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Vitamins by the Letter – Iron

April22
There are as many questions about vitamins, nutritional supplements, and how bariatric patients need to take care of themselves post surgically as there are post op patients.  By writing this column, I hope to help answer some of the more common questions regarding vitamins, dispel some myths, and help members of the bariatric community make educated decisions regarding their nutritional and supplement options.
What is iron? 
Iron is a mineral that is used by the body in a number of different ways.  It is part of all cells, but is most commonly recognized as  part of hemoglobin, or the proteins that carry oxygen from our lungs to the rest of the body.  Additionally, iron is part of the enzymes that digest foods as well as work throughout the body tp perform important cellular functions.
What is a lack of iron? 
A lack of iron is one of the most common nutritional deficiencies in the country.  This is most often referred to as anemia.  People who have a lack of iron may experience numerous symptoms, such as being tired or weak, cold, or may suffer from a decreased immune system.
How is an iron deficiency detected? 
There are a number of different tests that can be used to determine a person’s level of iron in the blood.  These tests are ordered by physicians, and can be done either in the physician’s office or in a lab facility.
  • Hemoglobin Test
  • Hematocrit Test
  • Complete Blood Count
  • Serum Ferritin – This test measures the amount of the stored form of iron in the blood.
  • Serum Iron – This test measures the amount of iron in the blood.
  • Transferrin Saturation  – This test measures the amount of the transported form of iron.
  • Transferrin Receptor – This test measures the amount of red blood cell production
Who needs to take iron? 
There have been changes in the ASBMS recommendations for Iron supplementation.  The 2008 recommendation is that patients should have a total daily  intake of 50-100 mg of elemental iron.  The 2013 recommendation is that patients should have a total daily intake of 45-60 mg of elemental iron.  Leaders in the bariatric community have differing opinions on which recommendation is correct.  However, it is recommended that patients consult with their surgeon or primary care team to determine which level is appropriate for them based on their most recent blood tests.
Where can I get iron from my food? 
Iron is present in a number of different foods.  Patients should strive to get as much of their iron from food as necessary, but understand that because they have a restrictive or malabsoprtive procedure they will need to supplement to some level.  The CDC publishes a list of foods that are high in iron, as well as a list of foods that are high in vitamin C that should be incorporated into the diet to get iron in a natural form.
What kinds of supplements include iron? 
There are different types of iron that can be used in supplements.  Because of this, it is important to read labels and ensure that you are taking the kind of iron that works best for you.   The optimal type of iron is considered a carbonyl iron.  This is because it is best absorbed in the post surgical stomachs of bariatric patients, who tend to have reduced acid levels.  This format of iron also has a reduced incidence of side effects including nausea and constipation.   Other types of iron such as polysaccharide iron and ferrous gluconate are also well absorbed by patients, but may not be as ‘gentle’ on the body.
What do I need to know about iron? 
It is possible to have too much iron in the blood.  This can be due to genetic causes as well as dietary causes.  In order to ensure that you have the optimal levels of iron to be healthy, you will want to coordinate with your primary care physician and/or bariatric surgeon to have frequent tests (twice a year is the recommended frequency) in order to determine if you need to adjust your supplements or diet.
Sources:
WLS Vitagarten:  Lab Tracker Workbook – Andrea Ullberg (www.wlsvitagarten.com)

The Key to Quinoa

April21
One thing that happens to me once in a while is that I get BORED with what I eat day to day.  And when I get bored, I find that I tend to binge or eat things that I really shouldn’t be eating.    So, I’m making an effort to eat more ‘unique’ things to keep my interest and reduce the urge to binge.    At the WLSFA event earlier this month, I picked up a cook book from BariWare that has all kinds of great bariatric recipes in it.  I figured I’d work my way through it, and add to my repertoire or exclude those that don’t work for my tastes.

The first recipe I tried was the Hot and Cruncy Quinoa recipe.  I modified it a little bit to suit what I had in the pantry, and what I was hungry for.
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My version of the recipe is here:
2 c cooked quinoa
4 oz crushed pecans
1 c diced strawberries
1/2 t ghee
1/2 t cinnamon
1/2 t coconut sugar
Pinch of Salt
While the quinoa was hot, I added the ghee (it melted into the quinoa and got nice and creamy).  I stirred in the cinnamon and coconut sugar and stirred until it melted.   To serve, (I’ll be eating this for the next 4 days) it’s 4oz (1/2 c) quinoa in a container, and top with 1oz pecans and 2oz diced berries.  Since I packed it for work, I put the quinoa and nuts and berries in separate containers.  This morning, I heated the quinoa for 45 seconds in the microwave and topped with the nuts and berries.
YUM – and it held me through until late afternoon when I felt ‘lunchy’ .  I will definitely be doing this again, and mixing in different berries and nuts.  (Raspberries and almonds?)  I’ll also be adding a little vanilla I think.

Review on Building Blocks – Chewable Iron Black Raspberry – 30mg

April21
Source – I was given samples at the WLSFA Meet and Greet to try – so I didn’t pay for these.  However, I have ordered a month’s supply using the savings code I got at the WLSFA event, so I’ll be taking them for a month to do a more ‘in depth’ review (I also have some blood tests during that time period, which should show if my counts have changed at all, and help me decide if I move from this one to something else)    You can order directly from this site:  http://www.bbvitamins.com/default.aspx  Also, some surgeons carry this product in their practices, so they may be available there as well.  (Score for source and accessibility – 1)
Price – The 30 day supply is 10.50 (.35 a dose) and the 90 day supply is 25.50 (.28 a dose)  I have not compared this to pharmacy iron as I haven’t been taking it – so I did a quick search on Amazon – the price is a little elevated compared to ‘main stream’ iron supplements – but there is nothing comparable (that i could find) in taste and formation.  (Score for price – .5)  (Note, if you were at the meet and greet and got the bracelet charm, the discount code does bring it down to comparable to the mainstream supplement prices)
Taste –  I was pleasantly surprised with how these tasted.  Usually Iron gets the ‘face of ick’ from me, but these were pleasant. (Now granted, I will not be eating them like candy – but hey, at least they went down with no problems!)  There was no bitter aftertaste, nor was there a chalky grit in my teeth – generally both problems I’ve noticed with chewable vitamins. (Score for taste – 1)
After Effects – Iron affects us all a bit differently – so I’m waiting to see if I have the ‘standard’ reaction to introducing iron to my diet.  That will take a day or so to make itself known (Hard to tell after a single dose).  If something crops up, I’ll definitely let you know! (Score for after effects – 1)
Ingredients – Coated Ferrous Fumarate – which results in 167% of the recommended daily allowance of iron in the diet.  The research that I’ve done on iron itself indicates that bariatric patients (RNY especially, since that’s my surgery type) are successful at absorbing iron in this formulation.  (Score for ingredients – 1)
Score – 4.5 Until the ‘after effects’ can be determined.
 
Disclaimer: I am not a nutritionist, a doctor, or a vitamin specialist.  I’m a bariatric patient who is starting to dig deeper into what I need, how I need to get it, and the best tools out there to help me get and stay healthy.  My information is based on my own research and I encourage you to work with your nutritionist and surgical care team to determine if this particular formulation will work for you.  My reviews are not compensated, nor is compensation sought for my opinions.  (If I am given samples to try, I will state that clearly).

Thinking Thinky Thoughts….

September7

I’ve been going through old news reader articles that I bookmarked, and decided that it’s time to start writing the ones that I’ve highlighted, sorting through some of the old ones, deleting what doesn’t interest me anymore – basically cleaning up the computer clutter (on top of some of the physical clutter I’ve been piling up too).  This article was posted on Lifehacker a few months ago – and I think is a good thing to think about:

What Moment in your life convinced you to change when you needed to?

My life has really been one that’s been a number of different events – good and bad, happy and sad.  I work through things as best as I can.  Sometimes, I’m able to get back on my feet easily – and sometimes I’m not.  Sometimes, I make big changes – and I’m able to learn and grow from the experience – sometimes, I sink into habits, and just can’t do what I KNOW is the right thing.

So, what things about me caused long lasting change?

Honestly, I’m still waiting for those things.

In 2008, I went to a convention for my company.  I had known for years that I had a weight issue, and on top of that, I was constantly trying one diet or another – just trying to get ahead (or keep ahead) of it.  And it wasn’t working at all.   But, I was confident in myself, and was glad to go to DC and represent my company.

When I got back, they had posted photos of the team members where I was working, and when I saw a photo of myself, I didn’t recognize who I was.    I honestly thought – that girl looks like me…but I don’t know who she is.  And low and behold – it WAS me.  🙁

Well, that started me down the road to getting my weight loss surgery  – I know now – that it was going to be a ‘quick fix’ for the problem.  It was going to be the one thing that was going to help me get skinny and healthy, and happy, and everything.   Nearly 5 years down the road…and notsomuch.  But I know, that the reason why it didn’t do what it should have done, was because I never worked on my head, that I never worked on the things that I needed to in order to resolve my problems with food.  How I self soothe, self medicate, and work to fix my problems with food.  How food is what I turn to when I’m stressed, or bored, or anxious.

Coming to grips with this is not easy.  I mean really.  Addictions  being what they are – some things – you can really live without – not easily – but you can.  You can live without shopping, you can live without alcohol, you can live without drugs.  But food?  No, you need it.  And unfortunately, when you have problems that play games with your head – those problems are hard to deal with sometimes, and you aren’t real sure how to deal with the thoughts and feelings – and food is the way you soothe yourself – it’s what you turn to.  And that is just really not that easy.

So, I’ve been working with friends of mine – in the same situation.  They may have other triggers or burdens – but we all deal with it in a similar way.  In talking – and listening – I’ve found that I’m really a lot like them.  One of the hardest things I’ve had to admit – but admitting it – well, is a burden off my shoulders – it makes things a little easier to deal with.  It’s all new to me – and I know that there will be more digging and sorting, and healing, and fighting, and working to come to grips with the things that go on between my ears.  But I’ll be taking that one step at a time.

My name is Kellie – and I’m a compulsive overeater.    THIS I know.  There are lots of things that I’m still working on – but I know that sometimes, I just can’t control what I put in my mouth – or why I do it, or what  I can do to make it stop.  They say that knowing is half the battle.   And admitting it is the first step.  (And wow, it’s a doozy).    I started really paying attention to things – and working on keeping focus, and preventing binges…it’s been 4 days…I’ve had struggles – but I’ve not given in.  I’ve not broken my promise to myself.  I’m planning, at least mentally – and I’ll start writing things down starting tomorrow. 🙂

Some of these posts will be locked down, because of the nature of things – this is private, and personal, and will most likely be painful as hell.  But it needs done.  So…here goes.

Product Review: Steve’s PaleoGoods – Paleo Krunch Cereal

June23

When I was in California a few weeks ago, a friend of mine gave me a Paleo Kit to try.  (More on that one later).  I was reviewing the Steve’s Paleogoods website – and stumbled across their Paleo Krunch Cereal.  One thing that I really miss since I’m eliminating grains and gluten from my diet is a crunchy addition to my morning yogurt.  So, since Steve’s has a few different paleo options for cereal, I figured I’d pick some up and give them a try.

And boy am I glad that I did! The stats on it are pretty good:

Per each 1.5 ounce serving:

  • 200 Calories
  • Fat 13g (6g saturated)
  • Carbs 16g (7g fiber, 6g sugars)
  • Protein 7g

I’m also really happy with the ingredient list – very short – and all real food:  raw almonds, shredded coconut, sunflower seeds, pumpkin seeds, coconut oil, honey and vanilla.

I use this a few tablespoons at a time to add crunch to my morning yogurt.  It has a great flavor, and is softer than some of the commercial yogurts that I’ve had.  It doesn’t hit my blood sugar that badly – it’s just a wee bit of honey – but I don’t think I’d want to have a larger serving of it at one time.

I would most definitely recommend this to any of my bariatric friends who are looking for a bit of crunch in their yogurt that also packs some nutrition into it as well.  The price is fairly good as well – especially since I only eat it a few tablespoons at a time.   It’s 6.95 a container, and because I got about 10 servings out if it – it is about $.70 a serving.  Well worth it in my opinion!

If you try it – let me know!