Vitamin Supplement Question?

I just got my 1st lab results back since getting out the hospital in July.  My PCP's nurse called me today and said all the tests they did looked good, except that I was low on Vitamin D.  Since I take 2 of the Centrum chewable multi-vitamins a day and they are supposed to have 100% of the needed vitamin D in them, she said this was probably due to the mal-absorption issues with RNY.  I tried calling Dr, Juarez's office, but they were already gone for the day.
Does anybody know of a good suplement for vitamin D?  In addition to the two multi-vitamins, I also take a B-12 sublingual dot, as well as 2 1000 mg TUMS a day for the calcium.

BTW- some have mentioned the light sensitive vitamin K tests, etc, and my doc didn't order those.  Is that one I need to get next time?  Is there a list somewhere of the important blood tests that we can ask our PCP to order?
THanks,
John Schlechty

Since we live in AZ, I would say get out in the sun for a little while everyday.   
The sun is a natural Vitamin D producer.

Hey there John!

SUNSHINE!  Get yourself a healthy dose of AZ's fabulous outdoors! 

And.....for those of us with D issues (most Rny'ers)....you should take a dry D.  I take the IUD2 from vitalady.com  ....  Unless you had a Distal or Extended Rny, you shouldn't really need a K test.  But, Dr. Juarez or Emile will give you the details.

Your supplement regiment sounds great ..... however, you may want to switch out your TUMS for a calcium citrate.  Tums is a carbonate and we do not absorb it as well or even at all.  Most "in the know" Bariatric programs recommend calcium citrate.  Costco has a good Kirkland brand.  They are like horse tablets but if you grind em up and sprinkle them in your protein drink then it's easy to handle.

Michelle (also known as vitaldy.com) can send you a detailed lab list. 

Want to meet me at the Bridges St Luke's support group tomorrow night?  If you go early (5 pm) then you'll hit Jenel's nutrition presentation.  She always gives plenty of time for Q & A afterwards and can give individual time if needed.  She'd probably have all of your D and K answers

Im having the same issue.

John,

because of malabsorption, it is very important to take vitamins that are easily digested by the RNY patient. A lot of your "commercial" brand vitamins have fillers and "other items" that make it impossible for the WLS patient to absorb the proper vitamins and minerals. Though we do live in a sunshine state, you would have to sit outdoors for approx 30minutes per day/every day (without sunscreen) to absorb enough Vitamin D. The easiest and most efficient way is to take at least 600-800 IU's per day of Vitamin D. Also, as Joyce mentioned, Calcium Citrate is what WLS patients absorb, and you should be taking approx 1000-1400 mg/day to assist in strong bones (yes men can get Osteo also). Since most WLS patients do not drink a lot of milk, it is important to make sure you are receiving the appropriate Calcium and Vitamin D supplements. There are companys that specialize in bariatric vitamins (i.e. Bariatric Advantage, Building Blocks, Metagenics) so give yourself the best possible vitamins and minerals possible. This is a regimen for the rest of your life, so find a product that specializes in WLS patients. Your body will be happy you did (present and future)!

Thanks for the ideas guys!  The sunshine idea makes a lot of sense.  I've definitely not been getting outside much at all due to trying to get my broken leg to heal.  I used to go for a couple of walks a day.  I'll have to make an efort to get outside more - even if it's just sitting and watching the people go by. . .

I'll look into getting some vitamins specifically made for bariatric patients and finding some calcium citrate.

Joyce - I won't be able to make it tonight, thanks anyways.  BTW - wasn't the January Schlesinger support group meeting supposed to deal with the vitamins and blood tests?  IIRC, I was planning to go just for that reason.

John,

I take a Vit D3 that is sublingual and I just place it on or under my tongue.It is 10,000 iu's. You get 100 tablets for $15.00. I love them because they are so tiny and dissolve real fast. I did not know that Dr Schlesinger's Jan 2009 meeting was going to be a discussion of Vitamins and Blood Test. That is news to me because I am going to lead the group with a topic that I will pick. I don't have a problem doing Vitamins and blood test which is a very important subject for all preop and post op WLS surgery patients. I have a appt with Dr Schlesinger on Friday and will discuss the Jan 2009 meeting with him. Who knows maybe I am not going to lead the group but will have the issue settled for Friday and will post what the topic will be. Thanks for posting your comment about Jan 2009 group.

Thanks,.

Dawn

I got some of the Bariatric Advantage Calcium Citrate with Vitamin D in them - Dr.'s office says anything with a D supplement should work ok.  I'm hoping that changing to the calcium citrate will help my broken leg to heal a little better or quicker due to better calcium absorption.

Dawn - I might be mistaken about the January meeting.  I just thought I heard somebody mention that, but I'm not sure.  Perhaps somebody else that was there could chime in and let me know if I heard correctly or not.  If you're supposed to be planning it, then I apologize if I spoke out of place.  That was my 1st meeting, and I'm not sure of who does what, etc.