Question:
Long Term Post Ops: Caffeine and Vitamin D issues

Hi - as someone who has had serious health issues in the past (but 2 1/2 years post op lap RNY) I am still in close contact with my endochrinologist. When I had labs done at my 2 year WLS app't. my Vitamin D levels were checked. Although it was not flagged by the lab, and not mentioned at my checkup then, my endochinologist noticed the level at my appointment this week. It was pretty low. Low enough to precribed an elevated amount of vitamin D. <br><br> It is worth mentioning that I drink a fair amount of caffeine as a post-op, and my nutrition is rather poor, as I am prone to a huge lack of appetite (this is present with or without caffeine, so don't bother :) LOL. <br><br> With the lab info in hand, I checked out Medlineplus.org, a website highly reccommended by my medical librarian friend. This is what it had to say regarding caffeine and vitamin D:<br><br> http://ods.od.nih.gov/factsheets/vitamind.asp <br><br> Vitamin D and caffeine:<br><br> High caffeine intake may accelerate bone loss. Caffeine may inhibit vitamin D receptors, thus limiting absorption of vitamin D and decreasing bone mineral density. A study found that elderly postmenopausal women who consumed more than 300 milligrams per day of caffeine (which is equivalent to approximately 18 oz of caffeinated coffee) lost more bone in the spine than women who consumed less than 300 milligrams per day [58]. However, there is also evidence that increasing calcium intake (by, for example, adding milk to coffee) can counteract any potential negative effect that caffeine may have on bone loss. More evidence is needed before health professionals can confidently advise adults to decrease caffeine intake as a means of preventing osteoporosis. <br><br> So. Yet another reason to ease up on the caffeine, along with the fact that I suffer monster migraines as was ordered off the junk by neurology the same morning, or else :)<br><br>I should mention that I do get plenty of sun (both outside and tanning), so I don't think that is an issue... this is just an FYI about caffeine.<br> Thanks! -shelli    — kultgirl (posted on July 1, 2004)

July 1, 2004
I am 17 months post op with pretty darn good blood work. I take calcium, multis, Vitamin A,D,E and K along with B12 sublinguals. I was at my gyn a few months ago, and my bone density was off the charts high. My wls surgeon says that Vitamin A and D defficiencies are not uncommon with post ops. I don't know about caffiene and D, but I am going to a post op with him next week after having my gall bladder out and ai will ask his opinion. Feel free to e-mail me back after next Thursday. I do though, in general, stay away from caffiene due to the diuretic effects, for approximately 90% of what I drink/eat.
   — Fixnmyself

July 2, 2004
Thanks for this info, Shelli! My endo also checked my Vitamin D after my bone density test indicated a derease in bone density, and he also found that my Vitamin D level was low, and also ordered more Vitamin D for me, too. (This, despite me having taken quite a lot of D with my 1500 mg. of calcium citrate, but now I take D separately as well, with magnesium, and even *more* calcium citrate.) I drink a lot of cystal lite peach iced tea, and snapple peach iced tea, and I guess I'm gonna need to face up to the fact that they've both got more caffeine in them than I should be having, with my bone density issues. :-( Thanks for the info!
   — Suzy C.

July 5, 2004
Be aware that even proximal RNY people malabsorb some A, D, E. The Rx D is sooooooooooooo expensive, or at least my co-pays are frightening. I've worked with the dry form of D to maintain really nice levels (and I'm ridiculously distal) now. But then, I think everyone needs to take high doses of calcium citrate + D AND extra D from day 1. The problem is often getting someone to test the levels routinely. You would not believe how common rickets is among "us". In America. Yes. And in "fat people". Rickets. Amazing. Take your D. (preferably D3, in dry form)
   — vitalady