7 Ways to Sneak in Spinach Top 10 Foods for Weight Loss Celeb Diets May Cause Brittle Bones The Dish on a Detox Diet Sign Up for Our Diet and Nutrition NewsletterThanks for signing up!Sign up for more FREE Everyday Health newsletters.SubmitWe respect your privacy.New studies and claims about vitamins are published daily, and many seem to contradict each other.What does an average consumer really need to know about vitamins?“The fairly simple answer is, not much,” says Paul Thomas, EdD, RD, scientific consultant with the National Institutes of Health Office of Dietary Supplements.Almost everyone can benefit from taking a supplement with calcium because most people don’t get as much as they need through their diets — 1,000 mg a day for adults, increasing to 1,200 mg after age 50.Thomas notes that some vitamins become especially important at certain times in a person’s life. Pregnant women or women who may become pregnant should be certain to get enough folate, or folic acid, a B-complex vitamin — 600 units a day, rather than 400.And as you age, you should probably take a daily supplement to get additional B12, he suggests.“
You don’t have to become an expert or learn all the intricacies of all the vitamins — because you can't,” adds Dr. Thomas. There’s simply too much information to try to remember.What you need to do is eat a healthy diet, selecting recommended foods based on the USDA guidelines.Because few of us consistently eat a well-balanced diet, Thomas says taking an over-the-counter multivitamin, even a store brand, is a good idea.“It’s sort of like an insurance policy that covers all your bases,” he explains.Vitamins and Healthy Living: Not as Easy as A, B, C, and DMaintaining a balance of the vitamins we need is important yet tricky. While vitamins work together in the body to ensure our health — the most obvious being the way vitamin D aids in absorbing calcium — the interaction between vitamin supplements and prescribed medications can cause health problems. For example, calcium can interact with some pharmaceuticals, limiting the body’s ability to absorb the prescribed medication.
So whenever your doctor gives you a new prescription or changes one, it’s important to discuss all of the vitamin and mineral supplements you’re taking to avoid any potential problems.Vitamins and Healthy Living: Is Taking More Better? For people who have a healthy diet, taking a multivitamin according to package directions won’t trigger a vitamin overdose. But Thomas warns, “You run into trouble if you take vitamins and supplements where the dose is very large.”Some people take large amounts of supplements — hundreds or thousands of times more than the recommended amount — to treat or prevent illnesses or diseases, in effect treating vitamin supplements like drugs. “That’s different from taking them to get the recommended amount,” Thomas cautions.Using supplements as therapy should be done only with a doctor’s guidance, as side effects and complications can and do occur. As an example, Thomas points to niacin, or B3, which in very high doses can harm the liver. However, in many cases niacin is a good drug for reducing statin levels, he adds.
Even some very familiar advice isn’t yet proven medical theory, Thomas notes: “When you look at the use of large doses of vitamin C (to combat colds), the evidence to date is kind of murky.”To evaluate any supplement as a medical treatment, consider the body of evidence supporting any health claims and seek information from a pharmacist, dietitian, or your family doctor. “The folks who sell supplements probably aren’t the best sources of information,” Thomas says.Which Vitamins Do I Really Need? by Jacqueline Jacques, ND To view a PDF version of this article, click here After weight-loss surgery, one of the things that most people have to adopt as a new habit is taking vitamins every day. While there are general things that might be the same between what your doctor recommends and what another doctor recommends, some things might be different. When answering the question, “What do I really need to take?,” the first and most important answer is “Take what your doctor recommends.”
Somewhere along the way, your bariatric surgeon, or the dietitian in the office, probably gave you a list of the vitamins you needed to take after surgery based on your procedure. Also, if your doctor looked at your labs, you might have been given some very specific recommendations just for you. Either way, this is where you should start. If you have not seen your bariatric surgeon in many years, it is also wise to call the office and find out what the current recommendations are – knowledge about nutrition has changed a lot in recent years and they might have new recommendations that you were not given. Generally speaking, taking supplements after surgery is for three reasons: The most common types of supplements taken after surgery are multivitamins, calcium, vitamin B12 and iron. When you have bariatric surgery, no matter which procedure you have, one primary reason you lose weight is that you eat less. When people eat less, getting the vitamins and minerals they need each and every day is hard to do – the truth is that most people can’t do this even when they can eat as much as they want.
A study done in 2008 followed 210 post-operative patients for two years and compared the nutrition in what they ate to the Dietary Reference Intakes (DRI’s). They found that even though patients tended to eat better after surgery, not one was able to eat even the minimum requirement for Vitamin A, Vitamin C, calcium, iron, B1, B3, B6, Folate, biotin or pantothenic acid (B5) (1). The kind of multivitamin you need to take may vary by procedure, but most often patients are asked to look for something with 100 percent of the Daily Value (DV) for all the vitamins and the trace minerals. A multivitamin is very unlikely to have the DV for minerals such as calcium, magnesium or potassium. Products calling themselves “complete” may not actually provide all the vitamins and minerals, so carefully read labels. Doctors from the Mayo clinic recently looked at 97 patients from the past 20 years who had bariatric surgery (2). They found that 21 of these patients had suffered a total of 31 fractures – this is more than twice the fracture risk of the general population.
Most fractures occurred an average of seven years after surgery, with the primary locations being in the hands and feet. Other sites of fractures were the hip, spine and upper arm. Bone loss is a risk after all types of bariatric surgery and getting adequate calcium is one important part of helping to prevent bone loss. The American Society for Metabolic and Bariatric Surgery recommended intakes for calcium after bariatric surgery are as follows: The stomach is very important for B12 absorption. This is because stomach acid helps to release B12 from food, and another substance that is made by the stomach – Intrinsic Factor –is essential for B12 absorption. Some bariatric surgery procedures, such as gastric bypass and vertical sleeve gastrectomy, make B12 absorption more difficult for these reasons. Often people who have these procedures will be required to take additional B12 as an injection, intranasal spray or sublingual tablet. Low iron or iron deficiency anemia can be a complication of bariatric surgery, but is especially common after gastric bypass.
Iron levels are harder to maintain after gastric bypass because the primary area where iron is absorbed (the duodenum) is bypassed. Many doctors will recommend that patients take iron preventively to protect against developing a deficiency. Depending on your nutritional labs or on the specific concerns of your programs, you may be asked to take other nutrients. Some common nutrients include Vitamin D, Thiamine (B1) and protein supplements, but there may be others. Again, your doctor’s advice should be primary. One final piece of advice: if you don’t take your vitamins, they won’t work. Many people become overly concerned about what they should take, but don’t necessarily do a great job at taking the nutrients they need on a daily basis. It’s also not uncommon for people to do a great job taking their vitamins for a year or two after surgery, but they may stop taking them over time. Most nutritional deficiencies are easier to prevent than to treat, and once you have had surgery, your risk for developing a problem never goes away.