FAQ: Vitamins and Supplements in the Bariatric After Life

I get a LOT of questions about the vitamins and supplements I take on a daily basis. (Probably because I comment a lot about the vitamins and supplements I take on a daily basis). Most of the questions revolve around what, how much, and why I take what I take. So, I figured I’d make it easy and just encapsulate it here. Bear in mind that I am NOT a nutritionist, doctor, nurse, medical professional, healthcare practitioner, or vitaminologist. I did my research, paid attention to people I trust, and have gleaned all of this stuff from their expertise.

What supplements do I take, and why?

Multi-Vitamin. I like Celebrate chewables the very best, but I also sometimes take Bariatric Advantage multi. Either way, I ensure that the formula includes Vitamin K. Why? Because it has been suggested that Vitamin K can prevent or treat osteoporosis and the loss of bone density. Some studies also find that it might have anticancer benefits, and indication is that it prevents hardening of the arteries, which aids in preventing heart disease and heart failure. You can get Vitamin K from many green, leafy veggies, but if you can’t get them all there (and who can?), be sure your multi-vitamin includes it.

B-12 (Sublingual)
First off, the reason you take this sublingually is, that’s the best and fastest way for the body to absorb it. Now, B12 is needed to prevent anemia and aids folic acid in regulating the formulation of red bloods cells. It helps utilize iron, is required for proper digestion, absorption of foods, synthesis of protein and the metabolism of carbohydrates and fats. It’s ideal if your B12 supplement also contains folic acid (I buy mine from Trader Joe’s).

Possible signs of deficiency: Chronic fatigue, constipation, depression, digestive disorders, dizziness, drowsiness, enlarged liver, eye disorders, hallucinations (!), headaches, inflammation of the tongue, irritability, memory loss, moodiness, nervousness, palpitations, ringing in the ears, pernicious anemia (no, not promiscuous anemia) and other stuff.

Natural sources of B12: If you are veggie (like me), you must remember to supplement religiously, because B12 is found almost exclusively in animal tissue. It can be hard to spot deficiency because your body can store B12 for up to FIVE YEARS!

Folic Acid (as part of my sublingual B12)
Brain food. Folic acid is need for energy production and formation of red blood cells. It strengthens immunity by aiding in the proper formation and functioning of white blood cells. Aids in protein metabolism and may help depression and anxiety.

Signs of deficiency: A sore red tongue is one sign, but so are anemia, apathy, digestive disturbances (heck, I’m one BIG digestive disturbance since bypass – LOL), malabsorption problems (just what we need, right?) fatigue, insomnia and other junk. Important: Eat fresh fruits and veggies wherever possible because cooking them destroys the folic acid.

B-Complex (B1, B6, B12)
Why B6? Also known as pyrydoxine, it is involved in more bodily functions that almost any other single nutrient. It affects both physical and mental health and is beneficial if you suffer from water retention. This vitamin aids in potassium balance and is required by the nervous system for normal brain function. B6 helps the body absorb B12 and plays a role in cancer immunity.

Signs of deficiency: Anemia, headaches, nausea, flaky skin, sore tongue, acne, arthritis, conjunctivitis, cracks or sores in the mouth and lips, depression, dizziness, fatigue, hyper-irritability (and you thought it was all hormones!), impaired wound healing, weak memory and other stuff.

B1 (Thiamine).
This is also known as the energy nutrient and is responsible for many cellular interactions in the body. One of the key things is that it helps your cells use oxygen to convert carbs and other sugars into energy. Without adequate levels of B1, this process slows or stops altogether (eek!)

Possible signs of deficiency: Loss of appetite (okay, that might be a bonus), tiredness or feelings of extreme laziness, indigestion, constipation, muscle tenderness (like when you get charlie horses), numbness in arms and legs. It’s hard to overdose on B1, but still, you shouldn’t megadose on it

Of note: People who are at risk for B1 deficiency include: alcoholics and coffee or tea drinkers (basically, anyone who drinks more than 3 cups of coffee per day.) Why? Since you will excrete the B1 through your kidneys, you might need 5-10x the amount of B1 as other people Hmmm…maybe I should *stop* taking my vitamins with my coffee…

Natural sources of B1 include: Sunflower seeds (raw), tuna, black beans, lentils, asparagus and romaine lettuce. However, you kinda have to eat a LOT to get enough, so…while it doesn’t hurt to get B1 through food sources, it’s most likely not enough, so you must supplement!

Calcium
Okay, I’m not gonna go into the whys and wherefores of this stuff because everyone says something different. All you need to know is this: Most people agree that the best form for bariatric folks is citrate. How much you take is really going to depend upon your doctor’s advice, your bloodwork, and your own research. Again, depending upon who you talk to, you’ll be told that you need between 1200 and 2000 mg PER DAY of this stuff, over and above the calcium you get from food sources (like greek yogurt). The most critical thing you should understand is that, unless you are a professional, you mustn’t mix your calcium with your iron; separate them by at LEAST 2 hours. Also, don’t take more than 400-500 mg at a single dose, as your body will not absorb it. We all know that calcium is critical for bones and teeth, and we bariatric people don’t absorb it easily, so we are prone to brittle bone disease, osteoporosis and other stuff. Just take it, okay?

Iron
Here’s another supplement where your mileage may vary. Ferrate sulfate, elemental? Who knows, right? The bottom line is, just take it. Do your research, figure it out, and take it — BUT, don’t do it at the same time as your calcium and…try adding Vitamin C to help absorption. Some formulations will lead to constipation; others are more gentle, so find one that works for you. That’s all I’m gonna say about that (I’m no expert!)

Probiotics
Many bariatric surgeons have finally learned that probiotics are vital to the daily supplemental regimen of their patients — but sadly, many have not. Whether your doctor agrees or not is none of my business, but I’ll just tell you that I feel it when I don’t take it.

Why? Because I get bloated, constipated (especially if I take the wrong iron), am prone to yeast infections, fatigue and low immunity. Basically, probiotics (as the name implies) are the opposite of ANTIbiotics. They help put good bacteria back into your system (intestines and gut, mostly) to promote balance and good health. Probiotics keep your intestines clean and help you absorb more nutrients from the food you eat (especially protein!)

Find a good, stable probiotic (like Bariatric Advantage Chewable, or Jarrodophilus EPS capsule). These don’t need to be refrigerated, and each contains billions of live cultures — (no, you can’t see them move! LOL) The key to stability is, you want something that will last more than a year, or it loses its efficacy.

Fish Oil (EPA/DHA)
Omega 3 fatty acids are good for your heart, because they can decrease the risk of arrhythmias, lower blood pressure (slightly) and slow the growth rate of plaque in your arteries. You get Omega 3s from eating fish, but if you can’t eat enough fish, you can take capsules. Oh, you can also get it from flaxseed (which I just so happen to add to my morning shakes!) Now, you don’t want to go crazy with the capsules, just take 1 or 2 a day. This stuff also helps your skin and hair, so it’s a good thing.

Possible signs of deficiency: There are about a bajillion signs, but my favorite is listed as “aging.” Apparently, aging is a side effect of not taking enough Omega 3s. Okay, okay, I’m pretty sure that’s not what they meant, but still, it did stand out. I think they were referring to looking older than you are (wrinkles) feeling older than you are (depression, fatigue), and being prone to lots of nasty things (like alzheimers, diabetes, chorines disease, macular degeneration, obesity — um, yes, that would count, stroke, kidney disease and even cancer.) Bottom line: Just take it.

But, I hate it when I burp fish taste after taking a capsule.

Cinnamon Extract
Not only does cinnamon extract KILL the fish burps, it’s also great for maintaining health blood sugar levels! In other words, if you take one of these with each fish capsule, you shouldn’t experience peaks and valleys associated with blood sugar spikes. Oh, and it smells really nice, too.

Vitamin D3
First of all, Vitamin D3 isn’t really a vitamin at all, but is a hormone mainly used to signal the release and absorption of calcium and phosphorous from various body tissues. If you get sun, you should be able to synthesize Vitamin D3, but you can also get it in fortified foods like milk, butter, eggs, margarine, as well as beef, veal, egg yolks, liver and fatty fish. Yes, you CAN overdose on this stuff, but it’s fairly hard for us post-ops. Experts don’t agree on exactly how much you should take, and it is often contained in your quality multi-vitamin and calcium tablet, but I just take more because it can help with my depression (since I don’t get out in the sun too often) and it protects me from prostate cancer. Oh, I don’t have a prostate? Okay, then breast cancer. Either way, it’s good for boys and girls, so just take it.

Possible signs of deficiency: Rickets. Yup. You can get rickets, which is where your bones become brittle. Not good. You can also develop osteoporosis, which you won’t be aware of until the outwards signs are readily noticeable. In other words, you might not be aware of the deficiency until you break a bone, and by then, it’s kinda late.

Okay, so that concludes our presentation of the “ordinary” vitamin supplements that you hear about every day.

Now for the extra-ordinary vitamin supplements.

Ubiquinol + CoQ10
Ubiquinol is the pre-convered, active antioxidant form of CoQ10 which, when taken in this form, is ideal for those of us who are 40 and older. If you are under 40, then you can just take CoQ10.

Why take it? Well, it contributes to cardiovascular and cognitive health, increased energy and stamina and general health and wellness. It also regenerates other antioxidants (like Vitamins C and E) and may help protect your heart from free radical damage. So, what are free radicals (and why should I care, if I’m a political conservative)? Well, politics aside, free radicals are unstable oxygen molecules that every cell produces every day. In other words, our bodies generate them. But they are also available eternally (like environmental toxins) Basically, these nasty little buggers break down our bodies as we age (and the side effects aren’t pretty). Antixoidants help combat the effects of the free radicals (which is a good thing). Essentially, I take this so I have more energy, feel better, and won’t get old. Okay, I’m kidding about that last part — but…maybe?

Natural sources of antioxidants: Blueberries, blackberries, strawberries, grapes, garlic (probably best not eaten with your fruit), and extra virgin olive oil (apparently, olive oil which merely *abstains*, but does not take a permanent vow of *celibacy* doesn’t count. Be careful here).

Milk Thistle
Why? It’s for liver health, and I had hepatitis in high school. Darn near killed me, so I do lots of things to protect my poor liver. Milk Thistle not only my liver from toxins, it also helps repair cells and promotes the regeneration of new cells. If you still have your gall bladder (which I do not), this stimulates bile flow and can help prevent and treat gallstones. It is also good for your immune system, digestive system, can help smooth the uterine muscle (thus minimizing menstrual problems), and control food and sugar craving (time to up my dosage…)

Why is liver health important and how can I be at risk if I don’t drink alcohol? I’m glad you asked. Turns out that diets which contain “excessive” protein and carbs can DAMAGE the liver. We bariatric types do eat a lot of protein, even though we don’t absorb all of it, but guess what else we do? We take VITAMINS — things like A, D, E and K can be dangerous to the liver if you take too much of them; same with iron. SO, you want to just watch your liver when you get your blood work done each year, and make sure to exercise regularly. That’s the laymen’s explanation, anyway.

Amino Acids
Basically, our bodies need amino acids to function, but our bodies don’t make all that we need. Therefore, we have to consume them in food or through supplements. You’ll typically be able to spot an amino acid because it ends in an “ine” — though not always. Now, any aminos that your body cannot produce on its own are called ESSENTIAL amino acids, and they affect different things.
These are the ones I take. There are more, but I don’t want to get crazy. Whoops, too late.

L-Glutamine (Technically, this is a semi-essential amino)
Protects muscle tissue and supports immune function; also serves as a source of fuel for cells lining the intestines. It is involved in more metabolic processes than any other amino acid and can help maintain balance during times of severe stress. Yes, I have that.

Glucosamine, Chondroitin with MSM
Promotes healthy flexible joints. I work out a lot and really trashed my joints — especially knees — when I was obese. This helps with stiffness. Some people doubt its efficacy, but I truly notice it when I don’t take it. No, not right away, but that’s because I am slow to notice sometimes – LOL.

Alpha-Lipoic Acid:
Antioxidant (hey, where have I heard THAT before?) that helps detox the liver! Again with the liver. This is one that I *don’t always take* and am *not sure I notice* anyway. I may not “renew”…

L-Carnitine:
It’s an amino acid derivative which is manufactured by the body and used in energy metabolism and for proper use of fats by transporting fatty acids into mitochondria (the powerhouses of cells). In other words, it can help you recover when you work out AND it reduces the accumulation of lactic acid (all the gain without the pain).

Benefits: Good for your heart, good for your thyroid, good for your kidneys, good for immune problems, cardiomyopathy and a bunch of other stuff. Most people don’t need it, however, people with a history of liver disease (hey, that’s me – again!) seem to benefit from therapeutic use

Quercetin with Bromelain Enzymes
Allergy support that maintains the proper functioning of the body’s histamine response. Brings natural sinus support. Quercetin is an antioxidant (there’s that word again) that supports the body’s inflammation response and histamine processes, while bromeliad increases the absorption of quercetin. The ‘ole 1-2 punch It is also a powerful inflammation response supporter AND (wait for it) protein-digesting enzyme! Hey, we need that. I take it because I am allergic to everything. Simply everything. My throat likes to swell and then I cough and gag — nice. This helps.

That concludes our presentation of vitamins and supplements in Gastric Bypass Barbie’s Bariatric regimen.

SO. How much of all this stuff should you take, and do you need it all?

I can’t answer that question; only you and your healthcare professional can make that determination. What I would suggest is this: If you are taking the vital supplements as outlined by the bariatric surgery guidelines, and still don’t feel “quite right,” look into adding some supplements (responsibly), based upon your medical history and particularly symptoms. I’d recommend adding slowly, doing your research, and monitoring your blood work closely. It is important to determine the proper dosage for your body, and also recognize that you can take too much (or too little) of something to derive the benefit, so be educated.

I hope you found this information to be useful, but if you didn’t, that’s okay too. You don’t need to ask me why I take all of this stuff, and you don’t need to tell me I shouldn’t be taking it, and you don’t need to tell me I misspelled “rickets”, or something.

After a year and a half of studying it, I KNOW why I take it, how much to take, and how to spell it — LOL.

GOOD LUCK AND GOOD HEALTH!

Product Review: Bariatric Advantage Chewable Probiotic

About a month ago, my friend Ed (from Bariatric Advantage) and I were chatting about their product line, and he mentioned that he’d love to send me a bottle of their new Strawberry Flavored Chewable Probiotic to use and review.

Now, before I go any further, there are a few provisos, a couple of quid pro quo…

Ahem (Clears Throat):

FORMAL LEGAL DISCLOSURE

This disclosure officially follows the new guidelines set for the the FTC concerning the use of endorsements and testimonials in advertising (effective December 1, 2009).

1. By definition, I am (apparently), an “expert” because I am the reviewer and got FREE product from Bariatric Advantage
2. I did not receive any money for this review, but I did receive (2) Bottles of Bariatric Advantage Strawberry Flavored Chewable Probiotic (90 Capsules per bottle; 2.4 Billion CFU) The reason I got two bottles is that the first one was lost in the mail stream for, like, 2 weeks. So, Edward rushed me out another bottle, so I wouldn’t have to wait to try the product. About a week after I got the replacement bottle, my new bottle rolled in. So, effectively, I’m reviewing TWO bottles of the product.
3. I am currently a bona fide user of the product. As a matter of fact, because I had something containing milk earlier today, I am a little gassy, so I just chewed a tablet to help aid in my digestion. My husband will appreciate my use of the product — trust me.
4. I have no connection to the company, and am not related to Ed. In fact, the only two things we (me and the company, not me and Ed) have in common, are a) the fact that I live in southern California, and b) have the word ‘Bariatric’ in my name, too!
5. I am not selling the product or profiting from this review.
6. My review is truthful and honest. Duh. Why would I lie? It either works, or it doesn’t. Trust me — you’ll get the straight poop (pun intended.)
7. I did not ask my attorney if it was okay for me to review this product, because he doesn’t like Strawberry. I think he’ll be okay with what I wrote, though…

Okay, that is the legal stuff (I think).

On to the review!

PRODUCT DESCRIPTION:

• Strawberry Flavored Chewable Probiotic
• Bottle contains 90 Tablets
• Each tablet contains 2.4 billion organisms at time of manufacturing.
• Suggested Serving size is 1 daily with food (Note: I took 3 Daily — 1 with each meal, as that is what I have found works best with my system. That means that each bottle would last one month for me).

WHY USE THIS PRODUCT?
According to the Bariatric Advantage website: The human digestive system is normally home to several kinds of healthful bacteria or “flora” that play a role in bowel health and regularity, immunity, carbohydrate fermantation and absorption and more. It is sometimes possible for this flora to be come altered due to medications (such as antibiotics or acid blockers), illnesses, or surgical procedures. Bariatric Advantage Chewable Probiotic is designed to assist in the maintenance of healthy normal flora in the digestive system as well as to support overall digestive health and wellbeing. This delicious strawberry flavored product provides 2.4 billion CFUs (colony forming units) of probiotic activity from lactobacillus acidophilus and bifidobacterium lactis – two of the best-studied supplemental forms for probiotic. It also supplies short chain fructoligiosaccharides (FOS) as a prebiotic and is Dairy-Free.

WHAT HAPPENED WHEN I TOOK THE PRODUCT?
I’ve long known about the benefits of probiotics, and had been taking another brand for some time. So, when Ed contacted me and asked me if I’d be interested in trying the BA brand, I was hesitant, and told him so. I mean, I didn’t want to waste his time if I was already pretty happy with the brand I was taken, but he persisted, because he was so confident i would love the product. Maybe it was the strawberry, or maybe I was just weak that day, but I agreed to let him send me a bottle, and promised I’d give my most honest review. In other words, if I didn’t like it, you were going to hear about it. He was cool with that — either because he knew I’d love it, or because the formal guidelines say that reviewers must be truthful, even if the review is negative.

The first thing I noticed about the BA probiotic was how good it tastes. It’s pretty yummy, actually, and that’s not a bad thing. But, I have a feeling that’s NOT why I’m supposed to take it! After about 3 days on the product, I began to notice that my bloating had gone away and I wasn’t…well..gassy. That’s just the truth. Gastric bypass people suffer from gas and it can be quite unappealing, to say the least (or, maybe it IS “appealing,” as in “you’re a-peeling the paint off the walls with your gas.”) Anyway, the next thing I noticed was my stomach wasn’t unhappy and I didn’t have any indigestion. The third thing I noticed was probably more mental than anything else, but I seriously felt like my food was being maximized in my system — that I was getting more benefit out of my protein. Again, This is probably just the “placebo effect” at play, but I went with it.

Now, for me, here’s the REAL advantage to taking chewable probiotics: You don’t need liquid, so if you just ate, you don’t have to wait! With other probiotics, you have to take them with liquid, That can be a negative, especially when you really need to get one down, but just ate.

Just to be sure about my experience, I stopped taking them for a few days and — lo and behold — the bloating and gas returned with a vengeance. So, that was enough proof for me. I believe the product works and I would buy it for regular use. I do recommend it for all bariatric patients, and wonder why more doctors/surgeons don’t mandate probiotics as part of the daily vitamin/mineral/nutritional supplement regimen. Perhaps more will catch on, but in the meantime, if you aren’t sure probiotics are right for you, why not ask your physician what he or she thinks? Then, when you get the green light, order up a bottle from the folks at Bariatric Advantage. Each 90-count bottle costs $17.95 (plus S&H — of course,  but you could just tag it in with the other supplements on your order, right?)

Barbie’s Bottom Line: 2 Thumbs Way Up. I thank you and my husband thanks you even more for this product!

Buy it, use it, be happy.

Why Am I Taking All This Junk?

(or: What Are These Supplements For?)

As many of you know, I’ve been on a mission to achieve supreme health. So, in addition to my healthy diet and regular exercise, I’ve learned that vitamins, minerals and other supplements are critical to my quality of life.

When I first had surgery, I was told to take a Flintstones chewable vitamin each day, chew some Tums (for calcium), and make sure I got my iron in.

I pretty quickly learned that, as a bariatric patient, I am malabsorptive (so I don’t get the benefit of everything I take or eat), and I have very little room to take a ton of stuff at once. I immediately started looking for better supplements, beginning with the multi-vitamin and calcium. I knew that Bariatric Advantage offered a full line of supplements that were formulated especially for me, so I began taking those.

And then I got my blood work results: I was severely anemic. So anemic, as a matter of fact, that I might need iron transfusions.

Uh-oh. Time to reevaluate my daily supplementation.

I immediately contacted my good friend, Mark Becker, who just happens to be the director of communications over at Jarrow Formulas. He immediately told me to start taking a probiotic and some Co-Q10 (which I did). Soon after, he recommended some other supplements: silicon (for nails and hair), a better calcium, a better iron, ribose (for recovering after strenuous workouts), Jarrow Whey protein (for better quality protein shakes), glucosamine with condroitin and MSM (for joint pain), SAMe joint formula (for mood and joints)…and a bunch of other stuff.

Then I was invited to be a guest on his weekly radio program (!!!). The doctor who co-hosts the program gave me a whole list of OTHER stuff to take.

So I did.

And then it occurred to me that I might not be taking the stuff in the right order, at the right times of day, or even in the proper dosage! Of course, by now, I had pre-bagged everything in little Ziplok baggies marked “morning” or “night”. This was after I had handily numbered all of the lids (1-15) with an “M” or an “N”. It had become to cumbersome to open 15 lids each day, so I counted them out in individual days.

Bad idea.

Now I don’t know which capsule is which (aside from the obvious ones: Flax seed capsule, Co-Q10, Wellbutrin and B12), so I can’t be sure when to take what! Worse still….I can’t really tell you what each thing is for.

Time to regroup.

Starting today, I am reviewing my supplement list, so I know EXACTLY what I’m taking and why. I will be affixing little labels to each bottle, telling me WHAT it’s for, WHEN I need to take it, and HOW MUCH I need to take.

This stuff can add up in a hurry, and since we’re on an austerity program, I most likely will not be able to refill everything when I run-out. That’s why it’s important to know what i can do without (for awhile) and what I can’t.

Anyway, I’ll be reporting back to you – one supplement at a time — as I advise how it’s going, if I’m noticing any difference — and when and how much of it I’m taking.

Stay tuned….

Dr. Bob Berger Recommends

I was fortunate enough to be a guest on HEALTHLINE, a nationwide radio program based in South Florida on station WLVJ (and simulcast on the Internet every Friday morning.) We talked about my gastric bypass surgery and the happy, healthy “after life” I’m enjoying, and the co-host (Dr. Bob Berger) asked a few questions about my diet and supplementation, etc. He then made some recommendations for supplements I should add to my current daily regimen.

Here’s what he suggests (and why):

BroccoMax (Sulforaphane) – Rid toxins/estrogens out of the body that are released from fat stores after this kind of weight loss. These toxins, poisons, estrogens, xenoestrogens, etc, are very dangerous because now they can go and reattach themselves to “other available” fat stores, such as in the breast tissue (an obvious cancer issue).

Stomacin-U – Very crucial, as this surgery (and the ensuing weight loss), undoubtedly lowers/reduces immune function and totally disturbs the ability for the stomach/GI tract to function properly. It may actually go into a type of “shock”, which in turn, will halt the already-poor functioning protective mechanisms, especially mucin production and Goblet Cell health. Must replenish mucin and get its production and release up and functioning properly.

CoQ10 (QH-absorb) – Because absorption and bioavailability are now major factors (the purpose of Bariatric surgery is to cause “malabsorption”), we have to make sure that the GI tract gets the most bioavailable CoQ10 to support the extra required oxygen and aerobic healing–we do not want dangerous anaerobic conditions, which if present, would cause segments of important (remaining) stomach/intestinal tissue to die. They would have to go back in and do more surgery!

L-Carnitine Fumarate or the Liquid L-Carnitine — (Formulation depend upon absorption factors). Must be concerned with the continuation of proper fat transport/utilization for energy, and should avoid/or not rely on caffeine and other stimulants to release and burn fat now.

Milk Thistle (Jarrow’s Silymarin 80%)– In this situation, when this type of weight loss occurs after Bariatric Surgery, one major complication is the formation of gallstones, and this strength of Silymarin will be very protective of the cellular membranes of the liver, will help control the production of excessive bile, and will control gallstone formation. Many physicians will advise reducing calcium intake, but do not take into account that this surgery reduces calcium absorption, and in woman especially, this could be a potential issue with future bone health (osteoporosis, etc.)

Alpha Lipoic Acid — I would advise the Jarrow product, Alpha Lipoic Sustain 300 (Bi layer tablets). Liquid Alpha Lipoic acid is not very stable and this is why this bilayer is available for sustained release. Usually after this type of surgery and recovery, the recommended diet is high in protein and low in carbs (need to regulate blood sugar and insulin production, as well as fat-cell membrane insulin receptors, etc.)

Finally– Must have available a good vitamin/mineral/trace mineral supplement or combo of some kind. A good liquid source along with the Jarrow product Yum Yum D3 liquid would be very good.

Where to Buy:

Vitacost.com
Tunies.com
NutritionExpress.com
N101.com
VitaminShoppe.com

I’ve ordered these items and am anticipating their arrival on my doorstep this week. I’ll be sure to report back on the noticeable improvement I expect to see after adding these important products to my regimen!

PS — An archive of my radio interview should be available by about mid-October on tunies.com.

My Daily Supplemental Regimen

Many people think that they can take one multi-vitamin every morning to ensure good health and a long life. Others think they are a good idea, but “don’t like taking pills,” so they don’t take them at all. Somewhere in the middle is the crowd that takes them…sometimes…when they think about it.

As bariatric patients, we don’t get a vote on the matter. We MUST take supplements every day for the rest of our lives, period. Why? Because our new digestive systems are malabsorptive, making us highly susceptible to brittle bone disease, osteoporosis and anemia.

the best way to protect from these serious conditions is:

• Have your blood checked regularly (at least once per year, but more if you are having problems, such as iron or calcium deficiency.)
• Get plenty of exercise
• Sleep at least 8 hours a night
• Eat a healthy, well-balance diet filled with non-processed foods
• Take the very best supplements you can find.

For today, I’m just going to discuss the last point: Take the very best supplements you can find.

A little history…Immediately after surgery, I took a generic chewable multi-vitamin from Trader Joe’s, in order to get my “vitamins” out of the way. Then I’d chew some Sugar Free Tums (for Calcium), toss in a chewable iron tablet from Bariatric Advantage, and pop a B12 under my tongue. I’d usually take them all around the same time — one after the other, as space in my pouch became available. I had no idea that calcium couldn’t be taken with iron, or that calcium citrate would work better than calcium carbonate. I didn’t realize that my chewable vitamin was not good enough for a five year old, or that I really was absorbing more B12 than I needed. The surgery manual told me I only needed to take it once a week, but I took it more like three times per week, just to be sure.

At some point, it occurred to me that I might not be supplementing as well as I should, so I started doing some research and ended up buying Bariatric Advantage vitamins and supplements. I figured that anything specifically formulated for my post-WLS body would be a fool-proof way to get my vitamins in without really thinking about it.

The first sign of trouble was when I learned that I needed to chew SIX of the calcium tablets — not THREE, in order to get my recommended milligrams in each day. Then, I learned that I could not chew them one after the other, since our bodies are not able to absorb more than about 450 mg at a time. Next, I realized that the recommended serving of 6 tablets was still lower than the new guidelines — by about HALF!

Next, I learned that I was seriously anemic, which told me that my body was not absorbing all of the iron I was taking. Clearly, the formulation was not correct for my body.

Finally, after reviewing my lab work with my nutritionist, I learned that the mass quantities of protein I have to eat every day, combined with my vitamin supplements, was having a negative affect on my liver and kidneys, meaning that, all of the “good” stuff I thought I was doing wasn’t really that great at all.

Needless to say, I was pretty confused about the whole problem and didn’t know where to turn. I mean, I followed the directions from the Bariatric Center, and that was almost as bad as taking nothing at all. Then, I tried supplements specially formulated for bariatric patients, and found that they weren’t really formulated well for ME. Finally, I learned that I was taking everything at the wrong time, so it wasn’t really working anyway!

Back to the drawing board.

The more I researched the problem, the more I realized that finding a solution to my supplement problem would be like trying to nail sugar free jello to a wall! For starters, the more “experts” you talk to, the more “answers” you’ll get — but those answers are usually caveat-ridden, as no one can ever really say with 100% certitude what YOU should do for YOUR particular situation. They’ll always tell you to “Start with this, see how you feel, and adjust accordingly.” Well, HOW DO I ADJUST WHEN I DON’T KNOW HOW I’M SUPPOSED TO FEEL!?

Aside from the fact that I am NOT a particularly structured person (outside of my office, anyway), I’m not especially OBSERVANT either. Oh, and I forget stuff, too. With all of these handicaps, you can imagine how hard it is to build a program that I can stick with. I mean, not only do I need to remember to take stuff every day, I have to take it at the right times, and in the right amounts, and make sure that the formulations are correct, so I’m getting maximum benefit. A daunting task, for sure, but one which was made considerably easier by my good friend, Mark Becker — Director of Communications for Jarrow Formulas in Los Angeles.

When I told him about the problems I was having, he immediately suggested that I add a probiotic (Jarro-Dophilus EPS) to my supplement regimen. He thought I should do this before anything else, as it would aid my digestion, control the bloating, and enable my body to get better use of the small amount food I’m able to eat.

The effects of the probiotics were immediate and powerful: The bloating went away and I started to feel better and more balanced. Clearly, that was a good first step.

Next, he suggested adding Glucosamine with Chondroitin and MSM, some SAMe, and a good Co-Q10. In doing so, he said that my joints would feel better after my workouts, I would recover faster between exercise sessions, I’d be more emotionally stable, and my overall energy levels would increase. I will go into greater detail on each supplement in separate postings, but for now, I’m just giving you the “big picture” of my noticeably improved health.

To help rebuild my ferritin levels (and hopefully avoid iron transfusions), Mark suggested IronSorb, and for Calcium, he recommended Bone Up. I haven’t had my blood work done yet, so I don’t know the net effect of these two supplements, but at least I know that I’m getting quality formulations into my system, so the results should be positive.

In addition to the items above, he also suggested that I add a few things (some of which I just haven’t bought yet, because they cost money) like: Fish Oil (MAX DHA), a Women’s Multi, and Ribose.

For now, here’s how my day looks:

Jarro-Dophilus EPS (Enhanced Probiotic System)
Enteric Coated; 5 Billion Organisms per capsule.
3 per day (1 after each meal)
Benefits: Aids digestion, can help metabolize protein and breakdown lactose (milk sugar) supports intestinal health, boosts immune system

Jarrow SAM-e Joint (includes glucosamine)
200 mg SAM; 535 Glucosamine HCI
1 Tablet on empty stomach
Benefits: Joint strength, brain metabolism, longevity, liver function

Jarrow Q-absorb CO-Q10
200 mg/1 per day (morning)
Benefits: Improved heart function, can reduce cholesterol from oxidation, antioxidant protects mitochondrial membranes , more energy

Jarrow IronSorb
18 mg elemental iron – IPS (iron protein succinylate)
2 tablets per day (morning with protein shake)
Benefits: Protects against anemia; critical for transport of oxygen to tissues

Bariatric Advantage Chewable Multi-Formula with Vitamin A, D, E & K
2 Tablets (morning with protein shake)

Jarrow Bone-Up Calcium w/Vitamin D & Magnesium
1,500 mg per 9 capsule serving.
(Bariatric patients need 2,000 mg per day including calcium from food sources)
3 Capsules (afternoon, early evening & bedtime)
Benefits: promotes bone growth to reduce osteoporosis and brittle bones

JarroSil Silicon Drops

10 Drops (in protein shake)

Benefits: Essential partner of calcium for bones, glucosamine for joints and antioxidants for arterial health. Promotes healthy skin, nails and hair.

Jarrow Milk Thistle
150 mg/1 Capsule (morning with protein shake)
Benefits: Protects liver function

Glucosamine+Chondroitin+MSM
2 Capsules (morning with protein shake)
2 Capsules (evening)
Benefits: Protects joint tissue; helps produce synovial flud (which lubricates joints

Stool Softener (Generic Colace is fine)

Trader Joe’s B-12/Folic Acid/B-6
Sublingual; 1 tablet (morning with protein shake)
Benefits: Promotes energy, stamina, mental clarity, improved mood; helps metabolize carbs and burns fat; combats some detrimental effects of stress.

Spring Valley Organic Flaxseed Oil with Omega-3 Fatty Acids
1000 mg/2 Softgels (morning with protein shake)
Benefits: Good fats with heart-healthy effects. Contains lignans with plant estrogen and antioxidant qualities; may have a protective effect against cancer (especially breast, prostate and colon), helps cardiovascular system (anti-inflammatory action which normalizes heartbeat), improves blood sugar (good for type 2 diabetics), reduces inflammation.

Jarrow Femdophilus
5 Billion Organisms Per Capsule
1 Capsule (morning with protein shake)
Benefits: Urinary & Vaginal Health

Jarrow Acetyl L-Carnitine Arginate & Alpha Lipoic Acid
1 Capsule (morning with protein shake)
Benefits: Mitochondrial (heart valve) nutrition for energy production

Trader Joe’s Odorless Garlic
400 mg/1 Tablet (morning with protein shake).
Benefits: Lower total cholesterol (but raise HDL); increases immunity, lowers blood pressure, reduces risk of blood clots, regulates stomach function, improves blood circulation

Now, I’m not going to tell you that this is easy or fool-proof, because it’s not! It’s really challenging to stuff a bunch of supplements into a tiny pouch, at just the right times each day. But, I will promise you that, as long as you manage to accomplish this feat at LEAST 80% of the time, you’ll notice a dramatic improvement in your overall health, and most likely see better lab results on your next blood draw!

Oh, and you probably noticed that I have a LOT of Jarrow products in my list. Well, that is because they are a trusted name in the health supplement industry and have a long-standing and excellent reputation for manufacturing stuff that actually works. As Mark would say, their products are “ROCK-STAR” quality  – Who am I to disagree?

Now for the tricky part: Starting your own program and making it stick. I’m all about making things as easy as possible, so I’ve set up some “fool-proof” systems for getting my supplements in — every day:

1. I bought one of those big, stackable plastic drawers, loaded it up with all of my bottles and put it in the closet.
2. Then, I took a big Sharpie marker and wrote a letter on the top of each bottle: “M” (for morning), “N” (for night).
3. Next, I added a number (currently it starts at “1″ and goes to “15″ — but I know that number is gonna go up!) In other words, I have “M1″ which happens to be my Iron, “M2″ (multi-vitamin), “M3″ (Co-Q10), “N1″ (Calcium), etc.
4. I also created little baggies of everything (for when I’m in a hurry and don’t have time to sit and count everything into a little cup). The little snack-size Ziplok bags work GREAT! I have one for mornings and one for nights. So far, it’s been working great, and I’ve been at it for about 2 months.

BOTTOM LINE: You only have one body and one life. Making the decision to have bariatric surgery was the first most important thing you could have done to save them both — eating right is tied for second — right there with taking proper supplements!

DISCLAIMER: I am NOT a certified ANYTHING. I’m just a girl who happened to have gastric bypass surgery to change her life, and wants to share her successes with the online world. If you have a nutritionist you like to work with, talk to him or her about your particular needs, so you can work together to formulate a solid program. You can also talk to your doctor, but remember that many doctors are not well-versed in the discipline of vitamins, minerals and other health supplements, so don’t be discouraged if they aren’t as helpful as you might hope.

Announcing an exciting new category on Gastric Bypass Barbie:

Superlative Supplements

In addition to getting enough protein into our bodies every day, there’s an equally critical (and often undervalued) component we need to address if we want to live a successful, healthy and energetic bariatric After Life: QUALITY SUPPLEMENTATION.

One of the more common (yet surprising) questions I hear at weekly group meetings is, “Will I have to take vitamins for the rest of my life after surgery?” The best answer I’ve heard (so far is), “Only as long as you plan on living.”

Now, that might sound glib, but the truth of the matter is, gastric bypass surgery patients suffer from malabsorption at considerably higher rates than the average individual. This fact is a double-edged sword. One the one hand, we don’t absorb as much of the “bad stuff” from our foods, but the flip side of that is, we don’t absorb as much of the “good stuff” either thus, we are prone to osteoporosis, anemia, rickets, heart disease, infection and a host of other nasty little conditions which spring from the lack of proper mineral, vitamin, enzyme and amino supplementation.

Many people are errantly led to believe (because they are misinformed by their surgeons and doctors) that “popping a Flintstones chewable and some Tums” once a day is all they’ll need after their surgery. Most bariatric centers even give you a handy little chart that tells you when and how much of everything to take. The list includes sublingual B12 and iron, but that’s about as far as their vitamin program goes. The dosage amounts are shockingly undervalued, especially considering the volumes of medical data readily available on the supplemental needs of bariatric patients.

Bariatric surgery is serious business, and yet, most people focus only on the food requirements, completely ignoring supplementation. This is a BIG mistake, as by the time most people learn they are deficient in a particular area, it can be too late to reverse the damage that has already been done. Having said that, if the best time to plant an oak tree was 20 years ago, then the next best time is now! In other words, it’s never too late to do something about your supplemental health!

Since day one post surgery, I’ve been vigilant in getting my supplements in. I started with a respectable Centrum Multi, sublingual B12 from Trader Joe’s, some CitraCal and a chewable iron tablet from Bariatric Advantage. I thought that would be enough — until I got my blood work back at about 14 months out from surgery.

The findings were not as good as I’d hoped; I was anemic — seriously anemic – like to the point where I might need iron transfusions if I can’t get my body to absorb the iron I’m taking.

I’ll leave the particulars for individual postings on each supplement that I’ve added to my regimen, but for now, this is what you need to know as a bariatric After Lifer:

• All post-ops have a vital need for quality supplements
• Though you might be taking supplements, you might not be getting the proper dosage.
• Improper or ineffecient formulation of your supplements could be negating the health benefits to your body.
• When you take your supplements is every bit as important as how much and what type you take.

I will do my best to address each of these concerns in the coming days, as I write about my personal experiences with various supplements, and make recommendations for what works for me. Bear in mind that I am NOT a doctor, a nutritionist or health expert, so the best I can do is share information that I’ve learned, and let you determine its value. in your life.

Be sure to check back regularly as I add reviews of several, “rock star quality” (as my good friend, Mark would say) supplements that have literally changed my life.