smg

12 and 6 were seriously high. I use the garden of life womens once daily. all of my other labs were normal. so, we'll see how things are tomorrow and if any changes need to be made. I will say I do eat chicken breast, red meat, eggs, almonds, green veg. but I'd hardly say I eat a lot of anything - a lot less than I ever used to, that's for sure.

Garden of Life is another good brand. I use Probiotics from them and really like them. Good to hear that you're Vitamins and diet are working...nothing better than leaving the doc with a thumbs up and good labs

Welcome @ !

"Nervous" and "Excited" are certainly both normal feelings, and expected this early on. Glad to hear you are doing your research and getting involved in discussions early on. Be sure to ask any questions you have.

Your wife being nervous is also normal. It comes from a place of love. My wife was also nervous but tried to hide it once she saw that I was happy with my research and decision to move forward, and now, I think she realizes it was one of the best decisions I've made for my health!

Best of luck to you on your journey and welcome again!

Sounds great! Similar to the recipe I use, but I leave out the sugar free maple Syrup. Will have to try adding the lemon. Thanks for sharing!

Yep I was that way as well for the first 6 weeks. A few bites and I was done. Your sleeve definitely lets you know when you're done...especially in the beginning.

One thing I did notice is that it mattered a great deal what I was eating that determined how much I could eat. For instance, I could typically eat about 1/4 cup of ricotta bake, but only about 3-4 bites of cottage cheese.

Everyone and every food is different. Keep trying new things slowly, make sure you get in your Protein and fluids, and things will get better as you heal more.

Best of luck!

Actually pureeing my own food (other than soups) never really sat well with me (texture I guess), so I relied on Soups, over-steaming veggies so they were really, really soft, hummus, refried Beans, and other things that were typically prepared pureed.

I liked soups a lot (still do) and so I would make some veggies (broccoli, asparagus, carrots, etc), add some unflavored Protein, and then puree it in the pot with a stick blender. I couldn't do the pureed chicken or fish personally.

I drink the Vitamin Water zero - I have to limit myself to 2 per day because my b Vitamins were too high at my last appointment. curious to see where they will be tomorrow at my six month check.

I have no idea what kind of B is in there - but clearly it is working for me.

Vitamin Water Zero contains Vitamin B3, B5 and B12 from cyanocobalamin. I'm assuming you also take a Multi-Vitamin? There are also a lot of foods that are fortified with B Vitamins in the United States. Which B-Vitamins were you high in out of curiosity? The one most bariatric patients are prone to deficiencies in is B-12 because of the absorption issues due to a reduced amount of intrinsic factor being produced. As far as B-12 in foods, there is plenty in most meat/dairy products, and if your stomach is producing enough intrinsic factor to methlyate it you would certainly get enough.

It is possible that your stomach, though smaller from the sleeve, is still producing enough intrinsic factor to methylate the cyanocobalamin and B-12 from foods and synthetic cyanocobalamin sources. Since your body can't use B-12 until it becomes methylcobalamin, then either your other supplements include this form or your body is producing enough of the intrinsic factor Protein to absorb it....either way it's a good thing

If you look at most supplements, the amounts of B-Vitamins they include are FAR BEYOND the recommended daily amounts because most of us can't absorb all of it. B-12 can be added in some supplements as high as 16,000% of the daily amounts to make sure you get enough, so having high readings is not out of the question.

For most people, "too much B-vitamins" won't be an issue, although for some it may be. Too much B6 or B3 *could* be an issue for some, but the amounts needed for symptoms in most people are astronomical and won't be a concern for most if the sources of B-vitamins are coming from supplements (at the directed dosage) and food.

Some people who take cholesterol meds may want to check if their meds contain high levels of Vitamin B-3 (Niacin), though.

Depends on what kind of juice you're talking about. If it's fruit juice, then no...extracting the sugar in fruit from the Fiber is never a good idea. If you're talking fresh vegetable juice (leafy greens, broccoli, celery, etc) then it's going to be low in sugar and packed with vitamins/nutrients, but you should check with your doc first. I juiced pre-op, and immediately post-op, with only vegetables and some lemon or 1/2 green apple to cut the taste of the greens. You could add Protein to that.

If you're talking about the "Juice+" product, I've never used it personally, but what I saw of the product, it was pretty high in sugar per serving for a "protein shake" choice that you'll be using 2-3 times per day. (the one I saw had 11g of sugar per serving).

You should always try to take the methylated form in Vitamins, they are more readily absorbed into your system.

I use the following multi, it has all the correct methylated Vitamins in excellent quanitities.

I have not had any nutritional issues since my surgery so far.

http://www.lifeextension.com/vitamins-supplements/item02001/one-per-day-tablets

I like LifeExtension products. They consistently rate high in various tests on labdoor. I use their Magnesium product. I don't use the "Natural Vitality Calm" stuff that's pretty popular as it's known to have super-high levels of arsenic in it. Love the LifeExtension Magnesium as an alternative.

For my multi, however, I choose a "bariatric formulated" version that I know to be clean, simply because it includes higher amounts of vitamins that are easy to become deficient in, but that's just me and based on recommendations from my surgeon/NUT. Thanks for sharing!

@@missdeeAus There are many products that use the Metthylcobalamin form of B-12. I don't know if Centrum is one of them or not. The Multivitamin that I use has most of the B-Vitamins including methylcobalamin B-12, but I also take a B-Complex Vitamin where the B-12 is methylcobalamin.

The Multivitamin I take: http://www.opurity.com/products/opurityr-complete-capsules-for-gastric-sleeve-gastric-bypass-and-gastric-band-360-capsules.html

The B-Complex Vitamin I take: http://www.orthomolecularproducts.com/ortho-b-complex/

I get the opurity Multi from the above link. The B-Complex vitamin I get from my surgeon/NUT but they also sell them online at Amazon -- http://amzn.to/2bp3pYd

So prior to surgery I was informed by my GP to "make sure I watch my Vitamin B levels after surgery", and I heard it again from doing research online, and then I heard it again from my Nutritionist in my pre-op class. Obviously, all Vitamins are important, but Vitamin B is what I heard the most, and that made me concerned, but also curious as to why.

What is Vitamin B and why do we need it?

Why are bariatric patients prone to Vitamin B deficiencies?

What are good food sources that are high in Vitamin B?

I did a lot of research, confirmed my findings with my Nutritionist and surgeon, and thought that I would share them here for those still in the research phase pre-op, or even those that have concerns post-op about Vitamin B.

**DISCLAIMER**

I am not a Doctor, Nutritionist, or Medical Professional. Please consult your Doctor before starting or changing any recommended supplements. This is simple research that can be found on the Internet and should NOT be taken as medical advice!!!

WHAT IS VITAMIN B AND WHY DO WE NEED IT?

First off, let me clear up one common misconception. "Vitamin B" is not actually a singular vitamin. It's a class of vitamins. It's 8 vitamins overall that make up the Vitamin B family, they each play an important role in our bodies, and they are often classified under various names aside from "Vitamin B-1, Vitamin B-2, etc".

The biggest role B-Vitamins play in our bodies is maintaining cell health, as well as keeping us energized. Each B-Vitamin plays its part, and each come from various sources. Foods or supplements that contain all 8 B-vitamins are known as Vitamin-B Complex. Knowing where each comes from and what it does is important for everyone, especially those of us who have had bariatric surgery as we are at greater risk for deficiencies in these important vitamins. Other factors contributing to a higher risk of deficiency are; older age, pregnant women, people with Crohn's disease or Celiac disease to name a few.

Below is a brief summary of each of the B-Vitamins, what they do, and what foods they're in.

Vitamin B-1 (THIAMINE)

Description: In short, Vitamin B-1 helps convert food into energy. It is a coenzyme in the catabolism of sugars and amino acids.

Deficiency: Symptoms of Deficiency in Vitamin B-1 can include emotional disturbances, encephalopathy, weakness or pain in extremities, irregular heartbeat, edema, heart failure.

Food Sources: Whole Grain Wheat, oatmeal, Flax, Sunflower Seeds, Brown Rice, Whole Grain Rye, Asparagus, Kale, Cauliflower, Potatoes, Oranges, eggs, Liver (Beef, pork and chicken). Many additional foods are fortified with Vitamin B-1 in the United States.

Vitamin B-2 (Riboflavin)

Description: Vitamin B-2 is an essential requirement for enzymes to perform various actions including the catabolism of fatty acids, but it is also important for maintaining good eyesight.

Deficiency: Symptoms can include cracked lips, sensitivity to sunlight, sore throat, edema, tongue swelling, dermatitis, hyperemia.

Food Sources: Milk, cheese, Eggs, Dark Green Vegetables, Leafy Vegetables, legumes, mushrooms, almonds, liver, kidneys. Many additional foods are fortified with Vitamin B-2 in the United States.

Vitamin B-3 (Niacin)

Description: Vitamin B-3 is needed for many metabolic processes. It helps convert food into energy and also aids in proper digestion and appetite.

Deficiency: Symptoms can include digestive issues, nausea, cramps, aggression, dermatitis, insomnia, weakness, mental confusion, diarrhea, dementia

Food Sources: Liver, chicken Breast, Beef, Fish, Eggs, Venison, Avocados, Peanuts, Leafy Greens, Broccoli, Asparagus, Dates, Tomatoes, Carrots, Sweet Potatoes, Nuts, Legumes, Seeds, Mushrooms, Peanut Butter, Tofu

Vitamin B-5 (Pantothenic Acid)

Description: Vitamin B-5 aids oxidation of fatty acids and carbohydrates, and used in the synthesis of Coenzyme A (CoA), which is important in energy metabolism.

Deficiency: Deficiency is rare but symptoms can include acne and parasthesia.

Food Sources: Whole Grains (not refined), meat, Avocados, Broccoli, Alfalfa, Fish, Mushrooms, Brown Rice, Yeast.

Vitamin B-6 (Pyridoxine)

Description: Vitamin B-6 helps convert food into energy. It also helps the immune system fight off infection. It also helps women who are pregnant or breastfeeding to help babies brains develop normally.

Deficiency: Symptoms can include dermatitis, pink-eye, epilepsy, neurological issues, anemia, depression, confusion, nausea, rashes

Food Sources: tuna, Salmon, Chickpeas (Garbanzo Beans), Whole Grains, Beef Liver, Ground Beef, Chicken Breast, Watermelon, Potatoes, Spinach

Vitamin B-7 (Biotin)

Description: Vitamin B-7 is necessary for cell growth. It also plays a key role in the production of fatty acids, and the metabolism of fats and amino acids. It also assists in various metabolic reactions involving the transfer of CO2. It may also be helpful in maintaining a stable blood sugar level. It's often recommended as a supplement to promote strong hair and nails, but the scientific data supporting these claims are weak and heavily scrutinized.

Deficiency: Deficiency does not typically cause symptoms in adults, but can impair growth and cause neurological defects in infants.

Food Sources: Peanuts, Swiss Chard, Leafy Greens, Egg Yolk, Liver, Saskatoon Berries

Vitamin B-9 (Folic Acid)

Description: Vitamin B-9 helps with the growth of red blood cells. Folic Acid helps reduce birth defects. Folic Acid is also used by the body to make and repair DNA, as well as methylate DNA. It's especially important in aiding rapid cell division and growth during infancy and pregnancy.

Deficiency: Symptoms can include anemia, diarrhea, and deficiencies in pregnant women can cause birth defects.

Food Sources: Whole Grains, Leafy Greens, Beets, Meat, Fish, Legumes, Liver, Citrus. Many additional foods are fortified with Vitamin B-9 in the United States (cereal).

Vitamin B-12 (Cobalamin)

Description: Vitamin B-12 helps regulate the nervous system. It also plays a key role in red blood cell growth, the production of bone marrow, and the cellular metabolism of carbohydrates, Proteins and lipids.

Deficiency: Symptoms can include anemia, confusion, fatigue, weakness, irritability, depression, tingling in extremities

Food Sources: Vitamin B-12 is found primarily in animal based foods, and those on a strict vegan diet can be at more risk than others. Eggs, Cheese, Milk, Fish, Shellfish, Liver, Kidney, Beef, Red Meat

WHY ARE BARIATRIC PATIENTS AT RISK FOR B-12 DEFICIENCIES?

Vitamin B-12 relies on proteins for successful intestinal absorption in the human body:

Haptocorrin (transcobalamin) secreted by the salivary glands is essential in protecting Vitamin B-12 while traveling through the acid of the stomach.

Intrinsic Factor: This is a glycoprotein that is produced by the cells of the stomach. It is essential for the absorption of Vitamin B-12 in the small intestine.

Because bariatric patients of certain procedures have up to 85% of their stomachs removed, the majority of the cells that produced intrinsic factor are also removed. Simply adding a Vitamin B-12 supplement may not be enough in these patients as some supplements still require intrinsic factor to be properly absorbed. There are two major types of Vitamin B-12 found in supplements:

Cyanocobalamin: A synthetic form of Vitamin B-12, This is the more common form of B-12 found on the market, because it is the easiest to make, not because it's the best (certainly not for bariatric patients). This form is made with a cyanide element that is excreted. The presence of cyanide in this amount is nothing to be alarmed about (although I gasped the first time I saw it). The problem with cyanocobalamin is that it needs to be methylated before the body can absorb it properly. To do this it requires intrinsic factor, which is reduced in bariatric patients. Basically your body needs to convert Cyanocobalamin into Methylcobalamin before it can be used by your body.

Methylcobalamin: Vitamin B-12 in this form remains in your body for longer periods, and at higher levels than cyanocobalamin, making it available to your body for a longer period of time. Because this form of Vitamin does NOT need intrinsic factor to be absorbed by the body, it is far more available for use by your body as a bariatric patient, and you are not restricted to oral use. sublingual (under the tongue), melts, Patches, sprays, and creams are alternative ways to use this form of Vitamin B-12 and make it available immediately.

When researching supplements and vitamins, make sure to look at the label. The label should read: "Vitamin B-12 (as Methylcobalamin)". Be sure to look. As I mentioned previously, Cyanocobalamin is more common because it is cheaper and easier to make.

I hope this helps someone during their research and those who have questions about the B-Vitamin family. If I missed anything, please add it below and I'll edit this post.

Best of luck!

There is nothing you can do to stop the hair loss. If it's going to happen, it's going to happen. I've heard people say that Biotin works, which is a B-Vitamin, and you should be taking a B Complex Vitamin anyway, but I don't believe that adding extra Biotin will prevent Hair loss.< /p>

Having said that, I also don't think it's a bad idea to add additional B Vitamins to your routine either, as it's easy to become deficient in them post-op. Look for a B-complex vitamin where the B-12 comes from methylcobalamin and NOT cyanocobalamin. B Vitamins need a Protein called "intrinsic factor" to properly be absorbed by our bodies and that Protein is made within our stomachs. Remove 85% of your stomach and you remove 85% of the protein production. Pre-methlyated (methylcobalamin) B-12 will be absorbed without the need for additional Proteins secreted by the stomach. Maybe that will help with hair loss, maybe not, but it will help you from becoming deficient in B-vitamins, which is a good thing.

Best of luck!

It happens. You recognized it immediately and that's an important step. Get back on track now and keep going forward.

Once you do start getting back to solids, try having healthy Snacks available 24/7 so if you are tempted to eat, you can always grab something that will help, not hurt your progress.

Even more important than the pizza not being a healthy choice, it's extremely important that you be careful so soon after surgery because things are still extremely fragile and healing. Something as rough as Pizza Crust could really do some major damage that could cause severe complications and you certainly don't want that!

But good job for coming clean and acknowledging it. It's not easy, but it is worth it....you fell off the horse....now get back on!

We're all cheering for you!

My plan allowed for (runny) scrambled eggs as soon as you could tolerate them after surgery...everyone's plans are different. It is possible that eggs are just not sitting well with you right now. I would take a look at your Protein shakes and make sure it's not higher in sugar than others out there. There are some that are ridiculously high in sugar and sugary liquids can cause irritation and "dumping syndrome-like" symptoms like sweating, shaking, chills, heartburn, etc.

Hope it calms down for you soon!

I think it has a lot to do with the fact that nutrition itself isn't an "exact" science. Every nutritionist has his or her own beliefs, based on practice and science together. I think that surgeons rely on their nutritionists to develop the pre-op and post-op diet plans.

Some places have "standards" that they recommend patients stay within, while others tailor specific diets to each patient (not likely for busy surgeons). These standards can be deviated from, especially if something may not work for you or if you have specific allergies or needs.

For instance, my nutritionist has a plan that every patient gets before the surgery. It explains the pre-op diet and post-op diet. Fortunately for me there was never any period that was 100% liquid. We were allowed some soft foods (foods that could easily slide through a funnel) as soon as we could tolerate it after surgery. The diet was full of typical recommendations....soups, yogurt, cottage cheese, scrambled eggs, etc.

I mentioned to my nutritionist that I was interested in more of a "whole foods" based approach post-op and her eyes lit up and she provided me with a ton of information on how to accomplish that. It wasn't the normal plan that was handed out because eating a whole-foods based diet is often not the most "convenient" and certainly not the most budget-friendly, but it's what I wanted to do. I was set on taking this opportunity to completely retrain my tastes and focus on nutrient-dense foods and lean Protein sources.

It's worked out well for me so far and really all it boils down to is staying away from processed foods.

The key is to speak with your nutritionist about your specific wants/needs and then make that plan reality. I'm just glad I spoke with my NUT before surgery because I wouldn't have had the information or help that I have now if I didn't speak up.

Best of luck!

My nutritionist had hopes that people would give up caffeine, but she is also a realist and knows that people want their coffee and has no issue with it (black coffee) if you are drinking 1-2 cups per day.

It's the ones who drink a pot or two a day with cream and sugar that have real issues I think.

We were only told to stay away for a few weeks post-op because coffee is acidic and could irritate a healing sleeve. I have no issues drinking a cup or two now. Doesn't irritate me in the slightest.

Yeah the carbonation doesn't work for me either. Tried soda Water and it didn't sit well so I can't imagine the fizz sticks would do well for me either.

Everyone reacts different though. If you are going to try them, I would definitely say try a small amount and give yourself a few minutes to see how your sleeve reacts before drinking more.

Best of luck!

I agree with @@JamieLogical that bread (any bread) can really fill you up quick. For me, I found the best thing to do was focus on Protein grams, while making sure that any other food I ate was indeed "feeding" me and not just filling me up while providing little else as far as nutrition is concerned.

I would make sure that the lean Protein was primary, and then (if there was any room left) focus on nutritious foods like steamed veggies, fruit, nuts and seeds. Couldn't eat very much at that point so typically protein and a bite of broccoli pretty much did it for me, but everyone's different.

If I did get that "carb craving" I would (and still do) fill that craving with fruit and/or quinoa, where the latter also helps meet your protein goal.

I did have some paleo crackers a few times early on that were made of nuts and seeds and included a few grams of protein, but no wheat or flour.

Best of luck!

Hmmm....I had labs done at 1 month and 3 months post-op and everything <-- EVERYTHING was actually better than pre-op labs. Not sure that this is consistent with all patients...certainly not consistent with my results.

It does make sense, thought, that breaking down those fat stores as energy could cause numbers to rise in certain areas so I don't discount the study. I do discount the advice not to listen to your physician if they feel you should be using a medication to treat something they believe is necessary to be treated. I think it would be wise to mention the weight loss to them so they are aware (my surgeon actually wrote a letter to my GP with a surgery report, as well as recommendations for labs at specific time-frames), but I would in no way recommend refusing medication if your doc prescribes it, especially if you had these issues pre-op. You can always be tested again once your weight becomes more stable, and if it was the weight loss that caused the increases, adjustments can be made at that point....

First off, welcome to the forum @@TWW200 !

Not sure what procedure(s) you are considering, but I can only speak to the Gastric Sleeve (VSG). When you have the procedure done, there are possibilities that your "tastes" can change. You may not like things you liked before the surgery, and vice versa. For instance, since my procedure I am very sensitive to foods that are overly salty and also drinks that are overly sweet, even though before surgery, those same foods or drinks didn't bother me.

Sometimes, for whatever reason, some tend to have difficulty with Water after the surgery. I did not. I loved Water before the procedure and love it just as much after. I do find it interesting that before the surgery I would drink purified bottled water at room temp, but now after the surgery, I prefer spring water or enhanced water (smart water) cold. But still love it just as much as I did before the procedure.

Everyone is different and for some, none of their tastes may change. The other thing to keep in mind that drinking after surgery (especially immediately pre-op) can be difficult if you were used to "guzzling" large amounts of liquid. You certainly won't be able to do that for some time, if at all, and it can be painful to try. It can also be painful if you take in a large amount of air while drinking, which is why straws are not recommended immediately post-op.

For most, constant sipping throughout the day will allow them to get all of their hydration needs and more. Most complications people have are related to dehydration and it's the #1 reason bariatric patients end up back in the hospital. It takes some dedication to hit those goals early on, but it does get easier. At least it did for me.

Best of luck on your journey!

My doc and NUT recommend forever as well. I do have a cup of coffee or tea now and again never more than a cup. I'd check with your team and see what they say.

Have you tried the Vitamin Patches? Getting in your Vitamins and hydration daily is vital to your success and nutritional needs. Are you drinking anything other than Water? Other liquids can count toward your overall hydration goals. Also, you should try adding lemon to your Water, or try some of the "enhanced" waters like smart water. This way you're getting in some electrolytes also to keep you hydrated. Super important. Also eating water-rich whole fruits and vegetables can help on the hydration front as well.

It's good to hear you're getting in all of your Protein. Need to figure out Vitamins and hydration for sure. I'd focus on that before anything else. It's also what could be the biggest contributing factor to your slow-down in weight loss.

Also, with regard to exercise, I think you need to find something you enjoy. Walking, running, biking swimming....whatever, but you should really try and see which you like, interest or not. I don't *like* to go the gym every day (I do like it some days), but I go anyway because I need to, and sometimes building up that necessity can be strong motivation.

You will definitely still need Protein Shakes to supplement what you can't get from food. In fact, you'll probably need those for quite some time. There are lots of options for Protein shakes/drinks, so look into different flavors, or even unflavored and add it to your food.

Not sure how you feel about quinoa, but it satisfies my "carb cravings" and it's a healthy Protein source, as well as a great vehicle to include other healthy foods (fruits & veggies). The "California Quinoa Salad" from Whole Foods is really, really good, and I found a recipe that is very close to that...if you like quinoa, give it a try. If you want to add more protein to it, try adding some scrambled egg or chicken to it...a lot you can do with it!

(It goes without saying that you can add/subtract whatever you want/don't want to your tastes)

http://www.cinnamonspiceandeverythingnice.com/california-quinoa-salad-whole-foods-copycat/

I don't think you should have told this person about your surgery plans. You obviously knew the type of person she was, so I am baffled by why you would've decided to open up to her.

I understand and can appreciate the fact that you found some common ground with dogs, but honestly, you should've stopped there. She's clearly unhappy and the only "validity" she gets is when she's able to make others "seem" worse-off than she is.

Honestly, if this is what you deal with on a daily basis, my best recommendation would be to either remove the problem (her - which, unless you're the boss you probably can't do), or remove yourself from the situation, (look for a new place to work).

You are entitled to make your own choices, but since you are *asking* for others' opinions here, I'll give you mine.

It's my opinion that doing this will trigger some very bad things for you. The salt and flavoring is bad enough (health-wise), but it's just going to cause you to want more of it. Sooner or later you'll just be eating doritos again, which, for most of us, might be one of the things that landed us here in the first place.

The surgery is a chance for you to "reboot" and start over by making healthy food choices. Don't squander that opportunity for a few seconds of manufactured satisfaction.

Best of luck