| Preoperative prevalence | Postoperative prevalence | Symptoms of deficiency | RDA[2] | Supplementation | Repletion | |
| Vitamin A[1,3] | Up to 17%[3] | 8 to 11% after RYGB 70% after BPD/DS | Early signs:
Advanced signs:
| Men: 900 mcg (3000 IU) Women: 700 mcg (2300 IU) | LAGB: 5000 IU daily RYGB or SG: 5000 to 10,000 IU daily BPD/DS: 10,000 IU daily | Without corneal changes: 10,000 to 25,000 IU daily orally until clinical improvement (1 to 2 weeks) With corneal changes: 50,000 to 100,000 IU daily IM for 3 days, followed by 50,000 IU daily IM for 2 weeks |
| Vitamin D | 25 to 68% | 25 to 80% | Hypocalcemia, tetany, tingling, cramping, metabolic bone disease, muscle pain | General: 600 IU Pregnancy, lactation, or over 71 years of age: 800 IU | 3000 IU D3 daily from all sources to maintain a 25(OH)D level of >30 ng/mL | 3000 to 6000 IU of D3 daily (preferred), or 50,000 IU of D2 1 to 3 times per week |
| Vitamin E | 2.2% | Uncommon | Neuromuscular disorders and hemolysis | General: 15 mg (22.4 IU) Lactation: 19 mg (28.4 IU) | Adults and adolescents 14 or older: 15 mg (22.4 IU) daily Lactation: 19 mg (28.4 IU) daily | 90 to 300 mg (100 to 400 IU) daily |
| Vitamin K | Uncommon | Uncommon | Impaired coagulation | 90 to 120 mcg | LAGB, RYGB, or SG: 90 to 120 mcg daily BPD/DS: 300 mcg daily | Acute malabsorption: 10 mg of parenteral vitamin K Chronic malabsorption: 1 to 2 mg per day orally or 1 to 2 mg per week parenterally |
| Vitamin B1 (Thiamine) | 16 to 29% | 1 to 49% | Numbness, tingling in extremities, gait ataxia, edema, vomiting, confusion Wernicke-Korsakoff syndrome:
Beriberi:
| 1.5 mg | >12 mg daily, preferably 50 to 100 mg daily from a B-complex supplement With IV hydration, 100 mg of thiamine should be added to the solution (should not contain glucose if Wernicke encephalopathy is suspected) | Oral: 100 mg two to three times daily until symptoms resolve Intravenous: 200 mg three times daily to 500 mg once or twice daily for 3 to 5 days, followed by 250 mg daily for 3 to 5 days, and subsequent oral maintenance (100 mg daily) indefinitely Intramuscular: 250 mg daily for 3 to 5 days, or 100 to 250 mg monthly |
| Vitamin B12 | 0 to 18% | 33% after RYGB; 4 to 20% after SG | Macrocytic (megaloblastic) anemia, mild pancytopenia, neuropsychiatric findings (eg, depression, neuropathy) | 2.4 mcg | Oral dose of 350 to 1000 mcg daily, or 1000 mcg IM or SQ monthly, or by nasal spray | 1000 mcg daily until the level is normalized, then resume maintenance dose |
| Folate | 0 to 54% | Up to 65% after RYGB; 18% after SG | Macrocytic (megaloblastic) anemia, mild pancytopenia, neural tube defects | 400 mcg | General: 400 to 800 mcg daily from multivitamin Women of childbearing age: 800 to 1000 mcg daily Should not exceed 1 mg per day | Oral dose of 1000 mcg daily until the level is normalized, then resume maintenance dose |
| Iron | 0 to 58% | LAGB 14%, SG <18%, RYGB 20 to 55%, BPD 13 to 62%, DS 8 to 50% | Anemia Pica Impaired learning | Men ages 19 and older and women ages 51 and older: 8 mg per day Women between the ages of 19 to 50: 18 mg per day | Males, post-menopausal women, and patients without history of anemia: 18 mg of iron from a multivitamin Menstruating women and men or women who have undergone RYGB, SG, or BPD/DS: >45 to 60 mg of elemental iron daily from all sources* | Oral: 150 to 300 mg 2 to 3 times a day Parenteral iron for those who do not respond to oral supplementation |
| Zinc | 24 to 28% overall; 9 to 74% seeking BPD/DS | 70% after BPD/DS, 40% after RYGB, 19% after SG, 34% after LAGB | Growth retardation, delayed sexual maturity, impotence, impaired immune function | Women: 8 mg Men: 11 mg | BPD/DS: 16 to 22 mg (200% RDA) RYGB: 8 to 22 mg (100 to 200% RDA) SG or LAGB: 8 to 11 mg (100% RDA) Maintain a ratio of 8 to 15 mg of zinc per 1 mg of copper | Optimal repletion dose unknown Overdose can be associated with toxicity or copper deficiency |
| Copper | 68% in women seeking BPD | 90% after BPD/DS, 10 to 20% after RYGB | Anemia, neutropenia, ataxia | 900 mcg | BPD/DS or RYGB: 2 mg daily (200% RDA) SG or LAGB: 1 mg daily (100% RDA) Maintain a ratio of 8 to 15 mg of zinc per 1 mg of copper | Mild-to-moderate deficiency: 3 to 8 mg copper orally until levels normalize Severe deficiency: 2 to 4 mg intravenous copper for 6 days or until symptoms resolve |
| Selenium | 2% | 14 to 22% after RYGB and BPD/DS | Skeletal muscle dysfunction and cardiomyopathy, mood disorder, impaired immune function, macrocytosis | 55 mcg | Unknown but likely higher than 100 mcg/day[4] | 2 mcg/kg/day in patients who develop cardiomyopathy[5] |
| Calcium | 1 to 10%[6] | 3.6% after bariatric surgery (1.9% after RYGB, 9.3% after SG, and 10% after BPD/DS) | Bone disease, secondary hyperparathyroidism | 1000 to 1200 mg | RYGB, SG, or LAGB: 1200 to 1500 mg daily in divided doses BPD/DS: 1800 to 2400 mg daily in divided doses | RYGB, SG, or LAGB: 1200 to 1500 mg daily in divided doses BPD/DS: 1800 to 2400 mg daily in divided doses |
