Because the duodenum (first 12 inches of small intestine immediately below the stomach where bile and pancreatic fluids flow into the small bowel through ducts from the liver and pancreas) and 100 cm of the small intestine are bypassed in the RY gastric bypass, poor absorption (the process in which digested food is absorbed by the lower part of the small intestine into the bloodstream) of iron and calcium can cause low total body iron and a greater chance of having iron-deficiency anemia.

• 1 multivitamin with minerals every day
  Flintstones Complete, One a Day Kids Complete, Centrum, or generic equivalent
• 600 mg calcium (calcium citrate) with vitamin D twice a day. Calcium citrate can be dissolved in a small amount of water, if desired.
  Citrical, Nature's Basics Chewable Calcium or generic equivalent
• 1000 mcg B12 sublingually (under the tongue) twice per week or 500 mcg pill (swallow) once a day
  Twinlab B-12 Dots, Dr. Natural No Shot B12, GNC Sublingual B12
• 50-66 mg of elemental iron every day, for menstruating females or people with anemia.
  Ferrous fumarate taken with with vitamin C 250 mg to improve absorption of iron.

1. Take your calcium in individual doses throughout the day. Do not take calcium with your iron supplement or within 1-2 hours of taking any medicine since calcium can interfere with their absorption.
2. Since calcium citrate is too large to swallow whole, cut it up into 3-4 pieces or dissolve it in water or Crystal Light. (Note: Do not drink the sediment in the bottom of the cup.) You may also take a chewable calcium carbonate for the first few weeks after surgery.
3. Take your chewable multivitamin with minerals each night before you go to bed and your B12 supplement before breakfast. Be sure to take only the "sublingual" B12 tablet and not the pill form. This type dissolves under your tongue and is better absorbed after gastric bypass surgery.