What Daily Supplements Do You Need for Optimal Health?



The new RDAs set for vitamin D had me thinking. In some ways medicine seems so advanced. And in other ways, we are in the beginning stages of figuring out the big picture and there are so many little components that haven’t been completely accounted for.


Nothing works in isolation in our body, which makes identifying all of the things one antioxidant or nutrient does and is responsible for difficult. And, though all Nissian Maximas built in the same year may look the same to a mechanic, you look nothing like the other males or females who are your same age (on the inside or the outside; unless of course, you have a twin).


Making things more complicated, the math is fuzzy at best. 1 + 1 doesn’t always equal 2 and sometimes we can’t even accurately add up the numbers on each side of this equation (how do you know your total vitamin D intake? Did you add it up based on what you ate today? How did you account for sun exposure and how much vitamin D you produced through this exposure?)


It All Depends On Interpretation

All of these factors make interpreting scientific studies in easy to understand terms for the masses, skewed at best. And therefore, any dietary guidelines that are given to an entire country, should be taken as just that, a general guideline. To figure out what levels of any nutrient, dietary supplement or food may be best for you given your health status, activity level, current dietary intake and goals; you need to sit down with a registered dietitian (RD) who specializes in your specific area of need or goal and let that RD take a comprehensive assessment of where you are, what you need and where you can improve. If you want to lose weight, go to someone who specializes in this, if you have Type 1 diabetes and you are an athlete, go to a RD who works with diabetic athletes.


Each Individual’s Needs are Unique

I understand all the angst for or against certain supplements or recommended intakes of specific supplements but, there is no one dietary recommendation that will ever fit all people. Therefore, you should take any recommendation as just that – a broad recommendation for all. And, if you think you are an outlier to the masses, talk to your physician or dietitian. I assure you, you aren’t alone. As a dietitian, I don’t follow some of the diet recommendations put forth by our government because I know the research and I know what my needs are.


After all, I’m going to do what’s best for me, and so should you.


Iron Deficiencies After Bariatric Weight Loss Surgery

Iron Deficiency and Weight Loss

Graphic from www.dailyiron.net, a fantastic resource for iron information


Iron deficiency is the most common cause of anemia after bariatric surgery and can be found in 20-49% of patients.


The severity and type of nutritional deficiencies experienced by post-op patients varies based upon the type of procedure performed. As can be expected, malabsorptive procedures cause the most impact to vitamin and mineral absorption and result in deficiencies much faster, while restrictive procedures limit food (and therefore nutritional) intake, but do not bypass any part of the intestine.


Supplementation is recommended for all procedures at the levels and frequencies specific to each patient’s surgery type, loss rate, sex, age and medical history.  The inherent malabsorptive qualities of RYGBP, BPD and BPD/DS bring about a strong requirement for daily iron supplementation. Iron deficiency has been reported in many studies to be present in up to 50% of RYGBP patients, and most frequently in women.1


Amino Acid Chelate
The form of iron can make a huge difference in both absorbability and stomach irritation.  Iron as Amino Acid Chelate, is a water soluble, highly absorbable form of iron, equally as soluble as ferrous ascorbate and as absorbable as ferrous sulfate. This form of oral iron, by virtue of how it is absorbed, with iron dissociating from the chelate as it enters the nonheme pool in the same manner as other nonheme iron compounds, benefits patients with enhanced absorption and fewer side effects.1


Iron is an essential component of proteins involved in oxygen transport.
A deficiency of iron limits oxygen delivery to cells, resulting in fatigue, poor work performance and decreased immune system function.2,3  Bariatric patients post surgery, especially in the first few weeks as healing is still occurring, will need full immune function, and as much energy as possible to recover from surgery and successfully transition to daily home maintenance.


Gentle Supplementation – Ferrous sulfate is inexpensive, but many patients experience unpleasant side effects from its use, particularly gastrointestinal intolerance, which for a bariatric patient can be detrimental to supplement compliance. Symptoms such as constipation, nausea, vomiting and diarrhea, are all common, especially when ferrous sulfate is taken on an empty stomach. Comparatively, Iron bisglycinate chelate has a much lower incidence of gastrointestinal issues, and in a double-blind crossover study comparing side effects of ferrous sulfate with iron bisglycinate chelate, 61% of study participants preferred the use of the chelate for that reason.1


It is imperative that you have your blood levels checked at each follow-up visit after weight loss surgery to check for possible anemia.  If Iron supplementation is needed, a liquid iron from amino acid chelate is a great option due to high absorbability and ease of taking.  Dosage can be easily adjusted according to recommendation from your health professional.


1. Coplin, M.; Leichtmann, G.; Lashner, B. 1991 Clinical Therapeutics 13:5.
2. Miret S, Simpson RJ, McKie AT. Physiology and molecular biology of dietary iron absorption. Annu Rev Nutr 2003; 23:283-301.
3. Haas JD, Brownlie T 4th. Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship.
J Nutr 2001; 131:691S-6S.



Healthy Energy – Who May Benefit from a B-Complex Supplement?


Want more energy without the added sugar and caffeine and crash later on?  A B-Complex supplement may be the answer for you.


no more energy drinks


Though many drinks on store shelves claim they give you energy, they typically contain caffeine so you temporarily feel “awake.” But, a food or beverage that really provides more energy must have calories, typically from carbohydrates and fats – the two primary sources of energy in our diets. In addition to calories, there is another necessary component to the energy equation – B vitamins


The B vitamins help convert carbohydrates and fats into energy your body can use to move, think and perform. In addition, certain B vitamins help form red blood cells – the cells that carry oxygen to tissues throughout your body.


B vitamins are prevalent in our diets. They are found in a wide variety of protein-rich foods including fish, chicken, meat, eggs and dairy foods. Leafy green vegetables, beans and peas also contain certain B vitamins. In addition, some cereals and breads are fortified with B vitamins (look at the Nutrition Facts panel to see which B vitamins a cereal contains; if none are listed then the cereal probably isn’t fortified). And while B vitamins are prevalent in the diet, you need to consume them on a consistent basis because there’s only one that is stored in the body – B12. The rest are water-soluble meaning that they leave the body in your urine.


What Are The Best Sources of B Vitamins?


So how do you know if you need more B vitamins? You may not know unless you have a registered dietitian take a thorough look at your diet and determine which nutrient-rich foods you aren’t eating on a consistent basis or by having your blood levels checked by a doctor. Keep in mind that most physicians will only test for folate and B12.


Another clue may come from your overall energy levels. If you are dragging from day to day, you may not be getting enough of certain B vitamins.


Will taking a B complex supplement help? If your intake of certain B vitamins is below recommended daily values than yes, a supplement may help. Or if you have certain conditions or have had surgery that causes decreased absorption of key nutrients like B12 and folic acid, a supplement may be needed. Consult with your healthcare professional to be sure.