Ask a Dietitian

Well, I know there is at least one pharmacist who follows this board, so I hope he or she can help you too. Here are my thoughts - is the anti-convulsive medication that you are taking the only one you can take? Is there another option? If so, possibly one that does not have such a strong reaction with folate? I am not very familiar with the anti-convulsive meds, so unfortunately I can't make any recommendations. You may want to check with your neurologist as well .... I am assuming you've been diagnosed by a hematologist in regards to your anemia. Are you sure it's from a folate deficiency? Could it possibly be a B12 deficiency? They look similar .... if you have not been diagnosed by a hematologist, you may want to make an appointment to be 100% sure you've got the right diagnosis. My only real suggestion to you, and I'm hoping the pharmacist chimes in to help me here, is to load up on folate from food, rather than meds. It seems that some anti-convulsant meds make you waste folate (which low folate can also cause seizures ...) -- anyway, the only other way I know of to get more folate in, is food .... and, just so we're clear, dealing with anti-convulsive meds is unfamiliar territory for me, so, I am hoping someone has better advice than me ........ High folate foods: Dark green, leafy vegetables Whole wheat bread Lightly cooked beans and peas Nuts and seeds Sprouts Oranges and grapefruits Liver and other organ meats Poultry Fortified breakfast cereals and enriched grain products One cup of orange juice provides half the RDA for folate (to give you an estimate). Please note that folate in foods is very susceptible to heat. It is really important to eat these foods raw or lightly cooked as they retain their nutrient value the best. Cook in minimal in water -- through steaming, stir-frying, or microwaving. Gosh, I'm sorry I can't be more help .....

B12 folate and hemogloban iron defitioncies. and all anti convolsives have this reaction I am a medical student and it is right in the medication warnings. I have tried several and none work with me and now I know why.

I am hoping a pharmacist will answer your question. Or possibly your neurologist. It seems to me that just having folate in your system shouldn't counteract the anticonvulsant. When they are taken at the same time, or even a few hours apart, yes, I see that. But, if you are taking your b-vitamins sublingually or IM, it should be OK. In addition, aren't these shots monthly? They shouldn't be daily ..... whereas your anti-convulsant is daily ......

MaryTeresa, I also wanted to mention that alot of anti-convulsants are time-released. As a WLS patient you may require higher doses for a med to work or it may not work at all. I don't know which one's you have tried, but this may be part of the problem.LM

MaryTeresa, basically most anti-convulsives cause the body to require more folic acid due to altered absorption. Some people take up to 4mg/day of folic acid. You may even require more than this with RNY, but I would consult a neurologist. Also Dilantin blood levels are decreased by folic acid. This would require you to take a higher dose to be effective. However, there are alot of anti-convulsants that are not affected by folic acid. A neurologist should be able to find one that works for you, regardless of folic acid supplementation. Like I said, people on anticonvulsants typically take more folic acid than normal. Good luck.

I was banded almost a month ago and am looking for some menus for fast and successful wieght loss.  I am allowed 3 meals a day and protien suppliments and I am burning out on my choices and need to make meals for the family too.  any help or direction would be appreciated.  Thanks in advance.

i had rny in january of this year so im almost 4 months post op. for the past month-ish i really havent been able to tollerate any foods, they almost instantly upset my stomach. protien dirnks are hard as well. the only one that does remotely well is K20. once i began eating solid food in feb. i was doing fine. i watch my sugar and my fat. why all of a sudden does my stomach not like anything? i do attempt to eat but nothing sits right. are there any problems that i could ask my dr. about that could be related to this?

I am 5 months out and am wondering how many calories I sould be taking in each day.  I workout twice a day most days and between the two workouts I burn about 800-900 calories.  I am 28, 5'2" and weigh 199 pounds.  Please let me know where I should be calorie wise at this point in my journey.  Thank you so much for any help you can give me regarding this matter.  ~Nicole

You will need a full nutritional assessment to adequately answer this question for you. Assessing calories, protein, carbs & fat is not a quick & easy calculation. There are a lot of factors that go into this calculation: weight, height, exercise, social habits, previous weight loss habits, type of surgery, age .... etc. I'm sorry it's not a quick & easy answer for you. Consider making a personal appointment with a registered dietitian. If one is not connected with your surgeon, then you can check www.eatright.org, enutritioncare.com, or click: find a: other professional on the OH website. Good luck!!

Thank you, this actually does help!  I am going through a nutrition program (3 day intensive program) next week and will wait to see what they have to say there.  If they do not answer my question then I will go back to the dietician that I was seeing pre-op.