HealthRX.com · Printable lab tracker
After bariatric surgery: tirzepatide nutrition-lab, glucose and symptom record
Record your procedure and weight history, the nutrition labs before starting and at each check, and any low-glucose episodes, with what the evidence and the label say and the symptoms that need a same-day call.
Surgery and weight history
Procedure and datesleeve, Roux-en-Y bypass, one-anastomosis bypass, band or revision
Weight before surgery
Lowest weight after surgery, and when
Weight now
Supplements you take now
Nutrition labs
Record results with the lab's reference range; your team decides which tests and when.
| Test | Before starting | Month 3 | Month 6 | Month 12 |
|---|---|---|---|---|
| Ferritin | ||||
| Vitamin B12 | ||||
| 25-OH vitamin D | ||||
| Thiamine | ||||
| Zinc | ||||
| HbA1c | ||||
Low-glucose episodes
| Date and time | Time since eating | Reading, if checked | Symptoms | What you did |
|---|---|---|---|---|
What the evidence and the label say
- Pooled from 8 retrospective studies after bariatric surgery: 13.63% weight loss with tirzepatide (95% CI 4.67% to 22.59%) and 10.97% with semaglutide.[1]
- In one single-centre observational cohort of 34 patients, with no comparison group, mean weight loss at 24 weeks was 18.1%.[2]
- With insulin or a sulfonylurea, the label says lowering those doses may reduce the risk of low blood sugar.[3]
- Low blood sugar signs listed in the label include dizziness, sweating, confusion, shakiness and a fast heartbeat.[3]
Call the same day
- Vomiting or diarrhea that stops you keeping fluids down: fluid loss can cause kidney problems.[3]
- Upper stomach pain with fever, yellow skin or eyes, or clay-colored stools: possible gallbladder problem.[3]
Questions for the bariatric team
- Is my weight regain anatomical, such as a stretched pouch, or something medicine can address?
- How slowly should my dose go up after my procedure?
- Do I need a glucose monitor before I start?
- Which supplements should change while I am eating less?
Sources for the facts on this sheet
- Osorio Manyari AA, Armas Alvarez AL, Osorio Manyari JD, et al. Effects of Semaglutide and Tirzepatide on Recurrent Weight Gain After Bariatric Surgery: A Systematic Review and Meta-analysis. Obes Surg 2025. PMID 41313431. https://pubmed.ncbi.nlm.nih.gov/41313431/
- Vinciguerra F, Di Stefano C, Guccione F, et al. Tirzepatide for Recurrent Weight Gain after Bariatric Procedures: Real-World Evidence of Efficacy and Safety. Obes Surg 2026. PMID 42247124. https://pubmed.ncbi.nlm.nih.gov/42247124/
- Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.