(Hey, if it works for Rob Uzzel, it works for Andrea)

There is often a ton of hoopla on the boards about flintstone vitamins.  Another day, another post.  But the newest craze of vitamins is the "gummy vitamin," and these are the absolute worst things you can call a vitamin.  In comparison?  Flintstones are a ton better.

Not only are pediatric dentists warning against the various gummy vites (because the first two ingredients of Flintstones Gummies are two forms of sugar), they hold very little nutritive value.

Now, keep in mind, that I am speaking of multivitamins.  I have seen a D gummy that looks acceptable for normal-gutted folks.  Is it oil or water-miscible and thus usable by us?  I don't know -- and maybe I'll check some day.  The calcium gummies are alright for normal-gutted folks, but not for us as they are either carbonate or dicalcium phosphate (which, like carbonate, requires a fair amount of stomach acid to absorb properly).

So I've decided to pull out a few of the biggest offenders -- including an adult gummy multivite and let you make the decision for yourself.  I can preach the horrors of these pieces of candy until the cows come home -- and some will listen to that.  But I'd rather you take a gander for yourself and learn *why* I am so freaking adamant that my toddler does not even get them.

So come along now. 

+ For purposes of this post, I am using the RDA's for Males 31-50 and non-lactating non-pregnant Females 31-50.
+ Conversions from IU to mcg are based on an average of values set forth by the RDA.  It is not an exact science as various forms of each vitamin will translate from IU to mcg differently.  If you really want this specific info, lemme know.
+ This test will evaluate a single dose adult dose per the label (2 vitamins, 6, etc.) for the following vitamins - VitaFusion Adult Gummies (dose = 2 vites), L'il Critters Gummy Bear Vites (dose = 2 vites), Flintstones Gummy Vitamins (dose = 2 vites)
+ RDAs do not take in account lack of Intrinsic Factor or malabsorption -- *we* need more of these things, but until they form a Bariatric RDA, then we have to go with what the government is giving us
+ Values flagged in red do not meet the RDA for either subgroup

Vitamin A
RDA M 900 mcg/day, F 700 mcg/day
VitaFusion 400 mcg
L'il Critters 400 mcg
Flintstones Gummies 320mcg

Vitamin C
RDA M 90 mg/day, F 75 mg/day
VitaFusion 30 mg
L'il Critters 20 mg
Flintstones Gummies 30 mg

Vitamin D
RDA M 5 mcg/day, F 5 mcg/day
VitaFusion 5 mcg
L'il Critters 5mcg
Flintstones Gummies 2.5mcg

Vitamin E
RDA M 15 mg/day, F 15 mg/day
VitaFusion 7.5 mg
L'il Critters 8mg
Flintstones Gummies 10mg

Vitamin K
RDA M 120 mcg/day, F 90 mcg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Thiamin
RDA M 1.2 mg/day, F 1.1 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Riboflavin
RDA M 1.3 mg/day, F 1.1 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Niacin
RDA M 16 mg/day, F 14 mg/day
VitaFusion 10 mg
L'il Critters 0
Flintstones Gummies 0

Vitamin B6
RDA M 1.3 mg/day, F 1.3 mg/day
VitaFusion 2mg
L'il Critters 1.04mg
Flintstones Gummies 1mg

Folate
RDA M 400 mcg/day, F 400 mcg/day
VitaFusion 400mcg
L'il Critters 260 mcg
Flintstones Gummies 200mcg

Vitamin B12
RDA M 2.4 mcg/day, F 2.4 mcg/day
VitaFusion 6mcg
L'il Critters 5.1mcg
Flintstones Gummies 5mcg

Pantothenic Acid
RDA M 5 mg/day, F 5mg/day
VitaFusion 10mg
L'il Critters 5.2mg
Flintstones Gummies 5mg

Biotin
RDA M 30 mcg/day, F 30 mcg/day
VitaFusion 0
L'il Critters 60mcg
Flintstones Gummies 75mcg

Choline
RDA M 550 mg/day, F 425 mg/day
VitaFusion 40mg
L'il Critters 40mcg (note, MCG, not MG)
Flintstones Gummies 38mg

Calcium
RDA M 1,000 mg/day, F 1000 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Chromium
RDA M 35 mcg/day, F 25 mcg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Copper
RDA M 900 mcg/day, F 900 mcg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Fluoride
RDA M 4 mg/day, F 3 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Iodine
RDA M 150 mcg/day, F 150 mcg/day
VitaFusion 0
L'il Critters 42mcg
Flintstones Gummies 40mcg

Iron
RDA M 8 mg/day, F 18 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Magnesium
RDA M 420 mg/day, F 320 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Manganese
RDA M 2.3 mg/d, F 1.8 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Molybdenum
RDA M 45 mcg/day, F 45 mcg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Phosphorous
RDA M 700 mg/day, F 700 mg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Selenium
RDA M 55 mcg/day, F 55 mcg/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Zinc
RDA M 11 mg/day, F 8 mg/day
VitaFusion 0
L'il Critters 2.7mg
Flintstones Gummies 2.5mg

Potassium
RDA M 4.7 g/day, F 4.7 g/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Sodium
RDA M 1.5 g/day, F 1.5 g/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0

Chloride
RDA M 2.3 g/day, F 2.3 g/day
VitaFusion 0
L'il Critters 0
Flintstones Gummies 0


So given this information, why would *anyone* take a gummy vitamin, much less an adult bariatric patient who needs a ton more vitamins than the normal human?  If you can help me to understand, I'd appreciate it -- but for all I can see, these are just expensive candy.  Period.

Info taken from the ASMBS Reccomendations for Postop Bariatric Nutritonal Supplementation... pages 5 and 6.

Suggested biochemical monitoring tools for nutritional status

Serum thiamin - B1 (thiamin)
Normal range: 10-64 ng/mL
Postop deficiency: Rare, but occurs with RYGB, AGB, and BPD/DS

PLP - B6 (pyridoxine)
Normal range: 5-24 ng/mL
Postop deficiency: Rare

Serum B12 - B12 (cobalamin)
Normal range: 200-1000pg/mL  (Andrea's ideal is around 1200-1800)
Postop deficiency: Common with RYGB in absence of supplementation, 12-33%

RBC folate - Folate
Normal range: 280-791 ng/mL
Postop deficiency: uncommon

Ferritin - Iron
Normal range: Males 15-200 ng/mL, Females 12-150 ng/mL  (Andrea's ideal is 200)
Postop deficiency: common with RYGB for menstruating women (51%) and patients with super obesity (49-52%)

Plasma retinol - Vitamin A
Normal range:  20-80 mcg/dL
Postop deficiency: common (50%) with BPD/DS after 1 yr, <= 70% at 4 yrl may occur with RYGB/AGB

25(OH)D - Vitamin D
Normal range: 25-40 ng/mL (Andrea's optimal is 80-100)
Postop deficiency: Common with BPD/DS after 1 yr; may occur with RYGB; prevalence unknown

Plasma alpha tocopherol - Vtiamin E
Normal range: 5-20 mcg/mL
Postop deficiency: Uncommon

PT - Vitmain K
Normal range: 10-13 s
Postop deficiency: Common with BPD/DS after 1 yr

Plasma zinc - Zinc
Normal range: 60-130 mcg/dL
Postop deficiency: Common with BPD/DS after 1 yr; may occur with RYGB

Serum albumin - Protein
Serum total protein
Normal range: albumin 4-6 g/dL; total protein 6-8 g/dL
Postop deficiency: Rare, but can occur with RYGB, AGB, and BPD/DS if protein intake is low in total intake or indispensible amino acids

I get alot of PM's asking what I take.  I will not name brands specifically unless forced to do so simply because there are too many good brands.  I'd rather say what not to take (Flintstones, gummy vites of any variety, tums, viactiv, caltrate) because it's a much shorter list.

So every day I take the following:

#1 Calcium Citrate 515mg (1 petite, 1 regular), 5,000 i.u. water miscible vite D, 1000mcg B-12 tablet (not sublingual)

#2 150mg carbonyl iron (6x 25mg tabs), 1000mg vite C (2x500mg)

#3 Calcium citrate 515mg, 5,000 i.u. vite D, super B-complex, multivite, folic acid 400mcg, magnesium oxide 400mg

#4 Calcium citrate 515mg, 5,000 i.u. vite D, multivite

#5 Carbonyl iron 150mg, vite C 1000mg, super B-complex

#6 Zinc 60mg (2x 30mg), copper 4mg (2x 2mg), water miscible vite A 25,000 i.u.

#7 Calcium citrate 515mg, 10,000 i.u. vite D, magnesium oxide 400mg


Click here if you want to read what the American Society for Metabolic and Bariatric Surgeons recommend for vitamins postop.  Recommendations begin around page 7 for RNY, DS, and AGB.