Opurity vits- Question for Vit experts
Well, I stand corrected! I just looked them up. They do have copper now. I wonder when they changed the formula (and why they didn't bother to notify me personally since, you know, I like to know everything). They have 100% of the RDA of copper which is most likely fine even though it's less than the 200% we want of stuff. Lots of multivitamins don't have a full 100% of some of the minerals like copper and selenium. Make sure they check your copper when you get labs done (no matter which multi you go with) and you should be fine.
I'll add that I would also keep an eye on your vitamin A, which you should do as well no matter what multi you take, but especially because Opurity only has 150% of vitamin A and half of it is from beta carotene which we don't absorb very well.
I'm really excited to see they put copper in these. I think they are a pretty good choice now.
I'll add that I would also keep an eye on your vitamin A, which you should do as well no matter what multi you take, but especially because Opurity only has 150% of vitamin A and half of it is from beta carotene which we don't absorb very well.
I'm really excited to see they put copper in these. I think they are a pretty good choice now.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
As long as you know that your multi is only your BASE, not your all.
We still fluff in around the completely malabsorbed stuff.
- iron + C
-dry forms of A (retinol);
-D3 (not soft gel);
-E again in a capsule, d-alpha tocopherol succinate (there are 8 forms of E, only 1 is right);
-K1 if you use it
-zinc
-copper
-a B complex - B's are not tasty, so are often left out or minimzed in a chewable vit.
-B12 by sublingual or shot
I also add a dry form of selenium and Co Q 10, and of calcium citrate, there is no such thing as too much.
Magnesium citrate pills (not the bowel prep) can be a booster to many of the other vites.
Mag oxide can help with pokey slow bowels, but otherwise doesn't do anything for any other body part.
So, when you ask about a multi vit, if it has a dash of everything, it's a good base and you build upon it.
We still fluff in around the completely malabsorbed stuff.
- iron + C
-dry forms of A (retinol);
-D3 (not soft gel);
-E again in a capsule, d-alpha tocopherol succinate (there are 8 forms of E, only 1 is right);
-K1 if you use it
-zinc
-copper
-a B complex - B's are not tasty, so are often left out or minimzed in a chewable vit.
-B12 by sublingual or shot
I also add a dry form of selenium and Co Q 10, and of calcium citrate, there is no such thing as too much.
Magnesium citrate pills (not the bowel prep) can be a booster to many of the other vites.
Mag oxide can help with pokey slow bowels, but otherwise doesn't do anything for any other body part.
So, when you ask about a multi vit, if it has a dash of everything, it's a good base and you build upon it.
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
I know you have your list of vitamins and supplements that you recommend and I do use many of your vitamins personally but I dont' understand why you recommend some of them as a rule of thumb.
I personally became vitamin A deficnient pretty early out and do need to take a large dose of your of dry vitamin A but most don't need anymore than is in a multi and taking too much vitamin A is toxic. It isn't like the b vitamins that we just pee out the excess.
Why extra vitamin E and K for RNY patients? I know you had a different form of RNY than the average but the rest of us, dont' malabsorb E and K. I do get them checked every 3 months just to be sure and thankfully they have both been fine and if there is a vitamin to be deficient, I will find it.
Zinc - we get enough in our multi and too much is no good. I know just from taking my multi 2 times per day, my zinc runs high at times which get my doctors nervous. I wouldn't think anyone would want extra zinc unless they were dificient in zinc or high in copper.
b complex I am not a fan of - we get all the necessary b vitamins we need in the multi's excess for B1 and B12 - so I always recommend taking an extra B1 by itself but not a b complex. Taking a b complex gives us extra B 6 which does go toxic and I am constantly seeing people with dangerously high B6 levels.
Selenium - should be in everyones multi but if not, then it should be supplemented. I personally need both. But if in the multi and levels are normal, then extra shouldnt' be taken - high selenium levels aren't good either.
I personally became vitamin A deficnient pretty early out and do need to take a large dose of your of dry vitamin A but most don't need anymore than is in a multi and taking too much vitamin A is toxic. It isn't like the b vitamins that we just pee out the excess.
Why extra vitamin E and K for RNY patients? I know you had a different form of RNY than the average but the rest of us, dont' malabsorb E and K. I do get them checked every 3 months just to be sure and thankfully they have both been fine and if there is a vitamin to be deficient, I will find it.
Zinc - we get enough in our multi and too much is no good. I know just from taking my multi 2 times per day, my zinc runs high at times which get my doctors nervous. I wouldn't think anyone would want extra zinc unless they were dificient in zinc or high in copper.
b complex I am not a fan of - we get all the necessary b vitamins we need in the multi's excess for B1 and B12 - so I always recommend taking an extra B1 by itself but not a b complex. Taking a b complex gives us extra B 6 which does go toxic and I am constantly seeing people with dangerously high B6 levels.
Selenium - should be in everyones multi but if not, then it should be supplemented. I personally need both. But if in the multi and levels are normal, then extra shouldnt' be taken - high selenium levels aren't good either.
I'm glad you asked. I think ppl assume my list is what it is because of what I do.
I started with the basic list my doc gave us back i*****
protein
iron
calcium
A D E
zinc
No B12, or complex or copper or K and so on.
Over the years, I've seen so many thousands of labs from all surgery types and studied the "map of what is absorbed where", listened to and read presentations and so on.
When I asked my doc for these tests: E, K1, selenium, he said, "Well, we've never had any trouble with those". True, I pointed out, but we've never tested them. And by then I had hundreds of results showing they should be tested. He agreed to a "baseline" and added a few tests to go with them, such as PTT and so on.
I'm sure he was surprised to see that we both needed to trim our E back a hair, and hit the K1 with a sledge hammer to get it to move. BUT He had no idea how to do that. And I say that with all due respect, since I, like most, think my two surgeons walk on water. Dr. Fox, just smiled and watched me fix those levels. Dr. Oh said, "You can test K1?" LOL He started to write rx for Don and I asked the dose, and he told me and I said, "Oh we can do that" and he just rolled his eyes and ripped it in half. LOL Can you imagine the horror of being MY surgeon? They indulge me tremendously on labs and vitamins and when they are working with someone and either get bored of trying rx or are busy, they send me the ppl to fix.
It's not medical. If it was, docs and RN's would know it. It's not taught.
I'm very fortunate with most of my docs. My PCP is scared of "natural things", like magnesium. My naturopath is fascinated by all things malabsorption. My hematologist didn't know iron has to be taken with C!! But as I show him new stuff, he asks all the right questions (does it hurt the gut?
My original starter list was much shorter. I added folic when I saw a repeating pattern of shortages across the board by maybe the 3rd year. I K when I saw, again, across the board, saggy levels in RNY, too. And copper, when it fixed my own issues with folic. We were launched on the 50mg zinc. I had to tweak mine several times but a level of 200 (50 x 4) is what holds me in the bottom half of the range.
I've meet a few ppl who are high in zinc without taking any, so my guess is they have access to water with more minerals? Zinc is definitely in the malabsorption zone.
B complex. I'm also not huge into having to load oneself with B vites (other than B12, which is not counted in a B plex), but back to across the board, B1 thiamine can help abate random nausea and by the same token, nausea/vomiting early on deplete B1 very quickly. The damage is as serious as B12, but so much easier to prevent. We even have our own, Bariatric Beri Beri, which they say is because ppl don't take a good multi. I suspect what depletes it is a heavy case of nausea/vomitig right out of the gate. Once fixed and steadied, a good multi taken regularly will prolly hold a person at a good range, providing they're not pukey or involved with alcohol.
Remember above all, I'm a fan of zealous testing. If you started on my plan and your zinc level was high, it doesn't hurt my feelings that you stop taking zinc and test again later. It's nothing personal to me, if the starter doesn't fit Every Body the same.
Although most starters don't include iron, mine always has. I know YOU understand the how's and why's of iron, so I don't have to wrestle you on that one.
Since my "other life" is on a yahoo board with ppl who are mainly 10 yrs+, it's so sad to see ppl disabled by iron or B12 anemias, and commonly, damaged teeth and see-through bones.
I'm not certain we can save our bones, because it's likely that all the dieting and weight losses before WLS have already taken some bone mass, but no one knows because........... who tests a fat girl? Everyone knows they'll eat ANYTHING. (you know I'm growling and rolling my eyes here). Yes, of those who are able to get a full dexa scan more than 50% are already showing thinning! Then drop a coupla hundred pounds while trying to build or hold onto bone at only 1500mg calcium per day?
OK, wait. I have warmed to my subject entirely too much! LOL
As you know, if something is too high, it's not the same as toxic. Toxic means poison and in the case of some vites and minerals, to reach toxicity, one has to hold a ridiculously high level for eons before damage is done.
A good example is vit D. Once thought to be toxic at doses more than 400 per day, but referring to D2 in oil, we now laugh at that infintessimal dose. Especially for anyone who carries fatty tissue and/or has malabsorption. Even as water SOLUBLE, not misclible, D3, 400 is the same as nothing at all. So now we know that a level of 50, once considered "instant death" is now not nearly good enough to cover all the body systems and tha****er SOLUBLE D3 and retinol A do not store in the liver in the same way that the fatty lesser forms do.
I become enraptured with the vites, so if I missed anything, ask me again. I hope I didn't sound angry at YOU, because I am most certainly not. If you met me IRL, you'd stand there amazed that so many words could pour out in 2 seconds. LOL
I started with the basic list my doc gave us back i*****
protein
iron
calcium
A D E
zinc
No B12, or complex or copper or K and so on.
Over the years, I've seen so many thousands of labs from all surgery types and studied the "map of what is absorbed where", listened to and read presentations and so on.
When I asked my doc for these tests: E, K1, selenium, he said, "Well, we've never had any trouble with those". True, I pointed out, but we've never tested them. And by then I had hundreds of results showing they should be tested. He agreed to a "baseline" and added a few tests to go with them, such as PTT and so on.
I'm sure he was surprised to see that we both needed to trim our E back a hair, and hit the K1 with a sledge hammer to get it to move. BUT He had no idea how to do that. And I say that with all due respect, since I, like most, think my two surgeons walk on water. Dr. Fox, just smiled and watched me fix those levels. Dr. Oh said, "You can test K1?" LOL He started to write rx for Don and I asked the dose, and he told me and I said, "Oh we can do that" and he just rolled his eyes and ripped it in half. LOL Can you imagine the horror of being MY surgeon? They indulge me tremendously on labs and vitamins and when they are working with someone and either get bored of trying rx or are busy, they send me the ppl to fix.
It's not medical. If it was, docs and RN's would know it. It's not taught.
I'm very fortunate with most of my docs. My PCP is scared of "natural things", like magnesium. My naturopath is fascinated by all things malabsorption. My hematologist didn't know iron has to be taken with C!! But as I show him new stuff, he asks all the right questions (does it hurt the gut?
My original starter list was much shorter. I added folic when I saw a repeating pattern of shortages across the board by maybe the 3rd year. I K when I saw, again, across the board, saggy levels in RNY, too. And copper, when it fixed my own issues with folic. We were launched on the 50mg zinc. I had to tweak mine several times but a level of 200 (50 x 4) is what holds me in the bottom half of the range.
I've meet a few ppl who are high in zinc without taking any, so my guess is they have access to water with more minerals? Zinc is definitely in the malabsorption zone.
B complex. I'm also not huge into having to load oneself with B vites (other than B12, which is not counted in a B plex), but back to across the board, B1 thiamine can help abate random nausea and by the same token, nausea/vomiting early on deplete B1 very quickly. The damage is as serious as B12, but so much easier to prevent. We even have our own, Bariatric Beri Beri, which they say is because ppl don't take a good multi. I suspect what depletes it is a heavy case of nausea/vomitig right out of the gate. Once fixed and steadied, a good multi taken regularly will prolly hold a person at a good range, providing they're not pukey or involved with alcohol.
Remember above all, I'm a fan of zealous testing. If you started on my plan and your zinc level was high, it doesn't hurt my feelings that you stop taking zinc and test again later. It's nothing personal to me, if the starter doesn't fit Every Body the same.
Although most starters don't include iron, mine always has. I know YOU understand the how's and why's of iron, so I don't have to wrestle you on that one.
Since my "other life" is on a yahoo board with ppl who are mainly 10 yrs+, it's so sad to see ppl disabled by iron or B12 anemias, and commonly, damaged teeth and see-through bones.
I'm not certain we can save our bones, because it's likely that all the dieting and weight losses before WLS have already taken some bone mass, but no one knows because........... who tests a fat girl? Everyone knows they'll eat ANYTHING. (you know I'm growling and rolling my eyes here). Yes, of those who are able to get a full dexa scan more than 50% are already showing thinning! Then drop a coupla hundred pounds while trying to build or hold onto bone at only 1500mg calcium per day?
OK, wait. I have warmed to my subject entirely too much! LOL
As you know, if something is too high, it's not the same as toxic. Toxic means poison and in the case of some vites and minerals, to reach toxicity, one has to hold a ridiculously high level for eons before damage is done.
A good example is vit D. Once thought to be toxic at doses more than 400 per day, but referring to D2 in oil, we now laugh at that infintessimal dose. Especially for anyone who carries fatty tissue and/or has malabsorption. Even as water SOLUBLE, not misclible, D3, 400 is the same as nothing at all. So now we know that a level of 50, once considered "instant death" is now not nearly good enough to cover all the body systems and tha****er SOLUBLE D3 and retinol A do not store in the liver in the same way that the fatty lesser forms do.
I become enraptured with the vites, so if I missed anything, ask me again. I hope I didn't sound angry at YOU, because I am most certainly not. If you met me IRL, you'd stand there amazed that so many words could pour out in 2 seconds. LOL
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
I was B1 deficient at about 4 or 5 months out - no vomitting and very little nausea that I remember but didnt' take any B's other than my B12 injections and my Centrum silver 2 times per day. I was put on 300mg per day to get my levels up and have had to continue on 300mg 5 times per week to keep them at the high end of normal. I was told once deficient, I will always have to supplement at high doses.
As far as vitamin D3 - I know you say the Dry D3 isn't toxic but we have had this discussion before. My Endo who I love but she , gets really nervous when she sees my levels and about 3 months ago, she went absolutely nuts. I got a phone call to totally stop my D - they couldnt' measure my level - it was greater than 150. They retested it 3 times to verify. So, I stopped it for 3 weeks and got retested and it went down to 112 and I then went back on 2 times per week instead of 3 times per week and I am now holding steady at 107. She told me at my last visit that she really didn't want my numbers so high because high vitamin D levels can cause kidney stones and that I dont' need that complication with all I have been through this past year. Well, on that same visit I thought I had a bladder infection and my urine showed alot of blood, protein, and white cells. So, she put me on macrodantin and sent out a culture. Well when the culture came back negative, she sent me to a urologist. The urologist again did a urinalysis and she said it looked highly infected - put me on cipro while we waited for the culture - I was also going nuts because the burning and frequency were unbearable. Well, again the culture was negative. I went for a CT scan and 1 hour later I got a call from the urologists office that I needed surgery ASAP - I had major kidney stones on both sides. The left side, there were 2 - 1 one was obstructing the ureter and one was higher up in the kidney and the right side there were many in the kidney but nothing obstructing. So, I had surgery the next day - cystoscopy with a laser to blast them and the insertion of a stent. It was supposed to be a same day procedure but I ended up in the hospital for 5 days. I ran a high fever - never found a source of infection and I lost an enourmous amount of blood - thought I would need a tranfusion but was on the borderline - Hemoglobin 8.1, hemacrit 25.1, WBC 2.7 and platelets 67. I was seen by a hematologist who I followed up with a week later and my numbers improved - 10.4, 30.4, 3.4 and 190. So, now I need the other side done but they are making me wait a month to make sure my levels go up even further. I had bloodwork done today - 16 vials - ouch. So, they can't say for sure if the vitamin D caused the stones but it is a possibility. I have an appointment on Sept. 12 with a Nephrologist to get 24 hour urine testing done to hopefully find out what my urine is concentrated with - causing the stones. Since my urologist blasts the stones with a laser, they can't be tested.
Folic acid - I am curious to see what happens with me. I have had high folic acid levels for atleast 20 years, as long as I have records and I have never taken any.
As far as vitamin D3 - I know you say the Dry D3 isn't toxic but we have had this discussion before. My Endo who I love but she , gets really nervous when she sees my levels and about 3 months ago, she went absolutely nuts. I got a phone call to totally stop my D - they couldnt' measure my level - it was greater than 150. They retested it 3 times to verify. So, I stopped it for 3 weeks and got retested and it went down to 112 and I then went back on 2 times per week instead of 3 times per week and I am now holding steady at 107. She told me at my last visit that she really didn't want my numbers so high because high vitamin D levels can cause kidney stones and that I dont' need that complication with all I have been through this past year. Well, on that same visit I thought I had a bladder infection and my urine showed alot of blood, protein, and white cells. So, she put me on macrodantin and sent out a culture. Well when the culture came back negative, she sent me to a urologist. The urologist again did a urinalysis and she said it looked highly infected - put me on cipro while we waited for the culture - I was also going nuts because the burning and frequency were unbearable. Well, again the culture was negative. I went for a CT scan and 1 hour later I got a call from the urologists office that I needed surgery ASAP - I had major kidney stones on both sides. The left side, there were 2 - 1 one was obstructing the ureter and one was higher up in the kidney and the right side there were many in the kidney but nothing obstructing. So, I had surgery the next day - cystoscopy with a laser to blast them and the insertion of a stent. It was supposed to be a same day procedure but I ended up in the hospital for 5 days. I ran a high fever - never found a source of infection and I lost an enourmous amount of blood - thought I would need a tranfusion but was on the borderline - Hemoglobin 8.1, hemacrit 25.1, WBC 2.7 and platelets 67. I was seen by a hematologist who I followed up with a week later and my numbers improved - 10.4, 30.4, 3.4 and 190. So, now I need the other side done but they are making me wait a month to make sure my levels go up even further. I had bloodwork done today - 16 vials - ouch. So, they can't say for sure if the vitamin D caused the stones but it is a possibility. I have an appointment on Sept. 12 with a Nephrologist to get 24 hour urine testing done to hopefully find out what my urine is concentrated with - causing the stones. Since my urologist blasts the stones with a laser, they can't be tested.
Folic acid - I am curious to see what happens with me. I have had high folic acid levels for atleast 20 years, as long as I have records and I have never taken any.
My folic had dropped to unreadable and I wasn'****ching it. Imagine MY surprise that my PCP caught it before I did. It took years, but the sulfa drug I take for rosacea can block folic intake via food or supplements. I took mega doses to get it back on board.
I take a low maintenance dose of it, but the dose for a UTI for example is way much higher. But it's for 7-10 days, so one can easily recover from that little bit.
interesting that yours is high naturally. Is it that you simply LOVE foods that contain it?
*I* don't say that dry D3 isn't toxic from my head. It's in the studies.
Those who are not up on the latest D studies tend to panic when we finally get it up into the therapeutic ranges, where all the benefits kick in. Much like B12. We want optimal levels, not the levels on our antiquated labs.
I'm not encouraging D levels in the thousands or anything crazy. It would take levels over 700 to produce problems, but I like to see my own and Don's right around 100. The highest lab range I've seen is 150.
My last was 161, and the one before was 141. I didn't do anything different than the full year it held at 91. And the increase was between Nov and April, not summer, just to clarify, but I'm long past believing in the sun myth.
I take a low maintenance dose of it, but the dose for a UTI for example is way much higher. But it's for 7-10 days, so one can easily recover from that little bit.
interesting that yours is high naturally. Is it that you simply LOVE foods that contain it?
*I* don't say that dry D3 isn't toxic from my head. It's in the studies.
Those who are not up on the latest D studies tend to panic when we finally get it up into the therapeutic ranges, where all the benefits kick in. Much like B12. We want optimal levels, not the levels on our antiquated labs.
I'm not encouraging D levels in the thousands or anything crazy. It would take levels over 700 to produce problems, but I like to see my own and Don's right around 100. The highest lab range I've seen is 150.
My last was 161, and the one before was 141. I didn't do anything different than the full year it held at 91. And the increase was between Nov and April, not summer, just to clarify, but I'm long past believing in the sun myth.
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
Hopefully I won't have that problem with the folate since I am allergic to sulfa. I had rosascea many years ago and took doxycycline when really bad or used MetroGel. Maybe if you you have trouble with sulfa, you could try one of these. I know my dad took the sames meds I did for it. I was one of the lucky ones and my rosascea went away.
I don't know if it is from foods - what foods have folic acid? Is it due to the fact that I have been on B12 injections for the past 15 years?
I understand about the D and I read many of the studies you sent me, it just seems so coincidental that I got the stones so fact and right at the time that my D was unmeasurable. We don't even know how high it actually was. I had numerous CT scans this past winter - Oct-March and none of them showed stones. So, for me to have so many stones and for them to be as large and obstructing as they are is very odd. From what I have already read is that they take years to grow.
I am going back for an X-ray = KUB (kidney, ureters and bladder) in 2 weeks to see what is going before my next surgery. Hopefully things remained stable and nothing new shows up in the left side.
In the meantime, I will try to keep my D down around 80 instead of over 100 - just to play it safe. Once I get the results of urine tests from the nephrologist - then I will feel better if he tells me it is something else. The urologist says it is usually Oxylates with us.
I don't know if it is from foods - what foods have folic acid? Is it due to the fact that I have been on B12 injections for the past 15 years?
I understand about the D and I read many of the studies you sent me, it just seems so coincidental that I got the stones so fact and right at the time that my D was unmeasurable. We don't even know how high it actually was. I had numerous CT scans this past winter - Oct-March and none of them showed stones. So, for me to have so many stones and for them to be as large and obstructing as they are is very odd. From what I have already read is that they take years to grow.
I am going back for an X-ray = KUB (kidney, ureters and bladder) in 2 weeks to see what is going before my next surgery. Hopefully things remained stable and nothing new shows up in the left side.
In the meantime, I will try to keep my D down around 80 instead of over 100 - just to play it safe. Once I get the results of urine tests from the nephrologist - then I will feel better if he tells me it is something else. The urologist says it is usually Oxylates with us.
I use metroCREAM (non-drying) but I tried 2 other topicals first. The sulfa is the most benign for me. But the info that it blocks folic was in my books - the docs didn't know it.
So, I take a very low dose of sulfa, 200mg. For a UTI, they'd rx 800mg 3-4 times per day!
So, I take a very low dose of sulfa, 200mg. For a UTI, they'd rx 800mg 3-4 times per day!
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
I have taken a Vitamin E supplement for years because of my circulatory issues so I am curious about the various varieties. I checked the label on the ones I have now and they ARE the d-alpha tocopherol succinate, but this is a different brand than what I had been taking. Is the issue a problem of absorption? I also noticed that some advertised that they are "natural" as opposed to "synthetic" but I'm not sure how much of a difference that makes (and most say nothing about that aspect).
Lora
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
There are 8 forms of 8. Yeah, like more than 2 wasn't already enough? One guy argues for a 9th, but let's pretend he didn't say that.
dl-alpha is the synthetic. d-alpha, etc is natural. I also was caught on that when Costco offered a water miscible form. But we all noticed our hair and skin dried out as if we had stopped. huh? So, when I noted the difference, we all went back to dry d-alpha. The dl-alph was around $17 for 300 vs $27 for 250. It would be another 10 yrs before I knew WHY, but the book backs up what we found for ourselves.
My original suggestions for serious malabsorbers went like so: 400 to absorb, 400 to malabsorb. Scientific, huh? Then the 800 studies came out, showing it takes 800 to save a heart. For us (Don and me, primary guinea pigs), it became 800 to absorb, 800 to malabsorb, but I didn't suggest it to anyone else unless they asked.
A guy with an early proximal RNY called me after surviving a heart attack and his docs had told him that the 800 iu he was taking had given him the time to get to ER. (using the 400 + 400 formula). After that, I had (1) how we felt (2) how the studies spoke (3) a life saved. After that, there was no backing down from E for me.
Dr. M Gagner presented a study at ASBS (no M in there then) in 2005 about the deficiencies in rny vs DS. Fascinating, because the deficiencies were there, which I knew, but not as severe.
So, when ppl ask me why I suggest certain things, there are often 6-8 stories encompassing 10+ yrs that make up WHY I suggest what I do. I still use the better safe than sorry approach. If something is a bit high that should be low, jerk a pill out of the pile and it will tumble fast enough.
That, of course, does not apply to things that should be way low, like PTH, that are way high. Then you add pills to make the number fall. Nother story, nother time.
dl-alpha is the synthetic. d-alpha, etc is natural. I also was caught on that when Costco offered a water miscible form. But we all noticed our hair and skin dried out as if we had stopped. huh? So, when I noted the difference, we all went back to dry d-alpha. The dl-alph was around $17 for 300 vs $27 for 250. It would be another 10 yrs before I knew WHY, but the book backs up what we found for ourselves.
My original suggestions for serious malabsorbers went like so: 400 to absorb, 400 to malabsorb. Scientific, huh? Then the 800 studies came out, showing it takes 800 to save a heart. For us (Don and me, primary guinea pigs), it became 800 to absorb, 800 to malabsorb, but I didn't suggest it to anyone else unless they asked.
A guy with an early proximal RNY called me after surviving a heart attack and his docs had told him that the 800 iu he was taking had given him the time to get to ER. (using the 400 + 400 formula). After that, I had (1) how we felt (2) how the studies spoke (3) a life saved. After that, there was no backing down from E for me.
Dr. M Gagner presented a study at ASBS (no M in there then) in 2005 about the deficiencies in rny vs DS. Fascinating, because the deficiencies were there, which I knew, but not as severe.
So, when ppl ask me why I suggest certain things, there are often 6-8 stories encompassing 10+ yrs that make up WHY I suggest what I do. I still use the better safe than sorry approach. If something is a bit high that should be low, jerk a pill out of the pile and it will tumble fast enough.
That, of course, does not apply to things that should be way low, like PTH, that are way high. Then you add pills to make the number fall. Nother story, nother time.
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
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