Everyone who knows me a little bit, knows that I have strong opinions about vitamins.
I had my surgery 4 years ago with a *wonderful* surgeon. I truly love Dr. Burry. His supplement advice was to take two flintstones and tums for the rest of my life. And I trusted him. Keep in mind that 4 years ago, there was little nutritional evidence that has since come out about multivitamin regimens in RNY patients.
Surgery was August of 04. I had regular blood draws. And in those draws, I was normal for the most part, but slowly trending downwards. Was I told? Nope. Did I ask to see my lab sheets? Nope. I *trusted* my healthcare providers.
4 years later, 2 kids later, and my ferritin sucks, my D was in the toilet, and I was in serious pain from my bones being leeched of their calcium. Osteomalacia is not very fun, let me tell you. And the zombie-like feeling of not having any iron reserves is pretty crushing as well. I started to study vitamins, read everything I can get my grubby paws on (and hey, I have a ton of stuff to still go through), and share this info with others in hopes that someone will listen to my advice and not travel this road. Avoiding a defiency is much easier than recovering from one.
So now what? Oh. I thought I'd share and site some info for you. Take note, JinPA.. this is the kinder, gentler Andrea (don't blame me, I have narcotics floating through my system).
Ahh yes, the most controversial of the subjects are flintstone vitamins. First off, let me say right here and now that an adult dose of flinstones (and I'm not talking gummies.. yet) is 2 tablets. The American Society of Metabolic and Bariatric Surgeons recommends two times the adult dose, so that makes 4 Flintstone chewables a day.
Got it? Not two. Not three. Four. As in 2+2 == 4.
Perhaps the lamest excuse I see for taking Flintstones vitamins is price. Yes, times are tough.. but are you really willing to relegate your health to the lowest priced vitamins on the market? I mean, we had surgery to be in better shape.. and you are willing compromise that health on crap vitamins? Give me a break.
But, ok. Let's look at price.
Amazon.com has a bottle of 200 Flintstone Complete vitamins for 17.99
. For ease, let's call it $18.00 ok? 4 a day (remember, bariatric dosing), makes for 50 days, each day costing 36 cents
Amazon.com has a bottle of 100 Centrum Adult vitamins for $13.16.
For ease, we'll call it $13.20. 2 per day (because they are adult vitamins), makes for 50 days, each day costing 26 cents
So don't tell me you buy Flintstones for the cost factor, kay? That argument does not fly when you are taking a bariatric dose of vitamins. Period. Moving on.
Additionally, the flintstone complete vitamins are, in fact, missing some key things. Even Centrum's KIDS vitamins are better for you than flintstones. Period.
Flintstone Gummies (or any other child's gummy vitamins)
These are not vitmains -- they are candy. I *cringe* when I even see these in the store. I would not give these to my toddler.
Why? Because they are only good in the yummy b-vitmains. They have no iron, no copper, no selenium, etc. I mean, really, they are deficient in so many things, it's not even funny. The first two ingredients are sucrose and fructose. So two forms of sugar are the first ingredients? Oh, and the adult dose is 6 vitamins, so 12 per day for a bariatric patient? Give me a break.. not only is it an insuficient vitamin, it's even more expensive than the bariatric vites that people shy away from due to price tags.
Tums and Viactiv
Note: these are the wrong calciums. Period. No discussion. Calcium carbonate requires a high amount of stomach acid in order to break down into usable parts. No ifs, ands, or buts. In a study conducted on post-menopausal normal-gutted women, calcium citrate was found to be 27% more absorbable than carbonate -- and that's with a full complement of stomach acid that RNY, Fobit, and DS'ers don't have at their disposal. Take calcium citrate. Chew it, melt it, swallow it, whatever.. but calcium citrate is what you need, and you need 1500-2000mg every day in addition to food sources.
My labs are fine...
Really. Are they? Can you say that equivicably? Is it because you *trust* your doc to have your health as their absolute most important priority in the world? Or are you now thinking that *maybe* the doc is just looking for numbers that are highlighted by the lab as abnormal results?
Have you done your own independant research to find out what your numbers should be, and how to get them to that point if they aren't there already? Have you tracked trends to know when you've started sliding down a slippery slope, or have you trusted someone else to look at the data and spoonfeed you the results? Do you know how long specific nutrients are stored in your body for long-term storage in case of emergency? Did you realize that b-12 begins to run out at 6 weeks to 6 months? That the body has no, nada, zip storage for certain micronutrients?
If you can't answer basic questions about your lab values, please do not tell me your values are "perfect" because I will ask you to validate your claim every single time.
Folks -- WLS is a learning thing. No, no one has the answers.. but there is quite a bit of research showing the no-no's if you are willing to 1) do the research yourself or 2) listen to someone who has. Do I know everything? Nope.. and I will gladly admit that fact. But I can tell you where I get the nuggets of info I do have and will publish my sources if so asked. I'm not claiming to be a medical expert, but it doesn't take one to read a study about 137 patients, you know? It's a matter of actually taking the time, doing the footwork, and understanding the data presented.