Optisource

On January 23, 2011, in Fat Solubles, Minerals, Reviews, Vitamins, Water Solubles, by Andrea

Shamelessly stolen from Nestle Nutrition

Perhaps the first, and definatly longest lasting bariatrc vitamin formulations out on the market today has got to be Optisource.  In fact, they have even hit the “big time” by being easily accessible in Walgreens.

Nestle says:

Get at least 100% of the daily value for 23 vitamins and minerals in just four tablets.

With the recommended daily dose of just four OPTISOURCE chewable tablets, patients recovering from malabsorbtive bariatric surgery will receive at least 100% of the daily value for 23 vitamins and minerals! These include high levels of calcium, vitamin B12, iron and folic acid for increased absorption. Chewable tablets that pack a huge nutritional punch.

I’m stating for the record right now that I’ve not tasted these suckers in many, many, many years.  And I have no desire to go and buy a bottle at $32 just for this review.  Therefore, there will be no taste test.  Sorry, get over it.

These vitamins are a prime example of why something labeled “bariatric” is not always a good thing, why doctors really should learn to read labels or leave the nutrition thing to people who do, and why patients must learn to read the labels, read the studies, and self-advocate.

In a nutshell?  Just no.

But you aren’t reading for nutshells, are you?  You want the long and dirty review.  Well.  Okay.  I don’t blame you – I would too.  Especially since so many bariatric docs are recommending these, and so many patients are taking these.

First off, the American Society of Metabolic and Bariatric Surgeons (ASMBS), which is a group your surgeon SHOULD be a part of, recommends the following for supplement guidelines until a deficiency dictates otherwise:

Multivitamin
- Adjustable Gastric Band/VSG: 100% of daily value
- RNY: 200% of daily value
- BPD/DS: 200% of daily value

  • Choose a multivitamin that is a high-potency vitamin containing 100% of daily value for at least 100% of daily value of 2/3 of nutrients
  • Begin with chewable or liquid
  • Progress to whole tablet/capsule as tolerated
  • Avoid time-released supplements
  • Avoid enteric coating
  • Choose a complete formula containing at least 18 mg iron, 400mcg folic acid, as well as selenium, and zinc in each serving
  • Avoid children’s formulas that are incomplete
  • May improve gastrointestinal tolerance when taken close to food intake
  • May separate dosage
  • Do not mix multivitamin containing iron with calcium supplement, take at least 2 hours apart
  • Individual brands should be reviewed for absorption rate and bioavailability
  • Specialized bariatric formulations are available

Additional cobalamin (B12)
- AGB/VSG: Not Applicable
- RNY: 350-500mcg if taken orally, 1000mcg / mo intramuscular injection
- BPD/DS: NA

Additional elemental calcium
- AGB/VSG: 1500mg /day
- RNY: 1500-2000mg
- BPD/DS: 1800-2400mg

  • Choose a brand that contains calcium citrate and vitamin D3
  • Begin with chewable or liquid
  • Progress to whole tablet / capsule as tolerated
  • Split into 500-600 mg doses; be mindful of serving size on supplement label
  • Space doses evenly throughout day
  • Suggest a brand that contains magnesium, especially for BPD/DS
  • Do not combine calcium with iron containing supplements
  • Wait 2 or more hours after taking multivite or iron supplement to take
  • Wait 2 or more hours between doses
  • Promote intake of dairy beverages and/or foods that are significant sources of dietary calcium in addition to recommended supplements
  • Combined dietary and supplemental calcium intake greater than 1700 mg/day might be required to prevent bone loss during rapid weight loss

Additional elemental iron
- AGB / VSG: NA
- RNY: Minimum 18-27mg / day elemental
- BPD/DS: Minimum 18-27mg / day elemental

  • Recommended for menstruating women and those at risk of anemia
  • Begin with chewable or liquid
  • Progress to tablet as tolerated
  • Dosage may need to be adjusted based on biochemical markers
  • No enteric coating
  • Do not mix iron and calcium supplements, take at least 2 hours apart
  • Avoid excessive intake of tea due to tannin interaction
  • Encourage foods rich in heme iron
  • Vitamin C may enhance absorption of non-heme iron sources

Fat-soluble vitamins
- AGB / VSG: NA
- RNY: NA
- BPD/DS: 10,000 IU of vitamin A, 2000 IU of vitamin D, 300 mcg of vitamin K

  • With all procedures, higher maintenance doses may be required for those with a history of deficieincy
  • Water-soluble preparations of fat-soluble vitamins are available
  • Retinol sources of vitamin A should be used to calculate dosage
  • Most supplements contain a high percentage of beta carotene which does not contribute to vitamin A toxicity
  • Intake of 2000 IU vitamin D3 may be achieved with careful selection of multivitamin and calcium supplements
  • No toxic effect known for Vitamin K1, phytonadione (phyloquinone)
  • Vitamin K requirement varies with dietary sources and colonic production
  • Caution with vitamin K supplementation should be used for patients receiving coagulation therapy
  • Vitamin E deficiency is not prevalent in published studies

Optional B complex
- AGB / VSG: 1 per day
- RNY: 1 per day
- BPD/DS: 1 per day

  • B-50 dosage
  • Liquid form is available
  • Avoid time released tablets
  • No known risk of toxicity
  • May provide additional prophylaxis against B-vitamin deficiencies, including thiamin, especially for BPD/DS procedures as water-soluble vitamins are absorbed in the proximal jejunum
  • Note >1000mg of supplemental folic acid provided in combination with multivitamins could mask B12 deficiency
Since most of you are RNYers, we’re going to go with the RNY specs.  Change as needed.

Nutrition Facts

OPTISOURCE® Chewable Vitamin & Mineral Supplement
Amount Per Serving**
1 Tablet (2.8 g)
% Daily Value
Calories kcal 5
Total Carbohydrate g 1 < 1
Sugars g 1
Vitamin A IU 1875 37
Vitamin C mg 15 25
Vitamin D IU 100 25
Vitamin K mcg 40 50
Thiamin mcg 375 25
Riboflavin mcg 425 25
Niacin mg 5 25
Vitamin B6 mcg 500 25
Folic Acid mcg 200 50
Vitamin B12 mcg 125 2083
Biotin mcg 75 25
Pantothenic Acid mg 2.5 25
Calcium mg 250 25
Iron mg 7.5 42
Phosphorus mg 50 5
Iodine mcg 37.5 25
Magnesium mg 100 25
Zinc mg 7.5 50
Selenium mcg 17.5 25
Copper mg 0.5 25
Manganese mg 0.5 25
Chromium mcg 30 25
Molybdenum mcg 18.75 25
Sodium mg 5 < 1
Ingredients

(Citrus)
Sugar, calcium carbonate, dextrose, dicalcium phosphate, magnesium oxide, D,L-alpha tocopheryl acetate, gelatin, natural and artificial flavors, starch, citric acid, Yellow 6 lake, magnesium stearate, ferrous fumarate, talc, silicon dioxide, mono & diglycerides, zinc oxide, ascorbic acid, sodium ascorbate, aspartame, niacinamide, sodium hexametaphosphate, calcium pantothenate, manganese sulfate, hydrogenated and partially hydrogenated soybean oil, acacia, vitamin A acetate, pyridoxine hydrochloride, cupric oxide, sorbic acid, riboflavin, thiamine mononitrate, sodium benzoate (microbial inhibitor), folic acid, cyanocobalamin, coconut oil, lactose (milk), chromium chloride, biotin, phytonadione, BHT (to preserve freshness), potassium iodide, sodium selenate, sodium molybdate, calcium stearate, cholecalciferol, D,L-alpha tocopherol.

The dosing is listed at 4 tablets a day, however this is broken into single tablet amounts for ease of.. well, whatever.  For the following, I will list how many tablets will be needed to get the ASMBS recommendations.

Vitamin A: 1875 IU as acetate 37% (kudos for using a good source)
6 tablets needed to get to 200%

Vitamin C: 15mg 25%
8 tablets needed to get to 200%

Vitamin D: 100 IU 25%
8 tablets needed to get to 200% (Note: we need more than 800IU)

Vitamin K1: 40mcg 50%
4 tablets needed to get to 200%

Thiamin: 375mcg 25%
8 tablets needed to get to 200%

Riboflavin: 425mcg 25%
8 tablets needed to get to 200%

Niacin: 5mg 25%
8 tablets needed to get to 200%

Vitamin B6: 500mcg 25%
8 tablets needed to get to 200%

Folic Acid: 200mcg 50%
4 tablets needed to get to 200%

Vitamin B12: 125mcg 2083%
1 tablet needed to get 200% (4 tablets = 8332%)

Biotin: 75mcg 25mcg
8 tablets needed to get to 200%

Pantothenic Acid: 2.5mg 25%
8 tablets needed to get to 200%

Calcium: 250mg 25% (as carbonate)
Not applicable.  We won’t absorb this.

Iron: 7.5mg 42% (as fumarate, not highly absorbed)
5 tablets to get to 36mg iron per ASMBS standards

Phosphorous: 50mg 5%
Not applicable.  Standard amounts are low.

Iodine: 37.5mcg 25%
8 tablets needed to get to 200%

Magnesium: 100mg 25mg (as oxide)
8 tablets needed to get to 200% (not bioavailable – this is constipation help)

Zinc: 7.5mg 50%
4 tablets needed to get to 200%

Selenium: 17.5mcg 25%
8 tablets needed to get to 200%

Copper: 0.5mg 25%
8 tablets needed to get to 200%

Manganese: 0.5mg 25%
8 tablets needed to get to 200%

Chromium: 30mcg 25%
8 tablets needed to get to 200%

Molybdenum: 18.75mcg 25%
8 tablets needed to get to 200%

Chloride: 0

Potassium: 0

Sodium: 5mg <1%
NA – mostly gotten from food

The way I look at Optisource is this – you can either take 8 a day to hit ASMBS, thus making this a $64/month vitamin, plus your calcium citrate, iron, vitamin D, B-complex, and perhaps anything else that you need to supplement around it.  Or you can take Optisource 4x a day at $32 and buy your calcium, vitamins A, D, B-complex, iron, copper, selenium, molybdenum… well.. practically everything IN it.  Because it simply does not meet ASMBS guidelines of 200%.  Period, end of story.

And if you ARE taking Optisource and are not taking supplemental calcium, iron, and D?  Then you are in serious trouble.

I’ve been on this road before.  Please take heed.  I’m not bashing it just to bash it.  I wish all bariatric formulations were honest and accessible.  However, this one is not worth your time or your money.  Buy something better like Bariatric Advantage and be healthy.

I am NOT linking it with a place to buy it.  Just no.

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6 Responses to “Optisource”

  1. Sally says:

    OKAY this was just PERFECT– but how many years do you think a RNY post op has to pay through the nose for bariatric vitamins? when can we utilize Centrum etc– help!

  2. JaimeK says:

    Your brain amazes me. I have never heard of these, so I guess that is good thing. Great review.

  3. Andrea says:

    Sally – there is chewable Centrum in two varieties now. And some people leave the hospital on pills. So it’s up to your comfort level and your program’s discretion before you choose to move to Centrum tablets.

  4. Judy Stocker says:

    I am 7 months post RNY and currently use Bariatric Advantage Multi. Is there another vitamin/brand that would be better for me? I also take BA B-Complex, BA Biotin, BA B-12. I am post-menopausal so my PCP says I don’t need additional iron. Until I hear back, I will continue my current regimen!!!

  5. Andrea says:

    I like the BA’s, but the ASMBS and I both disagree with your PCP as we simply do not have the ability to absorb iron from food anymore.

  6. Karen Carson says:

    Thank You so much Andrea!!!!

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