Calcium, Iron and zinc

Hi friends,
I have questions about calcium, when did you start taking them?
My doctor told me to start with multivatamins and nothing more for now.
He says I don't need them. When is it necessary and why?

My surgeon has his gastric bypass patients take multivitamins, calcium citrate and iron as soon as we get home from the hospital.  Did your doctor tell you why it wasn't necessary?

Hi Pam,
He says I have enough reserve for 3 months. Mexico is different I suppose but I have already bought everything from bariatric advantage and not sure wether to start or not.

 your best bet is to always listen to your surgeon, if you question their opinion then i would look into a second surgeon and see what their thoughts are on the subject. my surgeon had me wait to take anything other than the multi-vitamin as well. now i'm able to take additional supplements. but i definately wouldn't recommend going against your surgeon especially not when you very early out of surgery. 
 
Good luck!

What virtue is there in NOT supplementing? If the supplements could HARM someone, I could see why they should hold back, but I can't quite get why you would suggest to follow the surgeon's plan if there can be no harm in supplementing early? I loook on it this way... if my surgeon says to wait and "use up your stores" (and you STORE calcium in your BONES)... and this causes me to have brittle bones, then his bones are fine, but your bones are dust. If he's right, and you supplement when you didn't need to, then you're out a few bucks. Ultimately, if you supplement you win whether or not he is right. You can't LOSE by supplementing. My bones are worth too much to gamble on "using up my stores"

I always wonder why post-ops (in general, not specific to this post or poster) are so reluctant to take the "better safe than sorry" approach when it comes to vitamins and protein.

Lora

you may have a reserve for 3 months but should you be depleteing that reserve without replacing? My surgeon had me start multi, calcium, and b12 once discharged from the hospital.

Here is the link for the  American Society for Metabolic and Bariatric Surgery website with some good information.
http://asmbs.org/2012/06/asmbs-integrated-health-nutritional -guidelines-for-the-surgical-weight-loss-patient/

I was told to start my multivitamins immediately and my calcium after my 2 week follow-up visit.

Even though you may have stores of certain vitamins, if you deplete those stores it is VERY difficult to raise levels after RNY (it is hard enough sometimes just keeping them up, let alone eliminating a deficiency). Most of your calcium is stored in your bones and teeth... do you really want to pull calcium from your bones and teeth?!? Unfortunately, some surgeons know very little about nutrition. Does your surgeon's office or hospital have a nutritionist that they have bariatric patient's see? If so, I would get a second opinion on it from them. The ASMBS says you need to start calcium within one month.

Also, have you had labs done already so that you know that you have good levels to begin with?!?

Lora

Calcium citrate is the only form of calcium you should use.  I'd also highly recommend a higher dosage D3.  I'd suggest you start with 2-3 of the 50K IU dry D3 per week. Adjust when you get future labs. You really want D levels of 80-90, and that's difficult to attain with 5-10K "high dosage" D3 commonly seen at local stores.  I get my 50K IU dry D3 from vitalady.com.  BTW, you should not take your iron and calcium at the same time. Take them about 2 hours apart.  My first labs, about 2 weeks post op, had me at an 8 for my D.  I finally got it up to 104, but that was using 7 of the 50K IU dry D3 per week. Every patient is not identical, so only adjust upward based on lower lab levels. I agree with starting as soon as possible--playing "catch up" with supplements may take longer, and require additional labs (that you might have to pay for too). DAVE