Question:
How do I know whether I neeed Iron and B-12 supplements

How do I if I need to be taking Iron and/or B-12? (Open RNY 6-12-03)    — Cosmo K. (posted on July 16, 2003)

July 16, 2003
From the labs that your doctor will do regularly. Some folks take them all the time anyway but the best thing is to wait until your doctor tells you.
   — Delores S.

July 16, 2003
I am under the impression that iron supplements should be taken as a matter of course, as iron is one of the things we malabsorb (assuming you had the RNY). There are threads in the library talking about what type of iron to take (or maybe somebody will chime in on this -- I'm on a prescription one, so I don't really know the type). As far as B-12 goes, get copies of your lab reports as you go along. If you want until your doctor tells you to take B-12, *he* may not notice if your B-12 levels are dropping (but remaining in the normal range). I noticed a lack of energy, got my lab reports, and noticed my B-12 levels were within the normal range, but had been dropping steadily. Docs typically won't notice that; they wait until you drop out of the "normal" range to tell you to supplement. I discussed my lack of energy and dropping B-12 levels with my doc, and did B-12 sublinguals until I felt better and my levels rose to a better level for me.
   — Suzy C.

July 16, 2003
Hi! The other two posters are correct... if you want to be safe, take a slow-iron supplement... slow iron is a slow release iron supplement that reduces your chances of constipation. Also, by the time they notice you are low, it takes a minimum of 180 days to get back into "normal" range... (with iron, at least)...
   — Sharon M. B.

July 16, 2003
Iron is absorbed primarily in the upper intestines, which is bypassed in both proximal and distal RNY, so unless you eat HUGE quantities of iron rich foods, you will have to supplement with iron tablets (or liquid, if you can stand the taste). I was faithfully taking an iron supplement daily with 18 mg of elemental (the amount that is actually absorbed) iron - the FDA recommended daily allowance - and my hemoglobin counts dropped to below 10. I switched to a supplement called Vitron-C, which has 65 mg of elemental iron, and within 2 months, my hemoglobin counts came back normal. As for B12, if you are having a RNY, you MUST supplement with either sublingual B12 tablets or B12 shots. You need the intrinsic factor in order to breakdown B12 (in either food or supplements) and this factor is always bypassed in RNY.
   — Cyndie K.

July 16, 2003
I take a multivitamin with iron (prenatals) twice daily and my iron levels have been excellent. Most doctors have their patients take B12 as a precaution. My surgeon recommends a sublingual once a week but I don't like them and he gives me the shot once a month. When my labs were checked last, and I wasn't supplementing B12 at that time, my B12 levels were normal. I'm 19 months post-op and so far my labs have always been excellent. So, listen to your doctor and if he recommends iron or B12, take it.
   — Patty_Butler