Vitamin Help
Hello everyone. I don't post often, but I do get online daily and read all the posts to get answers to my questions and learn information about things I haven't even thought of yet. Education is so key! I am 47 years old, post menopause (since age 33) and had the DS surgery on 6-13-14. I started my journey at 350 lbs. I need some advice from the vets out there about vitamin supplementation. My preop labs showed low B and D. My surgeon has me taking a multi, calcium, D and B. Is this sufficient and how much of each should I be taking of each? Which ones are the best ones? I have been doing chews but am open to trying pills. Please Help! I have been doing great so far (hit the 100 lb lost mark this week) but want to make sure I stay on track. I also have had several B and D injections at 10 days, 6 weeks and 12 weeks out at my appts to help. Would love any and all advice.....thanks in advance.
I can tell you for me Vitalady's capsules, rather than pills, saved me. I follow her plan and adjust up or down based on my labs. Here is a link to the plan from 2010. It hasn't changed as a starting point.
http://www.gblcreations.com/Resources/Gina/ProgramDRNY_ERNY_ BPDDS3-2010.pdf
Here is a lab and targets file for you to look over as well: http://www.gblcreations.com/Resources/Gina/VitaLadysLabsandT argets_11-2009.doc
Let me know if they won't open for you.
--gina
5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
******GOAL*******
Starting BMI between 35 and 40ish?
Join us on the Lightweights Board!
DS on Aug 9, 2007 with Dr. Hazem Elariny
I'm so glad you asked! Definitely switch to pills. The chews don't have all that you need. Also, get to know your numbers on the labs yourself and understand the differences. I've found that when they tell you "your fine" - they may look at their favorite 'key items', but not really read the whole thing, and don't notice any downward trending from the last labs.
The key to the fat soluble vitamins A, D, E and K is to NOT take them with fat like normal people do. The standard dispensing method is with oil filled capsules. We absorb up to 80% of that. What we need are dry formulations of these vitamins, and in LARGE doses that scare most medical professionals that don't understand our needs. You'll see on Vitalady's plan 50,000iu of D, which is what I take to maintain. When my D dropped down to 12, I was taking 100,000iu for six months to get it back up. My surgeon suggested a extra 400 iu, which my body laughed at. I've found over the years that most surgeons and their wls specializing nutritionists have not come close to catching up on what DSers really need long-term. You can get the 50k IU Biotech brand from Vitalady, Amazon, or even Walmart if you ask the pharmacist.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Thank you so much I will read vitaladys plan. I already figured out I have been taking the wrong calcium. Ugh. I will have labs next month for the first time post op and will know more then but I need to buy more vitamins now so I want to do the best I can for now with a basic plan and will make adjustments as needed after I get my results. Thanks again.
I just read vitaladys plan.....that is overwhelming. There is no way I could take all that right now. I'm only four and a half months out and still struggle getting in enough protein and fluids most days. I'm thinking top priority is multi, calcium, and D and B because of preoperative labs. What do you think?
I would start with adding 1 50k vitamin D a day from Botech on the web or resold through Vitalady. Keep an eye on your other
fat soluble vitamins they can be easy to go low and harder to get back up. The fat solubles are A,D,E, and K.
You might also consider adding 25k vitamin A (palmitate - not from beta carotene) and 1,000 mcg K1.
Not to sure about the B's as a whole. Many of us start out at 500 units sub lingual of B12. If you are low across the board on B's you might
take a B-complex for a while. I haven't seen many people that needed to supplement the other B vitamins but as always
Your labs are your guide.......
At just over two months I am not a practical expert at anything, but I have been doing enough research so that I have even more questions now than when I started. I have a swallowing problem that they still haven't figured out, so I've had to get a little creative with my pills. One thing that helped me to get things into my head was to make the following table. It compares the different vitamin recommendations of the top experts in this field. Let me know if something does not make sense to you. If I were you I would go ahead and see if I could get my labs now. Many doctors recommend 3 month labs so you might be able to get them.
Post DS Vitamins
Best guess of vitamins specifically called out by all :
|
Daily Vitamin Recommendations: |
ASMBS |
Bariatric Advantage |
Celebrate |
Mexicali Bariatric Center |
VitaLady RNY & DS |
Twinlab Bariatric |
|
Protein |
90 g/d |
|
|
80 to 100 g |
120 to 150 g |
|
|
Approximate number of pills a day |
~15 |
~7 |
~7 |
~15 |
~35 |
~13 pills |
|
Calcium Citrate: |
2200-2800 mg |
150 mg in MV 1,500 in cal |
1,500 mg in cal |
3,200 mg |
2,200 mg |
300 mg in MV 2,000 mg in cal |
|
Vitamin A: |
17,000 IU |
15,000 iu |
7,000 iu in MV |
24,000 IU |
107,000 IU |
150,000 iu |
|
Vitamin B complex: |
B-50 |
(below) |
(below) |
1 b-complex pill every week |
B-50 |
(below) |
|
Vitamin D: |
2400 IU |
2,001 iu in MV 1,500 iu in Cal |
1,000 iu in cal 3,000 iu in MV |
3,600 IU |
50,800 IU |
1,200 iu in MV 1,600 iu in cal 1,600 iu in D+K |
|
Vitamin E: |
30 IU |
750 iu |
300 iu in MV |
370 IU daily |
860 IU |
90 iu |
|
Vitamin K: |
350 mcg |
180 mcg |
80 mg in cal 540 mcg in MV |
300 mcg daily |
1,050 mcg |
180 mcg in |
|
Iron: elemental |
36 mg
|
30 mg in iron |
30 mg in iron |
72 mg + monthly shot |
336 mg |
30 mg[i] |
|
Zink: |
22 mg |
22.5 mg |
15 mg in cal 15 mg in MV |
44 mg + 50 mg every 3rd day |
122 mg |
15 mg |
Vitamins called out by one or from the multivitamin:
|
Daily Vitamin Recommendations: |
ASMBS with 2 Centrum |
Bariatric Advantage |
Celebrate |
Mexicali Bariatric Center DS with 4 Centrum |
VitaLady with 2 Centrums |
Twinlab Bariatric |
|
Boron |
150 mcg |
|
|
300 mcg |
75 mcg |
|
|
Chloride |
144 mg |
|
|
288 mg |
72 mg |
|
|
Choline |
|
3 mg |
|
|
|
|
|
Chromium |
70 mcg |
150 mcg |
200 mcg in MV |
150 mcg |
35 mcg |
|
|
Citrus Bioflavonoids |
|
18.75 mg |
|
|
|
|
|
Copper: |
1 mg |
1.5 mg |
1 mg in calcium 2 mg in MV |
2 mg |
5.5 mg |
600 mcg |
|
Iodine |
300 mcg |
|
150 mcg in MV |
600 mcg |
150 mcg |
210 mcg |
|
Magnesium |
100 mg |
75 mg |
100 mg in cal 100 mg in MV |
200 mg |
400 mg |
60 mg in MV 1,000 mg in cal |
|
Manganese |
4.6 mg |
3 mg |
2 mg in MV |
9.2 mg |
4.6 mg |
|
|
Molybdenum |
90 mcg |
112.5 mcg |
75 mcg in MV |
180 mcg |
90 mcg |
|
|
Nickel |
10 mcg |
|
|
20 mcg |
10 mcg |
|
|
Pantothenic Acid |
20 mg |
15 mg |
20 mg in MV |
40 mg |
20 mg |
30 mg |
|
Phosphorus |
40 mg |
|
|
80 mg |
40 mg |
12 mg |
|
Potassium |
160 mcg |
|
|
320 mcg |
160 mcg |
|
|
Selenium |
110 mcg |
201 mcg |
100 mcg in MV |
220 mcg |
110 mcg |
|
|
Silica: |
4 mcg |
|
|
8 mcg |
4 mcg |
|
|
Tin |
20 mcg |
|
|
40 mcg |
20 mcg |
|
|
Vanadium |
20mcg |
37.5 mcg |
|
40 mcg |
20mcg |
|
|
Vitamin B – Biotin |
60 mcg |
450 mcg |
600 mcg in MV |
120 mcg |
60 mcg |
900 mcg |
|
Vitamin B: Niacin |
40 mg |
75 mg |
40 mg in MV |
80 mg |
40 mg |
60 mg |
|
Vitamin B: Riboflavin |
3.4 mg |
5.1 mg |
12 mg in MV |
7.2 mg |
3.4 mg |
5.1 mg |
|
Vitamin B-1 Thiamin: |
3 mg |
9 mg |
12 mg in MV |
6 mg |
103 mg |
4.5 mg |
|
Vitamin B-12 |
12 mcg |
150 mcg |
|
24 mcg |
5,012 mcg |
18 mcg |
|
Vitamin B6: HCI |
4 mg |
6 mg |
12 mg in MV |
8 mg |
2 mg |
6 mg |
|
Vitamin B-9 Folic Acid: |
800 mcg |
1,200 mcg |
800 mcg in MV |
1600 mcg |
1,800 mcg |
1,200 mcg |
|
Vitamin C: |
120 mg |
180 mg in MV 60 mg in iron |
60 mg in iron 180 mg in MV |
240 mg |
2,120 mg |
360 mg |
[i] Since iron is in MV it must be separated from calcium doses.
Other random things:
From what I can tell, very few people do the full 35 pills a day VitaLady program. They read their lab results and adjust accordingly. It seem many/most DS'ers do fine with their B vitamins just from the multi-vitamin, perhaps adding some B12 or biotin depending. If you are having problems getting in all the VitaLady pills, I would try cutting the B's first, but YMMV.
Proferrin ES (and one or two others) has a form of iron called Heme iron which you can take with calcium. That can simplify the whole day. It is expensive, but I'm relying on it until I get into the swing of things.
The reason why we are supposed to take the citrate form of calcium is because we don't have the stomach acid to really digest the other forms. The good news is that for the first month or two after surgery, DS people tend to run rather acidic. So try not to worry too much about taking the wrong form. In the long run it could have really hurt you, but your timing for that mistake was great.
I really recommend reading http://asmbs.org/resources/integrated-health-nutritional-guidelines. It is a bit of a slog, but it gave me the grounding I needed to really begin to understand these things.
Good Luck!!
August 2014 - DS @ Mexicali Bariatric Center / Ungson.
It took me one and a half years to lose 165 pounds.
Weight: High=314, Goal=155, Current=131
Thanks so much, The formatting is kind of messed up and makes it hard to read. It just seems so overwhelming to me. Im still struggling with the water and protein right now. I knew I would have to take a multi, calcium....now B and D due to labs. I wasnt prepared for all the rest. My doc gave me a list in the beginning of POSSIBLE vitamin supplements, but said it depended on labs. So I wrapped my brain around those four, but now hearing I need A, K and all the others too. UGH. If my labs are okay do I still need to take all of those other ones?
