please help my SIL

Hello there.  My SIL had Gastic Bypass 5 years ago and has not been compliant with her vitamins.  We both fear she is extremely deficient in many areas.  I had VSG so I am unsure of what vitamins are recommended for your particular surgery.  Could someone please give me a list of what is suggested for a GB patient?  Thank you!

Jennifer

I copied this from a post by poet_kelly a while ago:

I've been asked a lot lately where people can go to learn more about vitamins.  Unfortunately, there's not one place (not that I've found, anyway), that offers complete info about every vitamin and mineral out there.  If you want to learn a lot about vitamins, you'll need to check out a number of sources.  I've put together a list of what I think are good, reputable sources for people that want to begin educating themselves about vitamins.

• Vitalady.com – if you email Michelle (owner of vitalady), she is great at getting back to people with answers about vitamins.  She can also tell you where her information comes from so you can read the facts for yourself.
• Wlsvitagarten.com – Andrea is not currently blogging but the blog still has excellent info on vitamins of all sorts.  She discusses a lot of different studies and cites her sources. 
• http://wlsvitagarten.com/2011/01/10/adult-gummy-vitamins/
• The American Society for Metabolic and Bariatric Surgery nutritional guidelines  http://nutrition.otago.ac.nz/__data/assets/file/0005/4784/BariatricNutritionReading.pdf
• 2013 update to the ASMBS guidelines http://www.meltingmama.net/files/asmbstos2013guidelines.pdf
• Information about lab tests http://www.labtestsonline.com/
• Office of Dietary Supplements – good basic info on vitamins and minerals  http://ods.od.nih.gov/
• The Linus Pauling Institute – information about vitamins and minerals, very detailed, with info about current research  http://lpi.oregonstate.edu/infocenter/vitamins.html
• University of Maryland Medical Center – good info on a variety of dietary supplements http://umm.edu/health/medical/altmed
• Mayo Clinic – more basic info on a variety of dietary supplements  http://www.mayoclinic.com/health/drug-information/DrugHerbIndex

[I'd suggest starting with the ASMBS guidelines and their update, and making sure your SIL gets some tests done to see where she's at.]

Here's what the ASMBS says you should start with:

A multi with 100% of the RDA of most nutrients.  Take two a day.  Stay away from kids' vitamins and gummy vitamins, because those will not have what you need.  Even though Flintstones says “complete” on the bottle, they really are not complete but are missing a number of important things.  The ASMBS  recommends a multi with iron.  If you take a multi with no iron, you’ll need additional iron at a separate time.  They say to start your multi as soon as you get home from the hospital.

1500-2000 mg calcium citrate.  Make sure it's citrate, not carbonate.  That means no Caltrate and no Viactiv.  They say you can wait up to one month to start your calcium – not that you should wait, just that you can.

54-63 mg iron for menstruating women (18-27 mg PLUS 18 mg twice a day in your multi, if you use a multi with iron).  36 mg a day for people that do not menstruate.  We absorb carbonyl iron better than ferrous sulfate.  Ferrous sulfate will also make you constipated.  They say to start your iron as soon as you get home from the hospital.

B12.  You can use a sublingual, 350-500 mcg per day, nasal spray once a week, or shots once a month.  Unless your labs show you need more.  They say you can wait up to three months to start your B12 – not that you should wait, just that you can.

They say a B complex is optional.

Many people also need D3 so you should get your vitamin D level to find out if you do.  Don’t bother with the prescription vitamin D, because it’s D2 and in oil so we will absorb very little of it.  Everyone needs D3 and post ops need “dry” D3, not in oil.

Now, that's what is recommended if you have no deficiencies.  If she hasn't taken her vitamins in a long time, she almost certainly has many deficiencies.  So she needs to see a doctor and get a full set of labs done ASAP so she knows what else to take.

Your SIL should contact her surgeon's office.  She/He would likely run some lab work, and also provide her with specific information.  What's right for one person is not always right for another.  She shouldn't feel embarassed to contact her surgeon - they know people fall off-track, and they won't be critical.

May I ask how much D3 most RnYers generally take?

I've talked to a lot of RNy folks about their vitamins and their labs.  I've known one person that was able to have a good vitamin D level (at least 80 - many labs will consider it in range much lower than that, but the Linus Pauling Institute says it needs to be at least 80 for optimal health) on less than 5000 IU a day.  I've known two that could maintain a good level of 5000 IU D3 a day.  Everyone else I've known needs at least 10,000 IU a day and many  need a lot more than that  For instance, I have to take 50,000 IU D3 three times a week, which works out to about 28,000 IU a day, to keep my level around 100.