Vitamins made easy

We talk a lot about vitamins on this board, which makes sense because they are so important to our health, but sometimes it gets pretty confusing with all the different types of one vitamin, like calcium citrate, calcium carbonate and tricalcium phosphate.  And then add in the different forms, like liquids and chewables and tablets you swallow, and different brands and doses, and then how much you can absorb at once and all of that, and it starts to seem pretty complicated.  Some people share my fascination with all of that and wanna talk about it in great depth, but others just wanna know what the heck to go buy at the store.

So here is my short and easy version of what vitamins the American Society for Metabolic and Bariatric Surgery says we need to start off with.  If you wanna know why they say we need a certain kind or any more in depth info, I’m happy to talk about all that, but this is the short, simple version here.

The ASMBS says we need:

1. And adult multivitamin that has 100% of the RDA of most stuff in it.  Something like Centrum is fine.  Flintstones and gummies are not.  We need two of these a day.
2. 500 mg calcium citrate, three or four times a day.  It needs to be citrate, not carbonate.  Any generic calcium citrate is fine if you want pills to swallow.  If you want chewables, check the Vitamin Shoppe, or order online from Celebrate or Bariatric Advantage.  Tums, vitafusion gummies, Citracal gummies and Viactiv are all the wrong kind of calcium, so don’t get those.
3. 54-63 mg iron for menstruating women, 36 mg iron for everyone else.  Count the iron in your multi, if it has any iron.  Then add more iron if necessary.  Carbonyl iron is less likely to make you constipated than other kinds.  Brands you can get in stores include Sundown Perfect Iron and Feosol, or you can order chewable iron online from Celebrate or Bariatric Advantage.  Take your iron at least two hours away from your calcium.
4. B12.  You can do 500 mcg sublingual (a tablet that melts under your tongue) a day, a prescription nasal spray once a week, or shots (you can do them yourself at home or get them at your doctor’s office) once a month.

You might need other stuff, depending on your labs, but these are the basics.

 Thank you so much Kelly, this was just what I was looking for.  I do have another question, can you take vitamins with your other medication? I take metformin, high blood pressure and cipralex. I have surgery in a couple of weeks and i am trying to write down a schedule for myself.

With most medications.  Some meds should be taken by themselves, or not taken with certain vitamins.  You can ask your pharmacist, or you can also read the package insert that comes with your meds.  If you don't get a package insert, ask the pharmacist for it.  It will provide very detailed info about your meds (in very tiny print, so put on your glasses!).

 Kelly, as always, you provide good, concise information on vitamins and supplements.
Celebrate also makes an iron tablet that can be swallowed, in addition to the chewables.  I've used them for four years- easy on the stomach, too.

Vitamins can generally be taken with other meds.  Here's my schedule:
Morning: Celebrate multi vit, 2 calcium tabs, B complex
Noon: Celebrate multi vit, 2 calcium, Vit D
Evening: Multi vit, calcioum
Bedtime: Iron, sublinguial B12
Taking the iron a bedtime ensures that I am separating it from calcium or dairy by at least 2 hrs.

That's very close to my schedule.

Im still having trouble getting my calcium in. Right now I have a nasty liquid and I havent found anything else right now that I like either. I have gotten 3 doses in at most.

Kelly have you tried upcal D? Do you know anything about it?

Also with the super B50 I told her it was disgusting but she said after about a month I have to take it....no excuses.

She also NEVER wants me to take pills...only chewable and liquid. if I took small tabs once im on solid foods would it really be that bad? I want to follow her advice but my tastebuds are very sensitive and I just cant stand some of that stuff.

Yeah, I like Upcal D.  It has no taste.  I use it sometimes.

You HAVE to take the B50?  How is she going to force you to take it?  And why does she think it's imparative that you take it if you do not have B vitamin deficiencies?  And if you do have deficiencies, why not just supplement those vitamins instead of using a b complex?

No, taking small tablets or even large ones would not be bad at all.  The ASMBS says it's fine to take vitamins that we swallow as soon as we can tolerate them.  I wonder why she disagrees with their giudelines?

I guess I wouldnt HAVE to take it if I didnt want too. I didnt have any deficiencies before surgery. I was telling the nurse that I was having an issue with it and she said "well you wont be deficient for just being a few weeks out ,but you do have to take it..maybe mix it with food" excuse me lady I dont want to taint my food with that!!! Then I told the doc and she said that I need to take it. Im not sure exactly why she doesnt go with the ASMBS guidelines on that one thing. Then again im also on a 3week long liquid diet.Ive read what can happen if you are deficient in Thiamin and I guess im just freaked out about it. I think once I can have regular food I will take the tabs....cause I just cant do it...and if my levels are fine then I guess its all ok.

Some people do develop thiamine deficiencies after RNY but most people don't, as long as they take their multi twice a day.  And if your thiamine does start to get low, you could just take a thiamine supplement instead of a B complex.

I'm not trying to tell you not to take the B complex.  I'm sorry if I sound like that's what I'm saying.  What I mean to say is that it's your choice.  You'll need to decide if you really need it or not.  Getting your labs done regularly will help you know if you are low on any of your B vitamins and that will help you decide if or when you need to supplement any of them.

No I totally understand you are not saying not to take it. You actually told me something I didnt know. I had no idea it was an optional vit. or one to take when something like that is low. I honestly can NOT stomach the liquid. I dont know if you have ever smelled or tasted it but it is just wrong. I will definitely take a pill or something...just to feel like im doing the right thing. I am on top of my multivitamin...its just my calcium I have an issue with lol. Thank you for all the advice!!!