Tuesday, April 19, 2011

Vitamins and gastric bypass surgery

After gastric bypass, you're given a list a mile long of vitamins you should be taking.  The American public in general should be taking vitamins since the soils have been stripped of many nutrients and most people eat so much processed food.  However, after weight loss surgery, it is even more important to take your vitamins since you are malabsorptive and won't absorb most vitamins from your food.  I could get into fat and water soluble vitamins here, but that would just make this post way too long.  Just be aware that some vitamins dissolve and absorb better in different conditions (which is why having a little REAL salad dressing on your salad isn't necessarily a bad thing...fat can help you absorb some of those vitamins). 

I wanted to list all of the vitamins I take and why.  Everyone's list will be vaguely different.  I am seven years out from surgery, and each year I go in for my blood work, I'm low in some vitamin or another, and so it gets added to my list of vitamins to take.

I take a multivitamin.  There are many theories about which vitamin is best.  Store brand?  Designer brand?  I find that a prenatal (even a cheap store brand) works best for me.

A lot of patients have to take iron after surgery.  I do not take iron (other than the prenatal vitamin is supposed to have a little extra in it).  You have to be very careful not to take iron with calcium supplements, and can cause constipation, so be careful if you are advised to take iron.

For the fun of it, I take an echinacea-golden seal supplement.  I know there are conflicting reports about whether it actually helps you avoid colds, but I figure it doesn't hurt to take it. 

Sometimes I get cold sores, so I usually take a daily dose of L-Lysine.  If I have a break-out (which I haven't in a really long time), I take three doses twice a day and it usually helps it clear up quickly.  I am a stress case (and also have psoriasis, which is sensitive to stress), so taking a daily pill seems to help keep them away.

I take acidophilus/probiotic.  This is especially important for women if you are prescribed an antibiotic.  Stripping your body of the good bacteria can cause yeast infections.  You can also get probiotics from yogurt, but a lot of yogurts are very high in sugar, which isn't good for gastric bypass patients.

The number one vitamin a gastric bypass patient should take is B12.  They say you should take a sublingual dose (meaning it is dissolved under the tongue) twice a week.  I sometimes skip this pill (yeah, I know, I just said it was the most important pill), so when I'm taking it, I take it daily.  I was low on B12 early in my post-surgery days.  The tops of my feet tingled.  Getting too low in B12 can cause MS-like symptoms, so I suggest you don't skip the B12.  Some people can go to the doctor for shots if you aren't absorbing the pill or if you get too low.  I also suggest you not get to this point if you can help it.

I take a B1 (Thiamine) supplement as well.  I used to take a B-complex, but I am sensitive to Niacin (B3), and it makes my face red.  I stopped taking the B-complex a few years ago and then I was low in B1 two years ago.  So I added B1 back in.  B1 helps with food absorption.

I take a calcium supplement, which includes Vitamin D and magnesium, to help with absorption.  It is VERY, VERY important that we take calcium citrate, not calcium carbonate (Tums, etc.).  A lot of gastric bypass patients become lactose intolerant after surgery.  Even if you are able to drink/eat milk products, the malabsorpotion issue still gets in the way.  When you are overweight, you have a lower chance of getting osteoporosis (your body weight is keeping your bones strong).  However, once you lose weight, you need to make sure you are doing everything you can to keep your bones strong and healthy.

Last year, after my blood work, I had to add an additional Vitamin D pill.  I was low in Vitamin D (something you should be able to get from the sun but I must be spending way too much time indoors lately).  It's a tiny pill and I hardly notice I'm taking it.

I also take a Vitamin E natural pill.  My chiropractor recommended it years ago before I had plastic surgeries.  He said it helps with skin elasticity and healing. 

I now take a joint supplement.  That has nothing to do with surgery.  I just find that when I work out a lot, I hurt, and that helps keep my joints lubed and happy.

I also take an Omega-Three supplement.  For awhile, I was taking a "wholemega" pill, which claimed something like 16 omegas.  Now I just use the Trader Joe's brand.  It's just fish oil.  Ewww, I know.  But I take it with breakfast and it keeps me from burping fish taste, which would really bum me out.

Of course, another supplement that I try to take daily is my whey protein shake.  I still find that, even after seven years, that's the best way for me to make sure I get enough protein into my system on a daily basis.  I am currently trying to switch up how I eat, so I may be changing this to dinner instead of breakfast.  I use Champion Pure Whey protein powder.  However, there are many good brands out there.  Just make sure its high in protein (25 grams is plenty...the 55 gram shakes are a waste of calories) and low in calories and sugar (mine is 125 calories and I think 3 grams of sugar or less).

I also add whole ground flax seed to my protein shake.  It helps with constipation issues as well.

I take other vitamins and medications on and off but these are the ones I feel are necessary.  Yes, it's a lot of pills.  I usually just pack them into a little container and pop them as I'm driving to work after I've eaten breakfast.  And, as much as I hate popping so many pills, it's better than dying from malabsportion!


  1. Lori it is Kristen. I have my 6 months apt tomorrow. I got all my labs back... totally confused. From what I can see I know of 2-3 that are totally out of wack. One that concerns me the most is the parathyroid (PTH) 10-60 is normal... mine reads at 80.
    I really appreciate all the info that you post..

  2. Kristen, dont worry too much yet. Let your doctor go over everything with you. My liver panels are off every year but they aren't off enough to worry my doctor. I have my next blood test in June. The only way to fix the liver issues is to lost weight. :-/