Need help please

jenfasano
on 9/5/12 4:05 pm - CT
 Can someone please outline the EXACT vitamins & b12, iron etc. that we should be taking after gastric bypass please? I have to admit I have been horrible at not taking anything as I should and was reading some of the results of doing so.  I have been feeling dizzy lately , very tired, don't sleep well and just feel like crap in general :(! 

Can I take a whole calcium citrate pill or should I cut it in half ? I have Cvs brand muli, sublingual b12 500 mcg , iron not sure which kind to take ?  Please help NEED to get this right !!!

Thanks Jen :)
        
poet_kelly
on 9/5/12 4:23 pm - OH
Here's what the ASMBS says you should start with:

A multi with 100% of the RDA of most nutrients.  Take two a day.  Stay away from kids' vitamins and gummy vitamins, because those will not have what you need.  Even though Flintstones says “complete" on the bottle, they really are not complete but are missing a number of important things.  The ASMBS  recommends a multi with iron.  If you take a multi with no iron, you’ll need additional iron at a separate time.  They say to start your multi as soon as you get home from the hospital.

1500-2000 mg calcium citrate.  Make sure it's citrate, not carbonate.  That means no Caltrate and no Viactiv.  They say you can wait up to one month to start your calcium – not that you should wait, just that you can.

54-63 mg iron for menstruating women (18-27 mg PLUS 18 mg twice a day in your multi, if you use a multi with iron).  36 mg a day for people that do not menstruate.  We absorb carbonyl iron better than ferrous sulfate.  Ferrous sulfate will also make you constipated.  They say to start your iron as soon as you get home from the hospital.

B12.  You can use a sublingual, 350-500 mcg per day, nasal spray once a week, or shots once a month.  Unless your labs show you need more.  They say you can wait up to three months to start your B12 – not that you should wait, just that you can.

They say a B complex is optional.

Now, if you haven't been taking vitamins all along, you need to get labs done to see if you have any deficiencies because if you do, you'd need to take extra of those things.

And yes, you can swallow the calcium citrate whole, if that's comfortable for you.  I swallow two of them whole at a time.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

jenfasano
on 9/5/12 4:32 pm - CT
 Thanks Kelly 
never2late4change
on 9/5/12 5:06 pm - Virginia Beach, VA
RNY on 07/18/12
On September 5, 2012 at 11:23 PM Pacific Time, poet_kelly wrote:
Here's what the ASMBS says you should start with:

A multi with 100% of the RDA of most nutrients.  Take two a day.  Stay away from kids' vitamins and gummy vitamins, because those will not have what you need.  Even though Flintstones says “complete" on the bottle, they really are not complete but are missing a number of important things.  The ASMBS  recommends a multi with iron.  If you take a multi with no iron, you’ll need additional iron at a separate time.  They say to start your multi as soon as you get home from the hospital.

1500-2000 mg calcium citrate.  Make sure it's citrate, not carbonate.  That means no Caltrate and no Viactiv.  They say you can wait up to one month to start your calcium – not that you should wait, just that you can.

54-63 mg iron for menstruating women (18-27 mg PLUS 18 mg twice a day in your multi, if you use a multi with iron).  36 mg a day for people that do not menstruate.  We absorb carbonyl iron better than ferrous sulfate.  Ferrous sulfate will also make you constipated.  They say to start your iron as soon as you get home from the hospital.

B12.  You can use a sublingual, 350-500 mcg per day, nasal spray once a week, or shots once a month.  Unless your labs show you need more.  They say you can wait up to three months to start your B12 – not that you should wait, just that you can.

They say a B complex is optional.

Now, if you haven't been taking vitamins all along, you need to get labs done to see if you have any deficiencies because if you do, you'd need to take extra of those things.

And yes, you can swallow the calcium citrate whole, if that's comfortable for you.  I swallow two of them whole at a time.
Kelly, you are an awesome source of information. Thank you for sharing your knowledge.
 
Highest Weight: 283.6,  Post Op Weight: 273.6, Goal Weight: 160 lbs 
  

    
Pannelled
on 9/5/12 4:32 pm
Question...how many hours do you wait before taking another dose of calcium?  Also, do you take your calcium with the multivitamin or must it be taken "hours" apart??
         
poet_kelly
on 9/6/12 4:36 am - OH
The ASMBS says to wait two hours between doses of calcium.  You should also wait two hours between calcium and iron.  If your multi has iron in it and you want to absorb that iron, you should not take your calcium with your multi.  Otherwise, it is fine to take your multi and calcium together.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

jenfasano
on 9/6/12 9:16 am - CT
can i take my two multi at the same time or no? what brand of iron do you recmmend that has the correct iron I bought the wrong one :(
poet_kelly
on 9/6/12 9:23 am - OH
On September 6, 2012 at 9:16 AM Pacific Time, jenfasano wrote:
can i take my two multi at the same time or no? what brand of iron do you recmmend that has the correct iron I bought the wrong one :(
I take my two multis separately because we may only absorb so much of certain nutrients at a time.  The ASMBS does not say that you have to take them separately, though.

I use Sundown Perfect Iron, which is carbonyl.  It's easy to find in stores.  Another brand of carbonyl iron is Feosol, but they also make ferrous sulfate, so make sure you're picking up the right one.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

Jennifer P.
on 9/5/12 5:06 pm - MN
RNY on 07/31/12
 My advice is to ask your bariatric nurse.  I was told Flinstone completes are just fine.  And I've found it differs from person to person because not everyone has to take iron (like myself).  
                   
poet_kelly
on 9/6/12 4:34 am - OH
I think asking your bariatric nurse, surgeon, or registered dietician is a very good idea.  Keep in mind that some of them are not familiar with the ASMBS guidelines, and I think it is also a good idea to ask them why, if their recommendations differ from the ASMBS guidelines.  Flintstones are missing a number of nutrients that are important (according to the ASMBS and other sources) and while it may be OK with some nurses, surgeons and dieticians if their patients don't get those nutrients, it's not OK with me to go without those important nutrients.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

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