Question:
How much of each vitamin should I be taking after a DS?

I've read that the reccomended daily intake of calcium is 1500mg and protien 60g.But I can't find any info about the other vitamins and minerals.I'll be having a DS on the 8th of October 2001.I understand that the DS procedure is the least malabsorbtive of the distal weight loss surgeries.I was wondering if any DS patients out there could tell me how much of each vitamin they take post-op.My surgeon has been performing the old BPD and has only recently begun performing the new BPD with duodenal switch.He wants me to take Vita4life vitamins after the surgery,but he wants me to take as many as an old BPD patient would be taking.Surely this is too much to be taking.I've read posts on this site from other DS patients who say they only need to take one or two multi- vitamins a day.While I have nothing against Vita4life, my surgeon here in Australia imports it from America and sells it through his office for $70 per months supply.I think that there could be a conflict of interest here as he is clearly making a profit from this.There is no way that I can afford $70 a month on vitamins.Please let me know if I can achieve the reccomended daily intakes through some other and cheaper means. Thanks Kathy Edwards — Kathy E. (posted on July 21, 2001)

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July 21, 2001
Kathy, each DS surgeon has a slightly different recommendation, and I wouldn't advise you to deviate from what your doc says to do. I can tell you what I have been taking, and my bloodwork has been staying good all around. My common channel is 100cm, with a 250cm alimentary tract. My daily regimen includes one prescription-strength multi-vitamin/mineral tablet (Natalcare PIC Forte, which is the generic for Niferex PN Forte), plus an additional 1260mg of calcium citrate in the form of Citracal+D (4 tablets total). My surgeon, Dr. Rabkin, recommends 1800mg of calcium per day. I take 250mg in my multi, plus the 1260 of Citracal+D, which brings me to a pill total of 1510mg. I easily get the rest via dietary sources. So far my bloodwork has been staying good, and Dr. Rabkin orders very thorough bloodwork (something like 12 vials of blood drawn for it all!). If you're interested, take a look at these page of Dr. Rabkin's website: Patient Binder (lots of helpful info here): http://www.pacificsurgery.com/For_Patients/Patient_Binder/patient_binder.html Annual Lab Orders (to get an idea of how extensive his labs are): http://www.pacificsurgery.com/For_Patients/Patient_Binder/patient_binder.html (This is a .pdf file, so you need the free Acrobat Reader to view it, and that's found at http://www.pacificsurgery.com/For_Patients/Patient_Binder/patient_binder.html) Hope this helps! Best wishes to you! Feel free to email me if I can help further.
— mmagruder

July 21, 2001
OOPS -- CORRECTION! Sorry. :-) Kathy, each DS surgeon has a slightly different recommendation, and I wouldn't advise you to deviate from what your doc says to do. I can tell you what I have been taking, and my bloodwork has been staying good all around. My common channel is 100cm, with a 250cm alimentary tract. My daily regimen includes one prescription-strength multi-vitamin/mineral tablet (Natalcare PIC Forte, which is the generic for Niferex PN Forte), plus an additional 1260mg of calcium citrate in the form of Citracal+D (4 tablets total). My surgeon, Dr. Rabkin, recommends 1800mg of calcium per day. I take 250mg in my multi, plus the 1260 of Citracal+D, which brings me to a pill total of 1510mg. I easily get the rest via dietary sources. So far my bloodwork has been staying good, and Dr. Rabkin orders very thorough bloodwork (something like 12 vials of blood drawn for it all!). If you're interested, take a look at these page of Dr. Rabkin's website: Patient Binder (lots of helpful info here): http://www.pacificsurgery.com/For_Patients/Patient_Binder/patient_binder.html Annual Lab Orders (to get an idea of how extensive his labs are): http://www.pacificsurgery.com/For_Patients/AnnualDSLabOrders.pdf (This is a .pdf file, so you need the free Acrobat Reader to view it, and that's found at http://www.adobe.com/products/acrobat/readstep2.html) Hope this helps! Best wishes to you! Feel free to email me if I can help further.
— mmagruder

July 21, 2001
Kathy - I had the BPD/DS with Dr. Hess in Bowling Green, Ohio last May. I have lost 161# so far and have about 10# to go yet. I take the following vitamins: 2000mg of Calcium - Cal Apatite, 3 - Vit A&D, 2 potassium, and 1 multi-vitamin. My blood workups have been excellent. My cholesterol is 109, no more blood pressure medication, no diuretics, no blood thinners, and no longer have sleep apnea. I used a cpap machine for 8 yrs! And...I have so much more energy. Please feel free to write me if you have further questions. It sounds like you have made a good decision. Good luck!
— Ruth M.

July 21, 2001
Hi-- I'm almost 2 years postop...I take one Niferex PN Forte, and a couple of Viactiv. The Niferex is a perscription multivitamin and my insurance pays for it. My copay on it is $1.18/mo. If you have perscription insurance, I would ask for perscription supplements. Oh, my labs, checked every 3 months the first year & at 6 month intervals the second year, have all been great. Good luck to you!
— [Deactivated Member]

July 21, 2001
I take two multivitamins with minerals, although my surgeon only suggests one. My theory for this is I am twice the weight of a 150 pound person, I probably need twice the vitamins, and it can't hurt. I also take four tabs of Calcium 800mg with 400mg of vitamin D. I also take Twinlabs Allergy Free (non-fish) Vitamin D (10 tabs per day) and two tabs of TwinLabs Allergy Free Vitamin A&D. For DS people, the key to taking enough of fat soluable vitamins A,D,E and K, and Calcium. I used to take just 4 of the Vitamin D per day, but my blood and urine studies showed a low average level of vitamin D, so I increased my tabs to 10, 5 in the morning and 5 at night. A drop in this vitamin acts to impair calcium absorption, which in turn leads to leeching of calcium from the bones, or osteoporosis. I have a bone density study annually and blood and urine studies annually to make sure every thing is ok. So far, so good. Now, the really good news is that I buy whatever is on sale for the calcium and vitamins, usually a storebrand generic. I do make a point to get calcium citrate instead of calcium carbonate. When I hit 200 pounds, I will drop to one vitamin per day. The Twinlab stuff I buy by the case and get a 15% discount at the healthfood store. Good Luck to you! I started out at 494 and have lost 172 pounds in the past year. I expect to be having reconstructive surgery next year at this time.
— merri B.

July 22, 2001
Although we have all had the same surgery, I have seen some big differences in how any individual actually absorbs what they are taking in. So to some extent, it is going to depend on how your body specifically reacts. Careful monitoring of your blood work that first year will help you pinpoint exactly what *you* need to do. For me, I take two multi-vitamins (the store brand for Centrum - cheap!) and three Calcium Citrate (Nature's Best from vitalady - cheap!). I just had to add a zinc table since my zinc and copper absorption are warring with each other, but that is also the store brand - cheap! I spend maybe $15.00 per month on vitamins. -Kate-
— kateseidel

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