At our last meeting, the inevitable questions of supplementation came up - what vitamins do you take? Why? What does your surgeon suggest? How often are you getting your bloodwork done?
There is no hardcore answer to supplementation. You will hear a wide range of philosophies at each meeting. There is no hardcore truth here I will tell you that - opinions are all opinions and different people with different levels of expertise will answer that for you. So what do you do? What do you go by? Hard to know.
I will tell you about my philosophy and why I have that philosophy. The main thing is that with whatever approach you take - to supplement or not to supplement - that you find research to back up your thoughts (don't base it on the opinion of others who may not know wls needs) and that you are at "peace" with your decision. You are the one that will be living with the results of whatever your choice is.
For me, I've banned myself from Flintstones. I supplement religiously with calcium, vitamin d, and b-12. I take iron when I'm dragging. I wish I'd did that right away as a post op - because guess what? I was deficient and feeling tired and without energy totally sucked. Wish I would have prevented that rather than have had to supplement after and fix the problem. I don't want to "fix a problem". I want to prevent a problem.I read and I research a lot. Talking with others that have a "no supplementation" philosophy, I've found that is generally because they are counting on their general practioners for advice. We all know that doctors don't know diddly squat about weight loss surgery! The wait and see mentality is not good for bariatric patients. We need to be proactive about everything as we can have a tendency to crash and burn very easily.
One great article to read (I've posted to a website that contains it but yes it is a medical study - just posted on this website that makes it easier to read).
Info For Pharmacists: Another Interesting Read
Do you know that you can have severe neurological impairment with this surgery? You need to research those studies. Even a basic multivitamin is not enough and yet, there are people who still swear by Flintstones. Please at the very least do your research on the topic so that you are at peace with whatever your decision is about supplementation - but you need to know and you need to research. And yes, if you are researching go by medical journals - hardcore studies and NOT by word of mouth. You are an adult. At least take adult vitamins if you are not going to supplement anythng else...but I do suggest that you read, read and read about nutritional deficiencies - they are very real and very scary.
I do not believe and wait and see. I do not believe in waiting until problems happen to take action. There was talk about letting your bloodwork tell you what I need. You need to know this my friend: your blood panel that you are doing is probably not complete. If you've gotten your bloodwork done and have never paid money out of pocket - guess what? You have not gotten a full blood panel done.
Your doctor probably does not know that you should be getting tested for thiamine - B1. It is a very common nutritional deficiency as a post op patient. Many people do not know this. After a year out, I would suggest seeing an Endocrinologist who will know more tests to do for you and yes, you may pay out of pocket for this but it is totally worth it to have more piece of mind.
The other fear with waiting until a deficiency is in your bloodwork is that deficits can happen almost over night - you can plummet very fast. There are certain "givens" with this surgery and b-12 is one of them. You no longer have the part of the stomach that manufactures b-12 - yet many surgeons do not suggest supplementation. I recently read of someone who crashed her b-12 levels in half and went from feeling fine to hospitalization practically over night. Personally, I don't want to crash and burn.
An article titled, Don’t Forget Multivitamins After Weight Loss Surgery tells the story:
The 27-year-old woman attended hospital with a three-week history of dizziness, low-appetite, and vomiting, having had uncomplicated gastric bypass surgery two months earlier at University College Hospital (UCH) London.
Upon discharge after her weight-loss surgery, she was prescribed the standard treatments of multivitamins and lansoprazole - a drug which prevents the stomach producing acid, according to a release of UCH. The report was published in this week’s edition of The Lancet.
Upon examination, she had rapid heartbeat and dehydration, and was provisionally diagnosed with gastric outflow obstruction; but an endoscopy revealed nothing of note.
Since the surgery the woman had lost nearly 20 kg, and blood tests gave results consistent with dehydration. She was given intravenous fluids, including glucose, and also drank high-sugar energy drinks.
The next day, she felt light headed and collapsed in the shower, and had extremely low blood pressure. Further tests revealed abnormal eye movements, hyper-reflexia in her arms, weakness of the thighs, and reduced touch sensation - all of which led to the diagnosis of thiamine (vitamin B1) deficiency.
Intravenous administration of thiamine began, and the patient made a full recovery. She admitted that she had not been taking her multivitamins.
Following gastric bypass surgery, vitamin supplements are necessary to make up the shortage of vitamins entering the body through food intake. Total body thiamine stores last 18-60 days, and deficiency can cause wet beriberi (cardiovascular problems), dry beriberi (nervous system problems) or Wernicke’s encephalopathy (an acute neurological disorder characterised by eye movement problems).
The woman had symptoms of all these three conditions.
Oh and if you think that only early out you are at risk of having nutritional deficiencies, think again. Many of them happen after 2-5 years out.
Dawn
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