Hi all, I am still planning to have surgery, maybe in a few months (cash pay, trying to save my pennies!). I have looked under the "file" for vitamin suggestions, etc. but don't see anything that answers my questions. I hope that I am not violating any rules here, but...

My question has to do with the vits and supps that I am already taking. I usually order 90 days worth at a time. I am running out of some things, but I don't want to waste money and reorder something that I can't use after the surgery.

Could you please review what I am taking now, and comment on what you think...and what I will not be able to/need take after DS surgery? I am having my surgery in Mexico, and my PCP knows nothing about DS surgery, so I will be very reliant on you veterans to help me get what I need to stay healthy!

Thank you!

Alice

(cross posted)
>>>>>>

Magnesium Citrate tablet: 200 mg tablet, 1 am and pm

"Calciology,"tablet, Vitamin C, 500 mg; D3 600 IU; K2 126 mcg; Calcium 500 mg (as calcium citrate-malate); magnesium 250 (as magnesium oxide): 1 am and pm

Vitamin D3 tablet: (40 mg S. cerevisiae), 2000 IU 500

Krill Oil, soft gel: 1000 mg, 2 x am

Garden of Life Probiotic capsule: 50 Billion , 16 strains 1 x pm

CoQ10 soft gel: Vitamin E 67 mg, Coenzyme Q10 (ubiquinone) 100 mg; 1 x am

Aspirin pill, 81 mg, 1x am

L Methylfolate, 15 mg capusule, 1 x am

I also am taking the following meds for depression: Effexor XL capsule 150 bid, Lamictal 200mg tablet qd, Wellbutrin, 150 mg qd: Ambien 10 mg pill hs.

Finally my multi..."Vitamin Code, 50 and Wiser Women:"

Edited May 19, 20179 yr by A. Dixon
edited for typos

I had RNY gastric bypass surgery whereas you are having duodenal switch so your requirements are a little different from mine. They are actually more extensive than mine. But having said this, I will make the following observations.

Your surgeon office should provide you with a complete list of what vitamin requirements you will need to take daily.

After surgery I found that I could no longer swallow medium to large pills. As a result I used pill crushers or pill splitters to make them small enough for me to consume. This condition lasted for a couple months and then I was able to swallow them again.

Vitamin chemistry is important for absorption. Calcium supplements should be calcium citrate. There are also different chemistries of B12. I use the sublingual B12 and was told to use methylcobalamin. You cannot use a time-release version of B12. If you are taking iron supplements, it must be ferrous sulfate for the best absorption. Gummy vitamins are not absorbed properly and should be avoided.

It is important to put a 2 hour separation between the vitamins that contain iron and those that contain calcium. So in my case I found that what works best for me is to take the iron supplements just before bedtime. I put my vitamins in a weekly pill container. I have one container for the morning and one for the night. And I use a very small glass bowl for my calcium supplements. I put my calciums in the bowl in the morning and take them throughout the day. If I am up and about I put my calciums in a ziplock bag and carry them with me.

The directions I received also included a list of those who underwent duodenal switch surgery. These were:

Four Flintstone complete chewable multivitamins daily.

1800 to 2400 milligrams calcium citrate daily [this can be tricky because the dosage rate is per 2 capsules - therefore this can mean around 6-8 capsules per day of the large size [horse pill] supplements. Even more if you use the petite size.

A total of 5000 International Units of Vitamin D3 Daily.

1000 micrograms sublingual B12 weekly or a B12 injection once each month.

100 milligrams Thiamine (vitamin B1) weekly.

I suspect that after surgery they will place you on a blood thinner for a week or two to prevent blood clots. As a result they will restrict you intake of aspirin (another blood thinner) for the first month or two. Also they may restrict you from taking any other vitamins or medicine during the first few months. Since you are taking prescription medicine for depression, you will want to work these through with your surgeon's office. The absorption rate may vary after surgery.

Deleted.

Edited May 19, 20179 yr by Postop

carbonyl iron is also well-absorbed, and is much easier on most people's stomachs than ferrous sulfate. Heme iron is the best absorbed but is very pricey.

15 hours ago, James Marusek said:

I had RNY gastric bypass surgery whereas you are having duodenal switch so your requirements are a little different from mine. They are actually more extensive than mine. But having said this, I will make the following observations.

Your surgeon office should provide you with a complete list of what Vitamin requirements you will need to take daily.

After surgery I found that I could no longer swallow medium to large pills. As a result I used pill crushers or pill splitters to make them small enough for me to consume. This condition lasted for a couple months and then I was able to swallow them again.

Vitamin chemistry is important for absorption. Calcium supplements should be calcium citrate. There are also different chemistries of B12. I use the sublingual B12 and was told to use methylcobalamin. You cannot use a time-release version of B12. If you are taking Iron supplements, it must be ferrous sulfate for the best absorption. Gummy Vitamins are not absorbed properly and should be avoided.

It is important to put a 2 hour separation between the vitamins that contain iron and those that contain calcium. So in my case I found that what works best for me is to take the iron supplements just before bedtime. I put my vitamins in a weekly pill container. I have one container for the morning and one for the night. And I use a very small glass bowl for my calcium supplements. I put my calciums in the bowl in the morning and take them throughout the day. If I am up and about I put my calciums in a ziplock bag and carry them with me.

The directions I received also included a list of those who underwent duodenal switch surgery. These were:

Four Flintstone complete chewable Multivitamins daily.

1800 to 2400 milligrams calcium citrate daily [this can be tricky because the dosage rate is per 2 capsules - therefore this can mean around 6-8 capsules per day of the large size [horse pill] supplements. Even more if you use the petite size.

A total of 5000 International Units of Vitamin D3 Daily.

1000 micrograms sublingual B12 weekly or a B12 injection once each month.

100 milligrams Thiamine (vitamin B1) weekly.

I suspect that after surgery they will place you on a blood thinner for a week or two to prevent blood clots. As a result they will restrict you intake of aspirin (another blood thinner) for the first month or two. Also they may restrict you from taking any other vitamins or medicine during the first few months. Since you are taking prescription medicine for depression, you will want to work these through with your surgeon's office. The absorption rate may vary after surgery.

Thank you so very much!! That's very helpful!! I'm going to print/screen shot this....

14 hours ago, catwoman7 said:

carbonyl Iron is also well-absorbed, and is much easier on most people's stomachs than ferrous sulfate. Heme iron is the best absorbed but is very pricey.

Thank you! That's good information!

a lot of surgeons still recommend Flintstones, but the ASBMS now recommends adult multivitamins, not children's. Some patients use fancy bariatric vitamins, but a lot of people on another forum I'm on just use Centrum or the generic equivalent.

scroll down to Table 5 for vitamin recommendations. It specifically says to avoid children's vitamins:

http://asmbs.org/resources/integrated-health-nutritional-guidelines

update: I looked at it again and said to avoid children's vitamins *that are incomplete*. I'd just double check the stats on Flintstones Complete and compare it to the back of something like Centrum. It could be that Flintstones Complete have more supplements than regular Flintstones. I always just took Centrum (or the CVS equivalent) to avoid the problem altogether, but the Flintstones Complete should be OK if the stats are similar, I would think.