Calcium, Folate and Iron, Oh My!

Well, I attended the support group meeting on Sunday, and it was the best session I have attended to date.

Dr. Weinstein, spoke about the importance of supplements and vitamins for Bariatric patients. It was very informative. I’m posting a little of what he said coupled with some information I've found, for my reference only. This is not intended as medical advice. Each person should consult their own Bariatric-friendly physician for nutrient care.

One of the points he really stressed is the need to work with your medical professional to determine your individual deficiencies. Symptoms of various deficiencies overlap, so you run the risk of thinking you’re low in one thing, but it’s really another, or worse a pre-cursor to something altogether different.

Bloodwork coupled with symptoms should be used to determine deficiencies. And know that just becaue the local lab says a number should be in a certain range, the same does not always hold true for a Bariatric patient. A Bariatric-friendly physician will know what your ranges should be.

Also, even after all your follow-up appointments are completed with your surgeon, you should see a physician once a year for a full workup/physical. If you can find a physician who has expertise in Bariatrics, that’s a plus (and what you should look for).

So the biggies are Calcium, Vitamin D, B-12, Folate/Folic Acid and Iron. All of these vitamins and minerals participate in our body’s physiology. When one of these is deficient, it makes sense that body function becomes inefficient. Given the fact most WLS patients live with an 800 calorie diet, it’s a pretty good chance they’re not getting all the vitamins and minerals they need without a little help. Dr. Weinstein also warns that one should never take more vitamins/supplements than necessary. Yes, you do pee them out for the most part, but there’s no valid reason to take them randomly.

Natural sources of dietary calcium: Dairy foods are very high in calcium, especially milk, yogurt and cheese. Other good sources include calcium-enriched fruit orange, rice beverages, and soy beverages.

There is continuous movement of calcium between our skeleton, blood and other parts of the body. Calcium also plays a role in cell biology. Calcium is important in nerve impulse transmission and muscle contraction. Calcium is also needed for blood clotting, activating clotting factors.

Vitamin D (D2 and D3)
Natural sources of vitamin D2 are fish and fatty fish oils. There are fortified food sources available, including beverages like milk, soy drinks, Fish, liver, and egg yolk. Vitamin D3 is only available through sunlight – chances are most of our society is deficient in this area because of the lifestyles we lead.

The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Calcium keeps your bones strong and Phosphorus helps maintain good teeth and bones, and also keeps muscles and nerves working properly. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. Without vitamin D, bones can become thin, brittle and soft.

Vitamin B-12
Natural sources of B-12 include liver, meat, egg yolk, poultry and milk.

B12 is important in maintaining the nervous system and plays a vital role in the metabolism of essential fatty acids. Prolonged B12 deficiency can lead to nerve degeneration and irreversible neurological damage. Vitamin B12's primary functions are in the formation of red blood cells and the maintenance of a healthy nervous system. B12 is necessary for the rapid synthesis of DNA during cell division. If B12 deficiency occurs, this results in anemia.

Folate/Folic Acid
Natural sources of Folate include Leafy green vegetables (like spinach and turnip greens), fruits (like citrus fruits and juices), and dried beans and peas.

Folic acid is also referred to as the B9 vitamin and plays an essential role in the formation of DNA & RNA. It also Assists function of vitamin B12, as well as the formation of 'haem' (the iron content of hemoglobin'). Folate is necessary for the formation of red and white blood cells

Natural sources of iron include meat, liver, oysters, poultry, fish, legumes, dried fruits, green leafy veggies, wine and whole grains.

Iron enables the transport of oxygen from lungs to the tissues and stores oxygen in muscle tissue. It is essential for hair growth, contributes to a healthy immune system and aids in mental function

After Dr. Weinstein finished, we heard from Corey Graham. Corey had RNY 2 years ago when he was 17 years old. Evidently MTV followed Corey on his journey through their reality series “True Life: I’m Obese”. He fully acknowledges that having the surgery and subsequent abdominoplasty, now allows him to realize his dream of becoming a Police Officer. He would have never achieved that dream before. He shared with us his story and what he's doing now.


  1. Anonymous8:53 PM

    Hi, thanks for these facts. I actually google the keywords "Iron, vitamin B12, folate, and calcium". I had the GB last may and I already lost 103 pounds. After reading your page, i realize that Im not eating well. I forgot to take my multivitamins plenty of times and my thyroid medication as well. Im planning to get pregnant, and your page just made me realize that I have to work on it. Thanks :)


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