vitamins

Hello, I just had my two year follow up, I have lost 125 pounds and have kept if off without any gain.  The doctors want me to start taking iron and vitamin D.  My question is can anyone advise me on how and when to take all the vitamins?  for example can i take iron with calcium?  Can I take the vitamin D with my multi-vitamin?  What is your routine?   Thank you for any advice

No you cannot take iron with calcium.  I don't think there are any restrictions on vit. D. I think most people take pretty high doses of D to get it into range.

I use and know a ton of people that have had WLS with my DR still use the FUSION vitamins...  Even people 15 year out.  Chewable and 4 a day (2 tablets twice a day)  Easy, many flavors to try and reasonably priced.  I hope this helps some and it takes out the worry, hassle, and having to take so many pills.

So, just to confirm, you are two years out and have never taken vitamins? If so, is your doctor just suggesting them to you because he knows they are necessary or did you recently have blood work taken that shows deficiencies? If it is the former, I would highly advise you to get a full set of labs run to see your current numbers and to help determine how much to supplement. For example, I take more iron and calcium than others because they run low. 

But to answer your question, here is my routine:

Morning- 2 multis, vitamin D, calcium

Mid morning- calcium

Lunch- calcium

Mid afternoon- calcium

Bedtime- iron, vitamin C

Calcium and iron need to be separated by at least two hours. Calcium doses shouldn't exceed 500mg at a time, but since most folks need at least 1500mg a day, that means multiple doses. Vitamin D is best with calcium and Vitamin C helps with iron absorption. More info can be found if you google ASMBS nutritional guidelines.

I do pretty much what NHPOD9 does. In addition, I take another 5,000 of dry D3 per day, and a 2,000 B12 per week.

I totally spaced the B12. I also take that once a week.

Calcium and iron are absorbed by the same receptors, and if both are present, calcium wins.  That's the reason you need to separate them by a few hours.  If you had a VSG (sorry, I didn't notice whether there was a surgery type before hitting reply), you should be taking B12, either subligually or patch or injection, because the portion of the stomach that helps B12 absorption (when it's swallowed) is removed.  Both calcium and iron prefer an acidic environment in the stomach, so Vit C would help with both, especially if you're taking a PPI.

Most people take their iron and vitamin c alone, before bed, because a whole bunch of other things interfere with iron absorption as well. Tea, coffee, soy -- there are a long list of things you shouldn't be having with your iron.

You might need to ask your Dr. for a prescription for a slow release iron supplement. With RNY, according to my GI, OTC iron tablets are useless because they are absorbed in the part of the small intestine we get "bypassed".  I take Se-Tan which is a iron/multi combination (it is absorbed later) and can keep my iron levels high enough to donate blood.