T Nation

Supplements Building Post WLS

I am a Post weight loss surgery patient. I had an RNY in Feb of 06 and have since lost 287lbs I now weigh 205lbs .Down from the 492 I started at 13 mths ago.

I go to the gym 3-5 times a week but I am not seeing the gains I am looking for I was wondering on bodybuilding supps and when and how to take them I have been trying to build muscle in my arms and back to help with the sagging loose skin after loosing so much weight. I am trying to find a solution other than Plastic surgery.

I went to my local gnc and bought a 15 day kit but I am yet to try it as I do not know how it will react to my altered digestive tract. And weather or not my Body will break down the coatings and binders on the pills.

I currently Take in 120-130 grams of protein a day using food and protein drinks. My caloric intake is around 1400 cals a day and My goal is 80 oz of water.

A fellow WLS patient gave me this web site as a starting place to try and get some answers.
Douglas Sylvester

Hey, there, Douglas!!! Long time, no speak! (grin)

For everyone else’s benefit, WLS stands for Weight Loss Surgery, and RNY stands for Roux En Y, which is a type of WLS. With that out of the way, let me include part of what I wrote to you in PM and continue on from there …

First off, you do not need supps to put on muscle. Or let me put it another way. If your diet isn’t right, using supplements will not cause you to put on muscle. Additionally, if your diet is right, you will put on muscle whether you use supplements or not.

You’re on a good site for information in some respects, even though the subjects discussed do not take into consideration your special needs and issues. A few facts. In general, to put on muscle, you need to eat ever so slightly in excess of your maintenance calories. A slight twist to that that might be a bit more accurate, though, is that you would need to eat slightly in excess of what your muscles require to grow (hypertrophy) IN ADDITION TO providing a stimulus for growth (resistance training).

Additional considerations are diet. In non-RNY people, insulin is used to stimulate protein synthesis. One of the issues is getting optimal amounts of protein, which is quoted as 1g of protein per pound of TBW (Total Body Weight) or maybe 1.5g of protein per pound of LBM (Lean Body Mass, meaning everything that is not Fat Mass). But in addition to getting sufficient/optimal amounts of protein, insulin plays a role. And insulin is a hormonal response to eating carbs. I don’t know if eating starchy carbs is an option for you because of your malabsorption issues and the nature of RNY.

Even though I said you don’t need supplements to achieve your goals of increasing LBM, I would think adding in a “clean” protein powder might be helpful/supportive. It’s not that other protein powders are dirty – they’re not! – but I’m talking about a protein powder that doesn’t have a lot of extra sugars or fats or artificial “extras.” The sugar in particular is something I know you need to control.

I do have a few questions for you, Doug, before I start making recommendations.

  • How many times a day do you eat?
  • Do you take a good broad spectrum digestive enzyme with each and every meal?
  • Are you on any medications currently?
  • Are you taking any supplements or vitamins?
  • I know you can’t eat sugar, but are you able to eat fruit and fructose?
  • Can your body handle Sucralose, Equal, or stevia?
  • How about healthy starchy carbs like oatmeal, sweet potatoes, brown rice, whole wheat pasta, amaranth, quinoa, barley? Are you able to eat them in small amounts?
  • Other than sugar, are there any foods you are intollerant to, allergic to or can’t eat for whatever reason?
  • Have you been taking in any GOOD fats like flaxseed oil, fish oil or olive oil?
  • What does your blood work look like? In particular, I’m interested in cholesterol, blood sugar and anything that might be out of whack.

What I’d like to do, Douglas, is focus on a diet that will support your goals. I’ll make some recommendations and refer you to some articles. It would probably be a good idea for you to keep your nutritionist in the loop on what you’re doing dietarily.

I don’t object to your taking supps. Since you have some concerns on binders and fillers, I would recommend that you contact the company and ask for more information. Then you could run it past your nutritionist, pharmacist, doctor, etc., to see if any of them objected. Barring any objections by your health care team, I’d suggest you start off at the lowest possible dose of any supp to assess tolerance and then work up from there. There’s a lot we’re able to figure out on our own if we’ll just listen to our body.

Welcome to T-Nation, by the way!!! (grin)

Congrats on the weight loss, Doug.
Looks like Tampa Terry has covered most of the bases and asked soem very good (important) questions.

I just wanted to add a bit on the loose skin. With that much weight loss, you may have to have surgery to tighten your skin up. Many FFB on here have loose skin that will never tighten up no matter how lean they get. I don’t think most of them lost as much weight as you, either.

Good Luck.

Terry here are the answers to your questions. ? [quote]How many times a day do you eat? [/quote]I eat 5-6 times a day about every 3hrs I eat 3 oz

[quote]* Do you take a good broad spectrum digestive enzyme with each and every meal? [/quote]No

[quote]* Are you on any medications currently? [/quote]Yes I take Ambien Cr to sleep at night

[quote]* Are you taking any supplements or vitamins? [/quote]Yes I take a centrum multi 2 twice a day. Caltrate 600 2x a day 50000 icu?s of vitamin D. 2 twice a week. And every other day I take a Nox product.

[quote]* I know you can’t eat sugar, but are you able to eat fruit and fructose? [/quote]Yes I can eat fruit.

[quote]* Can your body handle Sucralose, Equal, or stevia? [/quote] Yes to sucralose,and equal have not yet tried stevia

[quote]* How about healthy starchy carbs like oatmeal, sweet potatoes, brown rice, whole wheat pasta, amaranth, quinoa, barley? Are you able to eat them in small amounts? [/quote]Yes to sweet potatoes,brown rice,and whole wheat pasta.

[quote]* Other than sugar, are there any foods you are intollerant to, allergic to or can’t eat for whatever reason? [/quote]I am lactose intolerant.

[quote]* Have you been taking in any GOOD fats like flaxseed oil, fish oil or olive oil? [/quote]Olive oil in our cooking.

[quote]* What does your blood work look like? In particular, I’m interested in cholesterol, blood sugar and anything that might be out of whack.[/quote] Blood work good. Low iron levels. Ferin at 10. Cholelsterol fine. Blood suger good. Low magnesium.

Lots of good information there, Doug. Thank you for that.

I know what your goals are, but there are some things that need to be addressed preliminarily.

Get some recommendations from your doc or nutritionist on the type and amount of iron they want you taking. People who have had RNY are typically deficient in iron and B12. Iron is one of those supps you don’t want to take more of than you need. Blood tests should tell whether or not they’ve found the right dose for you. Don’t be figuring that one out on your own. Correcting iron and B12 deficiencies should noticably improve energy levels.

You also need to add in some Vitamin B12.

I’d like to see you taking ZMA before bed. It’s not an expensive supp. It stands for Zinc Magnesium Aspartate, and taking it will help correct the magnesium deficiency along with helping you sleep. Magnesium is important to anyone working out.

Good news on the olive oil!!! Make sure you are consuming 2 tablespoons per day each and every day. Additionally, I want you to add in 2 tablespoons of flaxseed oil per day, too. You’ll also get some fat from the lean cuts of meat and eggs you eat. There’s a reason for all these recommendations.

I’d like to see you trade out the Caltrate, which is calcium carbonate, for a calcium supplement that uses calcium citrate or calcium bisglycinate. Calcium citrate is better absorbed than calcium carbonate by approximately 22% to 27%, and calcium bisglycinate has been shown to be even better absorbed than calcium citrate. Unless your nutritionist recommends higher numbers, you need 1,000mg of ELEMENTAL calcium. That words “elemental” is key to my recommendation.

Another question for you, Doug. Are you managing to maintain your weight at this point, or are you still losing?

I’d really like to see you start taking a digestive enzyme with every meal. Malabsorption is double-edged sword. You’re eating about 600 calories per day less than a person your weight should be eating on a diet. For you to achieve your goals, you need to be eating quality foods, packed with vitamins and minerals and phytonutrients. And, in addition, you need to be extracting/digesting/absorbing as many of those nutrients as possible. I’m talking nutrients, not calories. You’re wanting to build muscle. You need the nutritional building blocks to do so. Using a digestive enzyme doesn’t mean that you’ll be getting more caloreis. It means that you’ll be extracting more value out of the food you do eat!

FYI, “broad spectrum” means that there are a wide variety of enzymes that break down protein, fat and carbs. The enzymes you get can be plant based or animal based. It won’t matter.

Hit me with any questions you have, and I’ll jump into the dietary recommendations tomorrow.

BTW, if ever I miss one of your replies/updates, don’t hesitate to send me a PM and ask me to stop by.