Vitamins and Supplements

[Christie13]

Found this from John Hopkins about what vitamins sleeve patients should take. I could only copy and paste as it is a PDF you download and not a link. I think this is good information and lots of people ask what they should be taking. It even goes as far as to say when you should be taking them for maximum absorption.


Vitamin and Mineral Supplementation for Sleeve Gastrectomy


Multivitamin (MVI) with Minerals: 
-Take 1 or 2 MVIs every day for a lifetime. Serving size will depend on individual products. MVI(s) must provide at least 200% RDA for iron (36mg), folic acid (800mcg) and thiamine (3mg) and 2 mg of copper. It is best if MVI also contains selenium and zinc. 
-Chewable and liquid vitamins are best absorbed. Suggest vitamins in this form for at least the first 3-6 months if not for a lifetime. If you decide to switch to a pill form after 6 months, soft gels or capsules may be better absorbed than tablets. 
-Do NOT take MVI in gummy form. Gummies do NOT have all the vitamins and minerals you need. 
-Take with food (except dairy) to help with absorption.


Calcium: 
-Choose calcium citrate. Avoid calcium carbonate (Tums®, Viactiv®, OsCal®, Caltrate®), calcium triphosphate, oyster shell, bone meal, etc. 
-Take 500-600 mg of calcium three (3) times per day to equal at least 1,500 mg per day. Separate doses by at least 2 hours for maximum absorption. Look at the serving size on the label and adjust your dose to make sure you’re getting 500-600 mg of elemental calcium each dose. 
-Chewable and liquid vitamins are best absorbed. Suggest vitamins in this form for at least the first 3-6 months if not for a lifetime. If you decide to switch to a pill form after 6 months, soft gels or capsules may be better absorbed than tablets. 
-Chewy (NOT Gummy) calcium citrate supplements are acceptable. Do NOT take calcium in gummy form. Gummies are not calcium citrate and are not the best absorbed. 
-Must contain Vitamin D. 
-Take 2 hours apart from iron supplements or MVI with iron for maximum absorption.


Vitamin D: 
-Take 3,000 International Units of Vitamin D3 per day. 
-Chewable and liquid vitamins are best absorbed. Suggest vitamins in this form for at least the first 3-6 months if not for a lifetime. If you decide to switch to a pill form after 6 months, soft gels or capsules may be better absorbed than tablets. 
-Vitamin D is best absorbed when you take it with food.


Vitamin B12: 
-Take 500 mcg sublingual (under your tongue) tablet or liquid once a day or 1000 mcg sublingual tablet or liquid every other day.
OR 
-1000 mcg shot once a month (injections prescribed by your primary care physician). 
-500 mcg nasal spray once a week (available by prescription from your bariatric provider or primary care physician).


Suggested Timing of Supplements
-Breakfast 500-600 mgs Calcium & B12
-Lunch 500-600 mgs Calcium
-Dinner Multivitamin(s) & Vitamin D
-Snack 500-600 mgs Calcium

*May take vitamin B12 at any time during the day as it does not interact with other vitamins or minerals.

[GigiUSA]

That is an awesome list!! Thank you.

[Luna354]

Funny thing about vitamins. Before my last bloodwork I had pretty much not taken anything other than my regular pepscid in a month. My vitamin levels were all good except folic acid (which makes sense since I'm still not getting in a ton of veggies). I was pleasantly surprised that I wasn't lacking anything else.

[Shirl]

a quick search got me the link http://www.hopkinsmedicine.org/johns...astrectomy.pdf

[ghost_ryder]

Luna, please be careful. I would think it would take more than a month to deplete your vitamin stores. There are plenty of stories about people getting deficient.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784422/

[nakishaice]

I had surgery 3 years ago and have struggled with finding the right supplements for me. I finally have found a line of products I feel are user friendly for post WLS patients. I have been taking them for 3 weeks and am extremely satisfied with the products. I hope you will try them and find the same results. The Core Essentials is the product that will help with nutrition. There are others as well-- I actually take them all now but started out just taking Core Essentials and the Neuro capsules. Text or email me if you have questions.
nice.vasayo.com is the site.

[Shirl]

Luna, please be careful. I would think it would take more than a month to deplete your vitamin stores. There are plenty of stories about people getting deficient.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784422/

Completely echoing Greg here.

You need to be concerned with long term deficiencies down the road in five or ten years or longer.

Take your multivitamins and iron at least! Cannot emphasize more!

[GigiUSA]

I have printed this list in preparation for my surgery. THANK YOU (hugs)

[VeryLargeBob]

My last routine physical found that I had pernicious anemia (a common long-term side effect of sleeving). *gasp* it seems Centrum Silver for Men over 50 is the WRONG kind of multivitamin for sleeved men. Iron in a multivitamin is generally NOT recommended for men (and women) over 50, and I found out that this one-size-fits-all rule does NOT apply to bariatric patients. Long story short: sleeved stomachs cannot manufacture enough gherlin to extract enough iron into your bloodstream.

Simple fix: Most sleevers should take One-a-Day Vitamins for Women, including men and post-menopausal women. Problem solved.

Centrum Silver formula: 0 mg Iron
One a day for Men: 6 mg Iron
One a day for Women: 18 mg Iron

[VeryLargeBob]

And it's worth repeating that sleeved stomachs cannot process the Vitamin B12 in a multivitamin.

You absolutely have to take sublingual (under the tongue) little pills daily or a shot in the butt once a month.

I choose the latter with no issues.

Okay, one issue: my GF drew a heart on my butt one night while I was sleeping in permanent marker and the nurse giving me a shot the next day asked if that was a new tattoo.

[Ann2]

Great thread, except for the spammer trying to sell her products here.

[Sandra3]

Many obese patients have chronic vitamin deficiencies.
It can get much worth with the sleeve. And from my personal experience I do suspect that taking a PPI get our absorption much worth too.

The key is to focus on prevention, chose only nutritious food and take supplements regularly.

Because high dosage won't get absorbed really well if you take all your pills at once, it's better to take it little by little at each meal. I have to take high dosage of iron and take it with food morning and night. Never take iron when drinking tea, it will void absorption.

But even if the blood test is a good indication of how we are doing, about calcium it's also better to double check with a bone densitometry scan since our blood test could show a good level of calcium, but it could be taken directly from our bones, so checking for osteoporosis is important.

[nakishaice]

I didn't feel it was spamming.. It's sharing. I am a post WLS patient and feel it is important to have options for supplements that fit our lifestyle. I am sorry if you felt it was spamming.

[nakishaice]

Nice post, Sandra. Thanks for the info regarding dosing and spacing throughout the day.

[nakishaice]

I am glad to see you are able to manage this well.