to prevent deficiency. Those patients who maintain low iron levels despite taking a multivitamin might have to take an additional iron supplement to correct the deficiency, especially those patients at high risk.
According to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines, after bariatric surgery:
- Patients at low risk for developing iron deficiency (i.e. usually males) should take at least 18 mg of elemental iron daily whether it be in a multivitamin or as a standalone vitamin.
- Patients at higher risk, such as menstruating females and patients who have undergone malabsorptive procedures such as gastric bypass, should supplement with at least 45-60 mg of elemental iron daily.
When looking for a good iron supplement, you may find some that include ascorbic acid, or vitamin C. Some studies suggest that including vitamin C in an iron supplement increases the amount of iron that gets absorbed by the body. This might be because vitamin C increases the acidity of the digestive tract which is necessary for iron to be broken down and absorbed.
It is recommended that iron supplements be taken on an empty stomach with water or juice, but this can increase side effects such as nausea, upset stomach, and constipation. If upset stomach occurs, iron can be taken with food but not tea, cereal, dairy products, and other calcium-rich foods which can reduce iron absorption. Since an acidic environment is necessary for the absorption of iron, it’s also important to separate iron supplements from antacids such as Tums and Prilosec.
Finally, and most importantly, don’t forget to follow up with your doctor and pharmacist regarding follow-up appointments and any questions you may have about your medications and supplements. Remember that your health-care team is there to answer all your questions and to help guide you through your weight-loss journey!
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