Question:
Can someone please help me with a vitamin regimen. I read the questions already

posted on the subject but they are so conflicting. I had open RYN 11/27/02. I was anemic prior to the surgery but after surgery I am not able to take my iron supp (feosol pure form) or my multi vitamin (time released/ can't crush). I know I seem to be clueless but in a sense I am. Do wls patients not take regular multi vitamins because of their size? At just about 5 weeks post op I still am not able to swallow huge amounts of water without experiencing discomfort, so the smaller the pills the better. If there is someone who can post or e-mail me ([email protected]) a chart of the vitamins and quantities I should be taking until I get my labs back that would be great I could make the necessary adjustments after I get my labs back next week. Thanks and sorry this is so long..    — Tiffany S. (posted on December 31, 2002)

December 30, 2002
Hello Tiffany! I agree it can be confusing, since we are all different people with different surgeons, and some of us had different surgeries.. there are a multitude of answers for your questions. My first instinct is to suggest you contact your surgeons office and find out their advice in regards to you and your surgery type. Many vitamins can be ordered in liquid form, and I *think* iron is one of them, though I'm not 100% on that. As a post op BPD patient, I don't have the limited capacity that an RNY patient does, so sharing my regime would be more confusing to you than helpful. The only SOLID advice I can offer you is to not take your iron and calcium in the same time frame as they will negate each other. I too was completely clueless, I KNEW what I should be taking but it took me a couple months to get my own regime down properly. There is a great chewable multivitamin that you might ask your surgeon about, it's called ADEK. It's a fat soluable that I use twice a day, with a pleasant orange flavor. I'm going to stop yammering as I don't want to confuse you, but please consider consulting your surgeon for guidance in this area. ~Peace
   — Joscelin

December 31, 2002
I took chewable multivites for the first couple of months, then switched to the one-a-day type generic drug store brand. I took the Flintstones chewables, but didn't care for the ones with extra iron. I have listed on my profile the supplements I take, but here's the rundown (it's pretty simple): Breakfast = 500 mg liquid calcium citrate and 1000 mg liquid B12 (under the tongue). Lunch = multivit with iron. Bedtime = 500 mg liquid calcium citrate. I don't take extra iron on a regular basis but occasionally take Feosol if I haven't taken my multivit for a couple of days. Be sure and ask your dr, but for sure you will need the "big three:" calcium citrate in 500 mg doses (NOT carbonate), multivit w/iron (not taken with calcium), and B12 (sublingual or shots--we can't absorb tablets). Hope this helps!
   — ctyst

December 31, 2002
Cheri pretty much summed it up. Most of us take the chewable kids vitamins early on before we can swallow pills. I took the Flintstones chewables-2 a day and still take them(at bedtime) to this day because I like the taste of them. I also take 1500 mg of calcium CITRATE-3X a day (500 mg per capsule and it has magnesium and Vit D in it). But it was a while before I could swallow them and in the beginning I was also taking liquid calcium citrate. And once a month I get a B-12 injection from my doctor (some take the pills under the tongue every few days instead). I too do not take iron and labs have not indicated otherwise. Your labs should be a big help in determining where you may be lacking.
   — Cindy R.

December 31, 2002
Heya hun.. vitalady.com is where i go for my vitamins.. i had surgery 11-11-02.. i am just starting them.. but michelle (she is vita lady) was able to really help me with a regimen.. just ask ..she will help ya whether ya buy or not.. *huggles and bb*
   — johanna F.

December 31, 2002
Hi, I am open RNY proximal. I had it on 9/6/02. I had a really hard time in the beginning taking pills, but it gets much better. I had to find the smallest pills possible. I have found success with the Kmart brand multivitamin. It is in a blue and yellow bottle with a pink cap. It's very small. I take a small B-12 (from Sundown). They are so small I can take them together. I also take Calcium Citrate cills. They are med sized. I have to take two of those to get one serving. That's a little more challenging. Later at night I take the iron pill. I have found that I can only take my pills with OJ. It has been a struggle, but I am doing a little better. It is really something to get used to. But make sure you take that B12 pill because its very important.
   — alexis G.

December 31, 2002
hi, I haven't seen anyone else post it BUT it is my understanding that rny is not supposed to take time-released ANYTHING. It doesnt get absorbed. Also, I think, but not sure, that you are taking the wrong kind of iron. Please go to www.vitalady.com and ask Michelle. As the previous poster said, she is a wealth of info and will gladly help you get started. She sent me the breakdown on every vitamin we take. (whether we can absorb it or not ) just ask her. Good luck
   — Delores S.

December 31, 2002
I will be having surgery in 2 weeks. My nutritionist and surgeon will have me taking the following: Centrum Chewables Kids (2)-- has vitamin K and Iron Iron (because I'm a young woman) -- liquid Calcium Citrate with magnesium (helps bowels too)- liquid, taken 2 times a day B12, sublinguil, 500 mg a day (or 1000 every other day).<br> I've been told to take the centrum with a meal that has fat, and not to take iron and calcium within 2-3 hours of each other.<br> I found everything either at (1) The Vitamin Shoppe or (2) Giant (supermarket). Also, Trader Joes has some of these, too. I'd be glad to tell you the brands if you need them.<br> Good Luck! Beth
   — Beth S.

December 31, 2002
One note on taking some children's vitamins: The gummy bear types and gumball types are great BUT they usually don't contain iron just in case kids get hold of them thinking they are candy (iron can be toxic to children in relatively low doses). So if you take one that doesn't contain iron, make sure to supplement that separately. BELIEVE me, it makes you feel rotten if you don't take iron! <~~~~~former Vitaball victim :)
   — ctyst

December 31, 2002
Hi! I'm just 4 days post-op, but have had my vitamins, etc for a few weeks. These are specifically created FOR WLS patients. They come with a sheet that tells you exactly when to take what (there are 3 different ones) so that you will get maximum absorption. 2 of these come in gelatin-capsule form. These can be pulled open and sprinkled into water, food, etc if you can't swallow the capsule (like me). I guess later down the line I might be able to swallow it. The other is a sub-lingual B12 that melts away under your tongue. I chose these because there is no guessing as what I need to take when, etc. Here is the URL for the website. -- www.bariatricsupplementsystem.com The ones I'm taking cost about $45 a month, and that's a long way from what I used to spend on food for myself :). GOOD LUCK!!! SuzAnne
   — SuzAnne S.

January 1, 2003
I'm kind of surprised by your questions, because most WLS patients DO take multivitamins. In fact, most take two a day. Early post op, I took Centrum orange flavored chewable, but now I take a regular multivitamin that I bought from vitalady.com. I don't crush it, but I do snap it in half and take the two halves in succession. It's probably mostly habit at this point; I could probably take it whole. If you really feel you can't swallow vitamins, I'd advise the Centrums chewables, I thought they tasted fine. <p>I also take an iron supplement, and since you already had a problem with anemia you probably should too. You can find iron that is not time released. I know we're supposed to avoid iron in ferrous sulfate form and I think it's carbonyl iron that's supposed to be best. Mine is 18 mg GNC Ironchel, iron as Ferrachel, whatever that means. It's supposed to be gentler and easily absorbable. I'm having my first set of labs next week, so if my numbers aren't good enough, I'll look at upping that dosage or getting a better iron. <p>You should also be getting in at least 1500 mg of calcium citrate, apart from your multivitamins, each day. That's very important. Other vitamins that WLS patients typically take because of our absorption problems are B-12, zinc, C, E, A, and D. <p>Calcium citrate is often paired with D. For the B-12, you want to take a sublingual tablet a few times a week because B-12 is absorbed by something called intrinsic factor in the lower part of the stomach, which we no longer have. Therefore, unless we get regular shots, the only way we can get B-12 is sublingually (under the tongue), so that it absorbs directly into the bloodstream that way. I take one every three days. You should take iron alone, or with C only, and an hour apart from any other pills/vitamins for it to work best. Zinc is believed to be one of the vitamins that will help us prevent hair loss, though how well that works is anyone's guess! I tend to believe that if it's going to happen, it's going to happen and not much is going to help. Yet, I've started taking GNC's hair and nail formula with biotin anyway, LOL. <p>We all have different regimens, and doctors all advise something different. I think that at the very least, you need to concentrate on getting in a couple of multi vitamins, the calcium and some B-12, since you are not going to get ANY B-12 from your food. And since you are already anemic, extra iron is probably a necessity for you too. Then ask for copies of your labs whenever you have bloodwork done and you can adjust based on that.
   — sandsonik

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