Vitamins and Calcium Routines

[Swanton_Bomb 522]

Do you take chewy Calcium or pills? Do you take 1,000 or 1,500 mg. daily? Do you take your calcium with food or without? I am getting so confused by conflicting information. Some say to use chewable calcium because it is better absorbed, but the chewies give me an extra 30 calories per day. Some say pills are fine. I have seen sources state to take with food, and others say to take on an empty stomach. Stomach acid boosts the absorption of calcium citrate, so does that mean you should not take it too close to taking your acid reducer? Vitamins confuse me too. Some say 2 Multivitamins, others say 1 pill. I am trying to do everything right but there is so much conflicting information out there, even materials given to me by my NUT conflict with each other sometimes.

[sandee123 13]

Here is a link to "official" guidelines https://asmbs.org/resources/nutrition-guidelines. Of course if you have specific guidelines from your clinic follow/consider those as well. The number of pills/chews will vary based on the type/brand you choose.

The guidelines state to take Calcium carbonate with food. You can take calcium citrate with or without food. I believe most folks are encouraged to take calcium citrate. The guidelines state 1200-1500 mg calcium from all sources for vsg patients so depending what you eat (dairy etc) 1000 mg supplement may be fine. RNY patient Vitamin recommendations are generally higher than VSG.

The biggest timing instruction I follow is a couple hours between calcium and Iron. I don't worry about timing Vitamins vs meal times.

I also noticed that the guidelines say to space iron from acid reducers.

I'm currently using chewable but will likely switch to pills as I use everything up.

What I currently take:

1st am B12 pill, d3 pill, Multivitamin

2nd am. Multivitamin

3rd-5th. 500mg calcium citrate. I often only remember 2 of the 3 calciums.

[S@ssen@ch 745]

#1-when in doubt, consult your doctor or nutritionist. even if their literature is confusing or has conflicting info

For what it's worth, here's my routine:

about 30min to an hour before my morning meal I take my PPI (supposedly they're more effective on an empty stomach and first thing in the am) PPIs can lead to magnesium deficiency, so I always make sure my muti has a good amount of magnesium. If it doesn't, I will take an additional magnesium supplement.

Just after Breakfast, when my stomach still has food in it: 2 calcium citrate chews (500mg), a D3 capsule, a hair/skin/nails supplement, and any other morning meds I may need. When Calcium and D3 are taken together, they work better and in fact, you will find calcium and D3 together as one pill/chew/etc.

Just after evening meal, when my stomach still has food in it: 1 Women's One-a-Day, an Iron pill, and the other half of my hair/skin/nails dose for the day. I read somewhere that you don't want to be taking iron with calcium, something about interfering with absorption/effectiveness. So, I split my daily Vitamins like this.

I chose my vitamins based upon how I was tolerating it and not necessarily the method (pills/chewables/gummies). Early on, I really struggled with nausea and dizziness when I took any vitamins, so I wasn't too worried about the 30 calories vs getting sick for an hour or 2 after I took them. Overall, I look at the nutrients and try to stay close to 100% of recommended doses. When you are taking a Vitamin with multiple ingredients, you don't always have control over their formulation and you will often see doses well over 100%. For the most part, that just gets flushed down the toilet. BUT, I am careful with going too far over on the fat solubles (A, D, E, K) because if you take too much of these they can build up in the body.

[Jazzy1125 1,010]

I agree, this is a conversation and question for your surgeon. I think even when it comes to Vitamins and such each dr. is different. For example. I am almost 8 weeks out and have not started Calcium or Iron yet. He has me on Multi Vitamins only and said the others will come later. Try to follow your Doctors orders and not orders of those in here as we are NOT doctors, and your doctors plan may differ from somebody elses. The only thing i know is iron and calcium need to be taken a few hours apart because they counteract each other.

[FluffyChix 17,418]

I used to take the Celebrate chewable Multis, calcium chews, Iron chewables, B12 sublingual, Biotin sublingual, D3 drops. But I got tired of the extra calories and carbs and switched to capsules where I can. I still take the B12 and Biotin as sublinguals though.

I take these daily and get as many Vitamins as I can from the Bariatric Pal Store. They are pretty awesome and will get the order out mostly on the same day. I get my packages like within 2 days of ordering and they are very helpful with the order. The other ones they don't have, I either get from vitacost or Amazon:

3 Celebrate Multi-vits (without Calcium or iron) Capsules

1500mg calcium citrate Capsules from Solaray (2 capsules make 500mg, so I take 6 capsules per day) https://www.vitacost.com/solaray-calcium-citrate-240-capsules

100mg Thiamine Capsules

50mg Zinc caplets

2000iu Vitamin D3 Capsules

500mg sublingual B12

28mg Biferrous Iron (Feosol) Caplet

2000mg Vitamin C Caplets

5000mg Biotin

3 Colace

18g Miralax

[notmyname 593]

Honestly, my doc/NUT gave me the option of taking 4 Bariatric Fusion Multivitamins per day for all of my vitamins/calcium, so that's what I do. I found trying to plan individual multi/calcium too cumbersome.

[James Marusek 5,244]

When you take calciums it is important to spread it out over the day. I generally take 2 Citrical supplements every 2 hours until I meet my daily Calcium requirement. [I am a gastric bypass patient and my requirement is 1500-1800 mg per day. Sleeve patients requirement is less. It is 1200 to 1500 mg per day.] I just put them all in a small finger bowl first thing in the morning and take a couple out at a time throughout the day until the bowl is empty. If I am on the go, then I put them in a small zip lock back and take the bag with me.) As far as the Citricals are concerned be aware that the dosage rate is based on consuming 2 tablets. I didn't realize this at the beginning so I was only taking around half the recommended daily dose for the first month after surgery. It is also important to have at least a 2 hour separation between your calciums and your Iron. So I generally take the calciums during the day and the iron at night. The iron may be a separate pill or part of your multivitamin. Once you get the system down, it becomes routine. So don't get overwhelmed at the beginning.

[Swanton_Bomb 522]

7 hours ago, FluffyChix said:

I used to take the Celebrate chewable Multis, calcium chews, Iron chewables, B12 sublingual, Biotin sublingual, D3 drops. But I got tired of the extra calories and carbs and switched to capsules where I can. I still take the B12 and Biotin as sublinguals though.

I take these daily and get as many Vitamins as I can from the Bariatric Pal Store. They are pretty awesome and will get the order out mostly on the same day. I get my packages like within 2 days of ordering and they are very helpful with the order. The other ones they don't have, I either get from vitacost or Amazon:

3 Celebrate Multi-vits (without Calcium or iron) Capsules

1500mg calcium citrate Capsules from Solaray (2 capsules make 500mg, so I take 6 capsules per day) https://www.vitacost.com/solaray-calcium-citrate-240-capsules

100mg Thiamine Capsules

50mg Zinc caplets

2000iu Vitamin D3 Capsules

500mg sublingual B12

28mg Biferrous Iron (Feosol) Caplet

2000mg Vitamin C Caplets

5000mg Biotin

3 Colace

18g Miralax

Exactly, I hate wasting those carbs and calories on Vitamins that taste nasty anyway (well, the calcium chews aren't bad, but the vitamins are gross!). I could have half an apple or a couple of berries for those calories. Thanks for posting your routine, that helps!

[Swanton_Bomb 522]

Thanks all so much for the advice. I bought a bottle of Citrical Petites, which are on my surgeon's approved list. Petite my arse! They are huge, but I was able to tolerate them. I was cleared for pills at one month and I tried to go back to my old GNC Vitamins, which are even bigger than the Citirical, but had a frightening and painful episode when one of my vitamins got stuck, so I am going to wait a while until I try those again. I guess I am concerned because the Centrum chewables my NUT has me taking pale in comparison to my pre-surgery GNC vitamins, and since I am not getting much nutrition from food I am skeptical about taking such a minimal amount of vitamins.