Weight loss surgery patients are advised to compliment their diet with a vitamin B supplement often taken in sublingual tablet form or by monthly injections. Some surgical procedures for weight loss inhibit absorption of the B vitamins which may result in deficiency. In addition, the low calorie high protein diet following bariatric surgery does not provide adequate dietary intake of B vitamins. Patients should follow the specific directions of their bariatric center when taking B vitamin supplements. Annual blood tests are needed to ensure deficiencies are quickly identified and treated.
The B vitamins are eight water-soluble vitamins that play important roles in cell metabolism. B vitamins are found in all whole, unprocessed foods. B vitamins play a key role in supporting and increasing the rate of metabolism; maintaining healthy skin and muscle tone; enhancing the immune and nervous system; promote cell growth and division; including that of the red blood cells that help prevent anemia; and may reduce the risk of pancreatic cancer.
Vitamin B1: Thiamine
Thiamine is highly concentrated in yeast so cereal grains are an important source of this vitamin that is essential in helping the body transform food into energy and contributes to brain, nerve cell, and heart function. Pork, fish, sunflower seeds, rice, and pasta also supply good amounts of thiamine. Many processed foods are enriched with thiamine. The Reference Daily Intake (RDA) of thiamine is 1.4mg, however some studies suggest intake of 50mg increases mental alertness. Thiamine absorption occurs in the jejunum and ileum, therefore gastric bypass and gastric sleeve patients have decreased opportunity for vitamin B1 absorption from food.
Vitamin B2: Riboflavin
Riboflavin is found in dairy products, lean meats, eggs, nuts, legumes, leafy greens, and enriched breads and cereals. It plays an essential roll in the production of red blood cells, energy production, and growth. Riboflavin is an easily absorbed micronutrient that is best known visually as the vitamin which imparts the orange color to solid B-vitamin supplements. People who take a high-dose B-complex will notice an unusual fluorescent yellow color in their urine as they slough off excess vitamin B2. Riboflavin is continuously excreted in the urine of healthy individuals, making deficiency relatively common when dietary intake is insufficient. Visible symptoms of riboflavin deficiency included cracked and red lips, inflammation of the lining of mouth and tongue, mouth ulcers, cracks in the corner of the mouth, and a sore throat. The RDA for vitamin B2 is 1.3mg/day for men and 1.1mg/day for women. Most vitamin B complex supplements provide a much higher dose of riboflavin.
Vitamin B3: Niacin
Like thiamine, niacin is important in the conversion of food to energy. It is also required for normal growth and the synthesis of DNA and helps keep the skin, nerves, and digestive system healthy. Niacin occurs naturally in lean meat, poultry, and seafood. Milk, cereals, and some dietary meal replacement bars and drinks are fortified with niacin. The RDA of niacin for men is 16mg and women 14mg. Extreme dosages (1.5-6 grams/day) of niacin may cause flushing and itching and may also elevate blood sugar. Standard supplementation should not result in this toxic reaction.
Vitamin B5: Pantothenic Acid
Pantothenic acid also helps the body convert food into energy and plays a role in synthesizing hormones and other body chemicals. Deficiencies of pantothenic acid are virtually unknown. The name pantothen is Greek meaning “from everywhere” and small amounts of pantothenic acid are found plant and animal food sources including grains, legumes, eggs, meat, and poultry. The RDA for both men and women is 5mg/day.
Vitamin B6: Pyridoxine
Pyridoxine is important in the utilization of protein and in the production of red blood cells. It works with other B vitamins to boost the immune system and produce antibodies. Good sources of B6 are chicken, beef, fish, beans, bananas, and enriched cereals. Pyridoxine is not commonly found in plants.
Vitamin B7: Biotin
We frequently hear about the role biotin plays in hair and skin growth but this powerful vitamin also plays a key role in the metabolism of proteins and carbohydrates into energy. Studies indicate biotin may also be helpful in maintaining a steady blood sugar level. Biotin is found in eggs, dairy products, legumes, whole grains and cruciferous vegetables. People in the phase of rapid weight loss following weight loss surgery often experience hair loss, which may be the result of biotin deficiency. Increased biotin supplementation immediately following surgery may lower the risk of hair loss due to biotin deficiency.
Vitamin B9: Folic Acid
This B vitamin – also called folate or folacin, is vital to tissue growth and plays a role in the prevention of certain birth defects. It is important for women of childbearing age to get enough of this nutrient. It is believed folate may also help prevent certain cancers and help prevent heart disease. Good sources of folate include artichokes, asparagus, avocado, blackberries, broccoli, brussels spouts, chickpeas, green peas, lentils, orange juice, raw peanuts, pinto beans, romaine lettuce, spinach, wheat germ and wild rice. Many cereals and refined grain products are fortified with folate.
Vitamin B12: Various Cobalamins
Vitamin B12 plays a role in the formation of red blood cells and in the functioning of the nervous system and it enables the body to utilize folate. Called cobalamin, vitamin B12 is plentiful in meat, poultry, fish, eggs, and dairy products.