Bariatric Vitamins

You don't need a bariatric-branded vitamin or chewable. If you buy those from your doctor, they're just a revenue stream for them. I take 2 One A Day Women's 50+ Healthy Advantage multivitamins a day. I take them because they don't contain iron, which I supplement separately because calcium and iron impair absorption of each other, and I buy them at Costco to get the best price. I also take heme iron, calcium citrate, vitamin D, B12 sublingual, and magnesium.

Usually an all-in-one pill won't contain the right type or amounts of vitamins you need. And what is required is unique per person and needs to be determined based on lab results 1-3 times a year.

I had to do a chewable for the first couple of months but now can do regular one a day, but to get the minimums, even the one a day has to be taken twice a day, plus the calcium at a different point in the day. Right now, at 5 months out, I take a multi with iron in the morning and At bed time, and two calcium chews mid day, plus a b12 shot 1x a month.

the veterans here strongly recommended tracking your vitamin levels so you can see trending and I am doing that as well.

I'm not a real vitamin expert, but I will share what I know from my experience.

First, good news and bad news. The bad news is that there is no such thing as one pill that will meet all of our needs acceptably. Not all of the vitamins can be combined at once, such as iron and calcium, so taking them in one pill wouldn't work. Also even the bariatric vitamins don't have enough to only take one for the day. Plus the bariatric vitamins are terribly overpriced and it is not necessary to have chewables after the first few months.

I suggest finding a good multivitamin and taking it twice a day (you will need double the normal amounts to absorb enough). You can buy the multi from any reputable company but read the label carefully to be sure that it has full values.

Bariatric patients also need "extra" vitamins because their bodies don't absorb enough from their food. Extra iron is really important because it is very common to become anemic. Watch your ferritin levels like a hawk! Also it is very important to take extra calcium to avoid leaching calcium from your bones. Again as others have said, you can't take the iron and calcium within 2 hours of each other and your body can only absorb about 5-600 mg of calcium at once. That means taking spaced doses. I have also found that to help the absorption of the Calcium I need to take extra K2 and D, so find a Calcium supplement with these added. Also make sure that it is Calcium citrate, not carbonate.

Other vitamins that are really important are B12, Zinc and Magnesium. I started out taking B12 daily, but when I had my labs done, it was too high so I only take it 3 times a week now. As for the Zinc and Magnesium, many multis don't have enough of these and they are very important. As for Biotin for hair loss and skin, don't waste your money. It really doesn't help as much as sufficient protein and healthy fats.

The take-away from this is 1) don't waste your money on overpriced "bariatric" vitamins; 2) you don't need chewables with the exception that B12 MUST be sublingual; and 3) there is no acceptable 1 pill-a-day that will give you what you need. If 5 pills at once is too many, find some combination pills and spread them out throughout your day more. It is a bit of a pain, but you will get used to it and it is part of the commitment to long-term health.

Edit: Oh yeah, and like "Polly" said, take responsibility for your own health and get regular (every 3-6 months) labwork. My surgeon isn't very rigorous about it, so I have had to ask my PCP to write for the tests and I keep track of them personally. Not every doctor is as good about monitoring your health, but it is vital that you do it for yourself!

So right now, I take the Celebrate brand bariatric vitamins (with Iron) and a separate 500mg calcium citrate chew 2 times a day (spaced 2 hours apart from each other and from multi w/iron). I do use the chewable multi because for some reason you only need 2 per day and with the capsules you need 3.

although they may be more expensive than regular mutivitamins, I like the fact that they contain 200% of all my recommended vitamins so I don't need to supplement with extra's which would be an added expense on top of the multi anyway...so It kind of evens out. I also buy them in bulk from bariatricpal online so they are discounted as well as getting coupons and perks for each purchase.

I am only 5 months out so not sure how it will work in the long term but my 3 month labs were perfect and my B12 was even high because I was supplementing with extra B12 when I didn't realize the multi already had enough in there.

for me, the extra $15/month for the convenience of not having to take several extra pills per day is worth it...and I have the peace of mind that the vitamins are specifically formulated for my specific absorption needs.

Awesome feedback! That is the company I use for vitamins too! I hope I have great lab work like you do, thank you so much for your feedback I feel much better now!

Another reason that doing regular labwork is important is that each body's needs may be somewhat different. Some people can absorb and retain more vitamins than others. Also when you first have surgery, your body probably has reserves (particularly of Iron and Calcium), but as the months and years pass those reserves are depleted and your lab values may plummet even if you are taking "enough" vitamins. It is not unusual for people to need B12 shots or iron infusions even if they are taking appropriate amounts of their vitamins. Also bone density can plummet as calcium is leached from your bones. You may need to continue to adjust the types of vitamins that you take, the amounts and also supplement with injections and infusions. Don't wait until you have symptoms and complications to find out that your blood levels are too low.

I made a post a while ago that details what the ASMBS recommends as far as vitamin amounts. The good news is that you can hit those levels taking a double-dose of a complete adult multi (like Centrum), plus some additional calcium and iron.

https://docs.google.com/spreadsheets/d/1OO_3Nse1GJYJ0izLO9kF v2v32hkDX0N6yZVfH8jBnpw/edit?usp=sharing