As of Jan. 10th 2014 I am officially 9 months out (YAY!!!)
Now that I'm far enough out that I can swallow bigger pills without chocking I got rid of the chewables.
I know most of us with bariatric surgery have our nutritionist on speed dial so that when ever we have a question or concern we have them to fall back on. I however like to research things myself as well.
In reading many of the posts in the support groups I am a member of I noticed that many of us are told completely different dosages to take when it comes to Vitamins and supplements so I decided that was one area I really wanted to check out and know for sure what the majority rule was on doses and such. So I'm going to share wit you what I found.
MULTI-VITAMIN
Multi-vitamin/mineral supplements ensure that you are getting enough of all of the micronutrients you need.
I take 1 twice a day
Start taking one chewable multivitamin/mineral supplement twice a day (bypass) or once a day (band) while on liquids (Phase 1 liquid diet).
When you progress to Phase 2 (soft foods), take your supplement with meals.
one of the following is recommended:
Bariatric Advantage® Chewable Multi Formula (available in the office or online at www.bariatricadvantage.com)
Celebrate Vitamins® chewable (available at www.celebratevitamins.com)
OpurityTM chewable (available at www.opurity.com)
Centrum® Chewable
( My surgeon had me take flintstones chewables multi vitamin with Iron twice a day)
About 3 months after surgery (or when you are able to swallow pills and tolerate solid foods, in Phase 3), you can switch to a non-chewable if desired. However, it's recommended to use a bariatric-specific chewable multivitamin long-term over any other product. If you choose to take an over-the-counter vitamin, any of the following is recommended, to be taken twice a day with food (generic, store-brand equivalents are fine):
Celebrate Vitamins® multivitamin capsule (available at www.celebratevitamins.com)
One-A-Day® Men’s/Women’s Formula
Centrum Performance® (what I use)
Centrum Silver® based on your age
Take one multivitamin, twice a day (for example one at breakfast, one at lunch), rather than both at the same time to maximize your absorption of each vitamin.
CALCIUM:
Calcium is important for bone health. After weight loss surgery, you may be at risk for the brittle bone disease osteoporosis and related fractures. This is a direct result of the nature of the surgeries.
I take 1 twice a day
Since there is typically only a small amount of calcium in multivitamins. , it's recommended that you take an additional 1000mg-1500mg of calcium everyday when you progress to soft foods.
At the soft foods stage you will need to take a chewable form because most non-chewable supplements are too big and difficult to swallow. There are different forms of calcium such as calcium carbonate and calcium citrate. Calcium citrate is the most efficiently absorbed form of calcium following gastric bypass. However, citrate can be difficult to find in a chewable form, so it's recommended to use a bariatric-specific calcium which provides citrate in a chewable form.
Bariatric Advantage® Calcium Citrate Chewy Bites (2 chews 2 times per day)
Bariatric Advantage® Calcium Citrate Lozenges (one lozenge 2 times per day)
Celebrate Vitamins® Chewable Calcium Citrate (one chewable 2 times per day)
OpurityTM Calcium Citrate (2 chewables 2 times per day)
Taking a liquid vs. chewable form of calcium citrate is acceptable.
Wellesse Calcium and Vitamin D3 liquid can be found at
Kroger
Rite Aid
Walgreens
Walmart
Order directly at 800.232.4005
Switch to a pill form of calcium citrate when able to tolerate them, if desired. Take one dose (500mg-600mg) twice a day with meals for a total of 1000-1200mg of additional calcium per day. Be sure to check the dose on each individual brand to be certain you are getting the correct amount.
Citracal-any version
Again, take your calcium supplements twice a day in two smaller doses rather than taking one large dose all at once because you will absorb the smaller doses better. Also, calcium is best absorbed with taken with food.
***It is important to not take the calcium and iron supplements at the same time, as they interfere with the absorption of each other. Take your calcium and iron supplements at least two hours apart from one another. ***
IRON:
Vital to the formation of red blood cells that provide oxygen to the human body. Prevents anemia. Anemia is common in the months and years following weight loss surgery. Iron deficiency is the most common cause of anemia after bariatric surgery. This risk is heightened after gastric bypass and other malabsorptive surgeries in women who are still menstruating, and in the super-obese (body mass index of 50 or above).
I take once a day
It's recommended that you take an iron supplement daily when you progress to soft foods.
Nausea and constipation are common side effects of iron supplements. For this reason, it's recommended to take one of the most absorb able forms of iron: ferrous fumarate, ferrous sulfate or ferrous gluconate. All three forms of iron can both be found in over-the-counter.
Listed below are some specific products recommended. Take your iron supplement once a day with food.
Bariatric Advantage® Chewable Iron
Celebrate Vitamins® Chewable Iron
GNC Iron 18
Ferro-Sequels® (contains a stool softener as well)
Fergon
if you have trouble with nausea and/or constipation, try taking your iron every other day instead of daily.
***Do not take iron supplements with tea, cola, coffee, calcium citrate or the thyroid medicine levothyroxine because they can interfere with absorption. Taking vitamin C with your iron supplements aids iron absorption. Either a Vitamin C pill or glass of orange juice can do the trick.***
B-12:
Helps with proper blood cell formation and nerve function. Deficiency may cause certain types of anemia.
I melt 1 under my tongue every other day
Vitamin B12 is digested and absorbed differently than most vitamins. After gastric bypass surgery, you will no longer be able to digest and absorb sufficient amounts of B12 to maintain health. You must take your B12 in a form that directly enters the bloodstream, not through the digestive tract. There are three ways to do this:
A monthly vitamin B12 injection can be obtained at your primary care physician’s office after gastric bypass surgery. Your doctor or physician assistant can write a prescription so you can give yourself the monthly B12 injection.
A weekly nasal spray (Nascobal®) is an option for your B12 needs. also your doctor or physician assistant can write a prescription for you.
Another option is to take sublingual B12 lozenges or drops that dissolve under your tongue. A 500 mcg supplement may be taken daily. A 1000-2000 mcg supplement may be taken every other day. If you purchase the 5000 mcg strength, 1 per week should be sufficient. Specific products to ask about include:
Sublingual B12 Microlozenges (all three doses are available at Vitamin World® stores or www.vitaminworld.com)
B12 drops 1000 mcg (at Vitamin World)
B12 5000 Zipmelts® (at GNC)
Bariatric Advantage Sublingual B12 with Folate®
VITAMIN D:
Vitamin D aids the absorption of calcium, which is needed to build strong bones after weight loss surgery. It is known as the sunshine vitamin because the human body produces it only when exposed to sunlight. Vitamin D also is added to multivitamins and milk.
I take 1 a day
In addition to the amount of vitamin D found in your multivitamin and calcium supplement, begin taking 1000 IU of a supplemental vitamin D (cholecalciferol D3) a day. The pill is usually small enough to swallow without difficulty, but size varies among different brands. You may begin the vitamin D when able to tolerate the size pill you purchase.
the following are recommended:
Bariatric Advantage® Dry Vitamin D3 (take one dose per week)
Bariatric Advantage® Liquid Vitamin D3 (take one dose every two weeks)
GNC Vitamin D3 1000 IU (take daily)
**Vitamin D deficiency is linked to a host of chronic diseases, including certain cancers, heart disease, osteoporosis, stroke, diabetes, immune system problems and inflammatory diseases. What's more, obesity increases risk of Vitamin D deficiency.**
NOTE!!!
The amounts of Vitamins and supplements in this post are for bariatric patients only. None surgical patients taking these dosages can lead to overdose!!!
Example Medication schedules:
Breakfast
1 multivitamin/mineral supplement
1 calcium
Sublingual B12 lozenge or drops
Vitamin D
Note: If you are taking the Bariatric Advantage Vitamin D supplement, take it ONLY 1 TIME/ WEEK!
Lunch
Iron supplement (18-30 mg elemental iron if a man or post-menopausal woman; 50-65 mg elemental iron if a pre-menopausal woman)
Dinner
1 multivitamin/mineral supplement
1 calcium
*Remember to separate Iron and calcium by 2 hours to optimize effectiveness
2nd example (Bypass)
(Note: This is an example based on using an over-the-counter multivitamin.)
Breakfast:
1 multivitamin/mineral supplement
1 Sublingual B12 lozenge or drops
Vitamin D (Note: if Bariatric Advantage® Vitamin D, take one time per week, not daily!)
Lunch:
Iron (18-30 mg elemental iron if a pre-menopausal woman, not necessary as a man or post-menopausal woman)
Mid-Afternoon:
1 calcium
Dinner:
1 multivitamin/mineral supplement
Bedtime:
1 calcium
You can read more about the information I found at
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