Vets Vantage Point: Let's Talk About Vitamins

A fairly common concern among RNY candidates sounds something like this: "I can't POSSIBLY take all those vitamins every day!"

Or....

"Those vitamins! They're so expensive I'll NEVER keep up!"

Now, let's fast forward.

It's almost as common to hear comments from vets that sound something like this: "I've just fallen off the wagon where my vitamins are concerned....and now I'm afraid to get my blood work results."

So let's talk about vitamins. Vets and newbies alike are welcome to join with tips and concerns in the comments!

Over the years, I can honestly say that taking my vitamins is one aspect of post op life that I HAVE kept my commitment to. My blood work is steady and right where it needs to be, and I'm grateful for that. My own vitamin regimen includes:

• Calcium Citrate with D - 2 Citrical per day (or 4 petites)
• B1 - 100 mg daily
• B12 - sublingual 1000 mcg daily
• Multivitamin (Centrum or Kirkland equivalent) - 2 per day

I've added....

• 1 probiotic daily (recommended by my nutritionist)
• 1 cranberry extract tablet daily (because I'm very prone to UTI's)

Wait just a minute! Your list doesn't look just like mine? Well, that's to be expected. I am post menopausal, so I don't need an iron supplement. The B12 sublingual has kept my levels in good shape, so I have not needed B12 injections (which, honestly, some prefer). There may be other variations along the way but my point is this: For close to 10 years, this regimen has worked for me. It's the same regimen prescribed by my surgeon - the woman who changed my life. I have stuck to it and can't argue a bit!

Now, I just hate clutter on the bathroom counter and overflowing drawers. So: How do I keep track of them? Early on I invested in 4 simple pill organizers. About once a month I refill them with each day's dose of vitamins. I keep ONE organizer in my makeup drawer, and as I pop open each day's compartment, I know that what's in that compartment needs to be gone by the end of the day. Period! My "stock" of bottles can be tucked into a cubby in the linen closet or another cabinet a little more out of sight.

What about that expense? Early on, I made a personal decision to stick with readily available brands of supplements rather than the more expensive bariatric vitamins. I did a lot of label reading! Cost was one factor, but I also knew I'd do better if I could shop at my local drugstore vs. ordering. I also watch for sales (BOGO is the best of course) and comparison shop between Costco and Walgreens sales. If you're worried about cost, check out this mini breakdown based on today's prices at Walgreens:

• Citrical: .07 each = .14 per day
• Vitamin B1 (Walgreens BOGO sale): .05 per day
• B12 sublingual: .07 each
• Centrum Adult: .06 each = .12 per day

Grand total: my prescribed post RNY vitamin runs a whopping 38 cents per day. (My cranberry and probiotic add .20 per day with BOGO sale prices.) Yeah, I think I can work that into the budget.

Another question that is persistent in WLS circles is about "Flintstones Chewables" post RNY. In a word, the best answer is NO. We're grownups here, and children's vitamins come up short on many key nutrients. Want to know more? Search this forum, or cruise the aisles at your local store and read a few labels. I think the appeal of Flintstones vitamins is that they're chewable, and go down easily in the early post op stages. And I also know that some nutritionists (and even docs!) have limited knowledge of bariatric patient needs in the long run of things, so the Flintstones myth is a persistent one!

RNY friends, we have gone through a lot to get to this post op life. There's a lot that we need to do and learn and integrate into our daily lives.

I am still early out but I would like to chime in that the input from the vets on vitamins, as well as the Bariatric Society recommendation and test results tracking sheet that I found here have been invaluable! Because of the recommendation sheet, I can make good over the counter choices and because of the tracker I can see at a glance if anything is going sideways. My facility keeps all my prior records online for me but having my own set that lets me easily track test over test and see the trend -- HUGE!!

Partlypollyanna,

Where can I find the recommendation sheet and tracker?

thank you so much! ;-)

Can I ask how your iron levels are without supplementation? I have an IUD so therefore no periods, but my doctor still has me take iron-- same recommendation he would make for someone who is post-menopausal.

My last labs are several pages long but the ones that jump out at me are:

Red blood count = 4.24 (reference range 3.9-5.1)

Hemacrit = 41.9 (reference range 34.1 - 44.3)

Hemoglobin = 13.3 (reference range 11.7 - 16.0)

Your question was interesting to me so I checked around a little on line and sure enough there is some research about IUDs (Cu7 which is the one I used for a long time) and drops in iron. Dr. Google can fill you in a little bit there - or your own doc even! From a quick peek, it looks like it may be a preventive measure.

What is your Ferritin level? That is the lab test that is crucial for determining if you need iron supplement changes and/or infusions. It is a separate test from a standard bloodwork panel, such as CBC. If your doctor is not ordering this test then you need to ask her to start doing so right away.

Yes, my doctor is aware of the research. He still has me taking iron because the ASMBS recommendations do not distinguish supplementation guidelines by gender, therefore (we assume) menstrual status is not a factor to be considered.

Thank you for bringing this up Julie. Its a personal pet peeve of mine when I see women on here who say "oh I am post menopausal I don't need iron." If that was true then why do Bariatric Centres & the ASMBS advise MEN to take Iron pills post op, they have never menstrated but they need iron stores just like women do. Why do people want to take the chance of their Ferritin tanking post op, I just don't get it. Hala's experience (see her response below) is exactly what I am talking about...

Vitamins are not something we skimp on either. My daily regiment is similar to yours. I don't take iron either as I no longer have a monthly cycle because of an ablation I had done over 5 years ago. My labs are all within normal range. I took Flintstones early out of surgery but I didn't like them because of the chalky taste so thankful I am able to swallow my vitamins now. Our local paper just had coupons in it for the Centrum 50+ and the Citrical so we saved $11 for our next round of vitamins.

I am 10 years out from a lapband and am having trouble. May I chat with you since I notice you had a kapband? Most of the people in my group at Stanford had theirs remade into a sleeve or something. I'm one of 5 left, I think. Now the Medical Assistant is pushing me to take daily Vit B1 tablets, which I did for 3 months. The darn things smelled so bad, I just didn't care for them. Then she suggested I switch to Bariatric vitamins, much more expensive, I may go back to the Vit B1 tablets. May I ask what caused you to switch from a lapband to a RNY? I couldn't get anyone at Stanford to tell me. I have had problems with food not staying down for a spell and then I am OK for a time.

Thank you! Marti in San Jose