preventing deficiency vs. treating deficiency

It seems to me that there are two basic plans people tend to adopt after RNY regarding vitamins.

Well, really three plans, I guess.  The third being the people that choose not to bother taking vitamins and not to bother getting labs done and just hope for the best.  They don't take many steps to either prevent or treat deficiency.  I don't even know what to say about that, though.

But the two basic plans I see most people adopt are either a goal of preventing nutritional deficiency before it occurs or treating deficiency when it does occur. 

Now, even if you put forth your best effort to prevent deficiency, it's gonna happens sometimes.  But people with the "prevent deficiency" plan start out taking lots of vitamins, including everything recommended by the ASMBS, and get tons of labs done pretty often, and catch deficiencies early and then treat them right away.  This has pretty much been my plan since about a year out from surgery.  It's not what I started out doing because my surgeon was more of the "treat deficiencies" plan - he recommended not bothering to take any iron until I become deficient, stuff like that.  So I started out doing it his way, then decided that didn't really make sense to me, and changed my plan.

The downsides to the "prevent deficiency" plan, that I can see, is that if you take too many vitamins to begin with you could potentially get levels of some things that are dangerously high (though I think that's pretty unlikely, especially if you are following the ASMBS guidelines and getting your labs done regularly), and you may be taking a little more of something that you really need and therefore spending a little more on vitamins that you really have to spend.  Oh, and there is the expense of getting labs done regularly.

The "treat deficiency" plan, which seemed to be what my surgeon advocated, seems to involve not taking many vitamins to start with, doing labs to look for deficiencies, and then adding supplements as needed once a level of something gets significantly low.  I think the downside of this plan is that when something gets really low, we usually have unpleasant symptoms so we'd have to feel bad for a while until the deficiency was diagnosed and treated, and some deficiencies can actually cause permanent damage.  I really don't want to risk permanent nerve damage or damage to my eyes, but some people seem comfortable taking that risk.  The upside to doing it that way, I guess, is that at least for a while, you don't have to take many vitamins.

I really do believe we all have the right to make our own choices and if you choose to treat deficiencies rather than prevent them, it kind of confuses me but I do support your right to do it the way you prefer to do it.  You should do what seems right to you.

But what is your plan?  Is it to prevent deficiencies or just treat them when they occur?  Why did you choose your way of managing your vitamins?

I started out with the basics and have increased as my labs indicate.
So technically I prevent AND treat.

Having a friend die of multiple organ failure 10 years post op because she didn't take vitamins or get labs done was enough of a wake up call for me to start and continue this journey the right way.

Well, I prevent and treat, too.  It's impossible to prevent all the time because you just never know how your body will absorb certain nutrients down the road.  I think there is a difference, though, in saying, "Well, my iron is still in the normal range but it's dropped some since the last time I had labs done so I'm going to start taking a little more" and in saying, "Well, my iron has dropped since the last time I had labs but it's still in the normal range so I'm not going to take any yet.  Next time I get labs done, if it's actually below the normal range, then I'll start taking some."

I'm very sorry to hear about your friend.

I started out trying to take as little in the vitamin department I could getaway with. This did not work. I now take all the supplements I need to keep things working as they should. I just hated taking pills so I have had to adjust.

I hated taking a lot of pills, too, especially early out after surgery because I felt nauseous a lot.  So I was initally happy with my surgeon's plan, which did not involve taking all the vitamins recommended by the ASMBS.  When I saw my lab results, though, I was not so happy.

this is a great question to pose to people.  I think i am both, depending on the vitamin or supplement.

Vitamin D:  Been on 50000 of D2 for 2 years.  Stable.  Didn't feel the need to change, yet.  My endo told me about Replesta but at 15 a month, i am not convinced.  The Dry D3  i will try once i finish my D2 and see how the labs go.  

A's:  levels were ok.  Take when i remember.

B's:  So far, so good.  so i take B complex maybe every other day.  one dr said to take it to PREVENT and the other said i didn't need to .  So i take it when i remember.

Iron:  Had the infusions (anemic not due to RNY, but after).  Dr. said i should take a supplement to stay up, other said not to bcc it was too high.  I bought the carbonyl Feosol.  Cost a fortune.  Taking it every other day or so.  

Calcium:  get it in my shake and try for another during the day 1000 mg.  All my dr. said that is enough.  so this one i am a wait and see...
Protein:  I take my one shake, eat the rest.  If i feel like i am more active i will add Nectar to one of my waters

No more potassium supplements.  THey are gross and i am stable.

can't think of other ones off the top of my head other than my reg. synthroid which i never miss

Curious about what everyone does.  It felt cathartic to admit my flaws just now. 

I use Sundown Perfect Iron which is carbonyl too, but I think it's cheaper than Feosol.  I can get 200 tablets, 25 mg each, at Meijer for $5.99, but often they are on sale buy one, get one free.  When your Feosol is gone, you might wanna look for that if the cost is a concern (is cost not a concern for anyone?).

they are hard to find around here.  So were the FEOSOL, so when i found them i grabbed them.  Now i went to my local supermarket yesterday and they had them .  Two weeks ago they didn't.  I think it i**** or miss.

Supplements are just part of the commitment you have to make when you decide on this surgery. If you can't commit to a lifelong change, then this isn't right for you.

I agree, but also it is difficult to navigate when your surgeon or metabolic dr and other dr have differing opinions than each other, the guidelines, and anyone here. 

So yes, it must be a change, but who do you follow or do you just follow the labs/