It's been a LONG time...

Hello!  I'm not sure where to start here, as it's been several years since I've been to this site.  I had my RNY four and a half years ago (to the date actually!).  Things are going great, as far as keeping the weight off, but I haven't been going to the follow-up doctor appointments once a year and taking my vitamins.  I just had my labs done while I was admitted at Unity (female related) a couple weeks ago, the results are back, and they aren't great.  My iron and vitamin D levels are almost non-existant!!  So now I am back to the vitamins.  I guess it was a blessing that I was in the hospital!

My question is that I take Synthroid and I am trying to space everything out (since I can't take my iron supplement or calcium within 4 hours of taking my Synthroid).  Does vitamin D have to be 4 hours from everything else too?  Does anyone have any ideas?

Thanks for any suggestions you can offer!

My best advice to you would be to contact Michelle at www.vitalady.com - she is fantastic and knows her stuff!

Second would be to contact your bariatric nurse at Unity.

Good luck!

I'd call your pharmacist....they have such a wealth of knowledge and they have your med list right there and can tell you times to take all of it!

Christine, take the vitamin D with the calcium and do your doses at least 4 hours apart  the D helps to absorb the calcium..I usually take   the synthroid now about 4-5 am when I rise for potty, My vites are at noon and then calcium,D,Magnesium are at 4,8 and bed at midnight. you can learn a lot at the grad site or vitamin mineral site or even the protein site. it been said also that taking the calcium before bed gets a lot more absorbed through the night.   Just looking at our baker book it lists breakfast multi vite and B-12,lunch take calcium,dinner take calcium, and at BEDtime take calcium. so they agree on that. so it looks like you could take the iron with the vites and have 4 hours before lunch.

You can check on this, but I was told from Baker Bariatrics nurses that you can take calcium and iron together as long as it is calcium citrate. This type of calcium does not interfere with iron absorption. Here are some excerpts from articles about the topic...

Some facts about iron supplements

Iron supplementation is indicated when diet alone cannot restore deficient iron levels to normal within an acceptable timeframe. Supplements are especially important when an individual is experiencing clinical symptoms of iron deficiency anemia. The goals of providing oral iron supplements are to supply sufficient iron to restore normal storage levels of iron and to replenish hemoglobin deficits. When hemoglobin levels are below normal, physicians often measure serum ferritin, the storage form of iron. A serum ferritin level less than or equal to 15 micrograms per liter confirms iron deficiency anemia in women, and suggests a possible need for iron supplementation [33].

Supplemental iron is available in two forms: ferrous and ferric. Ferrous iron salts (ferrous fumarate, ferrous sulfate, and ferrous gluconate) are the best absorbed forms of iron supplements [64]. Elemental iron is the amount of iron in a supplement that is available for absorption. Figure 1 lists the percent elemental iron in these supplements.

Iron and mineral interactions

Some researchers have raised concerns about interactions between iron, zinc, and calcium. When iron and zinc supplements are given together in a water solution and without food, greater doses of iron may decrease zinc absorption. However, the effect of supplemental iron on zinc absorption does not appear to be significant when supplements are consumed with food [1,87-88]. There is evidence that calcium from supplements and dairy foods may inhibit iron absorption, but it has been very difficult to distinguish between the effects of calcium on iron absorption versus other inhibitory factors such as phytate [1].
(from http://ods.od.nih.gov/factsheets/iron.asp)

Actually, inhibitory effects of calcium on iron absorption is not well-established. I have found one textbook chapter from the 1980's that named calcium as an inhibitor of iron absorption, and a few studies demonstrating a short-term effect, but no formal studies that demonstrated this effect over the long term. In fact, two separate studies that investigated this claim, published in 2004 and 2005, respectively, in the American Journal of Clinical Nutrition, concluded that calcium supplementation had no effect on the absorption of non-heme (that is, plant-based) iron. (Read both studies here and here).

http://findarticles.com/p/articles/mi_m0887/is_n3_v10/ai_106 00750

So ultimately, ASK your Bariatric clinic.