Understanding Calcium and Iron Supplementation

After you have bariatric surgery you are required to take various vitamin supplements. Included in these requirements are a Calcium + Vitamin D and an Iron supplement. What many people do not know is that there is can be a right way and a wrong way to take these vitamins. Timing can be essential regarding how our bodies absorb certain vitamins. Products available over-the-counter can be very confusing if you do not know what to buy.

Our bodies need calcium supplementation following bariatric surgery. There have been multiple studies showing that the calcium provided by a multivitamin is not essential to the needs of a patient who has had bariatric surgery. When calcium levels are too low, the body takes necessary calcium stores from the bones. When the body constantly takes calcium stores from the bones this can lead to weak, brittle, thinning bones (osteoporosis). Calcium supplements should be taken in the form of Calcium Citrate. Calcium citrate is the only form of calcium that does not need stomach acid to help break it down. Since stomach acid is reduced after bariatric surgery (smaller stomach size) calcium citrate is the only recommended form. If you take acid-blocking medications (Omeprazole i.e. Prilosec, Pantoprazole, Nexium, etc) Calcium citrate is also the recommended form. Calcium citrate may be taken with or without food, unlike other forms where you need to take it after eating. Calcium should only be taken one dose at a time (500mg-600mg) because our bodies can only absorb this much at once. Take Calcium separately from any iron supplements (at least 2 hours) because iron can hinder the absorption of Calcium into the body.

Iron supplements bought over the counter can be very confusing. Most available forms sold over the counter come in either Ferrous sulfate, ferrous fumarate or ferrous gluconate. 325mg is the standard dose that you will find but you must look on the label to see how much “elemental iron” the iron supplement contains. Elemental iron is what is readily available for the body to absorb. 18mg-27mg is the recommended supplementation you should receive from iron. If you are iron deficient, this requirement will go up and you should ask your healthcare provider how much iron to take. Remember- it is easier to PREVENT iron deficiency anemia BEFORE it happens by taking an iron supplement and more difficult to treat once iron deficiency sets in. Did you know that if you take your iron supplement along with a Vitamin C supplement it can increase its absorption by up to 39%?! When taking Iron supplements, be sure to take it separately from Calcium (2 hours apart) and take it with a Vitamin C supplement (ascorbic acid) for maximum absorption.

Something as simple as taking vitamins can become very confusing with all the products available over-the-counter and via online sources. To ensure maximum benefit from taking vitamins there are simple rules you can follow to enhance the effectiveness. If you are ever unsure if a vitamin you have purchased is right for you please bring it into the office and we can review it with you.

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