Vitamin shots?

[Brandy]

I'm looking at the handout from Mexicali Bariatric Center and they recommend shots for iron and B.

I've never heard of these. What do you guys think? Where would I even purchase them? The nice thing is it sounds like they are only once a month. I made the mistake of ordering chewable B vitamins. NEVER AGAIN! A shot once a month sounds like heaven in comparison to one day on those horrors. Of course, a mega pill or two would probably be even easier.

Thanks!

 

[Larra]

I suspect that, just like in the good ole USA, they are providing generic advice aimed at RNY patients to all their patients. You can easily take B vitamins in pill form IF you need them. I'm over 8 years post-op and still don't need them. And of course you don't need chewable vitamins if you are ok with taking pills. You will need to supplement iron, but there are many different pill formulations you can try for that. If that doesn't work you may need iron infusions at some point, but I can't think of any good reason not to at least try pills first.

And even many RNY patients don't need B12 shots. They usually do just fine with the sublingual form. The shots are helpful for people who fall behind, or for the people for whom the sublingual, for whatever reason, just doesn't do enough.

 

[Brandy]

The hand out is a table with columns for Restrictive (Gastric Sleeve), Gastric Bypass and Duodenal Switch. For most entries there are rather dramatic differences, I.e. Multivitamin for Restrictive is 2 a day. For Gastric Bypass and DS it is 2 every 12 hours. Calcium Citrate is 600 mg every 12 hours for Restrictive, 600 mg every 8 hours for Gastric Bypass and for their DS people they want 1200 mg every 12 hours.

But you are right in that they have the same advice for all three types for the Iron "100 mg orally every day while fasting. 100 mg intramuscular once a month" and also for the B Complex sublingual shots "1 shot every month or 1 pill every week."

For the most part they only non-ds advice they have in their spiel or handouts is about fat intake. I think they just didn't have it in themselves to embrace the "fat is good" mentality. I admit, I am having some problems getting used to it myself.

..b.

 

[Larra]

4 multivits a day??? I take 1 daily and I'm doing just fine, others take 2/day at most. Also, taking 1200 mg of calcium every 2 hours means you'll be wasting a lot of it. We can only absorb so much at a time, probably 500-600 mg. Better to take 500 mg or 600 mg every 6 hours or so (or, since we need to sleep at night, I divide it into 4 doses daily as best I can).
I'm glad they at least realize that people with different surgeries have different needs, but their advice still seems somewhat off. And you're right about the fat intake part, this is a very difficult concept for many nutritionists to grasp. The way I see it, the easier it is to follow the rules, the more likely people are to follow them.

 

[DianaCox]

11+ years out - I take ONE prenatal vitamin/day, no B vitamins (other than what's in the prenatal), 1260 mg of calcium citrate/day (in two divided doses - NEVER more than 630 mg at a time or you're just pooping it out) (note - many people need more than I do, but there should be at least 2 and preferably 4 hours between multiple doses). And where are the fat soluble vitamin(s) in dry/water miscible form? Although I have never needed to take vitamin A or E (almost nobody needs E), I take D3, K1 and K2 (and there is no test for K2, so that's just a crap shoot - I take 3 capsules/week, figuring some is better than none, and 3/week is unlikely to be harmful).

 

[southernlady]

And I take THREE multi's (Costco's Kirkland Daily Multi) a day, no EXTRA B's, No A and NO E cause my labs on those are excellent.

Going thru iron infusions now but still taking oral iron to see if it helps KEEP it up once I have it back up.

 

[Elizabeth N.]

I take two multis twice a day, the Kirkland ones. I almost never need any additional b, sometimes b12 shots, but rarely.

 

[Brandy]

... And where are the fat soluble vitamin(s) in dry/water miscible form? ..."

I just didn't type in the whole chart. Here are their DS recommendations:

Protein:.......... 80 to 100 g
Multivitamin:..... 2 every 12 hours
Zink:............. 50 mg every 3rd day
Iron:............. 100 mg orally daily while fasting. 100mg intramuscular once a month
Calcium Citrate: . 1200 mg every 12 hours
Vitamin D:........ 2000 IU dailyor 500,000 iu every week
Vitamin A:........ 10,000 IU daily
Vitamin K:........ 200 mcg daily
Vitamin E:........ 250 iu daily
B complex:........ 1 shot every month or 1 pill every week​

(Their notes: Protein especially like isopure, matrix or unjury. Zink can be lozenge or gel caps. Take calcium separate from iron in chewable or liquid form. My notes: Where is the vitamin C? Magnesium and copper?)

OK -- otherwise you guys are blowing my mind.

Here is what I got from the vitalady chewable daily program:

Protein:.......... 120 to 150 g
Multivitamin:..... 2 a day
Zink:............. 100 mg
Iron:............. 300mg tender iron
Calcium Citrate: . 1800 mg divided into 3 doses
Vitamin D:........ 500,000 iu
Vitamin A:........ 100,000 IU
Vitamin K:........ 1000 mcg (K1)
Vitamin E:........ 800 iu
B complex:........ 50
PLUS
B-9 Folic Acid:... 1,200 mcg
B-1:.............. 100 mg
B-12.............. 5,000 mcg
Magnesium Citrate: 300 mg
Vitamin C:........ 2,000 mg
Copper:........... 5 mg
​

So, it sounds to me like even thought I thought the conventional wisdom was do the vitalady program, nobody really dose the whole thing. And it sounds like best plan is to do something reasonable until my first labs and then I can adjust from there. What exactly I mean by "something reasonable" I'm sure I don't know yet.

The good news was that other than the B chewables, I have no problems digestively with the vitamins. I despise the chewables though and so ran to Costco yesterday and picked up the happy horse pills. Taking vitamins was much better today. I figure I will try chewables again much later in my recovery.

Thanks for all feedback.

 

[southernlady]

So, it sounds to me like even thought I thought the conventional wisdom was do the vitalady program, nobody really dose the whole thing. And it sounds like best plan is to do something reasonable until my first labs and then I can adjust from there. What exactly I mean by "something reasonable" I'm sure I don't know yet.

What is reasonable...first couple of weeks, your multi, then add D, calcium and iron...from there, do the entire Vitalady regime UNTIL you get labs to see where you are post-op and start adjusting then.

I don't do the whole regime now but I am also 3.5 years out and adjusting to my personal lab values. And the ONLY chewable I use is my probiotic.

 

[Spiky Bugger]

Back to injections...my hematologist was not a big fan of iron injections. He said they were not as effective and stained the skin and that he often had to progress to the infusions anyway. So that's where we started.

And, fwiw, he said that I might want to abandon the idea of absorbing any iron via ingestion...whether food or supplements...because probably, I just would not. So I gave up on that, too.

 

[Elizabeth N.]

Iron is absorbed, as I understand, in the duodenum. We only have a little bit of duodenum in our alimentary tracts, so absorbing oral iron is dicey for a lot of us.

 

[Brandy]

If you count on infusions for all of your iron, how often do you have to go? Is it just like getting a normal IV banana bag?

 

[Spiky Bugger]

If you count on infusions for all of your iron, how often do you have to go? Is it just like getting a normal IV banana bag?

Well, I eat a lot of ribeyes, too! Lol

Probably every 9-12 months, depending on what my labs say. HOWEVER, I also have a genetic anemia that kept me right on the cusp of iron deficiency my whole life. So I was in trouble on this issue before the DS. The DS just kind of pushed me over the edge...and we can't ignore age here either. I have this tendency to keep getting older!

ETA: I don't know that I have banana bag experience.

 

[Brandy]

Sorry, 'banana bag' is medical slang for the saline + electrolytes general purpose bag they use for dehydration et all. So what I was trying to ask if this was just like getting a normal IV.

I, as my Mother before me, live on the cusp of anemia. It would not surprise me if I end up doing regular iron infusions. Before the surgery I did double heme iron for a month, but who knows if that did anything. I'm still taking the proferrin, so we shall see in two months if this has been enough. I can't wait to start ribeye therapy as well!

 

[southernlady]

Sorry, 'banana bag' is medical slang for the saline + electrolytes general purpose bag they use for dehydration et all. So what I was trying to ask if this was just like getting a normal IV.

I, as my Mother before me, live on the cusp of anemia. It would not surprise me if I end up doing regular iron infusions. Before the surgery I did double heme iron for a month, but who knows if that did anything. I'm still taking the proferrin, so we shall see in two months if this has been enough. I can't wait to start ribeye therapy as well!

Actually, the one I am using (ferelecit) is piggybacked to a saline bag...they start the saline, then attach the iron infusion bag (which is MUCH smaller) and once it is running, clip off the saline...when it beeps at the end, they let the iron and saline run together til it runs clear...I typically don't sit for the entire saline bag.