RNY patient going on Accutane

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A RNY patient's dermatologist wants to put her on Accutane. Apparently taking a MVI while on Accutane is contraindicated. Please advise. Anyone come across this situation or similar?

Periou

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[Guest guest]

We're giving them these amounts because we don't think they're absorbing it all, right? Plus they're getting minimal amounts in food. The Linus ing Institute statement below also refers to "older adults" which although not defined, I take to not apply to most of the Bariatric surgery population.

Maybe the best approach in terms of bones is to make sure they're getting bone mineral tests yearly, and taking the recommended doses of Ca and vit D as suggested by the Ntnl Osteoporosis Fdn., and to perform weight-bearing activity as tolerated.

According to the "white paper" Hypervitaminosis A occurs after daily ingestion of >50,000 IU/d x >3 mos. I don't know how much "Vit A" is in Accutane. And I don't know if anyone really knows how much vitamin A will increase risk of hip fracture.

Amy Long Carrera MS, RD Clinical Dietitian Northridge Hospital Medical Center & Center for Weight Loss Surgery Northridge, CA Amy.Long@... 818-885-8500 x4034

From: [mailto: ] On Behalf Of danaeswilley@...Sent: Wednesday, July 16, 2008 11:08 AM Subject: Re: RNY patient going on Accutane

5000IU of vit A as retinol negatively affects bones? What about the 10,000 IU doses (as palmitate) that so many patients get?

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From: "Long, Amy - NHMC" <Amy.LongCHW (DOT) edu>Date: Wed, 16 Jul 2008 10:55:48 -0700< >CC: , - NHMC-RB<.CHW (DOT) EDU>Subject: RE: RNY patient going on Accutane

I took this f rom Oregon State Univ Micronutrient Information Center...

"...following the Linus ing Institute’s recommendation to take a multivitamin/multimineral supplement daily could supply as much as 5,000 IU/day of vitamin A as retinol, the amount that has been associated with adverse effects on bone health in older adults. For this reason, we recommend taking a multivitamin/multimineral supplement that provides no more than 2,500 IU of vitamin A or a supplement that provides 5,000 IU of vitamin A, of which at least 50% comes from beta-carotene."

Some MDs say the extra vitamin A from a Multi, with the Accutane may increase dryness. Probably/hopefully the pt wou ldn't be on the Accutane long enough to contribute to toxicity. This is my take on it!

Amy Long Carrera MS, RD Clinical Dietitian Northridge Hospital Medical Center & Center for Weight Loss Surgery Northridge, CA Amy.LongCHW (DOT) edu 818-885-8500 x4034

From: [mailto: ] On Behalf Of PeriouSent: Wednesday, July 16, 2008 6:35 AM Subject: RNY patient going on Accutane

A RNY patient's dermatologist wants to put her on Accutane. Apparently taking a MVI while on Accutane is contraindicated. Please advise. Anyone come across this situation or similar? PeriouNew Orleans, LA

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