Supplement Question

What if anything are you all doing for supplements? I started off taking extra D and B-12 plus 2 multi vits a day and calcium carbonate 3 times a day. My D levels got to toxic levels probably 2 years ago so I stopped that. My B-12 is in the too high range, so I went down to 1 multi vit about a year ago. B-12 is still a little high. I am still taking the 1 multi vit a day and the calcium but all of my levels have tested normal except for the B level being too high. I don't I am tested for Calcium. I'm thinking of stopping the calcium. I eat yogurt probably 5 times a week and between my protein bar and the 1 MV, I get 30-40% of my DV of calcium. Just wondering what you all still take this far out???

First, you should know I am bad about taking medication :) So, that is my baseline.

Long ago, with CA diagnosis, I was found to have vitamin d in the teens. So, I of course supplemented because CA dx is one thing that scared the dickens out of me.

By the time I was tested with vsg, vitamin d level was very high, I sort of cut back, then eventually just defaulted to what is in my Calcium.

My b12 level was elevated too so I stopped taking that. I stopped taking MTV, I don't know why except always a bit of nausea. I never took iron because I had high ferritin which was probably inflammatory according to my hem-onc.

With VSG testing, I was incidentally found to have elevated PTH related to low calcium. This was worked up by endo and they found I am a calcium hyper-excreter. (Supah calcium excreter!) This has nothing to do with VSG, by the way....probably genetic. So, PTH was elevated because it was trying to compensate for low calcium.

So, I then had a double reason to take a CA supplement: VSG plus secondary hyperparathyroidism. Still, I wondered, tho, would my massive yogurt intake be enough calcium? I stopped Calcium, was checked, and no....yogurt is not enough. I restarted calcium and now PTH is normal. (I also have to take hctz because a side effect of hctz is to retain calcium. So, it helps my calcium but gives me a side effect of very low bp. How cool is that?)

I was also found to have low magnesium and I do try to take that....it helps with CA absorption, too. Maybe better sleep.

I have labs late next month.....for VSG. The calcium and vitamin D have been pretty well covered by endo department. (Vitamin D now lower third of range of normal just on what is in calcium supplement)

That's my story.

OH! By the way, calcium levels are sneaky. The body will use PTH to take calcium from bones to keep serum levels normal or near normal but the bones would be paying the price in the background to the eventual point of osteopenia/porosis.

Also, from the endo doctor who is also an obesity expert....in his opinion, VSG patients simply don't have nutritional deficiencies like RNY. He said of course it COULD happen, but typically, there was something else going on.....like there was with me. I am a hyper-excreter per urine collection....there is nothing wrong with absorption. It had nothing to do with VSG.

I'm not saying people should quit their vitamins, tho. Not in the least.

Here's my daily vitamin regimen:

1 Centrum Multi adult

630 mg calcium citrate (neither VSG doc nor regular PCP want me to take carbonate) with D3 (am supposed to take 1500 mg per day, but my levels are good at this supplemental level)

5000 iu D3 (PCP prescribed this level. He found my levels to be low for his liking, but within normal limits)

B1 3 times per week

2500 mcg B12 twice per week

E (I forget how much)

Fish oil (when I remember)

4 mg copper daily (my levels are low)

My levels are all good. Of course, B12 is always high. Copper is always low. I think it's PTH that measures the calcium and that's fine.

So there you have it.

So this is what I've been told: Since VSG does not have malabsorption, that is not an issue with vitamins. However, because our stomachs are smaller, we may not get the nutrients we need which is why my surgery center puts us on the same protocol as RNY. I'm not as far out as you, but the last time I checked everything was in normal range except B1 and B12 were high, but my surgeon didn't think it was a cause for alarm.

I take Bariatric Advantage Ultra Multi Formula with iron (3 capsules a day) plus 1500 mg of calcium citrate with vitamin D 3 times a day (chewable) - all taken at least 2 hours apart with the multi also at least 2 hours away from coffee. I may change to something else though as they are expensive AND they keep messing up the order (sending them to a Florida even though that address was removed from the account - I had to call 3 times to get them last quarter because their help people are helpless and I've already put 2 calls in this quarter with it looking like a third is needed).

I still take my bariatric chewables because they are easy. The brand is Optisource. I also struggle with hair loss from PCOS so I take some hair supplements that probably don't do anything but make me feel like I have some sense of control. I take a vitamin D too, but I don't know if I really need that still (I was low once, but my last tests were good).

There are several things I was told to take by my plastic surgeon because of my slow healing... I'm anemic for the first time in my life so I take iron supplements, extra vitamin C with those, and magnesium, zinc, Arginine, and a B super complex.

Bottomline, I probably take more than I need and have very expensive pee as a result.

All Dr. Cirangle's protocol for vsg is double dose of multivitamin and of calcium citrate. I do two multi chewables twice a day and 1200 calcium twice a day. I am scheduled to do the full blood panel here in a few weeks for annual physical. Haven't done that in a few years now but it was always totally normal. Dr. C says there is something about calcium and vsg that makes you need extra. Even though I eat lots of calcium rich foods I am borderline osteoporosis and I am kind of expecting that will come on - in the family. So thats the dope on all the dope. I am getting calcium now via half and half in coffee. They should make a half and half with extra calcium. Milk has D added. Diane S

Thanks for all of your input friends. Sounds like I should keep up with the calcium. I do take citrate, not sure why I typed carbonate. I also take an iron tab with Vit C and a probiotic daily. We do have Osteoporosis in the family as well so I guess I should keep up with the Calcium for sure.