How do you space out your vitamins and meds?

I am so confused. Help a newbie out?

I am told I can't take the calcium and iron together. I also can't take my synthroid with the calcium or the iron. I have to figure out a reasonable way to space all this out. But the iron says take 3 times a day and it seems to not be able to be taken with anything else except vitamin C.  Do I have that right? This is confusing.

My Ranitidine for my ulcers and GERD says it will inhibit the absorption of iron if taken at the same time, and I have to take that twice a day. I also take an antidepressant. I thought this was going to be as easy as chewing on a few flintstones. Does everything effect the absorption of everything else??? SOooo....   How do you make this work? I am so confused.

My Medications & Vitamin Regimen:

Levothyroxine 50 mcg
B Complex sublingual (1.7 mg riboflavin, 20 mg niacin, 2 mg B6, 1200 mcg B12, 30 mg pantothenic acid)
1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

1/2 multivitamin
400 mg calcium citrate w/500 IU vitamin D
2000 IU vitamin dry D

135 mg carbonyl iron
1500 mg vitamin C

I wait at least 2 hours in between each dosing.  I also have a bit of OCD and that's why I only take a half of a multivitamin at a time.  I keep my daily vitamins in one of those 7 day pill containers.  This makes each container have an equal number of pill in it, except the one with my iron and vitamin C and Tylenol.  It's a sickness, I know. 

After RNY, B12 MUST be taken in injection, sublingual, or nasal inhalant form.  It requires binding to an enzyme called intrinsic factor (IF) in order to be absorbed.  IF is secreted in the part of the stomach that was bypassed.  Therefore it is inaccessible to the RNY patient.

DO NOT take calcium and iron within 2 hours of each other.  They are both absorbed using the same cellular receptor sites.  The receptor sites like calcium better, therefore the calcium will be absorbed and the iron will be excreted in the feces.

DO NOT eat or drink any of the following within 2 hours of taking iron: dairy, eggs, fiber, tea, coffee, red wine, grapes, or spinach.  They each contain substances that bind with the iron.  The iron will then be excreted in the feces.

DO take the CARBONYL form of iron.  It does not have as many GI side effects as does the ferrous sulfate form.  Feosol offers a carbonyl iron that is 45 mg pure iron that is available at your local grocery or pharmacy.

DO take vitamin C with iron.  It enhances the absorption of iron.  If iron upsets your pouch, take it with a meat snack.  This will buffer the pouch and and enhance the absorption of the iron.

Calcium should be taken in divided doses NOT to exceed 500-600 mg at a time.  The body just cannot absorb more than that at a time, no matter your WLS status. 

Calcium CARBONATE is not readily absorbed by ANYONE, no matter their WLS status.  As someone who has had WLS, we really should be taking calcium CITRATE.  It is better absorbed.  I take Citracal Petites.

You will notice that I take my thyroid medication with my first morning dose of vitamins.  Yes, the calcium may interfer with its absorption, but my doctor says that if I take the same way EVERY day and have my TSH levels monitored regularly, my dosage can be titrated as needed.

Thank you so much. I know it wasn't easy to write all that out! But it does help. I will get a pill box too and organize. The iron you take at bedtime?

I thought this was going to be simple. Ha ha.

No trouble.  I just cut and paste from my profile. 

Ah, you had the VSG.  Your requirements may be different than mine.

actually I am still Pre op . My initial bloodwork was awful and I was deficient and anemic and I am trying to get my levels normal before surgery.   I am hoping to get a real date wednesday. But I've had this chronic anemia problem recurr over the last several years and I expect after surgery I will have to stay on top of things.  I was confused about the iron and calcium interfering and all that. Thank you for helping to educate me I didn't know about the different kinds of iron and calcium. I was hoping if I buy bariatric advantage brand it would be made of the right stuff.

How much iron do you take?  You probably don't have to break it into three different doses.  We can absorb a good amount of iron at once.

Try something like this:

when you wake up - synthroid

2 hours later- multi, calcium, B12, D3, antidepressant

lunch- calcium

dinner- multi, calcium

bedtime- iron, c

Kelly

If you can afford it, a heme iron (proferrin) is one that CAN be taken at the same time as calcium and does not need to be taken with vit C. It is more expensive, though.

Oh, and I don't know of anyone who takes their iron in multiple doses - most of us just take iron once a day.