Question:
I am so confused about the viamins!! Can someone help me w/Iron & b-12 questions?

I am actually pre-op. Trying to stay as healthy as possible before surgery to help with a better recovery. My Dr. gave me a list of vitamins that we are to take post-op. I am currently taking a multi-vitamin that has iron in it. Is it okay to take an additional iron supplement? I will not overdose, will I? Also about Iron, they say not to take it with yogurt, breads etc. So if you do have a sandwich with bread how long after you eat, should you wait to take the iron? Secondly, the paper the Dr. gave me says 500mcg of B-12. All I could find is 100mcg of B-12. Is it okay to just take 5 of them to equal the 500mcg recommended? Also, is this the vitamin that helps with skin & hair etc.? If not which one is it? Sorry about all the questions but I just want to make sure I'm doing this right! Thanks for your help!    — Allison T. (posted on December 29, 2001)

December 29, 2001
Wow! Sounds like they have overloaded you with information. First, step back and take a deep breath. Every surgeon is different but let me give you an idea of what is the protocol from my surgeon. I take two chewable Flintstones every day (one in the am and one in the pm), 4 tums per day for calcium, and iron pills. My iron pills are by prescription only. The reason being is the quality of iron you buy off the shelf is not too high. As a woman I need lots of iron and mine also has added folic acid (which is important in childbearing years). It is more costly but has gotten rid of the horrible anemia I had before surgery. I take my meds with a full glass of water first thing in the morning and then wait at least thirty minutes before eating. This may upset some stomachs but not mine. I also take prescription Prevacid to prevent ulcers. As for B-12, I am going to start giving myself shots. It sounds yucky but again because of our new bodies we don't absorb B-12 well through the tummy but better through shots. Other vitamins, stay away from them. Your body can only absorb so much right now and you don't want to bombard it with stuff that is doesn't necessarily need and keep your body from absorbing the good stuff you do need. Most importantly schedule a time to talk to your surgeon or his/her nurse to work this all out BEFORE surgery. After surgery is no time to try to figure it out. Sorry I was long winded, but I hope this helps. I would always love to talk further, so email me at [email protected]. Best of luck!
   — purdue_1993

December 29, 2001
You don't say what type of surgery you are having but if you are having the RNY here are some observations that I have learned from Mother Michelle aka Vitalady. I'm sure she'll answer this question to and much better than I can but first off, if you are having RNY do not waste your money on buying B-12 pills. You will be losing the portion of your stomach that creates intrinsic factor, which is necessary to absorb B-12. Without intrinsic factor, taking B-12 pills is worthless. You can take sublingual B-12 or injectable B-12. As for iron, from what I understand from Michelle, iron is best taken alone on an empty stomach with vitamin C to aid absorbtion. What I do is take my iron at bedtime with a glass of orange juice. Hope this helps some.
   — Kellye C.

December 29, 2001
First, Relax:) I take b12 shots, or you can get b12 sublinguals (melts under the tongue) at gnc, they are cherry flavored. Take iron with c, but do not combine iron and calcium. Iron blocks calcium absorption. With all due respect to the previous poster don't bother taking tums for calcium. Several tests have shown calcium carbonate, the calcium in tums, simply doesn't absorb for us. Calcium citrate is the most absorbable form. Take about 1000-1200mg a day, but spread it out as you can only absorb 500 mg at a time, this is all asuming you've had the rny. Take extra iron if you are a female who is still having periods. Otherwise ask your dr if you need extra. It sounds like a lot now, like you will be taking pills all day long, but it's amazing how fast you will get used to it and it becomes second nature. Good luck,
   — Becky K.

December 29, 2001
Actually, no disrespect to the previous poster, but you CAN take calcium carbonate such as in Tums vs calcium citrate... the only difference is that calcium citrate gets absorbed into your system at double the rate of calcium carbonate... I chew 3 Viactives a day (caramel flavored and made of calcium carbonate) and all of my blood tests have come back normal for calcium. It does not matter to be how fast my system absorbs it... just so long as it does. Good luck!
   — Kellie Jo B.

December 29, 2001
I buy my B-12 from a company called Nature Made (yellow label...you can find that brand at just about any grocery store, Wal Mart, CVS, etc.) Each pill is 250 mcg. After reading the answers to your post, I think I might get the sublingual kind though.
   — [Anonymous]

December 29, 2001
Well, yep, there is a sublingual 500mcg, Twin Lab is the brand. Iron + C need about an hour together, alone. Hopefully, you will have labs pre-op and then again at 3 months, and YOU will look at them yourself and file the copies for reference, and so then your iron levels will be safe because you will be paying close attention. B12 is not the hair, skin, nails thing. That's be bioitin & folic acid. They won't check your biotin levels, but should check folic acid in your labs. And addressing the calcium issue. Carbonate IS marvelous to store calcium in your blood, however it is useless to put the calcium into your bones. Carbonate to keep the nice bloodwork, perhaps, but citrate for the bones. I was fooled by bloodwork for years, right into osteoporosis and I assure you, I am WAY too young for it, or at least *I* think so.
   — vitalady

December 29, 2001
It's my understanding, through research and talking to drs, that blood tests really don't tell you what's going on with calcium. Parts of the body that need calcium, including blood, will leech it from your bones and teeth to fill in the need. Your blood can be testing fine for calcium as your bones crumble. By the time your blood actually shows a calcium deficiency you are in big trouble. The only accurate way to determine the calcium in bones is a baseline dexascan, then comparing it at a year out etc. I am a big believer in trusting your dr, but if my dr told me to take tums or carbonate in any form and i did the research I have, I'd take both forms just to be safe. I had done all the research before even looking into wls because synthroid, a medication I'm taking for hypothydroism, also interferes with the bodies ability to absorb calcium. I have a triple whammy, female, on synthroid, and now rny:) good luck
   — Becky K.

December 30, 2001
While it is true that your body will take calcium from wherever it is needed, it is not true that there are no blood tests out there that can check your "real" calcium level. There actually is a blood test that is considered "highly sensitive" for calcium in your body. It is called a Para-thyroid test and you have to specifically ask for it or they just run a normal "screening" or "panel" to check all your levels (including potassium, iron, B-levels etc...). In addition to the Para-thyroid test, I also get a dual energy X-ray densitomtery (DXA) test, an ultrasound of my heel to measure bone mass and a urine test to determine calcium. I am part of an ongoing bariatric study through the Division of the University of Pittsburgh that is conducting a study on Osteoporosis in people who have had WLS. It is the first one of it's kind in the United States. I have to have the tests done 5 times over a period of a year... Just wanted to clarify the answer I gave before regarding the use of Calcium Carbonate vs Calcium Citrate a little more.
   — Kellie Jo B.