chewable calcium?
(deactivated member)
on 8/20/09 4:22 am
on 8/20/09 4:22 am
Don't let the "labs were perfect" get you!
Did you know that the only way to tell if you have bone loss from lack of calcium is with a dexascan or knowing your PTH and vitamin D levels? That the "blood calcium" test that is drawn is going to be always great, unless you are ready to crumble? The reason is that your body will cannibalize itself to make those levels good. Teeth and bones will be leeched from. No turning the clock back...once it is gone, it is gone forever!
Citrate IS required for your new designer guts. You doc is miss informed. So was mine. It is scary how much ****ty information is being passed around from surgeons offices and nuts.
They aren't even hitting their ASMBS. Page 7 Table 5
74.125.93.132/custom
Table 5
Suggested Postoperative Vitamin Supplementation
Supplement AGB A high-potency vitamin containing 100% of daily value for
at least 2/3 of nutrients 100% of daily
value
RYGB BPD/DS 200% of daily
value
Comment
Multivitamin-mineral supplement
Begin on day 1 after hospital discharge Begin with chewable or liquid Progress to whole tablet/capsule as tolerated Avoid time-released supplements Avoid enteric coating
Choose a complete formula with at least 18 mg iron, 400
g folic acid, and containing selenium and zinc in each
serving
Avoid children’s formulas that are incomplete
May improve gastrointestinal tolerance when taken close to
food intake
May separate dosage
Do not mix multivitamin containing iron with calcium
supplement, take at least 2 hr apart
Individual brands should be reviewed for absorption rate and
bioavailability
Specialized bariatric formulations are available
Additional cobalamin (B12)
Available forms include sublingual tablets, liquid drops,
mouth spray, or nasal gel/spray
Intramuscular injection — 1000 �g/mo — Begin 0–3 mo after
surgery
Oral tablet (crystalline form) — 350–500 �g/d —
Supplementation after AGB and BPD/DS may be required
Additional elemental calcium
Choose a brand that contains calcium citrate and vitamin D3
Begin with chewable or liquid
Progress to whole tablet/capsule as tolerated
1500 mg/d 1500– 2000 mg/d 1800– 2400 mg/d May begin on day 1
after hospital
discharge or
within 1 mo after
surgery
Split into 500–600 mg doses; be mindful of serving size on
supplement label
Space doses evenly throughout day
Suggest a brand that contains magnesium, especially for
BPD/DS
Do not combine calcium with iron containing supplements:
To maximize absorption
To minimize gastrointestinal intolerance
Wait �2 h after taking multivitamin or iron supplement
Promote intake of dairy beverages and/or foods that are
significant sources of dietary calcium in addition to
recommended supplements, up to 3 servings daily
Combined dietary and supplemental calcium intake �1700
mg/d may be required to prevent bone loss during rapid
weight loss
Additional elemental iron (above that provided by mvi)
Recommended for menstruating women and those at risk of
anemia (total goal intake � 50-100 mg elemental iron/d)
— Add a minimum
of 18–27 mg/d
elemental
Add a minimum of
18–27 mg/d
elemental
Begin on day 1 after
hospital discharge
Begin with chewable or liquid
Progress to tablet as tolerated
Dosage may need to be adjusted based on biochemical
markers
No enteric coating
Do not mix iron and calcium supplements, take �2 h apart
Avoid excessive intake of tea due to tannin interaction
Encourage foods rich in heme iron
Vitamin C may enhance absorption of non-heme iron sources
Avoid excessive intake of tea due to tannin interaction
Encourage foods rich in heme iron
Vitamin C may enhance absorption of non-heme iron source
Did you know that the only way to tell if you have bone loss from lack of calcium is with a dexascan or knowing your PTH and vitamin D levels? That the "blood calcium" test that is drawn is going to be always great, unless you are ready to crumble? The reason is that your body will cannibalize itself to make those levels good. Teeth and bones will be leeched from. No turning the clock back...once it is gone, it is gone forever!
Citrate IS required for your new designer guts. You doc is miss informed. So was mine. It is scary how much ****ty information is being passed around from surgeons offices and nuts.
They aren't even hitting their ASMBS. Page 7 Table 5
74.125.93.132/custom
Table 5
Suggested Postoperative Vitamin Supplementation
Supplement AGB A high-potency vitamin containing 100% of daily value for
at least 2/3 of nutrients 100% of daily
value
RYGB BPD/DS 200% of daily
value
Comment
Multivitamin-mineral supplement
Begin on day 1 after hospital discharge Begin with chewable or liquid Progress to whole tablet/capsule as tolerated Avoid time-released supplements Avoid enteric coating
Choose a complete formula with at least 18 mg iron, 400
g folic acid, and containing selenium and zinc in each
serving
Avoid children’s formulas that are incomplete
May improve gastrointestinal tolerance when taken close to
food intake
May separate dosage
Do not mix multivitamin containing iron with calcium
supplement, take at least 2 hr apart
Individual brands should be reviewed for absorption rate and
bioavailability
Specialized bariatric formulations are available
Additional cobalamin (B12)
Available forms include sublingual tablets, liquid drops,
mouth spray, or nasal gel/spray
Intramuscular injection — 1000 �g/mo — Begin 0–3 mo after
surgery
Oral tablet (crystalline form) — 350–500 �g/d —
Supplementation after AGB and BPD/DS may be required
Additional elemental calcium
Choose a brand that contains calcium citrate and vitamin D3
Begin with chewable or liquid
Progress to whole tablet/capsule as tolerated
1500 mg/d 1500– 2000 mg/d 1800– 2400 mg/d May begin on day 1
after hospital
discharge or
within 1 mo after
surgery
Split into 500–600 mg doses; be mindful of serving size on
supplement label
Space doses evenly throughout day
Suggest a brand that contains magnesium, especially for
BPD/DS
Do not combine calcium with iron containing supplements:
To maximize absorption
To minimize gastrointestinal intolerance
Wait �2 h after taking multivitamin or iron supplement
Promote intake of dairy beverages and/or foods that are
significant sources of dietary calcium in addition to
recommended supplements, up to 3 servings daily
Combined dietary and supplemental calcium intake �1700
mg/d may be required to prevent bone loss during rapid
weight loss
Additional elemental iron (above that provided by mvi)
Recommended for menstruating women and those at risk of
anemia (total goal intake � 50-100 mg elemental iron/d)
— Add a minimum
of 18–27 mg/d
elemental
Add a minimum of
18–27 mg/d
elemental
Begin on day 1 after
hospital discharge
Begin with chewable or liquid
Progress to tablet as tolerated
Dosage may need to be adjusted based on biochemical
markers
No enteric coating
Do not mix iron and calcium supplements, take �2 h apart
Avoid excessive intake of tea due to tannin interaction
Encourage foods rich in heme iron
Vitamin C may enhance absorption of non-heme iron sources
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