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> But the protein powder doesn't provide potassium and calcium.

> Carnation provides additional multivitamins.

1. Designer Whey protein powder (the only one I have nearby) has 100

mg of potassium, 220 mg of calcium, plus other vites. I don't know

of ANY predigested protein powders that don't contain numerous

vitamins and minerals. Reasons I recommend predigested whey protein

over CIB were posted previously.

>Are you saying that

> bariatric patients should get protein only from whey protein

> supplement for the rest of their life?

2. No, RNY pts. should use protein shakes to supplement, not

replace, food.

> How does Calcium is absorbed

> from supplements not from the milk?

3. Most food (with the exception of simple carbs) passes through RNY

and DS pts. relatively unchanged. The exceptions are things that are

broken down by amylase (in saliva) or are water soluble (citric

acid, in calcium citrate). Some fats, especially emulsified ones,

may be absorbed with the incidental contact of gastric juices in the

gut, but the more distal the surgery, the less likely that is.

Calcium is bound to other elements (carbon, citric acid or glucose).

They must be exposed to acid, churned, then alkalized, and

optimally, run through the duodenum for absorption. That doesn't

happen for RNY and DS pts. Their food is chewed, then dumped

directly into the small intestine, where it may or may not meet

gastric juices. (They each go down different limbs, which may or may

not be the same length, and the juice and the food may or may not

travel at same rate.) Absorption of calcium from food/milk may or

may not occur.

Take a look at http://drrossfox.com/pp/pp-gastricbypass.cfm

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Ava,This website you linked to your answers below does not have a Registered Dietitian on board to provide nutrition counseling. Do you work with this program or just use as a reference? I noticed you had surgery back in 2004, are you a Registered Dietitian? This is a very good example about how each program has their own recommendations. Beth Whelan, MS, RD, LD Re: Calcium

> But the protein powder doesn't provide potassium and calcium.

> Carnation provides additional multivitamins.

1. Designer Whey protein powder (the only one I have nearby) has 100

mg of potassium, 220 mg of calcium, plus other vites. I don't know

of ANY predigested protein powders that don't contain numerous

vitamins and minerals. Reasons I recommend predigested whey protein

over CIB were posted previously.

>Are you saying that

> bariatric patients should get protein only from whey protein

> supplement for the rest of their life?

2. No, RNY pts. should use protein shakes to supplement, not

replace, food.

> How does Calcium is absorbed

> from supplements not from the milk?

3. Most food (with the exception of simple carbs) passes through RNY

and DS pts. relatively unchanged. The exceptions are things that are

broken down by amylase (in saliva) or are water soluble (citric

acid, in calcium citrate). Some fats, especially emulsified ones,

may be absorbed with the incidental contact of gastric juices in the

gut, but the more distal the surgery, the less likely that is.

Calcium is bound to other elements (carbon, citric acid or glucose).

They must be exposed to acid, churned, then alkalized, and

optimally, run through the duodenum for absorption. That doesn't

happen for RNY and DS pts. Their food is chewed, then dumped

directly into the small intestine, where it may or may not meet

gastric juices. (They each go down different limbs, which may or may

not be the same length, and the juice and the food may or may not

travel at same rate.) Absorption of calcium from food/milk may or

may not occur.

Take a look at http://drrossfox. com/pp/pp- gastricbypass. cfm

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Beth,

It's just a reference, regarding the different types of WLS and

their respective malabsorption issues. I often refer other WLS pts.

to it. I have not worked with SWLC, although I'm familiar with some

of Dr. Fox's articles.

Yes, each bariatric program is different, which can sometimes make

it difficult to develop the most effective aftercare program for

individual WLS pts. Forums such as this one are certainly beneficial.

My MS is in Human Nutrition. My PhD is in Human Environmental

Sciences, Nutritional Sciences.

Ava

>

>

>

> > But the protein powder doesn't provide potassium and calcium.

>

> > Carnation provides additional multivitamins.

>

>

>

> 1. Designer Whey protein powder (the only one I have nearby) has

100

>

> mg of potassium, 220 mg of calcium, plus other vites. I don't know

>

> of ANY predigested protein powders that don't contain numerous

>

> vitamins and minerals. Reasons I recommend predigested whey

protein

>

> over CIB were posted previously.

>

>

>

> >Are you saying that

>

> > bariatric patients should get protein only from whey protein

>

> > supplement for the rest of their life?

>

>

>

> 2. No, RNY pts. should use protein shakes to supplement, not

>

> replace, food.

>

>

>

> > How does Calcium is absorbed

>

> > from supplements not from the milk?

>

>

>

> 3. Most food (with the exception of simple carbs) passes through

RNY

>

> and DS pts. relatively unchanged. The exceptions are things that

are

>

> broken down by amylase (in saliva) or are water soluble (citric

>

> acid, in calcium citrate). Some fats, especially emulsified ones,

>

> may be absorbed with the incidental contact of gastric juices in

the

>

> gut, but the more distal the surgery, the less likely that is.

>

>

>

> Calcium is bound to other elements (carbon, citric acid or

glucose).

>

> They must be exposed to acid, churned, then alkalized, and

>

> optimally, run through the duodenum for absorption. That doesn't

>

> happen for RNY and DS pts. Their food is chewed, then dumped

>

> directly into the small intestine, where it may or may not meet

>

> gastric juices. (They each go down different limbs, which may or

may

>

> not be the same length, and the juice and the food may or may not

>

> travel at same rate.) Absorption of calcium from food/milk may or

>

> may not occur.

>

>

>

> Take a look at http://drrossfox. com/pp/pp- gastricbypass. cfm

>

>

>

>

>

>

>

>

>

>

>

>

>

>

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This is incorrect.

According to the nutritional information found on the labels, most

protein powders are chock full of vitamins, minerals, and a form of

protein that GB pts can readily absorb. They also contain less sugar

than Carnation and milk. In addition to food sources of protein,

protein powders are an excellent means of supplementing protein intake.

Steve Huntington, PhD, RD, LD

>

> ,

>

> You are not giving wrong advice. Drinking milk is totally appropriate

> for protein, as is eating yogurt and cheese.

>

> I encourage patients to drink Carnation or Glucerna because it's a

> complete supplement where so many of the protein drinks or powders are

> only protein and nothing else. I suggest they add whey/soy powder or

> non-fat dry milk to get in extra protein.

>

>

>

> Griehs, MS, RD, LDN

> Clinical Dietitian Specialist

> Bariatric Surgery Program

> Hospital of the University of Pennsylvania

> Phone: 215-614-0993

> Fax: 215-662-3148

> E-mail: rachel.griehs@...

>

>

> ________________________________

>

> From:

> [mailto: ] On Behalf Of

>

> Sent: Friday, November 10, 2006 8:46 AM

>

> Subject: RE: Re: Calcium

>

>

>

> Is there any research that states Ca and protein from milk is

> malabsorbed? Some of my pt's can only tolerate milk proteins early

> post-op. I don't want to cause malnutrition by giving the wrong advice.

> RD

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  • 7 months later...
Guest guest

,

The calcium citrate is fairly soluble. I would have the client dissolve it in a small amount of water and add it to a protein shake or other food/beverage. Just a thought.

Jeanne Blankenship, MS RD

Sacramento, CA

-------------- Original message from "amandavezina" <amandavezina@...>: --------------

Hello all, Does anyone know how much calcium carbonate (chewable) that someone should take if they are not able to take the calcium citrate?I have a patient who is having a lot of trouble swallowing pills even a month and a half after her gastric bypass. She's able to take chewable multivitamins but in Canada I am not aware of any chewable calcium citrate versions. But I'm not sure exactly how much a gastric bypass patient may absorb from calcium carbonate? Does anyone know of any numbers?Thanks, SchneiderClinical DietitianMedicine Hat Regional Hospital

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Guest guest

Do you have citrical – they have a

chewable formula.

K. Mackie, MS, RD, LDN

Southeast Bariatrics, P.A.

2300-A Randolph Road

Charlotte, NC 28207

(704) 347-4144 x 214

hkennedy@...

www.southeastbariatrics.com

From:

[mailto: ]

On Behalf Of amandavezina

Sent: Thursday, June 28, 2007 4:20

PM

Subject:

Calcium

Hello all,

Does anyone know how much calcium carbonate (chewable) that someone

should take if they are not able to take the calcium citrate?

I have a patient who is having a lot of trouble swallowing pills even a

month and a half after her gastric bypass. She's able to take chewable

multivitamins but in Canada

I am not aware of any chewable calcium

citrate versions. But I'm not sure exactly how much a gastric bypass

patient may absorb from calcium carbonate? Does anyone know of any

numbers?

Thanks,

Schneider

Clinical Dietitian

Medicine Hat Regional Hospital

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Guest guest

Citracal has a product called Creamy Bites, it is chewable Calcium Citrate 500mg/chew. There are also several brands of liquid Calcium Citrate on the market, as well as Twin Lab chewable wafers. Hope this helps. amandavezina <amandavezina@...> wrote: Hello all, Does anyone know how much calcium carbonate (chewable) that someone should take if they are not able to take the calcium citrate?I have a patient who is having a lot of trouble

swallowing pills even a month and a half after her gastric bypass. She's able to take chewable multivitamins but in Canada I am not aware of any chewable calcium citrate versions. But I'm not sure exactly how much a gastric bypass patient may absorb from calcium carbonate? Does anyone know of any numbers?Thanks, SchneiderClinical DietitianMedicine Hat Regional HospitalBrittany J. Ray, RD

Virginia Weight Loss Surgery Center 2280 Opitz Blvd. Ste. 320 Woodbridge, VA 22203 T. 703-878-7610 F.703-878-7614

Luggage? GPS? Comic books?

Check out fitting gifts for grads at Search.

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Guest guest

This is common with most of my patients. Citracal

has a Petite sizes and tend to work better. 3 pills= 600 mg.

Beth Whelan, MS,RD,LD

Outpatient Dietitian

Harbin Clinic

office: (706) 378-8163

fax: (706) 238-8037

From:

[mailto: ]

On Behalf Of jbship@...

Sent: Thursday, June 28, 2007 4:26

PM

Subject: Re:

Calcium

,

The

calcium citrate is fairly soluble. I would have the client dissolve it in

a small amount of water and add it to a protein shake or other

food/beverage. Just a thought.

Jeanne

Blankenship, MS RD

Sacramento, CA

-------------- Original message from " amandavezina "

<amandavezina >: --------------

Hello all,

Does anyone know how much calcium carbonate (chewable) that someone

should take if they are not able to take the calcium citrate?

I have a patient who is having a lot of trouble swallowing pills even a

month and a half after her gastric bypass. She's able to take chewable

multivitamins but in Canada

I am not aware of any chewable calcium

citrate versions. But I'm not sure exactly how much a gastric bypass

patient may absorb from calcium carbonate? Does anyone know of any

numbers?

Thanks,

Schneider

Clinical Dietitian

Medicine Hat Regional Hospital

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Guest guest

UpCalD makes a powdered calcium citrate with vit D3.

>

> ,

> The calcium citrate is fairly soluble. I would have the client

dissolve it in a small amount of water and add it to a protein shake

or other food/beverage. Just a thought.

> Jeanne Blankenship, MS RD

> Sacramento, CA

>

> -------------- Original message from " amandavezina "

<amandavezina@...>: --------------

>

> Hello all,

>

> Does anyone know how much calcium carbonate (chewable) that someone

> should take if they are not able to take the calcium citrate?

>

> I have a patient who is having a lot of trouble swallowing pills

even a

> month and a half after her gastric bypass. She's able to take

chewable

> multivitamins but in Canada I am not aware of any chewable calcium

> citrate versions. But I'm not sure exactly how much a gastric

bypass

> patient may absorb from calcium carbonate? Does anyone know of any

> numbers?

>

> Thanks,

> Schneider

> Clinical Dietitian

> Medicine Hat Regional Hospital

>

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Guest guest

,

Twinlab, KAL, Rainbow Light, and Solaray make chewable calcium

citrate. Citracal makes Creamy Bites. UpCal D is calcium citrate in

powder form that can be added to foods and beverages.

The RNY patient's stomach is bypassed, so s/he doesn't have access

to the normal stomach acid, required for calcium carbonate to be

absorbed.

It took me 3-4 months post-op to be able to swallow Citracal, even

though I'd taken it for years pre-op. If time doesn't help, one of

the above brands may work.

Ava, PhD, MS

Lap RNY 4/21/04

>

> Hello all,

>

> Does anyone know how much calcium carbonate (chewable) that

someone

> should take if they are not able to take the calcium citrate?

>

> I have a patient who is having a lot of trouble swallowing pills

even a

> month and a half after her gastric bypass. She's able to take

chewable

> multivitamins but in Canada I am not aware of any chewable calcium

> citrate versions. But I'm not sure exactly how much a gastric

bypass

> patient may absorb from calcium carbonate? Does anyone know of any

> numbers?

>

> Thanks,

> Schneider

> Clinical Dietitian

> Medicine Hat Regional Hospital

>

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  • 1 year later...
Guest guest

Has anyone tried medication specifically for osteoporosis? - like advertised on

tv

My daughter (22 with SMA2) is considering intravenous treatment for

osteoporosis.

Any advise would be appreciated.

Thanks,

Donna

>

> If it makes you tired try taking it before you go to sleep.

>

> Regards,

> Patti

>

>

>

>

>

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Guest guest

Hi Donna,

I opted not to do any of the osteoporosis medicine because they had not been

studied in pre-menopausal women.  I did not want to risk any issues with my

reproductive system since I wanted children.

I also have a history of calcium kidney stones so I didn't want to dump anymore

calcium into my kidney's.

Just my 2-cents.

 

Milinovich, SMA Type I

Wife to , Mommy to - 2 Years Old!

http://www.myspace.com/kindrana 

http://s174.photobucket.com/albums/w107/boramir/?start=0

 

________________________________

From: Donna <donnala_2002@...>

Sent: Saturday, April 11, 2009 6:54:52 PM

Subject: Re: calcium

Has anyone tried medication specifically for osteoporosis? - like advertised on

tv

My daughter (22 with SMA2) is considering intravenous treatment for

osteoporosis.

Any advise would be appreciated.

Thanks,

Donna

>

> If it makes you tired try taking it before you go to sleep.

>

> Regards,

> Patti

>

>

>

>

>

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Guest guest

I used nasal calcitonin until I learned that research showed that it only helped

hips and the lower back. My osteoporosis is worst in my legs. I was also told

by a few doctors that the meds really only help if one can also bear weight and

shift it.

Alana

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Guest guest

I recently switched to the monthly Actonel. We believe that this type of

medication has restored some of my bone health (hmm, I sound like a commercial).

My fracture history includes:

Two fractured knees due to a fall at summer camp when I was 14 y/o.

Three left hip fractures (1983: college mishap-don't ask, 2000: just started

having hip/back pain and not sure what happened, 2008: non-rough sex)

Lori

Sent from my Verizon Wireless BlackBerry

Re: calcium

Has anyone tried medication specifically for osteoporosis? - like advertised on

tv

My daughter (22 with SMA2) is considering intravenous treatment for

osteoporosis.

Any advise would be appreciated.

Thanks,

Donna

>

> If it makes you tired try taking it before you go to sleep.

>

> Regards,

> Patti

>

>

>

>

>

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Guest guest

I was diagnosed with advanced osteoporosis about 3 years ago at the age of 38. I

went on Forteo for two years; its a daily injection. Because I have some

difficulty swallowing and occasional problems with heartburn, my doctor and I

determined that Forteo was the right choice for me. There is a black box warning

for Forteo due to an increased risk for bone cancer.

 

I didn't have any problems with the Forteo. I never thought I would be able to

give myself shots, but I did. And the Forteo has helped, although I still have

osteoporosis. My doctor has decided not to put me on anything else for right

now. I take calcium supplements and vitamin D., and I'll get a bone density test

once a year.

 

I had wanted to do the four times per year intravenous medication, but my

insurance would not cover it, and it was too expensive without insurance.

 

Dina

From: Donna <donnala_2002@...>

Subject: Re: calcium

Date: Saturday, April 11, 2009, 5:54 PM

Has anyone tried medication specifically for osteoporosis? - like advertised on

tv

My daughter (22 with SMA2) is considering intravenous treatment for

osteoporosis.

Any advise would be appreciated.

Thanks,

Donna

>

> If it makes you tired try taking it before you go to sleep.

>

> Regards,

> Patti

>

>

>

>

>

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  • 1 year later...

Not to forget one of the leading causes os Osteoporous is an undxed Parathyroid

tumour ( adenoma).

In Hashimotos Disease - the parathroid levels ( PTH) may never rise above normal

as the fibrous Thyroid encapsulates the parathyroid adenoma. Please repeat this

10x.

Your PTH levels may NEVER be abnormal if you have Parathyroid tumour +

Hashimotos. Never.

It is not unusual to be 'fobbed off' by Drs for 10 - 15 years before a dx . Some

people probably never get dxed if they give up the fight.

It is also common for the start of Thyroid medications to unearth this

parathyroid problem. It is also common in Hyperparathryoid for the calcium

blood tests to waver around and change at every test. Some literally waste years

and years of their lives this way. A normal blood test for calcium should stay

consistantly level and be mid range.

In summary - blood test for calcium should be consistant and mid range normal

and if it is not - then start to look at parathyroid and remember that the PTH

may NEVER be abnormal during the diagnostic stage.

And Parathyroid adenomas are common and to quote Dr Norman " suck the life out

of you " . And give you Osteoporous.

More info

http://parathyroid.com/

http://www.ncbi.nlm.nih.gov/pubmed/6548840

http://www.parathyroidfoundation.org/

(FaceBook page from this link )

Jane ( who is at her 4 year stage now of trying for a dx)

>

> I'm sure you've heard that the cause of osteoporosis and the key to its

> prevention revolve around calcium, right?

>

> Unfortunately, nothing could be further from the truth.

>

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  • 2 weeks later...

Hi Carol, this includes ANY thyroid hormone replacement, i.e.

synthetic levothyroxine (T4), liothyronine (T3) or natural desiccated thyroid

extract and yes, Nutri Thyroid too. Try taking any iron or calcium containing

supplements just before you go to bed so they will be well away from such

thyroid hormone replacements.

Luv - Sheila

I've read where if you take calcium pills you

should leave 4 hours between taking thyroid pills does that include Nutri

Thyroid does anyone know

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  • 2 months later...
Guest guest

Should we also be taking calcium in addition to the magnesium? I used to only take calcium in the 2:1 calcium-magnesium ratio, but that changed when I started taking mg per the iodine protocol. Now I am having some muscle issues (lots of back pain) and I'm wondering if it's calcium deficiency.Thanks, Angie "Don't try anything stupid!" "I don't have to try!"

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