I have selected the RNY procedure, and am aware of the supplementation needed, but I have talked to people that do conflicting things. Some cover it with a simple multivitamin and others are taking the individual ones. What are so of your experiences? Do you stick with liquid/chewable forms exclusively?
You will find there will always be conflicting information. RNY is a very misunderstood thing. Doctors make their best hypothesis on what they think we might be missing out post op and go from there. Every surgeon will tell you to supplement something different. Some are uber cautious and have you supplement major things you don't necessarily need on the side of caution and others want you to supplement basics and then watch your bloodwork.
Some like liquids, some like pills....
Do what your surgeon says for the first few years and then see what your family physician thinks over time too based on your bloodwork.
I'd say you need to get blood work done post op to see where your difficiencies are
that will be a better indicator of what you need
Start with a multi
and a calcium
but don't wait years b/c difficiencies can get you sick
I'm going to say right upfront that I am a bit more proactive and self-reliant on the vitamin issue than most. That said, here are my suggestions:
Do not trust anyone, even a doctor or surgeon, to tell you what you need without understanding it yourself. Get copies of ALL your lab test results and track them yourself. A doctor will say "everything is fine" even if your Vit D was 80 pre-op and comes back at 32 at 6 months post-op because it's still "within the normal range." They won't look any further than to see if everything is in the normal range. But, in that example, you're clearly heading for trouble, so you should start supplementing additional D BEFORE it drops below the normal range and indicates a deficiency. So, track your own labs to watch for trends, not just "normal," "low," or "high" according to the standard ranges.
Make sure you are having enough tests run. I can't tell you how many people have told me their calcium levels are "fine" but have never had a PTH run. Well, guess what - your calcium level could very well be within the normal range while your body is sucking calcium out of your bones to keep your blood calcium levels normal, leading you quickly down the path to osteoporosis. Without a PTH test, you don't know if that's happening. This is only one example; there are many others that many doctors don't check that SHOULD be checked regularly post-op.
Don't waste your money on special "bariatric formulation" vitamins. Despite the marketing ploy to make you spend more $$ on them, they are usually no beter (or are even less adequate) than many vitamins you can buy locally or for much cheaper online. I've created a spreadsheet that you can download comparing many different vitamins, including the "bariatric" ones, and based on that comparison, I would quickly recommend TwinLab capsules (which I buy at Wegman's or Whole Foods locally or for much cheaper online) before I would suggest a single one of the usual "bariatric" formulations (Celebrate, Bariatric Advantage, etc.).
Start with 2 multivitamins, at least 1500mg calcium citrate (NOT carbonate, and no more than 600mg at one time), sublingual B12, and iron post-op. Adjust according to labs. Also, be sure you are aware of your PRE-op lab results. If you're already low (or on the low end of the normal range) in Vit D pre-op, you should include a Vit D supplement - things like that. (FYI, I use Vit D as an example often because most Americans, even without WLS, are low in D anyway.)
After the first month or so (as your doc about healing), you should be able to tolerate regular ol' pills. If you still prefer chewables or liquids, that's fine, but it's not normally required.
Can you tell this is a bit of a hot button for me?
I'm a chewable kind of girl. facing large pills still scares me. a couple have gotten stuck - and that's NOT something i want to face again. i've found - trial and error mostly - that i do better taking two multis a day. and occasional bouts of iron [depending on blood work]. and calcium, and 1000 mcg B12 sublingual a few times a month.
this regimen [which, as you can see is pretty loose!] has been working well for me. as others have said - especially the amazingly informative Jilly - watch your blood work, and you will sometimes have to remind your primary that you've had surgery and therefore you have special needs.
Jiff have you ever used Celebrate ENS it's a drink mix in a Mammoth drink stick with a multi calcium and a few others in it. I've tried the grape Celebrate does unlimited free samples (I'm unaffiliated with them just enjoy their products)
and their calcium bites are dreamy
Vitamins
