Vitamins & Minerals ~ Basic Info

I see so many threads about vitamins and minerals that I thought I would post some things that I know and do.  I am 5+ years post op and my last set of labs in September were perfect.  And I'm talking all the vitamins & minerals, in addition to the usual suspects.

My Vitamin Regimen:

B Complex sublingual (1.7 mg riboflavin, 20 mg niacin, 2 mg B6, 1200 mcg B12, 30 mg pantothenic acid)
1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

135 mg carbonyl iron
1500 mg vitamin C

I wait at least 2 hours in between each dosing.  I also have a bit of OCD and that's why I only take a half of a multivitamin at a time.  I keep my daily vitamins in one of those 7 day pill containers.  This makes each container have an equal number of pill in it, except the one with my iron and vitamin C and Tylenol.  It's a sickness, I know. 



After RNY, B12 MUST be taken in injection, sublingual, or nasal inhalant form.  It requires binding to an enzyme called intrinsic factor (IF) in order to be absorbed.  IF is secreted in the part of the stomach that was bypassed.  Therefore it is inaccessible to the RNY patient.

DO NOT take calcium and iron within 2 hours of each other.  They are both absorbed using the same cellular receptor sites.  The receptor sites like calcium better, therefore the calcium will be absorbed and the iron will be excreted in the feces.

DO NOT eat or drink any of the following within 2 hours of taking iron: dairy, eggs, fiber, tea, coffee, red wine, grapes, or spinach.  They each contain substances that bind with the iron.  The iron will then be excreted in the feces.

DO take the CARBONYL form of iron.  It does not have as many GI side effects as does the ferrous sulfate form.  Feosol offers a carbonyl iron that is 45 mg pure iron that is available at your local grocery or pharmacy.

DO take vitamin C with iron.  It enhances the absorption of iron.  If iron upsets your pouch, take it with a meat snack.  This will buffer the pouch and and enhance the absorption of the iron.

Calcium should be taken in divided doses NOT to exceed 500-600 mg at a time.  The body just cannot absorb more than that at a time, no matter your WLS status. 

Calcium CARBONATE is not readily absorbed by ANYONE, no matter their WLS status.  As someone who has had WLS, we really should be taking calcium CITRATE.  It is better absorbed.  I take Citracal Petites.

Products I use:

Citracal Petites ~ 2 tablets contain 400 mg calcium citrate & 500 IU vitamin D



Equate Mature Multivitamins ~ 2 tablets per day



B Complex ~ Nature's Bounty ~ 1 drop contains: B2 (riboflavin) 1.7 mg, B3 (niacin) 20 mg, B6 (pyridoxine) 2 mg, B12 1200 mcg, pantothenic acid 30 mg 


Iron ~ Feosol Carbonyl iron, each tablet contains 45 mg



Vitamin D ~ dry D3, 2000 internation units per tablet



Signs & Symptoms of Vitamin Deficiencies

Vitamin B1 (aka thiamine) deficiency can lead to an enlarged heart, cardiac failure, muscular weakness, poor short-term memory, confusion, and irritability.

Vitamin B2 (riboflavin) deficiency can lead to inflammation of the membranes of the mouth, skin, eyes, and GI tract.  

Vitamin B3 (niacin) deficiency can lead to diarrhea, abdominal pain, vomiting, an inflamed & swollen tongue that is bright red, depression, fatigue, loss of memory, headache, and rash on exposure of sunlight.

Biotin deficiency can lead to depression, drowsiness, hallucinations, numbness/tingling in the arms & legs, red, scaly rash around the eyes, nose, and mouth, and hair loss.

Vitamin B6 deficiency can lead to scaly dermatitis; anemia; depression, confusion, abnormal brain wave pattern, and convulsions.

Vitamin B12 deficiency can lead to anemia, fatigue, degeneration of the peripheral nerves with progression to paralysis. 

Folate deficiency can lead to anemia, mental confusion, weakness, fatigue, irritability, and headache.

Vitamin C deficiency can lead to scurvy ~ bleeding gums, pinpoint hemorrhages, abnormal bone growth and pain.

Vitamin A deficiency can lead to night blindness, softening of the cornea, corneal degeneration and blindness, and impaired immunity.

Vitamin D deficiency can lead to osteomalacia ~ loss of calcium, resulting in soft, flexible, brittle bones, and deformed bones; progressive weakness; pain in pelvis, lower back, and legs.  Osteomalacia can lead to osteoporosis.

Vitamin E deficiency can lead to red blood cell damage and liver damage.

Vitamin K deficiency can lead to hemorrhage.

Sodium deficiency can lead to muscle cramps, mental apathy, and loss of appetite.

Potassium deficiency can lead to muscular weakness, paralysis, and confusion.

Calcium deficiency can lead to osteoporosis.

Phosphorus can lead to muscular weakness and bone pain.

Magnesium deficiency can lead to weakness; confusion; convulsions, bizarre muscle movements, hallucinations, and difficulty in swallowing.

Iron deficiency can lead to anemia; weakness, fatigue, headaches, impaired cognitive functioning; impaired immunity; pale skin, nail beds, mucous membranes, and palm creases; concave nails; inability to regulate body temperature.

ETA:  The heart is a muscle, people!!!

Thanks....saved!

Thanks, Sharyn!

I copied this to a docment and saved it to my hard drive and also bookmarked it in case I need to refer to it again.

Dittos

Great information for newbies, recent post-ops, grads and whoever else!

Thanks for putting this together for us and posting it!

Sharyn from everything I've read the amt of Vitamin D you're taking is way too high UNLESS you're deficient.  I just looked at a few websites to make sure I was correct and one that I found was interesting.  It said:

Recommended dosages for Post-op WLS Patients is 500-1000 micrograms in an oil based gel-cap taken in conjuction with your calcium supplement. In other words, vitamin D tablets do not work and calcium tablets with added Vitamin D do NOT work.. It is shameful. Numerous WLS pateints taking calcium tablets with D–have been seen with Vitamin D blood levels of zero.

You may have to look, but if you want to enjoy the extraordinary benefits of vitamin D replacement, it must be an oil-based capsule.

I actually starting taking a TABLET of Vitamin D because I thought we wouldn't breakdown the gel caps due to lack of stomach acids.  I also only take 1000 mcg/day because too much Vitamin D can cause kidney stones.  I haven't had my D level checked but my bone density was perfect. Hmm, makes one think....

My vitamin regimen is a lot simplier than yours.  I take all mine at once cuz I don't take iron.  I'm almost 3 years out, have my labs checked every 6 months and so far all have been perfect too. 

Multivitamin (1)
B-12 sublingual (2-500 mcg each)
B complex (1)
Vitamin C (chewable)
Vitamin D (1000 mcg)
Zinc (50 mg)
Calcium (2-400mg Citracal Petites)

Thanks for proving us with some great info.  I wish there was ONE source where we all could go to that listed everything we need and the reason why.  The confusion on Vitamin D is just one thing that I'd like an absolute answer to.  It seems like if you look at 3 different sources, you'll get 3 different answers~it's so frustrating.

 

 Stephanie.....My surgeon has me and all his patients taking 500 mg of B12 daily.   I do the one's from walmart sublingual that are cherry flavor.   I do one a day and have for over 4 yrs and have never had a problem with my B12 levels.    

Hugs and blessings ~~~ Vivian

Everything I have read points to our need for a DRY vitamin D3, not the oil based D2.  We malabsorb fats, so we really can't absorb the oil based D2.  THEN, the D2 has to be converted into D3 in the kidneys.  I say, go straight for the D3. 

My D level was 75 in September.  Right on target.

 OMG....Sharyn......just realized who you are.   I like you avatar and the shorter hair.   It is really cute.   Good to see you back on the TMB !!!


Hugs and blessings ~~~ Vivian

Thanks, Viv.