Need vitamin advice

Per my surgeon, I'm taking a multivitamin (6 capsules a day), sublingual B12 (once a day), 29 mg. chewable iron with vitamin C, and Chewy Bites calcium citrate with D3 (six per day).  All are Bariatric Advantage.  My first labs were okay, although my doc said a little low in a couple of areas (iron, for one, that's why the 29 mg.).  I go back on Jan.3, and will have labs drawn again at that time to see if anything needs to be increased, added, or changed.

My question is, how to take the multi and the Chewy Bites.  I know to separate the iron and the calcium by several hours at least.  My routine has been two multis, my iron, and my sublingual in the A.M., along with my usual meds (levothyroxine, wellbutrin, lexapro, and metoprolol).  Then in the afternoon, I take 2 more multis (at the same time), plus another wellbutrin tablet.  Before bed, I take another two multis plus my wellbutrin and lamictal.  I start out in the morning (at least an hour after my iron) with one or two chewy bites, but then forget about the rest until the evening, and wind up taking the rest pretty close together. 

Should I be separating the multis by a period of time?  What about the calcium? 

Help would be appreciated, because I really want to do this right.  I intend to lose weight AND stay healthy!   

Beth

6 multis seem like a lot to me... what kind are you taking?  why are you taking so much?  I take 2 Centrum Silver multi (the walgreens generic version) and that covers most things, i take extra selenium and d3. no iron because i am post menopausal. and i take 4 Citrical (wlagreens version) 2 at a time, at least 4 hours apart.

take your C and iron together, at least 4 hours apart.

Your body can only absorb so much at one time, so I believe taking 2 multis at a time is a waste of money, since you arent benefiting from it.

I'm a little rusty giving advice here, its been a while since I last posted....Kelly will be able to help you in this category much better.

All my vitamins are Bariatric Advantage, which are formulated specifically for bariatric patients, and each vitamin is what my surgeon instructed me to take.  According to the multivitamin container, "take six (6) capsules daily with a meal".  

For more information, here is a link to ASMBS' supplementation guidelines/recommendations:

http://asmbs.org/2012/06/asmbs-integrated-health-nutritional-guidelines-for-the-surgical-weight-loss-patient/

(Seems to not be showing up as a link, but you can copy/paste URL.)

The iron and calcium only need to be separated by two hours.  You can take the chewy bites with your multis if you want.  Just not with your iron.

Okay, let's sort out what the American Society for Metabolic and Bariatric Surgery (ASMBS) says you need.

Two multivitamins a day that have 100% of the RDA of most nutrients in them.

1500-2000 mg calcium Citrate (NOT Carbonate) a day taken three or four doses of 500 mg each, because we cannot absorb more than that at a time.

54-63 mg iron for menstruating women, 36 mg iron for everyone else.

B12: 350-500 mcg if you use a sublingual that dissolves under your tongue, or the nasal spray once a week, or shots once a month.

Taking B complex is optional.

Remember to separate Calcium and Iron by 2 hours to ensure absorption.

You can make adjustments once you labs come back, but if your D is ever  low, take Dry D3 (NO Gelcaps) to get it back in range.

Based on this information I'd divide taking my pills to 4 times a day.

Morning: Any Morning prescriptions required, Muti to meet 100% RDA, Calcium, B-12, and D3 if ever needed.

Lunch: Any Lunchtime prescriptions required, Calcium

Dinner: Any Dinnertime prescription required, Mutil, Calcium

Bedtime: Any Bedtime prescription, Iron

I like Opurity chewable Calcium Citrate, so I keep a few in a plastic pill pouch in my pocket and briefcase which helps keep them conveniently available if I'm busy during lunchtime.

Kat