ASMBS Vertical Sleeve Gastrectomy Guidelines


2019 ASMBS Guidelines for VSG
Multivitamin (MVI)
Thiamine 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 5,000-10,000 IU (1,500-3,000 mcg) / day
Vitamin E. 15 mg / day
Vitamin K 90-120 mcg / day
Copper 1 mg / day from MVI
Zinc 8-11 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)
1,200-1,500 mg / day
Take in divided doses
Calcium Citrate may be taken with or without meals
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 thiamine 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