Hello - RNY or SIPS? That is the question of the week...

[Stefanie S.]

If that's all the vitamin instructions they gave you, you would be in trouble. With gastric bypass there is also malabsorption of B12 (and possibly of other B vitamins as well). B12 deficiency causes peripheral neuropathy, and I have seen threads on that other website where one person discusses their problems with peripheral neuropathy and a bunch of others chime in with their problems. And if left untreated, it can become permanent and disabling.

And the calcium, for both bypass and DS, should be calcium citrate, not the more common calcium carbonate.
People with both operations can have issues with iron, probably more with bypass than with DS but we see this with either operation. So you can't avoid supplementation for either calcium or iron.

With the DS, since we absorb so little fat, we also have to supplement the fat soluble vitamins - A, D, and K. E is also fat soluble but it's rare to have problems with E. And taking ADEK's won't work. They sound perfect, but in reality contain so little of each component as to be useless. So we take them separately in the "dry" form because if you take the prescription form, or the standard OTC ones, they are packaged in oil, and oil=fat so we don't absorb them.
There is a lot to know, and sadly most surgeons and their staff fail to provide adequate information. And then, they slam the DS for causing deficiencies, when in reality it's their crappy recommendations that caused the problem and not the operation.

Hi Larra - I forgot about B12... I do take that every day already due to being vegan. Already sublingual too. And I do take calcium citrate. Interesting on the iron... that bypass is more likely to need that extra supplementation. I guess I need to look up what dry form means... I know my current bariatric vitamin has those - Optisource Bariatric chewables. But you said you take them separate.... I will need to look into that, so thank you for sharing! Uggghhhh.... sucks that we can't rely heavily on BARIATRIC nutritionists

 

[Larra]

Yes, it does such that we can't rely on the supposed experts, but that's reality and we have to learn the vitamin stuff ourselves. Fortunately we have this wonderful group to help us along. The bottom line is that you will follow your labs and adjust your supplements as needed. Never rely on the office staff who will just tell you your labs are normal. You could be normal but trending towards trouble, so it's necessary to follow the trends, and adjust before you get into trouble.
Keep in mind also that any vitamins that are designed especially for bariatric patients will be geared for RNY at BEST, and not always adequate even for them. While there is some overlap on calcium and iron, our needs are otherwise very different from theirs. But you are clearly smart enough and assertive enough to handle this. Actually, it's more about just being willing to make the commitment and follow through. It's not rocket science.

 

[Munchkin]

I love your post! Your straight-talk really reached me. I have been researching and discussing this all day long. I am 99% sure I want the full DS now. And posts like yours really put my mind at ease. One thing... with the RNY, they had told me I will need to take the multi-vitamin every morning. And then 3-4 doses of calcium spaced evenly throughout the day. And possibly more iron. This isn't the case for DS?

I am not worried about you having the DS. The first and most important thing you have is a brain. The DS is not easy for people without intellect. You need to be smart and assertive. Sounds like you have that covered. Don't ever hesitate to stand up for your own best interests and ask questions. Always follow the money. Bariatric vitamins sold by a surgeon generate another income stream for him/her. So far, there is nothing out there labeled as bariatric that is all that great.

Check out the DS list at vitalady.com. It's a good starting point. You don't have to order from there but she gives you a pretty reasonable list. Then you tweak whenever you get labs done. Almost all NUTs and surgeons understand next to nothing about DS supplementation. You have to figure it out for yourself. There is also an Amazon store here with products lots of us use. If you are going to order anyway, order through here. We use the pennies to keep the site ad-free and help pay the expenses. Some DSers need more and some less, over time you will figure it out. My needs are pretty moderate and I spend about $350 per year on supplements. Cheaper than being fat but not free!

By all means read and learn as much as possible about the supplements. Knowledge is power. It's all about performance over time. What you do today means nothing. What you do every day means something. The bottom line is, just take the pills. Consistently. Some people get so wrapped up in what goes with what that they become paralyzed with confusion. MOST of us don't need to worry that much because as someone else already said, it's not rocket science. When in doubt, just take the pills. There is no doubt that the DS sort of takes over your life immediately post-op but over time, it becomes routine. Just life.

Moving on to the surgery, you have more research to do. Be ready to discuss CC and the Hess Method with your surgeon. Look these up and read. There is a lot of info here too. The easy explanation of the Common Channel(CC) is the length of small bowel you have left after surgery to absorb nutrients. Mine is 75cm, relatively short, and I wish it was shorter for even more malabsorbtion. The shortest one I know of is 40cm and the longest is 200cm. The average is right about 100cm. The Hess Method requires the surgeon to measure the whole small bowel and the CC is a percentage of the total length. Some people have more to start with than others! This stuff is important but take it all with a grain of salt. Intestines are motile. They move like earthworms. You could have 10 wonderful surgeons measure out a CC on the same patient and come out with 10 different results. It is not exact but it should be close! Some surgeons use the Hess Method and others prefer to just measure.

What did you figure out about the diet thing? Most of us shoot for around 100gr protein per day. I need a bit less because my body has had 14+ years to adapt to the surgery. I can't even imagine trying to eat that many lentils... We still like and enjoy food. Imagine, real butter and no more low fat anything! IRL, our diet is close to Atkins or Paleo. But it's always protein first.