Season 2 of The Big Ward, oh how I waited…
One thing that is a given for the rest of your life after bariatric surgery is the need to take vitamins every day. It depends on the surgery as there are differing levels of malabsorption afterwards but at the very least your future after bariatric surgery will include a daily multivitamin.
Post gastric bypass I am required to take two multivitamin tablets a day. I tend to space these out as my body can only absorb a certain amount at a time so if I take them at different times I get the most out of them. If I forget to take my second one (as I do occassionally) I take two the next morning.
Even before my surgery I have battled with low iron levels and have been taking prescribed iron tablets for years. After my surgery I thought what was in my mulitvitamins might be enough but it wasn’t and I have had to go back on them again. I was taking them at night with my second multivitamin but I was still really struggling with tiredness and finding it near on impossible to get out of bed in the morning.
It wasn’t until I went to my two year checkup and had a chat with the bariatric nurse that a few things struck me. On the prescription label it says not to take iron tablets with calcium as it inhibits the uptake of the iron. I didn’t translate this over to not taking it with my multivitamin or with dairy products.
Bariatric patients who have duoduenal switch operations need to take a much wider variety of supplements and need to space them out accordingly. The interaction between them is laid out pretty clearly to duoduenal switch patients and the importance of taking them apart is reinforced. I don’t know why but it never occurred to me after my bypass.
Now I have a new timeline I try to follow to make sure I get the most of my vitamins and supplements. In the morning I take my first multivitamin and my reflux medication. Then mid afternoon I take my second multivitamin. When I get home from work I take my magnesium supplement. My team do not recommend a magnesuim supplement usually but since I do a lot of exercise I really find it helps me. They are monitoring my bloods to make sure I’m not getting too much.
Then just before bed I take my iron tablets and I also take high strength vitamin C to help my body absorb the iron. If I take it just before bed it means if there was any dairy in my dinner there’s been enough of a gap that it won’t interferre with the iron uptake. I didn’t realise the calcium levels in dairy products were enough to impact the uptake of iron.
The whole point of this rambling is to make sure you’ve thought about the interactions between the different supplements you may be taking to make sure you get the best out of them. While I had been taking iron for ages it wasn’t doing anything for me and I was still struggling with tiredness and feeling absolutely exhausted. Sometimes I find it helpful to get a reminder about some of the things I have to do and why to make sure I keep myself on the right track.
Vitamin supplementation is so important after bariatric surgery. How do you make sure you keep on top of taking them? Do you have a routine, set reminders on your phone? Comment below and let me know.
Please keep in mind I am not a medical professional and I am using what I do and my experience to start a conversation not give medical advice. If this has made you think about how you’re handling this side of things and want some specific advice please speak to your surgical team about it.