Flintstone a Day doesn't cut it

  The American Journal of Clinical Nutrition has published the article "Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation".   One of the startling finds in their study to me was that only 33% were compliant in taking the vitamins at all.    Their study found that at three months 34% of the study participants needed at least one supplement, by 6 months the number had increased to 59% and by month 24 the number was up to 98%.   The conclusions of the study were (1) a single multivitamin is insufficient post-Roux-en-Y gastric bypass to prevent deficiencies.  In face 60% were deficient within six months and virtually all participants were deficient within 24 months. (2) the vitamin D and calcium deficiency prevalence corresponds with the length of the Roux-en-Y limb. (3) proper and adequate post-operative supplementation may become burdensome and expensive and challenge patient compliance.   I have to say that I was thrilled to see that there was a study done on this subject.  I still get emails that doctors are telling their patients to take a Flintstone a day after their surgery.   This study shows that you absolutely need to commit to much more than that.   I wish they had gone into what those deficiencies are, but I guess that can be for a later study.   I friend of mind developed peripheral neuropathy.   He also broke his leg one Christmas.  After six weeks in a cast, expecting to get his cast off, he goes to the doctor, they X-ray his leg and there had been absolutely no recalcification of the break.   And he was taking his Calcium Citrate.   I think they doubled whatever he was taking.   If anyone would like to read this study for themselves it is located at: or I can email it to you ([email protected])   I was astonished to see in this study that only 33% take their vitamins!

I cannot believe the doctors out there (mine included) that tell folks to take kids vitamins!  From Day 1 I've used Bariatric Advantage chewable multi (2x a day) and chewable iron (1x a day) and I take 500 mg of calcium citrate + D 3x a day (and not with the iron).  I do not miss taking my vitamins..I'm hardcore.  So far, so good--no deficiencies.  I go in a few weeks for my 2 year check up and blood work.

Thanks for sharing this.

Kim

 You look great.  Kudos for you for doing your homework and staying hardcore.    Two years would be the time when the deficiencies would start to sneak up on you, but since you've  been doubling up from Day 1, you sound like you are doing good.   You can probably tell a lot by how you feel.    You may want to consider adding magnesium.   I am big believer and it's one of those things that doesn't get a lot "press".   But you won't get all of the benefits from the calcium you're taking if you don't have plenty of magnesium and most of us are hugely deficient, and most supplements use magensium oxide which is about 4% absorbable (even worse for us).  I've added magnesium oil for transdermal absorption in addition to magnesium taurate.   Just a thought.  Most calcium comes with magnesium but from my reading it may not be enough.   I wish I had done what you had done - and known I needed to double to triple up from Day 1.   I hope your blood work comes up great and keep up the excellent work!   Did you make it to your Goal Weight?

Yep!  I made it to goal at 13 months and have been in maintenance ever since.  Thanks for the info on magnesium--I'll definitely check into it.

Kim

I'm almost 10 yrs post op from RNY and still take my vitamins as scheduled. I have been on Flintstones Complete chewables since a new post op and have never had a problem. I get lab work done once or twice a year and my numbers are still fine. I am a bit high on B-12 so I was able to cut down the amount of sublinguals I take during the week. My bone scans are good (I'm 53 now so get them regularly), and my calcium intake is the same as it was when I was a new post op. I eat a very healthy balanced diet and get a lot of nutrition from my food, and from the supplemental vits and calcium I take. For me the recommended chewable post op has worked well. My doc recommended it to all his patients and many of us are still on the same regiment we have always been on for Multivits, sublingual B-12 and calcium. It works for me and as my labs are good, my energy is good (I work 3 physical jobs) I'll stick to the plan I've been on for many years. Most of us have to find what works for us post op and tweek our food, supplement intake, exercise or water consumption so we are healthy and happy after surgery. As interesting as that study is, it doesn't pertain to many of us who are perfectly fine post op doing what we were told to do at the time of surgery. There are always exceptions and we have to be our own advocate when it comes to our health and our doctor appointments.
Thanks for posting this.
Jen 9+ yrs post op.

I'm very glad to hear you are doing great.   It sounds as if you have been very compliant with your vitamins and your diet.   Unfortunately that doesn't appear to be the case for many post-op RNY patients and the ramifications can be quite severe - as this study indicated.   I didn't mean to vilify Flintstones, merely to say one may not be enough for some whose diet either for choice or from the surgery doesn't provide all the nutrients, especially the micronutrients they don't typically test for.   For example, the test for magnesium levels is quite difficult to perform to get a real indicator of the levels actually in your tissues - as your body will automatically maintain the optimum level in your blood.   Again Kudos to you for doing so well - this is just a shout out for those that are having problems and what they might consider doing to help.   I wouldn't get rid of the Flintstones if I liked them - I would just consider taking two or three a day.   I do realize that for every one with problems there are two-three that are just fine - but I just feel 30% is too high to not try and get the word out.   No offense intended to you or Flintstones and for making such good choices from day 1.