This and That needing clarification

[Beckmo]

I have a few things I need some clarification on that I am confused.... Do we absorb any pills that are in "gel" form? Would those be the same as "fat soluble"? Roughly, what percentage of carbs do we absorb? Probiotics... are those in addition to vitamins? When do you start those? How do you know you need them? What do they do? Calcium.. the easiest/best way to get it in? Is your surgeon suppose to order your labs for the first year or do you request your PCP to do it?

I am sure more questions will come to mind... but those are just a few off the top of my head for now.

 

[weaura]

Hi!
1. DS'rs do not absorb pills in gel form - they are oil based so you don't get benefit of them. Yes they are the same as fat soluble.
2. IDK the % of carbs that are absorbed but I believe it's in the 80% to 100% range. However, I believe YMMV.
3. Yes probiotics are in addition to vitamins and they help you have good flora in your system which can help with bowel issues, both diarrhea/loose BMs or constipation. There might be more benefits that I'm not aware of.
4. I'm not sure when you should start them, or how you know if you need them. I'd like to know those answers myself.
5. Your surgeon or your PCP can order your labs. If your surgeon has an established follow up plan in place, I'd say start there. If not you can get it through your PCP. Be prepared to educate your PCP as you go. Get a copy of your labs every time, and keep track of your own levels and make vitamin etc adjustments as warranted. You'll need to get your labs at least twice yearly, but the first year you may want it more frequently. Don't do what I did, and just skip it cuz you think you're "fine".
If I'm successful at getting my DS again I will be extremely diligent!!!

 

[southernlady]

Do we absorb any pills that are in "gel" form? Would those be the same as "fat soluble"? Roughly, what percentage of carbs do we absorb? Probiotics... are those in addition to vitamins? When do you start those? How do you know you need them? What do they do? Calcium.. the easiest/best way to get it in? Is your surgeon suppose to order your labs for the first year or do you request your PCP to do it?

1) Depends on what is in the gel pill. Most of them are oil based and those are just expensive poop. But some gels, like my liquid ibuprofen is a gel and we absorb those easily enough so the answer is, it depends. For VITAMINS, stick with dry forms.
2) The ONLY study as to what we absorb was done for fat and it was a very small sample size of people. That study suggested 20% of fats absorbed. Common THEORY is that we absorb about 60% of the protein we ingest and anywhere from 60-100% of the carbs. And the sugar based carbs are figured at 100%. But there is no study.

These threads give you some idea of how it all works:
http://bariatricfacts.org/threads/ds-math.735/
http://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/

BUT it is theory NOT FACT!!! Each person has to find WHAT works for them and things will change as you get further out.

3) I started probiotics about 3 months after surgery after I was getting my vitamins in. As to whether we need them or not, the jury is out but gut health (and that means good bugs) need to be in abundance to avoid bloat/gas/stinky farts/ etc. If you don't want to take a probiotic, at least eat foods rich in good bugs such as yogurt, kefir, etc. http://bariatricfacts.org/threads/get-larger-variety-of-probiotics-through-food-sources.665/

4) Calcium is non negotiable. How much is needed is based on your labs, and that includes your vitamin D level AND PTH. http://bariatricfacts.org/threads/parathyroid-check-your-d-calcium-and-pth-first.1065/ Some handle pills, some prefer chews, but it HAS to be calcium citrate. Repeat, CALCIUM CITRATE! If it does not say citrate ON the front, it is the wrong kind.

5) My surgeon had to order my labs WHILE I lived in the same city as he did, my PCP was hogtied by the system. Now that I am in another state, my PCP orders mine. If your PCP doesn't cooperate, maybe it's time to find a new, fresh out of school, PCP who is willing to learn.

 

[DSRIGGS]

1) Depends on what is in the gel pill. Most of them are oil based and those are just expensive poop. But some gels, like my liquid ibuprofen is a gel and we absorb those easily enough so the answer is, it depends. For VITAMINS, stick with dry forms.
2) The ONLY study as to what we absorb was done for fat and it was a very small sample size of people. That study suggested 20% of fats absorbed. Common THEORY is that we absorb about 60% of the protein we ingest and anywhere from 60-100% of the carbs. And the sugar based carbs are figured at 100%. But there is no study.

These threads give you some idea of how it all works:
http://bariatricfacts.org/threads/ds-math.735/
http://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/

BUT it is theory NOT FACT!!! Each person has to find WHAT works for them and things will change as you get further out.

3) I started probiotics about 3 months after surgery after I was getting my vitamins in. As to whether we need them or not, the jury is out but gut health (and that means good bugs) need to be in abundance to avoid bloat/gas/stinky farts/ etc. If you don't want to take a probiotic, at least eat foods rich in good bugs such as yogurt, kefir, etc. http://bariatricfacts.org/threads/get-larger-variety-of-probiotics-through-food-sources.665/

4) Calcium is non negotiable. How much is needed is based on your labs, and that includes your vitamin D level AND PTH. http://bariatricfacts.org/threads/parathyroid-check-your-d-calcium-and-pth-first.1065/ Some handle pills, some prefer chews, but it HAS to be calcium citrate. Repeat, CALCIUM CITRATE! If it does not say citrate ON the front, it is the wrong kind.

5) My surgeon had to order my labs WHILE I lived in the same city as he did, my PCP was hogtied by the system. Now that I am in another state, my PCP orders mine. If your PCP doesn't cooperate, maybe it's time to find a new, fresh out of school, PCP who is willing to learn.

Liz I love this reply, especially to number 2. There is so much talk about carbs and often presented in statements that are quite declarative about our opinions making them sound as if it is fact. I know personally that I am sure that I have been guilty of doing that.

In any case I do believe it is a case of YMMV and we just don't know for certain about carb absorption.

 

[DSRIGGS]

Beckmo I will add that most DS surgeons are not great about follow up care, so personally I use my PCP for labs. I simply shoot him an email on their website that is part of the hospital system and tell him exactly what I need and he does it. We have a great relationship and to me having a great PCP with whom you have mutual respect and confidence is crucial.

 

[Munchkin]

You have to read what's IN the pills. If it's fat based, not the best choice for you. If the contents are water miscible they are just fine.

Anyone can order your labs. You can even do it yourself in most places.

Carbs. Very individual. My personal opinion is that until you are 10% BELOW goal the only good carb is one you don't eat. Lose the weight first, then find out what you can tolerate in the carb department. The easy weight loss does end and you don't want to run out of window before you run out of fat! The results from the DS are a Bell Curve and for every person you hear about who loses too much or sails effortlessly down to goal there is someone else who will never see that normal BMI. You get to decide what side of the curve you will fall on! Carbs are not your friend.

Calcium. Just take the pills. You can swallow anything you could swallow preop. Your esophagus is just the same. Most take Citrate. I take Citrate, Apatite, and Carbonate. In the beginning you have to take it slow. One pill at a time. Eventually you will take them by the handful again.

 

[Beckmo]

1) Depends on what is in the gel pill. Most of them are oil based and those are just expensive poop. But some gels, like my liquid ibuprofen is a gel and we absorb those easily enough so the answer is, it depends. For VITAMINS, stick with dry forms.
2) The ONLY study as to what we absorb was done for fat and it was a very small sample size of people. That study suggested 20% of fats absorbed. Common THEORY is that we absorb about 60% of the protein we ingest and anywhere from 60-100% of the carbs. And the sugar based carbs are figured at 100%. But there is no study.

These threads give you some idea of how it all works:
http://bariatricfacts.org/threads/ds-math.735/
http://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/

BUT it is theory NOT FACT!!! Each person has to find WHAT works for them and things will change as you get further out.

3) I started probiotics about 3 months after surgery after I was getting my vitamins in. As to whether we need them or not, the jury is out but gut health (and that means good bugs) need to be in abundance to avoid bloat/gas/stinky farts/ etc. If you don't want to take a probiotic, at least eat foods rich in good bugs such as yogurt, kefir, etc. http://bariatricfacts.org/threads/get-larger-variety-of-probiotics-through-food-sources.665/

4) Calcium is non negotiable. How much is needed is based on your labs, and that includes your vitamin D level AND PTH. http://bariatricfacts.org/threads/parathyroid-check-your-d-calcium-and-pth-first.1065/ Some handle pills, some prefer chews, but it HAS to be calcium citrate. Repeat, CALCIUM CITRATE! If it does not say citrate ON the front, it is the wrong kind.

5) My surgeon had to order my labs WHILE I lived in the same city as he did, my PCP was hogtied by the system. Now that I am in another state, my PCP orders mine. If your PCP doesn't cooperate, maybe it's time to find a new, fresh out of school, PCP who is willing to learn.

I'm confused with the Calcium Citrate as I read this on DSFacts. Can you help clarify the difference? I bought Calcium Citrate 500mg from Costco, but according to this the "citrate" was not in () so I am only getting 21% of the 500mg, which is 105mg. Is this correct?
Understanding Vitamin and Mineral Supplement Labels
Vitamin and mineral supplement basics continues with a lesson on how to read vitamin labels. A patient has to read the fine print; the labels on these bottles can be very deceiving. Pay particular attention to the dosages. What it says in big print on the label may not be per tablet and may need anywhere from 2-6 tablets to obtain that amount.

It is very important to understand the mineral potency of the supplements. We will use calcium as an example. Elemental calcium is the amount of calcium that is actually in the supplement from the source. (The same is true for all other minerals.)


Example A: Elemental Calcium: 315mg

This means there is 315mg of calcium per tablet.


Example B: Calcium (Citrate): 500mg

When the source of calcium appears in parentheses it means the amount of calcium listed is elemental calcium, so in this example a recipient is receiving 500mg of calcium.


Example C: Calcium Citrate: 500mg

When the source does not appear in parentheses it means it, the 500mg, is not a elemental calcium. Since calcium citrate is 21% calcium the recipient would actually only be receiving 105mg of calcium in this example.

 

[southernlady]

Pay particular attention to the dosages. What it says in big print on the label may not be per tablet and may need anywhere from 2-6 tablets to obtain that amount.

That is why it is recommended for a DSer to get 2000-2500 mg of calcium to get enough calcium citrate. Also it has to be broken up into several doses, not taken all at once.

 

[Beckmo]

I am really confused with what to take. I am taking BariatricAdvantage ADEK, the Calcium Citrate are 250mg each (so I would have to take 10 of those a day?) and sublingual B-12 (how much do I need?) Is there anything else?

 

[DSRIGGS]

I am really confused with what to take. I am taking BariatricAdvantage ADEK, the Calcium Citrate are 250mg each (so I would have to take 10 of those a day?) and sublingual B-12 (how much do I need?) Is there anything else?

Get on idividual A, D, E and K and the bariatric advantage isn't giving you enough of any of those 4.

How far post surgery are you?

I take:

Biotech Dry A 25K IU 2 twice a day = 100,000 IU
Biotech Dry D 50K IU 2 twice a day = 200,000 IU
Dry E 400 mg 2 twice a day = 800 mg
BIotech dry K 1K IU 1 daily

Calcium Citrate that I take is 600 per 2 pills and I take anywhere from 6-8 daily. I don't need as much calcium as others. I take 3 or 4 at a time twice a day.

B12 I take none and it is still high..I don't take any B vitamins

Vitamins are really no big deal once you get used to them.

 

[Beckmo]

Get on idividual A, D, E and K and the bariatric advantage isn't giving you enough of any of those 4.

How far post surgery are you?

I take:

Biotech Dry A 25K IU 2 twice a day = 100,000 IU
Biotech Dry D 50K IU 2 twice a day = 200,000 IU
Dry E 400 mg 2 twice a day = 800 mg
BIotech dry K 1K IU 1 daily

Calcium Citrate that I take is 600 per 2 pills and I take anywhere from 6-8 daily. I don't need as much calcium as others. I take 3 or 4 at a time twice a day.

B12 I take none and it is still high..I don't take any B vitamins

Vitamins are really no big deal once you get used to them.

I am 7 weeks out TODAY!!
Where is the best place, cost efficient to get these vitamins?

 

[Jen-2]

I am 7 weeks out TODAY!!
Where is the best place, cost efficient to get these vitamins?

You can use the store on this site to buy them through amazon. I've found amazon to have the best prices.

 

[DSRIGGS]

I am Amazon prime so I get free 2 day shipping. I buy the A, D, E, & K through them. The E is new foods dry. The D I buy either biotech 50k dry or there is another brand that is sometimes much cheaper. Just google dry vitamin d 50,000 and you will see it.


http://www.amazon.com/BioTech-Pharm...442411141&sr=8-2&keywords=dry+vitamin+d+50000

http://www.amazon.com/Now-Foods-E-4...&qid=1442411188&sr=8-8&keywords=dry+vitamin+a

http://www.amazon.com/BioTech-Pharm...&qid=1442411245&sr=8-1&keywords=dry+vitamin+a

http://www.amazon.com/BioTech-Pharm...&qid=1442411278&sr=8-1&keywords=dry+vitamin+k

Calcium citrate you can get at target, Walmart or I have found a good deal at CVS one time.

http://www.target.com/p/up-up-calci...6542#prodSlot=medium_1_1&term=calcium+citrate

I added links for the stuff I buy. NOTE: You have to watch because I think I paid $7 something for Vitamin A last time and the Biotech D can get up to $30 rather than $18 so I buy this one sometimes instead (exact same ingredients)

http://www.amazon.com/gp/product/B00LXNU684?psc=1&redirect=true&ref_=oh_aui_detailpage_o02_s00

 

[southernlady]

I am Amazon prime so I get free 2 day shipping. I buy the A, D, E, & K through them. The E is new foods dry. The D I buy either biotech 50k dry or there is another brand that is sometimes much cheaper. Just google dry vitamin d 50,000 and you will see it.


http://www.amazon.com/BioTech-Pharm...442411141&sr=8-2&keywords=dry+vitamin+d+50000

http://www.amazon.com/Now-Foods-E-4...&qid=1442411188&sr=8-8&keywords=dry+vitamin+a

http://www.amazon.com/BioTech-Pharm...&qid=1442411245&sr=8-1&keywords=dry+vitamin+a

http://www.amazon.com/BioTech-Pharm...&qid=1442411278&sr=8-1&keywords=dry+vitamin+k

Calcium citrate you can get at target, Walmart or I have found a good deal at CVS one time.

http://www.target.com/p/up-up-calci...6542#prodSlot=medium_1_1&term=calcium+citrate

I added links for the stuff I buy. NOTE: You have to watch because I think I paid $7 something for Vitamin A last time and the Biotech D can get up to $30 rather than $18 so I buy this one sometimes instead (exact same ingredients)

http://www.amazon.com/gp/product/B00LXNU684?psc=1&redirect=true&ref_=oh_aui_detailpage_o02_s00

Go thru the store here to help pay it forward. Even Amazon Prime works with the BF store: http://bariatricfacts.org/pages/store/

 

[Cantstalkthis]

I know that I'm only 5 weeks post-op but my vitamins came from my surgeon. There was a multivitamin specifically for the DS, A, D3 and Calcium with D. Multi+A+D3, then 2 calcium with D, then another multi, then two more calcium with D. That's what I'm SUPPOSED to be doing. He said that the doses have to be at least 2 hours apart. I'm trying to get it all in consistently. His office also scheduled the follow-up but I'm not close enough to the 6mo mark to know if they'll order labs or not.