Nutrition after the Whipple Procedure: What You Need To Know About Micronutrient Deficiencies

One of the most common questions patients ask after having a Whipple procedure is “what vitamins or supplements should I be taking?” The general answer is if you aren’t yet eating well, we recommend that you take a multivitamin to assure you meet all of your micronutrient requirements. This is something you can discuss with your surgeon at your first post-operative visit. If you are given the go-ahead, be sure to take it with food to avoid any stomach upset. You may tolerate two children’s chewable vitamins better in the weeks following your surgery.

After a Whipple procedure, patients may be at long-term risk for certain micronutrient deficiencies including calcium, zinc, iron, vitamin B12, and your fat soluble vitamins A, D, E and K. It is important for your primary care provider to test your blood for these vitamin and mineral deficiencies during your annual visit.

Why Are Micronutrients Important?

Here are the ways these important micronutrients work in your body (and why you want to be sure you do not become deficient):

Calcium: This mineral affects many important aspects of your body, from the health of your bones and teeth, to muscle, nerve, and cell function as well as blood clotting.

Zinc: Contributes to night vision, fertility, immune function, gene expression, the metabolism of fats, carbohydrates, and proteins, and is needed for the activity of many enzymes.

Iron: Helps carry oxygen from the lungs to the rest of the body, helps maintain a healthy immune system, and is vital for the function of several enzymes.

Vitamin B12: Essential for normal metabolism of all cells (especially gastrointestinal, bone marrow, and the nervous system). Avoid supplementing with folic acid (outside of what is in your multivitamin), as folate can mask vitamin B12 deficiency.

*Fat soluble vitamins:

Vitamin A: Essential for eye health, immune function, cellular function, gene expression, and reproduction.

Vitamin D: Most commonly known to be needed for bone and teeth health and to maintain an adequate amount of calcium in your blood. Vitamin D is also important for gene regulation as well as cell differentiation and growth for the skin, muscles, pancreas, nervous, immune system, and parathyroid gland.

Vitamin E: Important antioxidant that, with other nutrients, helps protect against arthritis, cancer, heart disease, cataracts, diabetes, and Alzheimer’s disease.

Vitamin K: Needed for blood clotting.

*If your pancreas does not produce enough digestive enzymes, then you cannot properly absorb fat or fat soluble vitamins. The only way to correct this is to take a pill form of pancreatic enzymes with your food.

While it important to have annual checkups with your primary care provider, it is equally important to discuss taking any vitamins or minerals with him or her. Not all supplements are safe to take, and some may cause harm in high doses. If you are receiving chemotherapy, you should not take any supplement form of antioxidants, as this may counteract your treatment. Common antioxidants include vitamins A, C, and E, though there are several dozen more. Last word of caution: many potential deficiencies can take years to develop, so make sure you continue your annual checkups every year.

Those who have pancreatic or gastrointestinal disease often encounter problems with eating or maintaining their weight. Nutrition counseling is a free service offered to all patients of The Pancreas Center. Learn more or request an appointment with Deborah Gerszberg at The Pancreas Center’s website.