For those of you several yrs or more post op

I see a lot of people talking about protein shakes. How long did you do these post-op?
Also, how many people have absorption problems?
I am almost 6 years post op and have no problems. I take a daily multivitamin and have no B or iron deficiencies. At the same time, I don't lose weight that easily, so maybe a little absorption problems are a good thing.

Is the multi all you take?

Are you sure you have no deficiencies?  you know that your vitamin D, vitamin A, b12, zinc, thiamin are all good?  And you've had a bone density scan and it was fine?

I'm just asking because it seems like most RNY folks do end up with deficiencies.  If you get labs done regularly, they are usually not too hard to correct.  But they do happen.  Some docs don't order all the labs we should get done, though, unless you specifically ask for them.  At least they don't order all the labs I think we should get done.

Absorption of calories is a different thing than absorption (or malabsorption) of vitamins and minerals.  We all have problems absorbing vitamins and minerals after RNY.  That's because the part of the small intestine that absorbs most of those things has been bypassed.  right after surgery, we don't absorb all the calories we eat because of part of the small intestine being bypassed, but our body begins to adapt and we grow more villi in the part of the small intestine that has not been bypassed to compensate, so after a while we do absorb most of our calories again.

I'm 3 years out and I still use protein shakes. They let me get in the protein I need so I can use the space in my sleeve for veggies and other things besides non-stop protein.

Also, I have issues with protein utilization even though my surgery has no malabsorption. 

I would need you to put your money where your mouth is,  so to speak,and post your labs. 

It is my understanding that even when the RnY malabsorption for calories ends that the malabsorption of vitamins, especially the B vitamins is for life.

I highly recommend you put your labs out here and ask for advice from some of the RnY lab experts.

~Becky

Yeah, the malabsorption of vitamins is for life, because there are only certain spots in the small intestine where certain vitamins are absorbed, and a bunch of those spots are bypassed for good with RNY.

 4.5 years out on a Lap Band , Not much for breakfast .. My WLS Doc said a shake for breakfast should be  my  wake up call! I have an Iron deficiencies also Vitamin  D , I did pre Op. A  Non malasorptive surgery was my only option for several medical reasons.  Since I take RX iron and  RX D my  morning  shake is a multi purpose elixir! Iced coffee and  4 tablespoons of Benefiber  , a quality protein powder of choice and Walla =  A   protein packed non constipated wake me up! :)   I take several vitamin supplements and do  supplement with protein powder .  I also  enjoy  fresh veggies and fruits , great healthy carb's  and good fiber!  I am at goal and maintain.  

I have had labs done twice in the last year. All my levels were normal, aside from Vit D which I did bring up using supplements (I live in the Pacific NW so many people here are deficient in Vitamin D). My D levels are now within normal but I still take extra supplements on a daily basis to be sure that they don't go down again.

Are there any specialty labs you recommend I get tested for? I will double check that I've been tested for them. Also, do I need to have a bone density scan?

To add more info to the discussion - for about 2 years after surgery I did take Calcium, B vitamins, and a bariatric multivitamin. I have recently begun taking B's, liquid calcium plus D. I have iron pills but rarely take them because my daily vitamins are pre-natals and they're pretty good for that. However, despite not taking much in the way of vitamins, my levels haven't gone low. My nurse practicioner did tell me that my B was within normal, but low side of normal, which is why I started taking the sublinguals.

Well, you should have had a bone density scan at one year post op and then every year or two after that.  So if you haven't had any yet, yeah, you need one.  Especially if you had a vitamin D deficiency and were not taking calcium for a significant period of time.

Labs to have done include vitamin A, thiamin, B12, iron, ferritin, vitamin D, folate, zinc, copper and PTH.

When you say your B was within normal, which B are you referring to?  B12?  And how low is "low normal?"  See, B12 is one that labs usually use a very low normal range for and will often say that it's normal all the way down to 200, but below 400 you can get permanent nerve damage. 

When you say your vitamin D is now within normal, what does that mean?  Labs usually use a low normal range for that one too.  We need it at least 80, though, or else we're at risk for stuff like osteoporosis and heart disease.

Hmm, I will have to get a copy of my labs. I'm seeing a nurse practioner and she's really into women's health and is savvy about things like this. I will try and get those numbers and find out.
I take a sublingual B12/B6. Is there a brand that you recommend? I had asked my primary doctor about getting a Vitamin B shot since I hadn't been taking supplements and I know they told me after surgery I'd probably need them monthly and he said he'd do one if my blood tests showed I was low. Since they weren't low, he said I didn't need one.
I will try and get my labs and will post here or PM you. I want to be sure I am staying on track and doing what I need to do. I've been so busy with my two young kids that I haven't even thought about things for 3 years.

No one ever mentioned a bone scan or I would have scheduled one after my 1 year. I was on awesome insurance back then too. I did take calcium for 2 yrs after surgery and was living in LA (lots of natural Vitamin D). I'm now taking a liquid D/Calcium supplement. Then I pop a few D pills with yogurt or milk as well.

Calcium levels MUST be checked through a scan. It is essential.

Your body will rarely show any calcium deficiency because if it doesn't get the calcium it needs it will just pull it from your bones. Therefore your bloodwork levels will be normal but your bones will be crap.

Dawn