First day on the patch!

Since the patch amounts are all above what I was taking to begin with, I'm not going to use anything else at this time and then see how my labs look. It's so nice the only pills I have to swallow are my Zoloft and Elevil. 

I emailed my NUT and Surgeon about the patches since I wasn't sure they met all of the specifications they had set. This is their response:

Can you use this patch for your multivitamin, iron and B12 requirement.   However, you will need a Chewable Calcium Citrate and Vitamin D3 supplement.  The Calcium Citrate doesn’t need acid for absorption while the Calcium Carbonate does and you will not be producing much acid due to the size of your stomach.  These products doesn’t have D3.  Vitamin D3 and D are different. 

Also, make sure you follow the direction on how to use the patch.  You can become vitamin and mineral deficient if it’s  use incorrectly.

Now, I know everyone's surgeons have them on different vitamin regimes, but wanted to share the feedback from my team. I'm still considering it, but not sure of the value if I still need to take Calcium Citrate 3x a day and a D3 supplement.

Also, for reference, here is a graphic of the nutrition from the patch:

The type of calcium only matters if you take it orally. That's why we take citrate because our digestive system cannot absorb carbonate well. When it goes through the skin then you are not absorbing through the stomach. That's why we need to wait two hours between calcium and iron as well. Because one inhibits the absorption of the other. But the patch eliminates that. My calcium requirement is 1200 mg a day and the patch has 1500. The vitamin D I was getting is 1500 iu a day and the patch has 5000iu. Maybe they didn't fully understand exactly what the patch has in it. 

That seemed curious to me as well, but she said it was appropriate for B12, so I would assume that means they understood that it is a skin patch you apply. I emailed for follow-up information and inquired if I truly needed an additional Calcium and D3 supplement whether the patch offered would work (and just wear 2 patches). I'll report what they say back.

Yeah my plan doesn't distinguish between D and D3. I'm curious if that is an absorption issue as well. Interesting. Let me know what you find out :)

Here's my dialog with the NUT in my surgeon's office:

Me:  

There is an additional patch offered for Calcium and D3 that has the following vitamins:

That type of Calcium is not going to work because Oyster Shell is another type of Calcium Carbonate which needs acid for absorption.  The Calcium Citrate doesn’t need acid.  Remember Iron and Calcium have to be taken 2 hours apart due to Iron doesn’t let Calcium of absorb.  Also,  you will need to take Calcium Citrate 3 times per day because the body only absorbs 500mg every 2 hours.  These patch can be used for your Vitamin D3 requirement.

Me:

Even if we're talking about a patch on the skin and not an ingested supplement?

Her:

Yes.

Now I don't know what to think. I believe either my NUT is wrong or PatchMD is wrong... has anyone else asked their Dr/NUT specifically?

Now I don't know what to think.

According to the Global Healing Center (not sure the credentials of the site):

1. Calcium Carbonate (the one found in the PatchMD Multivitamin Patches)
A common form of calcium supplement, calcium carbonate is an alkaline-based compound found in rocks, limestone, shells of marine animals, pearls, eggshells and snails. It holds one of the highest concentrations of elemental calcium (35-40%), but is not high in bioavailability and requires the production of extra stomach acid to be absorbed.

Bioavailability refers to the amount of calcium in the supplement that can be assimilated by the digestive system, and ultimately used for cellular activity and health benefits. Calcium Carbonate is currently one of the cheapest and most prevalent forms of calcium supplements sold today. Be sure to avoid this form and check all of your multivitamin / mineral supplement labels.

2. Calcium Citrate
Differing from the alkaline qualities of calcium carbonate, calcium citrate has an acidic base. This acidity requires less production of natural stomach acids, allowing this type of calcium to be better absorbed than the carbonate form. It does, however, have less elemental calcium concentration (20%), and again, low bioavailability.

3. Oyster Shell Calcium  (the one found in the PatchMD D3/Calcium Patches)
While it may seem like a more natural form of calcium, and thus higher in absorbable content, oyster shell calcium, as well as dolomite and bone meal, are difficult to quality-control and have been found to show levels of lead toxins. In general, these “natural forms” of calcium should be avoided.

 Well I don't know your nutritionist so I don't want to say that she's wrong. But I know the patch has been put together by prominent doctors so maybe look at the actual physicians information from the website.  I think it's strange that she saying it still has to be calcium citrate even if it's through the skin. Bariatric patients from my understanding are the main reasons I came up with this patch. And the amount of iron and it is almost double what I'm supposed to take in my supplement every day anyways. So it's my understanding that it safe to take it all at once.  Lora  got her labs back after a month I believe and they were in normal range. I do think she takes extra vitamin D and calcium but for other reasons I believe. 

I just had blood drawn since taking these for 9 months. I will let you know. Taking tons of pills was not working for me.  These are so easy and I only use these and 1 oz of liquid iron once a day.  Fingers crossed my blood work is good.