Question:
What vitamins are the best for us
What calcium supplament is best and how much do we absorb? I was looking at the liquid filled calcium caps and was wondering if they absorbed better than the non liquid ones. Also, does anyone take herbs for anything, and how do they work. — Lisa J. (posted on November 29, 2002)
November 28, 2002
Calcium supplementation can be a complicated issue; but there are a few
simple rules to follow that will probably keep you in good shape.
<ul><li>calcium CITRATE (Citracal calcium citrate and many
others) is the form we absorb best after RNY or other malabsorptive
procedures. Calcium CARBONATE (Tums, Viactiv, Caltrate, many other brands)
requires exposure to stomach acid for one hour, an environment we can no
longer provide, and it is also implicated in kidney stone
creation.</li><li>Calcium is absorbed in about 500 mg doses.
More than that at a time is a waste (though the brand I use supplies 630 mg
a dose, and I see that little bit extra as
"insurance").</li><li>Most adults need 1500-2000 mg a
day; that's 3-4 doses.</li><li>Optimum calcium absorption
happens when you take Vitamin D along with it. Many tablets are formulated
with 200 IU Vitamin D per dose for this reason. It's hard to get enough
Vitamin D from sun exposure during the winter to meet the 400 IU a day
requirement, and it's also hard to get too much Vitamin
D.</li><li>Calcium absorption is also facilitated by the
presence of magnesium (half as much as the calcium, so 250 mg magnesium for
every 500 mg calcium) and boron; 1 mg is the common amount of
boron.</li><li>Calcium directly competes with iron for
absorption sites in the small intestine; for this reason, make sure there's
at least two hours between your calcium and your iron
supplements.</li><li>To make sure you're getting the amount of
calcium you think you're getting, read the label carefully. It should say
"calcium (as calcium citrate)", "elemental
calcium" or "elemental calcium (as calcium
citrate)" on the label where it lists the RDA values. If it just
says "calcium", there's no way to tell if that's
ELEMENTAL calcium, or the total amount of calcium citrate, which are two
very different things.</li><li>Twinlab makes a chewable calcium
citrate; Sundown makes a liquid calcium citrate; and there are other
alternatives in liquid and chewable form, if you find that you cannot
stomach the large calcium tablets or capsules. However, scary as they look,
those big calcium tablets/capsules all dissolve within 5 minutes of hitting
your pouch, thanks to the combo of saliva, water, and body
heat.</li><li>Finally, calcium is best absorbed when your bones
are not supporting your weight, so make sure to take your last dose each
day right before you go to bed.</li></ul> I hope this
information is helpful. Calcium supplementation has been debated many
times, especially on the Graduate-OSSG Yahoo group, but the bottom line is,
we need it to keep our bones healthy, and calcium citrate is the best form
for us; the NIH says that calcium citrate should be the supplement of
choice for seniors and anyone else with reduced stomach acid.
<p>As for herbs, if you think my calcium list is long, an entire book
could be written about herbs and their use. :-) Fortunately, many good
books exist, and things are not much different for those of us who have had
WLS; in fact, I've heard a few naturopaths who are familiar with herbs and
WLS say that we actually can get MORE benefit from herbs since we don't
have stomach acid to denature some of the active ingredients in herbal
supplements. I don't know if that's true, but I recommend that you consult
with someone who has experience with herbal medicines if you are interested
in using them.
— Julia Z.
November 28, 2002
By the way, I forgot to mention that I have a long reading list of
scientific articles, peer-reviewed studies, and papers published in medical
journals, if people would like the list of citations for the material in my
answer posted here. Just email me, and I'll send it to you. I've done over
200 hours of research in this area, why should you have to do it over
again? :-)
— Julia Z.
November 29, 2002
I am 7 weeks post-op. When I first got home, I was taking Citracal for my
calcium. They are HUGE pills, and I had a difficult time getting them
down. I ordered some calcium capsules that are available on
www.vitalady.com. They go down soooooooo much easier, and you can also
open them up and add it to something to eat if you need to. Good luck!
— Want2bslim
November 29, 2002
BEING A YEAR OUT OF AN R,N,Y, OPEN, AT GOAL. SINCE THE OPERATION MY
DOCTOR TOLD ME TO TAKE A FLINTSTONE COMPLETE ONE IN THE MORNING AND ONE AT
BED TIME.. THEY ARE CHEWABLE, TASTE GOOD, AND ALL OF MY BLOOD WORK HAS BEEN
PERFECT SINCE THE W.L.S. IF I WOULD HAVE OFF IN SOME AREA HE WOULD HAVE
DEALT WITH THAT. BUT ALL HAS BEEN PERFECT.. GOOD LUCK
— bruce M.
November 30, 2002
Bruce,<br>I want you to ask your doctor when you are going to have
your bone density checked via a DEXAscan (Dual Emission X-ray Absorption).
Because the bloodwork you are having done doesn't mean a thing when it
comes to calcium and the strength of your bones. Your body will rob calcium
from your bones and teeth to circulate in your blood if you are not getting
enough from food and supplements, so the blood levels will seem normal, but
your bones are being depleted. Two Flinstones chewables will leave you
depleted (eventually, if not quite soon) in calcium, vitamin B-12, vitamin
E, and vitamin A, all for sure, and potentially vitamin D and iron as well.
Flintstones chewables are a good choice for the first few weeks when
regular tablets are too challenging, but we do not absorb many vitamins in
that form; the fat-soluble vitamins MUST be in DRY form for our bodies to
grab them; the vitamin B-12 must be administered sublingually or via
injection for our bodies to get them because we no longer have intrinsic
factor available in our stomachs, and the calcium must be in the form of
calcium CITRATE, because calcium carbonate, contained in Flintstones, needs
one hour of exposure to stomach acid to be converted to a form that our
bodies can process. <p>I'm sorry, but surgeons are great and cut and
paste, rearranging our bodies to give us a weight-loss tool. Most of them
have NEVER had any formal training in nutrition in their entire careers.
ZERO. It's up to us to own our health, to do the research, and to speak to
the people that do know, and then tailor our supplement regime to suit us.
It's also up to us to get and maintain copies of ALL blood test, DEXAscan,
and other test results so that we can compare trends over time. PCPs and
surgeons look at only one set of results at a time, and what looks good on
first glance might actually be a poor result for you if the result has
fallen to a low-normal range from a high-normal or normal place FOR
YOU.<p>I'm sorry to lecture but I strongly believe that each of us
has to own our own health. Most of our doctors will be retired by the time
osteoporosis is likely to set in from deficient calcium... they will not
see the results of their recommendations. You will, though, when you are 45
years old and have a broken hip. I hope this helps you to re-think your
supplement regime. Vitamin, mineral, and protein supplementation
requirements are one of the great silent areas about this surgery; many
people have no idea what they're getting themselves into for the rest of
their lives when they have this surgery because nobody tells them and they
don't know to ask. Good luck, and feel free to email me, or to do research
on www.vitalady.com if you have more questions about post-op nutritional
requirements. Open RNY 09/17/01, 310/128/125, perfect blood work AND
DEXAscan :-)
— Julia Z.
December 1, 2002
HI LISA...
JUST READ YOUR POST...I AM TAKING A PRODUCT CALLED SEASILVER THAT IS A
COMPLETE LIQUID NUTRITION INCLUDING CALCIUM AND ABSORBS DIRECTLY TO YOUR
BLOODSTREAM WITH 98% ABSORBTION...PLEASE CHECK OUT MY WEBSITE AT
http://www.myseasilver.com/HEALTHBABE THERE IS ALOT MORE INFO THERE....
— KATHY C.
December 1, 2002
Lisa,
I just had surgery on 11/26. My surgeon suggested I take Flintstone
Chewable Complete 2 tablets a day for my vitiamns. For my Calcium he
suggested tums. Hope this has helped.
— Lana Rush
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