Vitamin B1: also called Thiamin

Vitamin B12: also called Cobalamin

Folic Acid: also called Folate

*Fat Soluble Vitamins:

  Vitamin D, 25-OH, serum parathyroid hormone (PTH)

  Vitamin A, Plasma Retinal

  Vitamin E, Plasma Alpha-Tocopherol

  Vitamin K

*MineralS:

 Copper, Magnesium, Phosphorous, Sodium, Potassium, Chloride, Sulfur

*Common deficiencies after Bariatric surgery:

  Calcium, Vitamin D, Iron, B12, Folate, Zinc, Selenium, Copper, Vitamin A

(After a Duodenal switch, special attention should be paid to fat soluble vitamins levels)

*Related to Anemias:

  Iron, Vitamin B12, Folate, Zinc, Copper

*Related to Bone Health:

  Vitamin D, Calcium, Magnesium, Vitamin K

*Related to Neurology:

 Thiamin (Vitamin B1), Trace Minerals, Essential Fatty Acids,  All B vitamins

*Supplements:

Quality- In 2007 the FDA started evaluating most supplements and started the CGMP-“Current good manufacturing practice”. Unfortunately, this applies “after” the product hits the market. Some companies may elect to pay for additional seals like The U.S. Pharmacopeia (USP) or NSF International (NSF) or Consumer labs

Trusted brands are usually manufactured in a GMP facility, have a third party oversight, have a research and development team and come from a reputable company.

It’s always best that the company name appears on the product and the source of the nutrient is also of importance.

A “complete” multi-vitamin includes 13 essential vitamins: A, C, D, E, K, B1, B2, B3, B5, B6, B7, B9, B12

Minerals: Calcium, Magnesium, Phosphorous, Sodium, Potassium, Chloride, Sulfur

Trace Minerals: Iron, Zinc, Iodine, Selenium, Copper, Manganese, Fluoride, Chromium, Molybdenum

Minerals are naturally bound to other substances and that substance that it binds to impacts its absorption (bioavailability).

*Vitamin Forms:

• Tablets: Higher potency and may not break down in a low acid environment
• Capsules: Can be opened, disintegrates quickly
• Soft gels: Holds fluid and fish oil 
• Chewable: expensive
• Lozenges: can cause teeth staining
• Powders: Used for larger quantity nutrients
• Liquids: shorter half-life, can more expensive

(REMEMBER THAT TEMPERATURES CAN DENATURE B AND WATER SOLUBLE VITAMINS)     

* Bioavailability refers to the ability to be absorbed by the body. Some forms of nutrients vary depending on whether they are natural or synthetic. Ex. Vit. E (di-alpha tocopherol) is only ½ as biologically active as natural Vit.E (d-alpha tocopherol).

*Digestive juices also play a role. Stomach acid is necessary to absorb Magnesium, Iron, B12 and Calcium Carbonate. Pancreatic enzymes are needed to absorb Vitamins A,D,E,K.

*As far as timing, multivitamins and fat soluble vitamins should be taken with the largest meal of the day. Remember to separate large amounts of Calcium supplementation from other minerals due to competition for absorption.

*With vitamins and minerals, “more” is not better and claims of “new” or a “cure” require caution.