Vitamin Help

Hello everyone. I don't post often, but I do get online daily and read all the posts to get answers to my questions and learn information about things I haven't even thought of yet. Education is so key! I am 47 years old, post menopause (since age 33) and had the DS surgery on 6-13-14. I started my journey at 350 lbs.  I need some advice from the vets out there about vitamin supplementation.  My preop labs showed low B and D.  My surgeon has me taking a multi, calcium, D and B.  Is this sufficient and how much of each should I be taking of each? Which ones are the best ones?  I have been doing chews but am open to trying pills.  Please Help! I have been doing great so far (hit the 100 lb lost mark this week) but want to make sure I stay on track.  I also have had several B and D injections at 10 days, 6 weeks and 12 weeks out at my appts to help. Would love any and all advice.....thanks in advance.

I can tell you for me Vitalady's capsules, rather than pills, saved me. I follow her plan and adjust up or down based on my labs. Here is a link to the plan from 2010. It hasn't changed as a starting point. 

http://www.gblcreations.com/Resources/Gina/ProgramDRNY_ERNY_ BPDDS3-2010.pdf

Here is a lab and targets file for you to look over as well:  http://www.gblcreations.com/Resources/Gina/VitaLadysLabsandT argets_11-2009.doc

Let me know if they won't open for you.

--gina

I'm so glad you asked!  Definitely switch to pills.  The chews don't have all that you need.  Also, get to know your numbers on the labs yourself and understand the differences.  I've found that when they tell you "your fine" - they may look at their favorite 'key items', but not really read the whole thing, and don't notice any downward trending from the last labs.

The key to the fat soluble vitamins A, D, E and K is to NOT take them with fat like normal people do.  The standard dispensing method is with oil filled capsules.  We absorb up to 80% of that.  What we need are dry formulations of these vitamins, and in LARGE doses that scare most medical professionals that don't understand our needs.  You'll see on Vitalady's plan 50,000iu of D, which is what I take to maintain.  When my D dropped down to 12, I was taking 100,000iu for six months to get it back up.  My surgeon suggested a extra 400 iu, which my body laughed at.  I've found over the years that most surgeons and their wls specializing nutritionists have not come close to catching up on what DSers really need long-term.  You can get the 50k IU Biotech brand from Vitalady, Amazon, or even Walmart if you ask the pharmacist.  

Thank you so much I will read vitaladys plan. I already figured out I have been taking the wrong calcium. Ugh. I will have labs next month for the first time post op and will know more then but I need to buy more vitamins now so I want to do the best I can for now with a basic plan and will make adjustments as needed after I get my results. Thanks again. 

I just read vitaladys plan.....that is overwhelming. There is no way I could take all that right now. I'm only four and a half months out and still struggle getting in enough protein and fluids most days. I'm thinking top priority is multi, calcium, and D and B because of preoperative labs. What do you think?

I would start with adding 1 50k vitamin D a day from Botech on the web or resold through Vitalady. Keep an eye on your other
fat soluble vitamins they can be easy to go low and harder to get back up. The fat solubles are A,D,E, and K.

You might also consider adding 25k vitamin A (palmitate - not from beta carotene) and 1,000 mcg K1. 

Not to sure about the B's as a whole. Many of us start out at 500 units sub lingual of B12. If you are low across the board on B's you might 
take a B-complex for a while. I haven't seen many people that needed to supplement the other B vitamins but as always

Your labs are your guide.......

Thanks. I will have labs for the first time post op next month but need to restock now so I wanted to at least do the basics......then add as needed.

At just over two months I am not a practical expert at anything, but I have been doing enough research so that I have even more questions now than when I started.  I have a swallowing problem that they still haven't figured out, so I've had to get a little creative with my pills.  One thing that helped me to get things into my head was to make the following table.  It compares the different vitamin recommendations of the top experts in this field.  Let me know if something does not make sense to you.  If I were you I would go ahead and see if I could get my labs now.  Many doctors recommend 3 month labs so you might be able to get them. 

 

Post DS Vitamins

 

Best guess of vitamins specifically called out by all :

Daily Vitamin Recommendations:	ASMBS with 2 Centrum	Bariatric Advantage	Celebrate	Mexicali Bariatric Center BPD-DS with 4 Centrum	VitaLady RNY & DS with 2 Centrums	Twinlab Bariatric
Protein	90 g/d			80 to 100 g	120 to 150 g
Approximate number of pills a day	~15	~7	~7	~15	~35	~13 pills
Calcium Citrate:	2200-2800 mg	150 mg in MV 1,500 in cal	1,500 mg in cal	3,200 mg	2,200 mg	300 mg in MV 2,000 mg in cal
Vitamin A:	17,000 IU	15,000 iu	7,000 iu in MV	24,000 IU	107,000 IU	150,000 iu
Vitamin B complex:	B-50	(below)	(below)	1 b-complex pill every week	B-50	(below)
Vitamin D:	2400 IU	2,001 iu in MV 1,500 iu in Cal	1,000 iu in cal 3,000 iu in MV	3,600 IU	50,800 IU	1,200 iu in MV 1,600 iu in cal 1,600 iu in D+K
Vitamin E:	30 IU	750 iu	300 iu in MV	370 IU daily	860 IU	90 iu
Vitamin K:	350 mcg	180 mcg	80 mg in cal 540 mcg in MV	300 mcg daily	1,050 mcg	180 mcg in
Iron: elemental	36 mg	30 mg in iron	30 mg in iron	72 mg + monthly shot	336 mg	30 mg[i]
Zink:	22 mg	22.5 mg	15 mg in cal 15 mg in MV	44 mg + 50 mg every 3rd day	122 mg	15 mg

 

 

Vitamins called out by one or from the multivitamin:

 

Daily Vitamin Recommendations:	ASMBS with 2 Centrum	Bariatric Advantage	Celebrate	Mexicali Bariatric Center DS with 4 Centrum	VitaLady with 2 Centrums	Twinlab Bariatric
Boron	150 mcg			300 mcg	75 mcg
Chloride	144 mg			288 mg	72 mg
Choline		3 mg
Chromium	70 mcg	150 mcg	200 mcg in MV	150 mcg	35 mcg
Citrus Bioflavonoids		18.75 mg
Copper:	1 mg	1.5 mg	1 mg in calcium 2 mg in MV	2 mg	5.5 mg	600 mcg
Iodine	300 mcg		150 mcg in MV	600 mcg	150 mcg	210 mcg
Magnesium	100 mg	75 mg	100 mg in cal 100 mg in MV	200 mg	400 mg	60 mg in MV 1,000 mg in cal
Manganese	4.6 mg	3 mg	2 mg in MV	9.2 mg	4.6 mg
Molybdenum	90 mcg	112.5 mcg	75 mcg in MV	180 mcg	90 mcg
Nickel	10 mcg			20 mcg	10 mcg
Pantothenic Acid	20 mg	15 mg	20 mg in MV	40 mg	20 mg	30 mg
Phosphorus	40 mg			80 mg	40 mg	12 mg
Potassium	160 mcg			320 mcg	160 mcg
Selenium	110 mcg	201 mcg	100 mcg in MV	220 mcg	110 mcg
Silica:	4 mcg			8 mcg	4 mcg
Tin	20 mcg			40 mcg	20 mcg
Vanadium	20mcg	37.5 mcg		40 mcg	20mcg
Vitamin B – Biotin	60 mcg	450 mcg	600 mcg in MV	120 mcg	60 mcg	900 mcg
Vitamin B: Niacin	40 mg	75 mg	40 mg in MV	80 mg	40 mg	60 mg
Vitamin B: Riboflavin	3.4 mg	5.1 mg	12 mg in MV	7.2 mg	3.4 mg	5.1 mg
Vitamin B-1 Thiamin:	3 mg	9 mg	12 mg in MV	6 mg	103 mg	4.5 mg
Vitamin B-12	12 mcg	150 mcg		24 mcg	5,012 mcg	18 mcg
Vitamin B6: HCI	4 mg	6 mg	12 mg in MV	8 mg	2 mg	6 mg
Vitamin B-9 Folic Acid:	800 mcg	1,200 mcg	800 mcg in MV	1600 mcg	1,800 mcg	1,200 mcg
Vitamin C:	120 mg	180 mg in MV 60 mg in iron	60 mg in iron 180 mg in MV	240 mg	2,120 mg	360 mg

 

 

 

 

 

[i] Since iron is in MV it must be separated from calcium doses.

 

 

Other random things:

 

From what I can tell, very few people do the full 35 pills a day VitaLady program.  They read their lab results and adjust accordingly.  It seem many/most DS'ers do fine with their B vitamins just from the multi-vitamin, perhaps adding some B12 or biotin depending.  If you are having problems getting in all the VitaLady pills, I would try cutting the B's first, but YMMV. 

 

Proferrin ES (and one or two others) has a form of iron called Heme iron which you can take with calcium.  That can simplify the whole day.  It is expensive, but I'm relying on it until I get into the swing of things. 

 

The reason why we are supposed to take the citrate form of calcium is because we don't have the stomach acid to really digest the other forms.  The good news is that for the first month or two after surgery, DS people tend to run rather acidic.  So try not to worry too much about taking the wrong form.  In the long run it could have really hurt you, but your timing for that mistake was great. 

 

I really recommend reading http://asmbs.org/resources/integrated-health-nutritional-guidelines.  It is a bit of a slog, but it gave me the grounding I needed to really begin to understand these things. 

 

Good Luck!!

 

Thanks so much, The formatting is kind of messed up and makes it hard to read.  It just seems so overwhelming to me. Im still struggling with the water and protein right now. I knew I would have to take a multi, calcium....now B and D due to labs.  I wasnt prepared for all the rest.  My doc gave me a list in the beginning of POSSIBLE vitamin supplements, but said it depended on labs. So I wrapped my brain around those four, but now hearing I need A, K and all the others too. UGH.  If my labs are okay do I still need to take all of those other ones?

Brandy, you rocked this post!! Amazing thrill!!

Are you more than 2yrs pistol?  Do you find that your erequirements have decreased?