I am completely confused.

I received so many information (some discordant) about vitamins that I don't know what to do.

I have been told from the department of surgery to start with the vitamins. I received gastric bypass on 9/5 and in this moment I am not allowed to swallow big pills and I do not tolerate the powdered vitamins (8-10 oz twice a day it's a lot of room in my new small stomach).

-What should I take? I mean to be fully covered?

-Where do I go to buy them (I need them ASAP, so no online order)?

-which is the easiest regimen to follow at my stage (phase II, puree)?

Thanks for the help

After RNY surgery, you are required to take many vitamins for the rest of your life. This is because you body no longer synthesizes vitamins from food. That part of your stomach has been cut away, so this daily requirement is extremely important. 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 after surgery was:

Three Flintstone complete chewable multivitamins daily.

Additional 65 milligrams elemental iron daily for menstruating women.

1500 to 1800 milligrams calcium citrate daily [this can be tricky because the dosage rate is per 2 capsules - therefore this can mean around 5-8 capsules per day depending on the size (petite or regular)].

500 to 1000 micrograms sublingual B12 daily or 1000 microgram injection once monthly.

100 milligrams Thiamine (vitamin B1) daily for the first year and then weekly thereafter.

In the morning I put my Citricals in a small finger bowl. Then I take a couple every couple hours. When I am up and about I put them in a zip lock bag and take them with me. For me this is not difficult. Sometimes I take two at once.

But right after surgery, I lost my ability to swallow large pills and I had to crush them. It was like eating chalk. The only way I could down these was by mixing them with crystal light and drinking them down. Because they formed a paste at the bottom of the glass. I had to remix these and chug them down several times. Luckily my inability to swallow lasted only a couple months and then I was back to normal.

There are many different selections of vitamins out there. This is the regiment that I followed but there are many different vitamin options available today.

my program recommended chewable multis the first few weeks (although I still take chewable multis at over 2 years out). I just use Centrum chewable, or the generic equivalent (the latter is super cheap at CVS, especially when they go on sale, which is often). Some of the other vitamins I take are really small, so they were never a problem. Calcium pills tend to be huge, so I used (and still do) Upcal D (a powder which I mix into my morning yogurt) and calcium chews. Calcium *citrate* chews can be hard to find (although Vitamin Shoppe sometimes has them), but you can find them online.

p.s. I do have some calcium citrate horse pills at home. When I'm having a fruity protein shake, I'll drop a couple in. The acid dissolves them - although it can take awhile.