Question:
I was reading the complications forum......

I will be doing RNY in a couple of months and was reading the complications forums and I noticed a bunch of people 4-5 years out were having issues with their teeth rotting. Most of them said they took their vitamins. Is this an adverse effect for everyone to expect? Any feedback is appreciated.    — buggyboot (posted on April 5, 2009)

April 5, 2009
Many post ops do not take their vitamins. Also many post ops fail to take calcium citrate also. Both are very important for calcium in your body. My support group leader had RNY some 9 years ago. Her surgeon back then said to use calcium carbonate (TUMS). She switched to calcium citrate a few years ago, but the damage is done. A few years on the wrong calcium ,and she has a lot of dental issues. DAVE
   — Dave Chambers

April 6, 2009
Hi Michelle! Many people do take their vitamins, but I'm not sure they get their blood work done. If you don't have blood work done then you don't know if the vitamins you're taking really have your body in balance. The trick is to take your vitamins and get your blood work done to be sure you're not deficient in any areas. I am 2.5 years out from lap RNY and at goal weight for 1.5 years. I take bariatric advantage multi vitamin, B12, slo magnesium, and zinc daily. Blood work is great.
   — waferqueen

April 7, 2009
YES...mal-absorption is a HUGE part of RNY surgery taken for granted. Many RNYers do NOT take vitamin taking schedules seriously (I know I didn't after year 2-3... I thought I was pretty normal after that time and eating quite well...HA! Little did I know!)...I do not believe that many surgeons have a "great" long term maintenance program/information...Many WLS people stop seeing their surgeons after a year...(For many reasons) Regular docs treat us like we have a regular anatomy and that's not very helpful at all! Long term care is not discussed nearly in depth as it should be. Particularly about vitamins and labs. There are many surgeons skilled at the surgery they are performing and not so much in the nutrition and after care...Too many trust that they only need to chew a couple of kids vitamins for the rest of their life and that's that! Some RNYers have NO clue how their surgery affects vitamins and that SOME vitamins cannot be absorbed any longer because of the anatomy changes...I had a GREAT Registered Dietician and class before surgery and still nothing prepared me for the deeper truth of long term health maintenance...and like soooo many I was very casual about vitamins and labs after so many years. But I did at least learn the I had to take Calcium Citrate with Vit D3 and preferably magnesium for a good balance...I also learned the B-12 had to be sublingual and possibly... shots! It was suggested I take iron as well and nothing time released...And I learned that some vitsmins had to be taken away from others because of absorption conflicts...But no one explained in detail just how important VITAMIN labs were. OR that certain forms of fat soluble vitamins were needed...or that kids vitamins were not nearly the right doses needed to maintain health long term and neither were some adult chewables because they were not in the correct forms of vitamins for RNY...OR that Iron and fat soluble vitamins are toxic, and do not absorb well in the RNY body because fat is malabsorbed! NO ONE ran a full set of vitamins on me pre op or post op for 5 years! I just assumed that my yearly visits with labs were fine because doc said "labs look good"! NO ONE WAS RUNNING them ALL until I became anemic and we looked thru my medical records and found only basic CBC's...PREVENTION is possible, but YOU have to be your own health care advocate and get labs yearly and make certain they are taking some 20 tubes of blood for the vitamins tests! If they are only taking 1-3 tubes...You are not being tested! Then get copies of the labs and compare to last labs for vitamins dropping. Taking a kids chewable is NOT going to prevent vitamin deficiencies. Most show up at year 3-5. That's why so may new post ops believe they are fine taking the bare minimum in vitamins because their vitamin stores have only slowly been diminishing and NO ONE is telling them as long as they are in normal ranges! BECAUSE no one really cares all that much about your own health as you do...SO become involved in your own health care and demand all vitamin labs be run at least yearly! This way if you want to take kids vitamins and not take all the others on a schedule all day long, you can at least see for yourself how well that's working out for you! (Most likely it's not working well at all, but at least you'll see for yourself!) http://www.ajcn.org/cgi/content/abstract/87/5/1128 Read this study from the American Journal of Clinical Nutrition...I read all the studies on RNY and Health. This one in particular I even keep on my profile. PS: Vit D deficiency is very common in the US so not only RNYers are having trouble with crumbling teth and broken bones but many regular folks as well...WHY? All the sunblock we use, all the antacids we use (Which block Calcium and Vit D absorption just like an RNYer!) Knowledge is power for prevention...I see people respond to questions with "just listen to your doctor" and that's their only wise and wonderful advice ::::Sarcastic look::::: Know your Surgery...LISTEN TO YOUR BODY and it's signals/symptoms/warnings! AND make your DOCTOR listen to YOU! That's MY advice from experience!
   — .Anita R.

April 7, 2009
I can't really respond objectivly because I have had dentures since in my early 20's. How ever my surgeon did tell me that since i have not worn the bottoms for more that 10 yrs that I do need to get a new full set so I can chew my food better.
   — abuddingrose

April 9, 2009
I didn't post this question but as a person preparing for the RNY procedure I want to say....Thanks Anita, your post was very thorough, detailed and extremely helpful!
   — crystal220