I have a hatred of few things in life.  Flintstones, Tums, and Optisource are among them.

When I first had surgery, we were started on Optisource vitamins.  4x a day, that’s it.  Sounds fine, right?  It’s great — until you realize they have the wrong type of calcium in them.  They use calcium carbonate and not citrate — which is what someone who has a limited acid quotient has needs.

So then we switched.  I’m not really sure why, but we did.

To Flintstones and Tums.  Which is still the wrong type of calcium.

And then.  Then I had kids.  And it all goes downhill from there.  (doesn’t it always?)

Two years post-op, my iron was crap.  Three years, my b-12 was in the toilet.  At year 4, I had rickets.


I’ll let you ponder that one for just a second.  Rickets.  While taking the vitamins I was told to take.

So for 2 years, I sat with a ferritin in the single digits, taking 600mg of elemental iron a day and it wasn’t moving.  Finally, finally, I found Proferrin and got some movement.  It’s expensive, but it works.  Finally.

If only I had been on decent vitamins, have been up on watching my labs and trends, if I had known about citrate and D and such, MAYBE my life wouldn’t suck quite so much right now in terms of deficiencies.

But hey, a little anecdotal evidence here.

How about some science –

  • B-12 can stay in your system for up to 5 years before it tanks.
  • Vitamin D can take up to 3 years to tank, although many pre-ops are popping deficient.
  • B-1 will deplete faster if you puke alot.
  • Iron can take several years to tank as the body will supply hct and hgb from the ferritin storage.
  • Blood serum calcium (the “standard” test) will always pop normal while you have bones and is not a true test of your calcium state.  It will be a touch high if your PTH is high as your body is leeching calcium from your bones.. but if you aren’t looking for it, you will miss it.

So yeah — people 2 years out or less — when you say your labs are perfect — I don’t doubt you.  Come see me at year 3.  Bring your 3 years of labs and let’s look at trends while on those Flintstones and Tums.  Cause I’ve been there and I know where you’re going.

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12 Responses to “Flintstones and Tums”

  1. Melissa says:

    I have been telling my support grp members forever, optisource isn’t the catch all postop vitamin yet SO many docs recommend it, makes me batty! I realize compliance is an issue and creating a product such as optisource eases the burden for the pt but at the same time it isn’t doing a darn thing for them… makes me ill. Thanks for laying it out there Andrea. I hope postops take notice and read and are smart about it. You relaying this info will hopefully make them realize they aren’t invincible.

  2. Karen says:

    before I got preggo I was on Optisource, didn’t know about the calcium. Do you recommend Optisource if you supp calcium citrate along with it??

  3. I am glad to see this-My b1 was tanked 2 months post op- and I did not know it until 3.5 months later! Your time line is very helpful. I feel like when you are done- post op rny the further out you go the less anyone is there medically to cover you! I have an HMO- KP- and I have a window of time to see the surgeons office staff post op. After that years down the road- who the heck is watching my back- so to speak – with my proper WLS bloodwork-MY GP at KP? eegads!

  4. Andrea says:

    I don’t think I could ever recommend a bariatric vitamin that uses carbonate. Ever. Regardless of anything else in it.

  5. Andrea says:

    My PCP does my labwork.. And I read it!

  6. Katie says:

    At support group last week, the speaker was a surgeon who has had the sleeve himself. He was recommending Flinstones and gummies (because, you know, they taste good). *Face-palm* And the ferrous salts for iron. Yeah, I don’t think I’m going to be on his Christmas card list. I called him on his misinformation. (Repeatedly.) I’m that girl at support group. Unfortunately, he’s a surgeon and he has the procedure, so everyone thinks he walks on water and can’t possibly be wrong about anything.

  7. Teresa says:

    Thanks once again Andrea for looking out for us newbies…. I am 4 months out and have been taking Optisource..I also take 2000mg calcium citrate in the form of chocolate chews from bariatric advantage.. but I think I need to switch multi’s… what is your opinion on Centrum Senior Chewables.. would that be a good one to switch to??

  8. rny_alison says:

    Wow, I did not know that the half-life of B12 was so large.

    Wonder why mine tanks so quickly if I don’t give myself injections every other week?

    I’ve been lucky so far (knock on wood) in that my only big issues have been with the B-vitamins. My deficiencies came on quickly post-op and I get both B1 and B12 via injections every month.

  9. Andrea says:

    @Teresa – Centrum is a good vitamin, senior or not. Keep in mind that the Senior doesn’t contain iron or vitamin K.
    @Alison – B12 can be STORED for 5 years. Doesn’t mean it will last that long if you have none in your system. Eat more beef!

  10. Teresa says:

    Thanks Andrea.. I have gotten the senoir chewables and I bought some iron.. but I am not sure if it is the right iron to take.. I got the Spring Valley 65 mg Iron equivalent to 325mg Ferrous Sulfate.. I also got Vitamin C to take with it.. Do I need to suppliment with Vit K too being a RNY person.. Also I was wondering about fish oil… since we can not absorb fats will I get anything out of the 1000 mg Omega 3 Fish oil that I used to take.. I would love to take it again if I can..
    I bought the Tender Dry D and Tender Dry A you recommended and I am taking them.. I really appreciate all your advice… You have so much knowledge on vitamins.. I am trying to learn but man there is so much to take in.. and the nuts are mostly useless when it comes to vitamins and the docs are worse …
    Thanks again for looking out for us newbies.. I hope you are getting some relief from your pains and are feeling better soon..


  11. Andrea says:

    You may not need to supplement K for awhile — if ever. I’ve just now had to start at 5 years. But I also take a multi that has K in it. Just make sure you watch out for bruising.

    As for the fish oil, you’ll want to switch to Coromega. It’s a pudding-type consistency that we actually absorb well.

  12. [...] heard about my foray (after being told to, of course, by my surgeon) with Tums, Flintstones, and Optisource.  And the consequences it wreaked with my bones and iron [...]

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