Of course I have to start with:
“The information below is strictly what I have learned and want to share, and it should not be used as medical advice. Always consult with your doctor first before changing your bypass/vitamin/medical routine ”
I am almost 8 years post op, and just learning what I should have known from the beginning. My labs are low and horrible, and my health is suffering. Take it from me....learn as much as you can as SOON as you can for optimum health.
OK….now that’s over with! Let’s get to the good stuff:
Here are a few basic things that are CRITICAL TO KNOW that I didn’t learn till I was 7 YEARS post op!!! Yikes.
There are a few vitamins and minerals that all gastric bypass patients have to REALLY monitor: (Of course there are more, but the below are the “biggies” and the ones I am personally dealing with and learning about now.)
We need Calcium Supplements. Not all calcium is the same. We cannot absorb calcium carbonate…so check your labels, and throw away those Tums! We must take in at least 1500 mg of calcium citrate a day…and it should be taken with vitamin D3 to be properly absorbed. Also our body can’t absorb more than 500mg of calcium citrate at once, so take it spread out over 3 times a day.
We need iron Supplements. The amount you need will depend on your labs, usually 100mg of ELEMENTAL iron a day will keep your iron and ferritin (iron stores) up. Read the label carefully and see how much ELEMENTAL iron your supplement has…not just “iron”….”elemental iron”. Your iron must be taken with vitamin C….as we have no acid in our pouches, and iron needs acid to be absorbed. Vitamin c provides this acid.
We can NOT take iron and calcium within 3 hours of each other, as calcium blocks the absorption of iron. You must be careful if your daily vitamin has calcium, or your protein shake has calcium. Your iron and C intake is better off taken alone~ away from anything else~ all by itself.
We should have around 100mg of protein a day and whey protein isolate is the best absorbed. Wal mart has a cheap 14.00 tub of WHEY protein powder that tastes pretty good and will work just fine. 1 shake, 2 scoops has 50 grams of protein. The body can only absorb around 50mg protein at a time, so you need to spread it out over 2x during the day. We don’t need expensive powder with all kinds of added stuff in it. Our protein shake should be used for protein purposes ONLY….don’t count the vitamins or calcium or other things in the shake towards your daily total...just consider them a bonus.
Gastric bypass patients have issues absorbing B12. We can NOT absorb it from our tummies AT ALL, as we have no intrinisic factor...which B12 needs to be absorbed. B12 MUST be taken by a sublingual (under the tongue), the patch, nasal spray, or the shot. All that B12 that you are swallowing in your daily vitamin or protein shake or the liver you eat? Useless! I gagged down liver 3 times a week for 4 years thinking I was helping my low b12 and iron levels, and come to find out, it was all for nothing. Well, I got the protein, but NO b12 or iron!!
Listed RDA amounts for vitamins are a JOKE in the United States. They are way too low...again my personal opinion. Especially for us bypass people. If some amounts I recommend seem too high, it’s because we NEED it that high. If you have any questions, please ask your doctor…but to be honest, MY doctor knows less about vitamins than the people on this board!! Also remember, it is very hard to get TO MANY VITAMINS or “overdose”…...you are more likely at risk of NOT GETTING ENOUGH.
Also, lab results that show a range for NORMAL are usually too low for gastric bypass patients, and the levels set for NORMAL are a joke to begin with. For example: They say that 200-500 range for b12 is “normal range”. No way, not for us. Our b12 should be up over 900 for optimum health. You will learn all this as time goes by. Just take your correct daily vitamins at the correct times~faithfully every day. Then get your labs done every 3 months, yes, 3 months, don’t let it go to long when you are a new patient… something critical could be missing. Get your labs….then tweak your vitamins as needed. My b12 came back 300…and that is critically low for a gastric patient, and my general doctor wouldn’t give me shots because she said I was in the normal range! Uhhh, right.
We do not absorb some micronutrients and vitamins from food. Yes, once again, we do NOT absorb some vitamins from food. They took out the part of the intestine that breaks down certain micronutrients and vitamins from food. (This is SO important to know) Example: If you eat yogurt, you get the protein, but get no calcium. If you drink milk, you get the protein but DON’T get the calcium. If you eat steak, you get the protein, but you DON’T get the iron and b12. You will not get some of the vitamins you critically need FROM SOME FOOD.
Why? That part of the intestine that breaks them down was "BYPASSED" during our surgery.
SO…. How do we get these vitamins? We must count our daily vitamins and protein from pills and shakes, as the vitamins in these items are already broken down and the body can absorb them. I don’t count any vitamins or protein from FOOD in my daily totals. I just consider what I get from food as a “bonus”.
Please check out this link below….it is a diagram that is very important to know. Between the red lines is what part of the intestine we had removed, and the vitamins we cannot break down and absorb from FOOD.
Also, We have trouble absorbing "fat soluble vitamins" (A, D, E, K) due to not having a denodium even in pill/supplement
form. It would be in our better interest to take “water solubilized” versions of these vitamins. This means that in the laboratory they were created to be absorbed better through the intestinal wall.
You don’t have to break the bank buying your vitamins and protein powder. You can get most stuff you need at Wal-Mart or rite aid or cvs… Then as you get more experienced you can start tweaking things around and combining things and checking out other vitamin options on the internet.
Most doctors (well at least MINE!) don’t go into detail of WHY for the rest of your life you must take vitamins and protein on a schedule all day long, or HOW to take them or WHEN to take them…..and it is so very very important to our health.
They sent me away from surgery and said “Take 2 Flintstones chewables a day, get iron and calcium…bye”.
Wow, I knew nothing, they told me nothing, and I blindly trusted them. Gastric bypass was new back then…and no one I knew had had one. There was hardly ANY info on the internet, and general doctors were basically clueless in bypass nutrition. Now my labs are horrible, and its 7 years later. I am learning what I should have known 7 years ago. I commend you for investigating. If i could go back in time, i would have done A LOT of things differently.