Vitamins

Found this on the RNY main board.  Discuss among yourselves.....

From the American Journal of Clinal Nutrition, Volume 87, Number 5, May 1st 2008 edition:

Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation by Christoph Gasteyger, Michel Suter, Rolf C Gaillard, and Vittorio Giusti

Study included 137 morbidly obese patients (110 women and 27 men).  All patients were given a standardized multivitamin preparation.  Specific requirements for additional supplements were systematically assessed by a biologic workup at 3, 6, 9, 12, 18, and 24 months.

Three months after RNY, 34% of these patients required at least one specific supplement in addition to the multivitamin.  At 6 and 24 months, this proportion increased to 59% and 98% respectively.

Only 2% of patients were free from additional supplement use after 2 years.

59.8% of patients were receiving at least 3 and 37.2% were receiving 4 or more types of supplements.

There was no difference between men and women, and no correlation between the number of prescribed supplements and the absolute or relative weight loss.

Vitamin B-12 was the most frequently prescribed supplement (80% at 2 yr), followed by iron (60%), calcium + vitamin D-3 (60%), and folic acid (45%).

An estimate of the average cost of nutritional supplementation 2 yr after RNY is a mean of $417.96, not including B12 injections.


Main observations are as follows:  1) Standard multivitamin supplementation is not sufficient to prevent nutritional deficiencies after RNY.  The prevalence of vitamin D and calcium deficiency increases significantly with the length of the Roux-en-Y limb.  3)  Proper postoperative nutritional substitution can become a burdensome and expensive treatment, which may challenge a patient's compliance considerably.

I wonder what kind of vitamins they were using.  I mean, I haven't had surgery yet, but I know that they make multi-vitamins that are specially formulated for WLS patients and I imagine that they are formulated to maximize absorbtion under our special cir****tances.  Interesting article though.

It's so important to get a good vitamin. I use the Bariatric Advantage which are especially made for us gastric bypass patients. Some folks act suprised to read this, but hopefully their surgeons have told them prior to surgery that this is part of the lifelong commitment to health: taking vitamins and supplements.

I'm not sure if you know this or not, but flexible spending accounts (fsa's) will reimburse or cover the cost of vitamins, protein supplements, calcium, b12, iron, vitamin d for gastric bypass patients. Normally the IRS considers vitamins to be "well health" but in our case, they are mandatory. As long as you get your surgeon to write a letter stating that its medically necessary, you can receive reimbursement. I buy protein powders, ready to drinks, protein bars, vitamins, all my supplements through flex account moneies. Next year, I plan on putting even more into my fsa as I ran out by the end of July this year!!!!!

Mel is right.  Vitamins and supplements are not optional!  And, regular ones don't cut it.  I also take Bariatric Advantage because they are formulated for gastric bypass.  They also have a set that is formulated for lapbands.  My labs have been fine since I started taking my iron regularly.
Marilyn