Fat soluble vitamin absorption

[Guest guest]

>CHRIS HULL -- you would know this

> technical stuff --- Are calcium and other trace minerals mainly

absorbed in

> the duodenum? What about protein? Are the fat-soluable vitamins

(A, D, E,

> K) absorbed in the common channel???

>

From what I have read, Vitamins B12 and some calcium are absorbed in

the duodenum, or at least they need the intrinsic factor that is

produced in the duodenum. For this reason, RNY patients have need

B12 supplimentation, but DS patients do not.

Absorption of all fat soluble vitamins is affected by the BPD/DS. It

has not been documented (in any of the papers that I have read)

exactly where the absorption occurs, but it is presumed to be

primarilly in the common channel, with some absorption (possibly) in

the alimentary limb. Defeciancies of Vitamens D and Calcium are the

most serious, followed by Vitaman A. I have seen no documented

issues with vitaman E & K. Interestingly, Dr. Anthone prescribes

Allergy A & D vitamins plus a pre-natal multi-vitaman, and calcium. He

does not prescribe ADEK's, presumbably for the above stated reason.

In addition, Iron absorption can be an issue (particularly with

menstruating women). I think the duodenumm helps with iron

absorption as well.

Hull

[Guest guest]

> >

>

> From what I have read, Vitamins B12 and some calcium are absorbed in

> the duodenum, or at least they need the intrinsic factor that is

> produced in the duodenum. For this reason, RNY patients have need

> B12 supplimentation, but DS patients do not.>>>>

Hi, Chris: Thanks for the informative response. I forgot about B-12

b/c DS patients *rarely* need extra supplements there... But, yes -

the RNY patient has to focus on those sublingual B-12 tablets and

such...

> It

> has not been documented (in any of the papers that I have read)

> exactly where the absorption occurs, but it is presumed to be

> primarilly in the common channel, with some absorption (possibly) in

> the alimentary limb. Defeciancies of Vitamens D and Calcium are the

> most serious, followed by Vitaman A. I have seen no documented

> issues with vitaman E & K. Interestingly, Dr. Anthone prescribes

> Allergy A & D vitamins plus a pre-natal multi-vitaman, and calcium.

He

> does not prescribe ADEK's, presumbably for the above stated

reason.>>>>

Yes, I wondered about the E and K myself... I've heard others say that

their multis provide enough of these when they are taking Allergy A & D.

I've also heard conflicting reports that, even though they are

supposed to be (water?) soluable they may not be... So I'm confused!

I was researching the Twinlabs A & D as alternates to the ADEK because

of the outrageous price of those things. I was beginning to get a

little optimistic with the report of a Godiva chocolate flavor, but...

ROFL

I figure I'll stick with ADEKs for now (especially first 18 months

post-op) and perhaps try something new after that point (especially

since I think the malapsorption issues are most potentially serious

in this period).

I think you're really right about researchers not really knowing for

sure exactly where everything is absorbed. From what I've read, they

have isolated some nutrients and some are pretty particular about

where they get absorbed whereas others are absorbed throughout the

entire system... It's pretty fascinating to me.

>

> In addition, Iron absorption can be an issue (particularly with

> menstruating women). I think the duodenumm helps with iron

> absorption as well.>>>>>>

Oh, that's interesting. I'm so glad I have part of my precious

duodenum with this surgery. I'm pretty serious about taking my

iron pills. I gladly double them up with the calcium (I'm taking

citrate) every night and early morning. I would hate to become anemic

and have met some post-ops who have required iron injections, etc. --

OUCH!

All the best,

lap ds with gallbladder removal

january 25, 2001

Dr. Gagner/Mt. Sinai/NYC

10 months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: