How Much Iron Should a Bariatric Patient Take? Experts Share Best Practices

Written by Heather Smith, B.S. and medically reviewed by Dr. Stephen Boyce, MD

Key Takeaways

  • Bariatric surgery can put you at risk for iron deficiency due to decreased nutrient absorption and lower stomach acid production.
  • Common symptoms of iron deficiency include fatigue, pale skin, feeling cold, and shortness of breath.
  • Taking an iron supplement bariatric multivitamin with iron or a liquid bariatric vitamin, can help prevent iron deficiency and support long-term health after bariatric surgery.

Iron is an essential mineral we all need for our bodies to function properly. It is essential in transporting oxygen, producing energy, and supporting your immune system. 

However, changes to your digestive system from bariatric surgery can limit your ability to absorb iron from your foods. 

In addition to iron supplements, it’s important to consider other nutrients like the best calcium citrate for bariatric patients and the best collagen for bariatric patients, which are also essential for recovery and maintaining long-term health.

The American Society for Metabolic and Bariatric Surgery (ASMBS) says most should aim for 45-60 mg of iron daily. However, this may vary based on factors like the type of surgery, anemia history, age, and gender.

To support overall nutrition, many patients also take bariatric vitamins such as bariatric multivitamins and bariatric calcium chews. These supplements are crucial for ensuring the Kebody gets the right nutrients post-surgery.

A bariatric patient should also pay attention to their intake of fiber after bariatric surgery for optimal digestion, often pairing bariatric snacks with other iron-rich foods to improve overall nutrient absorption.

This guide will help you understand why you need iron, what happens when you don’t have enough iron, how bariatric surgery increases your risk of low iron, and what you can do to boost your iron levels.

The Importance of Iron in the Body

Iron is a mineral in our bodies that helps maintain the health of our blood. Iron is a component of hemoglobin, a protein in our red blood cells. Red blood cells carry oxygen from the lungs to the body. Without enough iron in our blood, red blood cells can’t carry oxygen. This deprives our tissues of energy. This can harm our lungs, muscles, and brain.

This issue is often mitigated by adding bariatric vitamins and bariatric protein shakes to the patient’s diet, which aid in overall nutrient absorption.

For bariatric patients, maintaining adequate iron levels is essential. Supplements like bariatric multivitamins with iron or bariatric probiotic supplements can play a significant role in maintaining a healthy balance of nutrients and digestion post-surgery.

While it may seem like a simple mineral, without it, your body cannot perform many vital functions

  • Oxygen transport: Iron is a critical component of hemoglobin, a protein found in red blood cells. Hemoglobin is responsible for picking up oxygen in the lungs and transporting it to other tissues throughout the body.
  • Energy production: Iron plays a vital role in cellular energy production, specifically in mitochondria, often called the “powerhouses” of our cells. Iron helps convert nutrients into usable energy your body needs for everyday activities.
  • Immune function: Your immune system needs adequate iron levels to work properly. The immune system fights off harmful invaders that may make you sick.

Our body stores iron as a blood protein called ferritin. It’s mainly in our liver, spleen, muscle, and bone marrow. This is a common test for iron deficiency. A doctor may also test transferrin levels. Transferrin is a protein that binds to iron for transport to tissues. Iron is vital for many body functions. It’s especially important after bariatric surgery when you’re also concerned with how much B12 should a bariatric patient take, a crucial factor for maintaining energy and nerve function.

Iron is found naturally in many foods and comes in two forms: heme and non-heme. Heme iron is found only in animal foods such as red meat, poultry, and seafood. Organ meats, like liver, are particularly high in iron. Non-heme iron is in plant foods. 

These are whole grains, nuts, seeds, legumes, and leafy greens. Many breakfast cereals are fortified with iron to boost our intake. Heme iron is more bioavailable than non-heme. It is absorbed better by the body.

This is because, when we eat meat, we eat the blood proteins and hemoglobin in the animal’s body. Heme iron is absorbed at 15-35%. Non-heme sources are thought to be absorbed at 2-20%. Thus, vegetarians and others who rarely eat animal products may need to consume twice as much iron each day.

Understanding Iron Deficiency: Causes and Risk Factors

Iron deficiency, also known as anemia, happens when your body doesn’t have enough iron to function properly. 

Anemia can happen for several reasons, including not eating enough iron-rich foods, problems with iron absorption, or if you lose a significant amount of blood.

Foods high in iron include red meat, spinach, and grains fortified with iron. Not including these foods in your diet can cause your iron levels to get too low. 

Bariatric patients are often advised to supplement with the best iron supplement for bariatric patients to avoid deficiencies.

Several conditions can decrease your digestive system’s ability to absorb iron in your digestive tract. For example, ulcerative colitis and Crohn’s disease decrease your intestine’s ability to absorb iron. Surgery on your digestive system can also have the same effect.

Similarly, choosing the best probiotic for bariatric patients can support gut health and enhance nutrient absorption.

Blood loss through heavy menstruation, physical trauma that causes significant bleeding, having surgery, or if you develop bleeding internally also depletes your iron stores and can lead to iron deficiency. 

Daily iron needs vary depending on the person and their health. Adult men need about 8 mg of iron daily. Premenopausal women need about 18 mg (after menopause, 8 mg). Pregnant women need almost 30 mg. 

Women are at higher risk for iron deficiency due to blood loss from menstruation. This is why they need less iron after menopause. About 1 in 5 women have iron deficiency anemia. So, it’s important to eat iron-rich foods every day.

Bariatric Surgery Procedures and Their Impact on Iron Levels

While bariatric surgery can have positive effects on helping you lose weight, it can negatively affect your body’s ability to absorb iron. 

Experts believe this occurs due to several factors. 

  • Reduced nutrient absorption: Bariatric procedures, especially gastric bypass, reduce the intestine’s ability to absorb nutrients like iron.
  • Decreased stomach acid production: After bariatric surgery, your stomach produces less stomach acid, which hinders the ability of your stomach to break down foods rich in iron.
  • Lower food intake: After surgery, your dietary restrictions can limit your intake of iron-rich foods.
  • Poor tolerance of iron-rich foods: Some people do not tolerate foods high in iron, such as red meats, after having bariatric surgery.

Common Risk Factors for Iron Deficiency in Bariatric Patients

Many people are already deficient in iron before having bariatric surgery.

This is because obesity causes your body to have higher levels of inflammation, which reduces your body’s ability to absorb iron.

Other common risk factors of anemia include:

  • Older age
  • Heavy menstrual cycles
  • Family history of anemia
  • Overdrinking alcohol
  • Not consuming enough vitamin b12 and folic acid
  • Chronic kidney disease
  • Inflammation from an infection
  • Autoimmune disorders
  • Taking chemotherapy

Symptoms of Iron Deficiency

You may not have any symptoms if you are slightly low in iron. However, if you are deficient in iron, you may have symptoms such as:

  • Feeling tired or weak
  • Pale skin and lips
  • Feeling cold
  • Shortness of breath
  • Headache
  • Feeling dizzy or fainting

Foods Rich in Iron

MeatsBeef, lamb, ham, turkey, chicken, veal, pork, dried beef, liver, liverwurst, eggs
SeafoodShrimp, clams, scallops, oysters, tuna, sardines, haddock, mackerel
VegetablesSpinach, sweet potatoes, peas, broccoli, string beans, beet greens, dandelion greens, collards, kale, chard
Breads and cerealsWhite bread (enriched), whole wheat bread, enriched pasta, wheat products, bran cereals, corn meal, oat cereal, cream of wheat, rye bread, enriched rice
FruitsStrawberries, watermelon, raisins, dates, figs, prunes, prune juice, dried apricots, dried peaches
Beans and other foodsTofu, beans (kidney, garbanzo, or white, canned), tomato products (e.g., paste), dried peas, dried beans, lentils, instant breakfast, maple syrup, molasses

To combat iron deficiency, it is important to consume iron-rich foods such as red meat, spinach, and grains fortified with iron. Bariatric protein bars are also a great option, providing both protein and essential vitamins. However, after surgery, many patients may experience difficulty consuming certain foods, which is why bariatric protein shakes and bariatric snacks become useful alternatives to meet nutritional needs.

Incorporating Iron-Rich Foods into Your Diet

Incorporating iron-rich foods into your diet is important for long-term health. 

Here are several ways you can include foods high in iron into your daily meals.

  • Eat a lentil soup with a side of iron-enriched bread.
  • Have some eggs for breakfast
  • Steam some sweet potatoes as a lunch or dinner side
  • Blend some kale or spinach into a smoothie
  • Cook a tofu stir-fry with peas and well-cooked string beans with a side of enriched rice
  • Include small portions of lean meats like beef, poultry, and fish in your diet.
  • Opt for iron-fortified cereals, bread, and plant-based milk alternatives to increase your iron intake.

Enhancing Iron Absorption

If you are having trouble meeting your iron needs through the foods you eat, it may be beneficial to take an iron supplement. This can be especially helpful after bariatric surgery. 

Bari Life offers a Just One daily bariatric multivitamin with 45 mg of iron. The vitamin contains all the ASMBS-recommended amounts of vitamins and iron in one easy, single-dose tablet. 

The simplicity of this option can help you achieve long-term success in meeting your daily vitamin and iron requirements. 

The Complete Bariatric Vitamin is another option Bari Life offers. A bariatric surgeon developed this easy-to-swallow vitamin. It contains 45 mg of iron as well as calcium citrate, vitamin B12, vitamin D, and meets all ASMBS guidelines.

Conclusion

Iron is an essential mineral that plays a vital role in oxygen transport, energy production, and immune function. 

However, bariatric surgery can have an impact on your body’s ability to absorb iron from the foods you eat, putting you at higher risk for iron deficiency. 

Incorporating iron-rich foods into your diet and taking a supplement with iron can help you maintain your iron levels after surgery. 

References

Bjørklund, G., et al. (2021). Iron Deficiency in Obesity and after Bariatric Surgery. Biomolecules.

Iron Deficiency: Anemia. (2022). National Heart Lung and Blood Institute.

Iron: Fact Sheet for Health Professionals. (2024). National Institutes of Health. 

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  1. Do not drink anything carbonated,do not eat a lot of fried greasy food if you over eat you will vomit I had a roun y done gastric bypass not a sleeve

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