Post transplant multi-vitamins

[MooseMom]

While we all know that generally speaking, the multi-vitamin/supplement industry is mostly a con, surely there are exceptions?

There are people who do need supplements of some sort, like those of us who have a transplant and who take the drugs that can leach necessary vitamins and minerals from our systems.

I was told to take a "multi-vitamin", but no one told me if there was one that was better than any other.

I did some research and settled upon USANA, which is widely used by tennis players on the women's tour.  But for all I know, this company may be a sham.

Do you all take supplements, and if so, what do you take, and who is the manufacturer?  I know I do need to take magnesium supplements at the very least, but is a bottle of magnesium tablets from Walgreen's or Boots good enough?  The USANA multi-vitamins I take are becoming pricier each year, and I am looking for a more affordable alternative.

Thank you!

[iolaire]

Non were recommended for me 

[Kathymac2]

The only supplements I currently need currently are magnesium, calcium and vitamin D. I was advised to take:  MG Plus Protein for my lowered magnesium levels and Citracal Maximum Plus (D3) to supplement calcium and vitamin D levels. I get them both from Amazon.

[MooseMom]

The only supplements I currently need currently are magnesium, calcium and vitamin D. I was advised to take:  MG Plus Protein for my lowered magnesium levels and Citracal Maximum Plus (D3) to supplement calcium and vitamin D levels. I get them both from Amazon.

Yes, magnesium, calcium and VitD do seem to be the crucial ones, particularly if you're female.

How did you come to choose MG Plus Protein and Citrical Maximum Plus (D3), specifically?

May I ask how much they cost?

[SooMK]

I take Vitamin D2 (script). I was not recommended a multivitamin or any other supplements. I take d-mannose and a probiotic (with the recommendation/ok from my neph) in my on again/off again fight against urinary tract infections.

[Simon Dog]

Mag, Potassium and Phosphorous - all prescribed based on lab values.

[MooseMom]

Mag, Potassium and Phosphorous - all prescribed based on lab values.

Well, this addresses part of my question.

My tx neph has always told me to take a "multi-vitamin", so I have.  She has not said which one, nor has she prescribed one.  Every year, she asks me if I'm talking a multi-vitamin, and each year I tell her, yes, yes I am.

All of my lab values are OK, but even with the USANA multi-vitamin I take, my mag is at the very low end of "normal".  My neph said she could prescribe mg if I wanted, but I didn't want, not really.  I didn't want to have yet one more prescription to keep track of.

All women my age are supposed to take calcium supplements + vit D, or so says every doctor I've ever seen.  Maybe it's all a lie, but my bone density scans have always been really good, so I don't want to stop taking them.

[MooseMom]

Non were recommended for me

See, now, why not?  I can understand you not having to take calcium, but I wonder why my neph wants me to take a multi-vitamin and yours does not?  You're quite a bit younger than I am, so maybe that's the reason?  I just don't know.

[MooseMom]

I take Vitamin D2 (script). I was not recommended a multivitamin or any other supplements. I take d-mannose and a probiotic (with the recommendation/ok from my neph) in my on again/off again fight against urinary tract infections.

That's interesting; why do you need VitD2 via a prescription?  Is it something to do with aiding calcium uptake?

I suppose I was under the impression that we all need to take a multi-vitamin to replace what the immunosuppressants leach from our system (particularly magnesium, which is why my multi-vitamin is also a multi-mineral supplement, too).  Looks like I'm wrong!

[tigtink]

I am currently taking:

Liquid Calcium by Nature Made (600 mg calcium, 500 mg D3) four capsules a day. I was taking D3 before the transplant, but the transplant center replaced it with the Liquid Calcium.

Folic Acid by Nature's Blend (1,000 mcg), one a day, per instructions from the transplant center.

Iron by Nature Made (65 mg, equivalent of 325 ferrous sulfate), two a day (was on one a day before transplant)

Centrum Silver multivitamin (they just said a multivitamin so I picked this one)

Fish oil by Nature's Bounty (1200 mg) two a day. I was on this before the transplant and was advised to continue it.

Aspirin by Bayer (81 mg one a day). I have been on this since my fistula surgery over 6 years ago.

Before the transplant I took probiotics but was told by the transplant center to discontinue it.

I see many of you are taking magnesium supplements. I was never advised to do so, but they haven't tested it since October 8. It was just below normal then. I guess I should ask my coordinator why it has not been tested since then.

[UkrainianTracksuit]

No, no multivitamins were prescribed for me. The tx nutritionist pretty much told me to “eat the rainbow” and get my vitamins/minerals from natural sources. That has worked so far in regard to all sorts of regular things. However, the tx doctor just advised me that if I start on multivitamins to get it cleared with someone on the team familiar with my meds (I guess, the local neph unit) so that they have nothing questionable.

I’ve just been prescribed supplements for specific problems. Magnesium is a definite. As well, everyone is at the conclusion I have “anemia of chronic disease” because my kidney is working fine, but I can’t get over low iron, so I take FeraMax.

Other than that, I just take biotin for my hair. Keep in mind, I am younger and I guess my body still functions fairly normally. Probably not old enough to have the osteoporosis talk, but perhaps, in later years, they’ll suggest calcium and Vit D supplementation, like my mom.

Besides magnesium and iron, everything else is swimmingly normal.

[MooseMom]

Tigtink, thanks for that.  Yes, do ask about magnesium because it is my understanding that one of the immunosuppressants commonly prescribed (can't remember which one) can leach that particular mineral from your blood.  I find it interesting that each year when I have my annual checkup, they specifically test my magnesium level.

UT, oddly enough, I never took any multi-vitamin before my transplant, not even iron as I never had trouble with anemia (which is odd, I think).  I make it a point to "eat the rainbow", so I am not entirely sure why my tx team is so gung-ho on the whole vitamin supplement thing.

OK, so, I may rethink the whole topic because man, the stuff I take now is getting expensive!

[iolaire]

Non were recommended for me

See, now, why not?  I can understand you not having to take calcium, but I wonder why my neph wants me to take a multi-vitamin and yours does not?  You're quite a bit younger than I am, so maybe that's the reason?  I just don't know.

I feel like I don’t need extra and they probably thought the same. I still have high PTH and high calcium. At one time I was told to take a basic vitamin with vitamin D but immediately they changed their mind and said no because they don’t want that to trigger the parathyroid to do something different.

I was on sodium bicarbonate and magnesium when I left the hospital but was off those as the levels normalized in the first six months.

I do eat a balanced generally not dominantly processed food diet with beans almost weekly, salads, mild meat consumption.

My dr did volunteer glucosamine was ok and might be beneficial or at least not harmful when I was having sore knees and feet. I’m taking that at 1/2 dose now. But I fixed the joint issue with four pairs of new work shoes and trashing the ones that hurt my joints.

Also I do wonder if I was a bit older if the would recommend vitamins as that need increases with age.

[UkrainianTracksuit]

I make it a point to "eat the rainbow", so I am not entirely sure why my tx team is so gung-ho on the whole vitamin supplement thing.

This is just one deranged theory, but perhaps, since your tx center wants their patients to have optimal health/vitality, but also know that average people suffer from a lot of vitamin/mineral deficiencies due to diet (as we often hear), they believe in supplementation? This is obviously just a generalized theory for those with a stable/good health situation than those with specific needs.



I don’t think you’ve ever discussed any such topic, but do you have any gastrointestinal diseases? Sometimes additional supplementation is required in those where vitamins aren’t absorbed in the various parts of the bowels. Just throwing that out there.

[Kathymac2]

Moosemom - MG Plus Protein is $11.36 for 100 tablets. I take one a day because more causes GI problems. The Citracal Max is $14.29 for 180 tablets. I'm taking one a day.

The specific magnesium product was prescribed by my transplant team. My magnesium level is thought to be suppressed by the tacrolimus (Prograf) and probably won't improve until my tacrolimus dosage is decreased at six months post transplant.

The Citracal was prescribed following my parathyroidectomy for an adenoma on one of my parathyroids about a year before my transplant. I was taking loads of calcium immediately following the surgery and scaled back gradually as my parathyroid and calcium levels normalized post surgery. Now I only have to take one a day to supplement calcium and vitamin D levels.

All of my medications including these supplements are prescribed based on my blood test results. I have never been advised to take a multivitamin, but was given lots of dietary advice immediately post transplant. 

So much of this is based on sex, age and how long ago you had your transplant. My medications are still being adjusted at every clinic visit. I'm so paranoid about my transplant, if the doctor told me to take a multivitamin, I would probably ask why (what needs to be supplemented?) and which multivitamin does he/she recommend?

[MooseMom]

UT, I think you're probably right in thinking that my tx center leans toward suggesting a general multi-vitamin for "optimal health" for those of us with compromised immune systems, etc.  I am aware, though, that any supplements cannot be taken along with the immunosuppressants, so I am careful about that.  I have always been in good health generally, but despite that, yeah, maybe they just want to make sure.

I don't have any sort of GI disease.

iolaire, perhaps you are right in thinking that suggesting supplementation may be a function of a patient's age. 

All I know is that whatever I have been taking for all of these years seems to be working, so I hesitate to change anything, but like I've said repeatedly, I'd like to switch to something cheaper.

Kathymac2, thanks for the extra information.  That's helpful.  I'd never had calcium/PTH concerns, so I take just generic calcium + VitD.

I hesitate to contact my tx coordinator for something this trivial, but when I have my next checkup in December, I will ask if they recommend anything specific.

Thanks very much for all of your replies.  I appreciate it.

[Deanne]

My neph never said anything about multi-vitamins, but I took them for a few years, until I recently changed my diet for the better. I'll get my labs done next month and and will see then how it's working. When I tool vitamins, I compared nutrients and used a generic variety.

My vitamin D level has always been on the high end of normal without supplements.

So now, I take:

Magnesium
Tums
Red yeast rice for cholesterol
Full dose aspirin (have been taking it for many years after a blood clot)
Fish oil to treat dry eye

[MooseMom]

Thanks for that, Deanne.  Let us know what your labs show next month.

Do you not take calcium+Vit D?  I've been taking it since before my tx, but that might be because I am "small boned" and a bit older.  I dunno.

Anyway, I've cancelled my super expensive vitamins and plan to take Centrum Silver for Women as tigtink mentioned.  I pride myself on eating healthily and am not really happy with the idea of having to take vitamins at all, but my tx center keeps on about it, and since my labs have been good for all of these years, I don't really want to stop taking them, either.

[PrimeTimer]

Since you transplant folks are talking vitamins thought I'd ask a question. Has anyone anything to say about those multivitamins that are like chewy gummy bears or fruit? Are you getting good labs? Are they absorbed well enough? I like them because they are chewy and fruit flavor and don't upset my stomach but wonder if they work.

[Cupcake]

chewy/gummy vitamins don't have minerals (calcium/iron) as minerals are hard and crunchy! Probably not worth it for most people.

I was prescribed no vitamins/minerals after transplant except for Vitamin D.

I was followed by Infectious Diseases (yikes! I hated to walk into that place) after a transplant related abdominal infection and asked about taking Probiotics after transplant. They said Probiotics were contraindicated in transplant patients. I never asked the transplant team but I would advise anyone taking them to run it past your team.