Post-op Vitamin Schedule

[Soonerjoseph]

I'm 2 weeks post-op today. I'm healing (and have healed) extremely well. Besides somewhat mild nausea that I'm unfamiliar with (I've only vomited a few times in my life), I'm pretty sure I can tolerate whatever Vitamins I need/want to take. In a lot of ways, it's like I never had the DS: my body is just taking it really well. With that in mind, I just received my order of vitamins from Amazon and want to know what/how to take them this early out. This is what I bought:

Pure Magnesium Citrate Powder - 1 Kilogram
Pure Ascorbic Acid (Vitamin C) Powder - 1 Kilogram
Pure Calcium Citrate Powder - 1 Kilogram (each gram will equal about 200 mg of elemental calcium)
Dry Vitamin D3 50,000 IU - 200 Count
Dry Vitamin A 25,000 IU - 100 Count
Dry Vitamin K-2 (MK7) 100 mcg - 120 Count
Dry Vitamin E-400 - 100 Count
Carbonyl Iron Perfect Iron 50 mg - 400 Tablets
Vitamin B-1 (Thiamine) 100mg - 100 Tablets
Boron 3 mg - 250 Capsules (Studies show it increases testosterone, at least at high levels)
Copper 2 mg 300 Tabs
*I have a ton of Walgreens and Equate multi-vitamins, that are comparable to most other multi-vitamins.
*I'm missing Vitamin B-12 because Amazon ran out of the kind I ordered and never said anything. I'll pick some up the next time I order stuff from Amazon (so I can get free shipping) or maybe locally.
*For some reason I didn't order any Zinc. I think I might of had a good reason for this but I'm going to have to look at my notes on why.

Probiotics:
Inulin Prebiotic Fos - 8 ounces
4 different probiotics, including one that is pure Saccharomyces boulardii (All-together I have close to a years supply of probiotics. I just wanted to buy different ones to try out)


Considering I'm a 33 year old male, what dosage of the above vitamins would you suggest I take. I'll get labs done at the 3 month post-op mark. I have my own thoughts on what I should take which I'll post in a bit but I'm curious to hear anyone else's opinion.

 

[Clematis]

No advice on dosage but IMO I'd start only one vitamin at a time, make sure it was well tolerated, and then try another. I started taking some vitamins pre-op as a test. Magnesium kinda gave me diarrhea. And carbonyl iron gave me can't-leave-the-house uber diarrhea. If I had taken them all at once, I wouldn't have known which one was the culprit.

 

[Munchkin]

Why all the powdered stuff? Don't make this harder than it has to be!

All this is based on the assumption of labs in now less than 3 months. You are doing well. Quite a few people are not even close to taking vites at this point.

Here's what *I* would do. And I'm sure others will all say different things.

2 multi's per day. You will get plenty of B's from these. Don't worry about them unless you learn later you are low. Almost all DSers absorb B's just fine.
2 D3 per day
1 A per day
1 K per day
2 E per day
1 iron per day(because you are male)
1 boron twice a week
1 copper twice a week
5 gr calcium twice a day
400mg magnesium per day
500 mg C

I don't take probiotics so I would just pick one and take it as directed to start with.

 

[newanatomy]

I would introduce the vitamins to my new stomach very slowly. Start with just a multi and see how that goes for a few days. Then, add your calcium, etc.

I doubt very much that you will need to supplement B12, many multi-vitamins contain it and that is all most of us need. I would only add it if your labs say you are low.

I personally do not take any extra B's except what is in my multi's. I have never run low on any of them and am almost two years out.

I see you have ordered vitamin K2, good. I take 100 mcg of that a day as well. However, I don't see any Vitamin K1. I take 1000 mcg of Boi-Tech Vitamin K1, a dry formula, per day as recommended by Vitalady.

I don't know how much Iron you will need. Watch your labs.

I do take 50 Mg of Zinc a day. This is why I do:

Copper
Taking large quantities of zinc (50 mg/day or more) over a period of weeks can interfere with copper bioavailability. High intake of zinc induces the intestinal synthesis of a copper-binding protein called metallothionein. Metallothionein traps copper within intestinal cells and prevents its systemic absorption (see the separate article on Copper). More typical intakes of zinc do not affect copper absorption and high copper intakes do not affect zinc absorption (6).

Iron
Supplemental (38-65 mg/day of elemental iron) but not dietary levels of iron may decrease zinc absorption (9). This interaction is of concern in the management of iron supplementation during pregnancy and lactation and has led some experts to recommend zinc supplementation for pregnant and lactating women taking more than 60 mg/day of elemental iron (10, 11).

Calcium
High levels of dietary calcium impair zinc absorption in animals, but it is uncertain whether this occurs in humans. One study showed that increasing the calcium intake of postmenopausal women by 890 mg/day in the form of milk or calcium phosphate (total calcium intake, 1,360 mg/day) reduced zinc absorption and zinc balance in postmenopausal women (12), However, another study found that increasing the calcium intake of adolescent girls by 1,000 mg/day in the form of calcium citrate malate (total calcium intake, 1,667 mg/day) did not affect zinc absorption or balance (13). Calcium in combination with phytic acid or phytate might affect zinc absorption, which would be particularly relevant to individuals who very frequently consume tortillas made with lime (i.e., calcium oxide). A study in 10 healthy women (age range, 21-47 years) found that high intake of dietary calcium (~1,800 mg/day) did not further impair zinc absorption of a high-phytate diet (14). For more information on phytic acid, see Food sources below.

Folate
The bioavailability of dietary folate is increased by the action of a zinc-dependent enzyme, suggesting a possible interaction between zinc and folic acid. In the past, some studies found low zinc intake decreased folate absorption, while other studies found folic acid supplementation impaired zinc utilization in individuals with marginal zinc status (5, 6). However, a more recent study reported that supplementation with a relatively high dose of folic acid (800 mcg/day) for 25 days did not alter zinc status in a group of students being fed low-zinc diets (3.5 mg/day); level of zinc intake did not impair folate utilization in this study (15).

http://lpi.oregonstate.edu/mic/minerals/zinc

I started with the Vitalady recommendations for dosage times and amounts. I found, at my 6 month labs, I did not need so much Vitamin A and zero extra B's. I have tweaked many others since then. You will get the hang of it.

 

[Soonerjoseph]

The reason I ordered the B-1 is I had an uncle that got the gastric bypass years ago. He subsequently (took about 3 years) went from losing weight to losing his mind. No one in the family knew anything about bariatric surgery, and not to speak ill of him but I've come to my own conclusion that he may have purposefully not taken vitamins and got bariatric beriberi (think he was a hypochondriac). How else can you explain an RN doing so bad with bariatric surgery that he lost his motor functions? (His surgery wasn't so long ago that all the vit deficiencies concerning bariatric surgery wasn't all over the internet) So ordering the B-1 and taking it is kinda my insurance (and peace of mind for my family) that the same won't happen to me.

I had a feeling I wouldn't need B-12 but I figured taking some wouldn't hurt. I just won't order any until any future labs deem it necessary.

The reason for the powders is because they're just ultra-cheap in that medium. From 1/2 the cost of pill form (vit C) to like 1/30 (Magnesium).

I thought I had a good reason to not take Zinc but I guess not. I'll get some from walgreens in the next few days.

@Clematis The reasons I didn't take the vitamins pre-op is because I thought that maybe by just having the DS it could change what effects anything had on me. The main reason though was that I went to Mexico for the DS. If by chance I wasn't approved for surgery, I didn't want to pour salt on the wound by coming home to hundreds of dollars worth of vits that I had bought.

 

[BebeZed]

@Soonerjoseph - Nina told me to wait until I was a month out to start vitamins. That being said, I didn't wait - I went back on my multis and calcium immediately after surgery and then added one more type every couple of days to see what would affect me. The iron initially plugged me up (as it always has) but recently it looks like I've adapted to it well. I really encourage you to go slow when adding the vitamins into your daily routine for the reasons others have stated.

Now... tell me about the powders. Cheap sounds good... but how difficult is it to measure out the correct dosages and how do you ingest the powder? I'm interested if it won't be a huge PITA.

 

[Clematis]

I wasn't suggesting that you take them pre-op. My point was only that some may give you intestinal issues so if you take one at a time you can figure out which one(s) and perhaps get them in a different form. (Like a different form of iron.)

And as bebezed says, the instructions I have from Esquerra is to wait a month.

 

[Soonerjoseph]

Aha, I get you Clematis. Sorry about the misunderstanding. I think I'll spend the next 2 weeks taking the max dose (pretty much @Munchkins dosage list with 2 tweaks: 2 boron a day and only 1 vit E a day) of a vitamin each day, to see how it effects me. Then I'll add the ones that work together (k2, calc, and magnesium as well as Vit C and Iron) and take them like that for a few days before taking them all at once.

Amazon forgot to send me my Vit K1. They're sending it out to me asap.

 

[southernlady]

Personally I started with the full Vitalady list and lasted 2 days before I had to stop all of them. When I did start back, I started slowly. Multi first, then my D cause I knew I had issues.

I still do not take ANY A, E, or B's at all based on my labs which are pulled every six months using this list: http://bariatricfacts.org/threads/generic-ds-lab-order.191/ My PCP orders them for me. I get hard copy copies and watch trends.

 

[Soonerjoseph]

@Soonerjoseph
Now... tell me about the powders. Cheap sounds good... but how difficult is it to measure out the correct dosages and how do you ingest the powder? I'm interested if it won't be a huge PITA.

@BebeZed My b-i-l who has pancreatitis is where I got the powder vits idea from. I only bought the above 3 in powder form for now and depending on how it works out I'll add more down the road. I'm going to try adding the powder to water first, then juice if that doesn't work. The 3 I bought shouldn't have a bad taste though. I'll also try encapsulating them once I can borrow some capsules from my b-i-l. I know you can also buy a machine to make the capsules in greater numbers but I'll try it by hand first. I bought a small scale to measure out the powder by weight.

I'll keep you updated on how it works. The company I bought them from was BulkSupplements on Amazon though if you want to compare prices.

And I think I'll start really slow after all. Every day my nausea is getting worse which is weird. I didn't have any the first 9 days or so. I can't say I totally hate the nausea though: I've been doing so well I was kinda worried the doc didn't really give me the DS LOL

 

[BebeZed]

@BebeZed My b-i-l who has pancreatitis is where I got the powder vits idea from. I only bought the above 3 in powder form for now and depending on how it works out I'll add more down the road. I'm going to try adding the powder to water first, then juice if that doesn't work. The 3 I bought shouldn't have a bad taste though. I'll also try encapsulating them once I can borrow some capsules from my b-i-l. I know you can also buy a machine to make the capsules in greater numbers but I'll try it by hand first. I bought a small scale to measure out the powder by weight.

I'll keep you updated on how it works. The company I bought them from was BulkSupplements on Amazon though if you want to compare prices.

And I think I'll start really slow after all. Every day my nausea is getting worse which is weird. I didn't have any the first 9 days or so. I can't say I totally hate the nausea though: I've been doing so well I was kinda worried the doc didn't really give me the DS LOL

Thanks for the info - I'll be watching for updates on this! I just bought a boatload of vitamins but eventually they will run out so I'll keep this info in mind.

I hear ya about being worried the doc didn't really give me the DS! I've been doing extremely well too.
Now if only I wasn't stalled... but this, too, shall pass