Confused about vitamins; why and how much? - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

MiladyB · 06-22-2008, 09:28 AM

I thought I would repost this article that I recently ran across. I found it really good information.

Cynthia Buffington, PhD. is the Director of Research at Celebration Health Hospital in Orlando. Her efforts in serving the morbidly obese community through science and research have elevated her to the top of this field. She is committed to gathering information and data as it relates to the morbidly obese. She excels in her ability to communicate these findings with a writing style that reaches and educates people from most every walk of life.

Dear Gastric Bypass Patient

Cynthia Buffington

Are you taking your vitamin and mineral supplements each and every day, as directed? Do you realize that it is necessary to take vitamin and minerals for life following gastric bypass surgery to avoid the risk of health complications?

Why are vitamins and minerals important for life? Because the gastric bypass procedure has changed the anatomy of your stomach and intestines in a manner that can cause deficits in vitamins and minerals that could negatively influence your health.

Nutrient deficiencies with the gastric bypass procedure occur for several reasons. First, the surgery reduces overall food intake. Secondly, the small gastric pouch produces negligible amounts of digestive enzymes and acid for complete digestion of certain foods. Third, the small stomach pouch no longer produces a substance called intrinsic factor that is needed for the absorption of Vitamin B12. Fourth, the stomach bypasses a portion of the gut that is necessary for the absorption of many vitamins and minerals.

For all of these reasons, you will need to take vitamins and minerals for life. Daily supplements should include a multivitamin that contain close to 100% the RDI for vitamins A (or beta-carotene), E, C, and D, zinc, selenium, copper, magnesium, manganese, molybdenum, chromium, and potassium. The multivitamin should also contain all of the B-complex vitamins, with amounts at least 200% the RDI for folate, thiamin and other major B vitamins.

If the multivitamin has been designed for bariatric patients, it will likely also contain vitamin B12 at amounts that greater than 1000% the RDI. With the gastric bypass procedure, the stomach no longer produces a compound, intrinsic factor, important for the absorption of vitamin B12.

Studies have shown that Vitamin B12 deficiencies are common after the gastric bypass procedure and can have very serious health consequences years and years after surgery, sometimes even causing permanent nerve damage and a loss of mobility. Signs of B12 deficiencies may include numbness or a loss of feelings in the legs (and later the arms), unsteadiness when walking, color blindness, confusion, irritability and depression, swollen and ‘shiny, smooth’ tongue, weakness and anemia.

Supplements of B12 that are 3300% the RDI and higher have been reported to prevent B12 deficiencies in more than 95% of gastric bypass patients. Monthly shots of 1000 mcg B12 are also very effective in prevention of B12 deficits, and daily sublingual intake of B12 may be helpful in prevention, as well.

Iron and calcium deficiencies are also common with gastric bypass surgery because the portion of the gut that absorbs these minerals has been bypassed by the surgical procedure and because the stomach no longer produces acid needed for optimal absorption. These minerals must, therefore, be supplemented and at amounts in excess of those generally included in a daily multivitamin/mineral.

Iron should be taken at prenatal levels (30 mg or more) and in its most absorbable forms, fumerate chelate or fumerate citrate. Iron deficiencies may occur shortly after surgery or years and years later. Symptoms and effects include: pica (a desire to eat ice, paint, dirt, paste, other such items), fatigue, weakness, and anemia.

Calcium deficiencies cause bone loss after surgery, irregularities in muscle, heart, or nerve functions, defects in certain hormones, and even weight gain. Calcium supplements for the gastric bypass patient must be in the form of calcium citrate– NOT calcium carbonate or phosphate or coral calcium. For optimal absorption, the calcium citrate should also contain vitamin D, ascorbic acid (vitamin C), or magnesium. The daily calcium needs are at least 1200 to 1500 mg must be taken at different times throughout the day in supplements of no more than 500-600 milligrams.

Folate deficiencies have been reported to occur with gastric bypass and can cause anemia, increase the risk for heart disease, and cause interference with your body’s ability to produce energy. Folate deficits can be prevented with 200% the RDI. Folate deficiencies can cause anemia and can increase your risk for heart disease. Symptoms of a deficiency may include weakness and fatigue.

Thiamin or vitamin B1 should also be contained in your multivitamin at amounts 200% the RDI or preferably higher. Deficiencies in thiamin may occur following an episode of vomiting, if you skip meals, or if you fail to take your vitamins.

Deficiencies in thiamine may have very serious consequences, including an inability to walk, a loss of memory (sometimes permanent), or even death. Symptoms include muscle cramps and pain, burning feet, numbness or tingling in legs or arms, racing heart, confusion, memory loss, and difficulty learning new tasks.

Because of the anatomy of the gastric bypass procedure, there will always be a risk for vitamin and mineral deficiencies which could have serious health consequences. It is, therefore, not only important that you remember to take supplements daily and FOR LIFE but also that you have regular (annual) blood checks for levels of vitamins and minerals, particularly iron, folate, vitamin B12 (and thiamin if symptoms appear), and to have from time-to-time a bone scan, parathyroid measurement or some other test that may identify calcium deficits.

Overview of Vitamin and Mineral Requirements:

Daily Multivitamin/Mineral

100% the RDI (or more) for vitamins A, E, C, D niacin

200% the RDI (or higher) for major B-complex vitamins, particularly folate and thiamin

100% the RDI for minerals, i.e. zinc, manganese, molybdenum, selenium, copper, chromium, potassium, magnesium, others.

Vitamin B12

At least 1200% the RDI for supplements

1000 mcg monthly shots

1000 mcg daily sublingual

Calcium

100% the RDI (or more) Calcium Citrate with ascorbic acid (vitamin C), vitamin D, or magnesium

Iron

Greater than 100% the RDI for fumerate or iron chelated to an amino acid or to citrate

Corrine · 06-22-2008, 10:14 AM

Beth!

Where would we be without you!

I cringe at the amount of people who still take nothing more than a couple of gummy bears and some tums....

MiladyB · 06-22-2008, 11:12 AM

Quote:

Originally Posted by Corrine

Beth!

Where would we be without you!

I cringe at the amount of people who still take nothing more than a couple of gummy bears and some tums....

I'm with you, Corrine. I don't know if there are those surgeon's and nutritionists out there that just don't explain the importance of not only taking vitamins but taking the RIGHT vitamins or if people just don't really listen. Hopefully if we keep educating others one day they will 'get it'.

Vitamins aren't optional. We all took this huge step in order to become healthy but to remain healthy we have to take the respondsibility of taking our vitamins for life.

izanmanyzanz · 06-22-2008, 09:56 PM

Ok here I go to take my vitamins. These posts always wake me up!!

Phoenixfire · 06-22-2008, 11:40 PM

Great list, and excellent material. Now the key question: which set of supplements/vitamins/minerals contains all of these ingredients? Who has found the set to cover all these needs, and where do I get it, since I'm doing it with a few and wishing I had an all-in-one (if one exists) so the numbers are all in one shot!
Thx for the post!

Marella · 06-23-2008, 03:17 AM

I just went over my paperwork.

My NUT gave me the freedom to choose. I have a list of what needs to be in them, and about 10 websites where I can find good vitamins. I guess I can choose what tastes good to me and what works for my budget.

I chose www.bbvitamins.com because they are specially designed for bariatric patients and the chewables dissolve well. (A store near me had samples and I liked them, and I can get them cheaper online in a 90 day supply: free shipping.) I felt that the cost offsets what I would normally spend for food anyway... and I'm still saving in the long run (for my plastic surgery and vacation) with no problem.

I mean, I used to hem and haw about buying something I HAD TO, but would not even blink an eye to drive thru somewhere 4 times a week and get a milkshake and burger. Frankly, I'd spend more on coffee and fast food in a week than I'd spend buying 90 day supplements at www.bbvitamins.com. AND worse, I got my son into the habit which I'm breaking. So it's time to stop saying, "wow, it's sooo expensive", it's time to be realistic: get out the spreadsheet and work it... if you do your own math according to your old spending habits, it's not even close to a big deal.

PLUS... I'm trying to be one of those who doesn't lose her hair in this WLS business... and not end up in the hospital with deficiencies I could have prevented by buying the right thing... and that means doing everything by the book.

-------------------

Just wanted to pass on the other sites my NUT approved:

www.bariatrix.com (Bariatrix Intetn'tl Bari Vitamin)
www.bbvitamins.com (they have it all)
www.centrum.com (Centrum Complete Chewable)
www.globalhp.com (UpCal D, powederd calcium citrate that dissolves well)
www.lifelinefoods.com (Buried Treasure Calcium Plus liquid)
www.mothernature.com (Rainbow Light Citrate Multi-Minerals chewable: vit D & Magnesium)
www.twinlab.com (Calcium citrate wafers with Vit D & Magnesium)
www.vistavitamins.com (Chewable Wellness Formula)
www.vitacost.com (Country Life Chewable wafers)
www.vitalady.com (Nature's Science Chelated Calcium Citrage 500mg + Magnesium 250mg+VitD 200 IU)
www.vitaminworld.com
www.webvitamins.com (Country Life Chewable wafers)

I'm going to ask my NUT Tuesday and my doc on Wednesday why Flintstones Chewables or Gummies are not on the list.

mistymee · 06-23-2008, 05:42 AM

Walgreen's near me also sells the "Optisource" brand of chewable vitamins for Bariatric weight loss surgery patients.

MiladyB · 06-23-2008, 07:14 AM

Phoenix, I use the Building Blocks vitamins that Marella is using. Actually that article that I posted came from their site. The person who wrote that article was involved in the development of the Building Blocks vitamins.

No, there isn't one pill out there, that I know of that contains it all but the Building Blocks vitamins is one of the vitamins that specifically was developed to fill our needs. I personally liked that when I picked what vitamins to buy. They do sell all the vitamins in a 30 or 90 day supply and have them in packages that include all of the vitamins that you need.

There is quite a bit of education on their site, which is something else I really liked. They not only are selling the vitamins they want to educate the bariatric population too.

MiladyB · 06-23-2008, 07:17 AM

Quote:

Originally Posted by izanmanyzanz

Ok here I go to take my vitamins. These posts always wake me up!!

Good for you, Izzy....EXACTLY what I hoped this post would do....I hoped it would reinforce the reason behind us taking our vitamins and wake some people up to the importance of taking vitamins.

Marella · 06-23-2008, 11:14 AM

Yesterday, I ordered a 90 day supply from www.bbvitamins.com because I new I wasn't going to change to any other brand. (The shipping was free and I calculated that I spent over $30 less than if I would have purchased from my pharmacy)

I felt that maybe later in my journey, I might switch to another brand, a big maybe, but at least not in the beginning when weight loss is so drastic, and intake is so limited.

TASTE: the Building Block vitamins and calcium both taste like sweetarts -- the vitamin tasting better. Both crumble up well before swallowing.

I also printed up the content of the Building Blocks chewables so that I can compare them to Flintstones. I mean, the chewables are horsepills (the size of a nickel and thick too)... are Flintstone chewables THAT big to encompass the needs of an adult bariatric patient?

Hopefully I can find Flintstones contents online... will look later.