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• Product - Bariatric Advantage Peppermint Sublingual B12
• Via - Bariatric Advantage
• Price - Peppermint, 90 count  $18.25
• Pros - So. easy. to. take.  The taste is magic.  Minty-fresh.  Mr. MM says "They're like those after dinner mints use you'd get at the restaurant,  you know, those ones in baby colors?"  I say, no.  They're a little pepperminty-er than THAT and not as sweet, of course, there is no sugar in them.
• Cons -
  

• Info from Bariatric Advantage - Deficiencies of B12 and folate have been demonstrated with virtually all bariatric surgery procedures. Our B12 was designed to meet the vitamin B12 needs of individuals who have undergone weight loss surgery. Each tablet provides 1000 micrograms of B12. This product is a 100 percent lactose-free formula that can be placed under the tongue or between cheek and gum and allowed to dissolve over a period of several minutes. This tablet also contains 200mcg of folic acid. B12 with Folic Acid. Vitamin B12 and folic acid are synergistic nutrients in the body, supporting many of each other’s functions. The 200 mcg of folic acid in this tablet also means that patients who are or wish to become pregnant can get a full milligram (1000 mcg) of folic acid when they take this product together with any of our multivitamins.
  
  100 Percent Lactose Free. Some percentage of patients who have undergone weight loss surgery such as gastric bypass or duodenal switch develop lactose intolerance. Others have heard about this potential problem and avoid lactose-containing foods and products without a confirmed problem. The vast majority of B12 products contain lactose for one of two reasons: 1) the tablet itself contains lactose or 2) the B12 is titrated in lactose. The latter may not show in the ingredient listing, and may cause symptoms for unidentifiable reasons. Our B12 is 100 percent lactose free. There is no lactose in the base and the B12 ingredient is titrated in calcium. Thus, this is the best choice formula for those who may need to avoid lactose.
  
  Great Taste. We consistently get feedback from customers on the great taste of our products, especially our B12. Great taste fosters compliance, and makes the process of taking daily vitamins more pleasant for patients.

• Rating - Wicked (deal with it, I'm in Massachusetts
• Pouchworthy, ^MM

Many post weight loss surgical patients deal with blood sugar fluctuations, particularly those of us whom have had roux en y gastric bypass.  Aside from dumping, we often have a blood sugar reaction after dumping -- and sometimes without -- called reactive hypoglycemia.  

Nutrition for Reactive Hypoglycemia -

via http://www.mckinley.illinois.edu/Handouts/hypoglycemia_nutrition_reactive.html

What is reactive hypoglycemia?

Reactive hypoglycemia can occur when blood glucose falls, stores of glucose from the liver are exhausted and an individual chooses not to eat. The body gradually adjusts to this situation by using muscle protein to feed glucose to brain cells and fat to fuel the other body cells, but before this adjustment takes place, an individual may experience symptoms of glucose deprivation to the brain. Symptoms such as: anxiety, hunger, dizziness, confusion, sleepiness, weakness, shaking muscles and racing heart may result. Most of these symptoms diminish five to ten minutes after eating a source of carbohydrate. Because these symptoms are common to many conditions, a health care provider should be consulted to assess an individual’s specific symptoms and concerns.

via http://www.mckinley.illinois.edu/Handouts/hypoglycemia_nutrition_reactive.html

Who is affected by reactive hypoglycemia?

Reactive hypoglycemia occurs in about 2-3 out of every 10 young women - more often in obese women and less often in people over age 45. While most people experience low blood glucose levels at times, if the symptoms are severe or ongoing it is important to learn to eat a balanced meal or snack promptly. Reactive hypoglycemia does not lead to more severe conditions.

How can I control reactive hypoglycemia?

Reactive hypoglycemia can be managed with:

• Nutritionally balanced meals
• Frequent meals and snacks
• Regular exercise
• Smoking cessation
• Weight management
• Medical supervision, if indicated
• Regular blood sugar checks, if advised

How can reactive hypoglycemia be controlled with nutritionally balanced meals?

When blood glucose falls, eating carbohydrate foods can bring blood glucose levels back up; a meal or a snack must be eaten. Some people believe the obvious solution is to eat a candy bar or drink a cola beverage. Such a meal or snack is very high in carbohydrate, and consists mostly of simple sugar. It may cause your blood level to rise quickly and then fall quickly. Some people then experience the symptoms of rebound hypoglycemia.

A more helpful choice is to eat food with complex carbohydrates (higher fiber whole grain crackers, bagels, breads or cereal). Complex carbohydrate foods deliver glucose over a longer period of time, eliciting less of a rise and fall in blood glucose. A cracker or other grain food with cheese or another protein/fat is the best choice. The protein/fat slows down the digestion of the carbohydrate and keeps blood sugar more stable.

Some snack and meal suggestions that meet the goal of including a complex carbohydrate, a protein source or a fat include:

• Meat or cheese sandwich on whole wheat bread
• Yogurt and fruit
• Cottage cheese and whole grain crackers
• Turkey, cheese slices and veggies on a salad
• Salad with beans or nuts added
• Peanut butter and whole grain crackers
• Cheese and whole grain crackers
• Bean soup and whole grain crackers or bread
• Cheese on baked potato with skin
• Whole grain bagel and cream cheese

Nutrition tips to manage hypoglycemia

• Eat a small meal or snack about every 2-3 hours. Skipping meals can make symptoms worse.
• Choose high fiber foods at each meal and snack.
  Fiber helps stabilize blood sugar. Increase fluid intake when you increase fiber intake.
• Eat a source of protein and or a source of fat with carbohydrate at each meal or snack.
  Protein and fat eaten with carbohydrates will help slow glucose release and absorption.
• Limit simple sugars. (candy, soda, fruit juice, sweets).
  Simple sugar intake can make hypoglycemia symptoms worse. Moderate your intake.
• Limit alcohol and caffeine (coffee, tea, soda, chocolate).
• Eat a meal or snack 1-3 hours before exercise.
  Extra carbohydrates may be needed before exercise to compensate for energy used.
• Nutrition for Reactive Hypoglycemia