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ASMBS Vitamin Guidelines: Biliopancreatic Diversion with Duodenal Switch (BPD / DS)
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| 2019 ASMBS Guidelines for BPD / DS | |
| Multivitamin (MVI) | |
| Thiamin | At least 12 mg / day * |
| Folic Acid | 400 – 800 mcg / day from MVI |
| 800 – 1,000 mcg / day total (female, child bearing age) | |
| B12 | Oral: 350 – 1,000 mcg / day |
| Vitamin D | 3,000 IU (75 mcg) |
| Vitamin A | 10,000 IU (3,000 mcg) / day |
| Vitamin E | 15 mg / day |
| Vitamin K | 300 mcg / day |
| Copper | 2 mg / day from MVI |
| Zinc | 16 – 22 mg / day from MVI |
| Zinc to copper ratio: 8 – 15 mg of zinc for every 1 mg of copper | |
| Iron (from all supplements) | |
| At least 18 – 60 mg / day ** | |
| CANNOT take with Calcium | |
| Calcium (from food and supplements) | |
| 1,800 – 2,400 mg / day | |
| Take in divided doses | |
| Calcium Citrate may be taken with or without meals | |
| Other | |
| Protein (often individualized) | Minimum of 60 g / day with some patients needing higher amounts of 80 – 90 g / day |
| Fluids (often individualized) | At least 50 oz / day to ensure adequate hydration |
| * At risk patients: rapid weight loss, protracted vomiting, the need for parenteral nutrition, excessive alcohol, neuropathy, encephalopathy, and/or heart failure. At risk patients need at least 50 – 100 mg of thiamin daily. | |
| ** Low risk patients (males and patients without a history of anemia) need 18 mg of iron from their multivitamin. Higher risk patients (menstruating females who have had VSG, RNY, or BPD / DS or those with anemia) need at least 45-60 mg of iron daily. | |
| Information adopted from Mechanick et al SOARD. 2020; 16:175-247 | |
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