I'm looking to transition from my Flintstones + Iron multi - which my surgeon recommended for the first several weeks post op. In researching vitamins I'm rather horrified to find that some contain both Iron and Calcium so they can claim to be a 'complete source' 'no other supplements required'. Iron and Calcium should not be taken together. A majority of us know this. If you haven't heard this rule, I'll quickly explain. Our intestines have all different sizes and shapes of "doors" for the nutrients to go through. Iron and Calcium have to use the same door. However, Calcium is a big bully, and refuses to let Iron go through the door, so the Iron has to move along the intestines and is eventually evacuated.

One thing that also occurred to me is that our Calcium supplements aren't the only source of calcium we get. A vast majority of our protein is whey protein and includes calcium as well. I had been popping my Flintstones and shortly after having tea with milk or a Premier shake. I'm at risk for not absorbing my iron during that time if I do that. I just wanted to share my thoughts in the hopes this helps others avoid iron deficiency as well.

Iron and calcium can also interfere with the absorption of thyroid medication.

Be careful about taking calcium, calcium-fortified orange juice, and calcium-rich antacids at the same as thyroid RXs. Allow at least 3-4 hours after taking your thyroid medication, so that absorption is not affected.

Taking iron along with some antibiotics might decrease the effectiveness of some antibiotics.

Examples: Cipro, Penetrex, Chibroxin, Noroxin, Zagam, Trovan, Raxar, tetracycline

As well, many bisphosphonates, which are used to treat osteoporosis, can be impaired by iron supplements taken too close together. As can Levodopa drugs used to treat Parkinson’s, high blood pressure medicines (e.g. Aldomet), and immunosuppressive drugs like CellCept.

Edited August 18, 20187 yr by MarinaGirl

Typically, the iron and calcium in multis are only a partial dose, so there isn't quite the conflict that there is if you try to take full doses of calcium along with full doses of iron (a multi may have only 200mg of calcium vs. 600-650mg as a normal maximum absorbed dose by itself. Likewise, a lot of the foods that we eat (or will eat again once we are through this.....) are rich in both calcium and iron, but the conflict is usually avoided by virtue that, again, there isn't a full supplement dose involved, and the time delay from digestion.

I generally ignore the iron or calcium in multivits as they are usually the cheapest and least absorbed forms (typically calcium carbonate vs. the preferred calcium citrate) so I only count that which comes form my food and from the specific supplements. If you find a multi without the iron and calcium in it, then you can take an iron supplement (if needed) along with it, and the vit C in the multi will help with the iron absorption, and that is one less pilling session for the day - you don't need to space out an iron supplement from the multi. This is less of a deal for us sleevers who usually don't need to take as much mineral supplements as the RNY guys so we don't usually have as many pillings during the day, but we still need to take some while we are losing and not eating well.

@RickM Thank you for your insight, I’m certainly no expert in nutrition and supplements and how they are absorbed. I’m just doing my best to avoid as many problems as I can.

Didn't I read somewhere you should drink orange or another citrus juice with iron or iron- containing foods so your body would assimilate the iron better? And is iron fumarate the preferred form?

On 08/20/2018 at 04:05, Frustr8 said:

Didn't I read somewhere you should drink orange or another citrus juice with Iron or iron- containing foods so your body would assimilate the iron better? And is iron fumarate the preferred form?

The Vitamin C In the orange juice does help with iron absorption but I don’t know that OJ is an appropriate drink for Bariatric patients because of its sugar content.

I read somewhere that if you get Chelated Iron that it is less likely to cause constipation. Im going with my multi of choice and don’t plan on adding additional iron unless my lab work indicates I need to.

On 8/18/2018 at 7:57 AM, MarinaGirl said:

Iron and Calcium can also interfere with the absorption of thyroid medication.

Be careful about taking calcium, calcium-fortified orange juice, and calcium-rich antacids at the same as thyroid RXs. Allow at least 3-4 hours after taking your thyroid medication, so that absorption is not affected.

wow, thanks. I did not realize that and I need my levothyroxine cause I don't have a thyroid at all.

I take the Bariatric Advantage Iron and Vitamin C chewables at a separate time frame than the chewable Calcium and Vitamin D. It means keeping track of when I take them, but way better than the 15 prescriptions I used to juggle.

I suspected all along --'--Bariatrics does a Body Good!