Daily Iron requirement? How many mg?

I believe the ASMBS now recommends identical supplementation levels for both RNY and VSG.

They probably do, given that most surgeons still seem to do blanket protocols between both procedures, irrespective their different characteristics - it's a lot easier on the staff to treat all the same and things should wash out eventually as labs come in and patients do their own thing as needed. Physiologically, the bypass is a lot more needy of mineral supplementation than the VSG; both will need some for a while given the limited nutritional intake we all have at the start, but the RNY needs more and it's up to the individual programs as to whether they want to split their patients up into two groups or treat them all the same. The ones that treat all the same tend to be the ones that have 1200 calorie diets, which the bypass can more readily accommodate with its transient malabsorption than the VSG

If you look at practices that specialize in the VSG, or VSG and DS, they will generally have different recommendations than those practices that are RNY based. It's much the same with the NSAID thing, where the bypass based practices are understandably a lot more strict about their use than the VSG/DS practices that tend to have longer experience with those procedures and appreciate the differences.

Yes, since I tend to run a bit low on iron anyway, I think it would be wiser for me to go with a higher dose rather than lower. But I'm going to talk to my center about it before I make any changes. just to be sure.

I agree with you about multivitamins, I like taking extra calcium and vitamins C, D, B12, and E, plus I usually take other supplements like evening primrose and borage oil. I can't help but wonder if some of my ongoing post-surgery fatigue is due to the lack of good quality vitamins my body is used to. These chewable bariatric vitamins are subpar imo.

The main reason to not count what is in the multivitamins is because the majority of them contain both iron and calcium, which impair absorption of the other if taken at the same time. Your best bet is to find a multi that does not contain iron and then take iron separately, away from your other vitamins, calcium supplements, and medical prescriptions.

That is part of it as well, though from what I have seen of those multi's that contain both (and even those that don't) they contain only a partial dose of each, so the conflict isn't there, at least not to the degree that there is if we try to take a full 600mg of Ca plus a full dose of Fe at the same time. Much like with real food that contains both, the doses aren't as high and the absorption is slower owing to the digestion process. What is Dr. K's take on it (other than to "eat dirt")?

You want not too much and from various sources. We can't absorbe elemental iron AT ALL ... but so what there are so many available forms of ferritin. Do your research and get yourself well !!

With the bypass there is significant impairment (not sure if I would go so far as to say not at all...) as most mineral absorption happens in the duodenum, which is bypassed along with the remnant stomach in the RNY, and only partially bypassed in the DS. This is why a greater proportion of bypass patients will need periodic iron infusions relative to DS patients. With the VSG as the OP has, mineral absorption is not significantly impaired so supplement needs are largely dependent upon dietary habits.

Thank you, I hope since I have a sleeve, I won't as severe a problem with malabsorption but iron can be tricky. And since I was a bit low before surgery, I want to be vigilant. It can confusing, but I'm researching as much as I can. It will be good when I can finally start eating meat again, as that is the most readily absorbable source of iron.

I'm a nurse and I mostly see iron in the form of ferrous sulfate in 65mg doses ordered daily. Unless anemic then some docs prescribe twice daily.

Thank you, Shannon. Your reply prompted me to finally look up what I dosage I was prescribed by the internist last year, and it was 70mg. I feel pretty comfortable now doubling my dose to 60mg, with a 500mg vit C chaser.