Can B12 be chewed
Vitamin B12 is normally very dependent on the stomach for digestion and absorption. When B12 is swallowed, at best, 1 to 3% is available for absorption. B12 can be absorbed in a few other places such as the mucosa of the nose or mouth. To absorb B12 in the mouth, it needs to stay in contact with the mouth for several minutes under the tongue or on the side of the mouth (between cheek and gum). If it is chewed and swallowed, the advantage of absorption in the mouth is lost.

Why does the B12 take so long to dissolve?
There is a reason why our Sub-lingual B12 doesn't dissolve as quickly as most of the others you will find out there. This is because our B12 is lactose-free. This prevents the tablet from breaking down too quickly to allow for maximum absorption time. The quicker the tablet dissolves, the more you are swallowing therefore not absorbing sub-lingually. We intentionally formulated our B12 to break down a bit slower than most others you will find.

What B vitamins can become deficient with WLS?
The most common B-vitamins that can become deficient with weight loss surgery are B12, folate and B1 (thiamine). Others include B6 and B2 (riboflavin).

Can I open the capsules?
Any of the capsules can be open and mixed into a liquid or soft food.

Why does B12 have to be sublingual?
After some forms of weight loss surgery like gastric bypass, it becomes much harder to absorb B12. Without some of the functions of the stomach, only about 1 to 2 percent of B12 can be absorbed in the intestines. Thus, a sub-lingual B12 that dissolves in the mouth is often preferred. Other good choices are shots or nasal preparations.

Supreme B-Complex is now B50-Complex

Bariatric Advantage® is pleased to introduce our NEW B-50 Complex with Active B-Vitamins. After much consultation with both doctors and patients we feel this product now meets the needs of weight loss surgery patients much better than before.

Some of the advantages of the new product include:

• Small capsule size – these are a very easy-to-swallow
• Activated forms of B-vitamins – we have really upgraded our ingredients to use the active forms of folic acid, B12 and B6 – this means better absorption and metabolism
• Adjustments of levels – we brought some nutrient levels up and others down to make a product that is more specific to the needs of our customers
• Fewer excipients – we have significantly reduced the levels of excipients (non-active ingredients) in this product

For our refill customers: Please note that your daily dose on this product is now 2 capsules. These can be taken at the same time for convenience, or divided into 2 doses if you prefer.

Why does B-complex make my urine bright yellow?
This is caused by the riboflavin (vitamin B2), which has an intense yellow color. This is a natural process and no cause for alarm.

What is the best time to take B vitamins?
It is generally best to take your B-vitamins with a meal. Some small percentage of people find that if they take B-vitamins too late in the day they have more trouble sleeping. If you find you have trouble sleeping after taking B-vitamins, you may want to take them with breakfast or lunch.

Is 1000mcg of B12 too much?
Though it sounds high, 1000 micrograms (mcg) is only one 1 milligram. This is a very commonly recommended dose of vitamin B12, even as a daily dose.

How often should I take my B12?
Your doctor should tell you how often they want you to take B12. Usually it is taken between once a week and once a day.

Amount of folate in a pre-natal (prenatal) vitamin
Folic Acid (folate) is a very important nutrient in pregnancy. Most pre-natal (prenatal) vitamins provide 600 to 1000 micrograms of folic acid per day. All Bariatric Advantage multivitamins provide 800 micrograms of folic acid. To reach the level of 1000 micrograms (1mg) the addition of our B12 with folate adds another 200 micrograms.

Sublingual B12: How long do I have to let the tablet sit under my tongue?
You should keep the B12 in your mouth until it completely dissolves.

If it is hard to keep it under your tongue, place it between your cheek and gum on the side of your mouth. You can also crack the tablet in half with your teeth to help it dissolve a bit more quickly.

Chewing and swallowing the tablet is not advised.

What is Biotin for?
Biotin is a member of the B-vitamin family. It plays a role in the metabolism of protein, fat and carbohydrate. It may help to maintain the health of nails and hair.

Do I need B-complex if I am taking a multivitamin?
A good multivitamin should provide you with a comprehensive B-complex. Some doctors like their patients to take more. Your doctor should tell you if they want you to take an additional B-complex.

Should I take Thiamine?
Thiamine deficiency can occur before or after weight loss surgery. A good multivitamin should provide thiamine, and this is enough for most people. However, if you have a deficiency, your doctor may instruct you to take more. If you are concerned about whether you get enough thiamine, you should discuss this with your doctor.

B12 and moisture
Our B12 tablets are designed as sublingual dissolvable tablets. As such, they easily take on moisture from the atmosphere. This may be especially evident if people live in humid climates. To decrese this effect, we place a dessicant pack in each bottle. This should be left in by the customer after the product is opened. Product should additionally be stored in a cool, dry location. The refrigerator, which is generally quite moist, is not a good place to store vitamins. The best locations tend to be kitchen cupboards. It should also be noted, that the B12 is not harmed by taking on some moisture like this.

Do we have IF in our Sublingual B12?
Bariatric Advantage does not have IF (intrinsic factor) in the sublingual B12 product.  While IF is an issue of B12 if swallowed, when it is absorbed in the lining of the mouth or nose, IF is not needed. The reason IF is not needed is the binding sites in the GI tract that require a B12-IF complex for absorption are not involved. For this reason we really encourage people to allow the tablet to dissolve in the mouth (We suggest between the cheek and gum) rather than to chew it up and swallow it.  If chewed and swallowed, most people will only absorb 1% - 3% of the B12.  Bariatric Advantage encourages people not to swallow the pill, to best assure that they get the B12 they need.

Iron, B12 and Folate after Sleeve Gastrectomy
A new study has shown that there is a risk of B12 and folate deficiency, and a lesser risk of iron deficiency one year after vertical sleeve gastrectomy. 151 patients who underwent the vertical sleeve gastrectomy procedure in Saudia Arabia, had their labs followed for one year. The incidence of B12 deficiency increased from 8.1% pre-operatively to 26.2% post-operatively. Folate deficiency developed in 9.8% of patients and iron deficiency developed in 4.9% of patients. These findings suggest that vertical sleeve gastrectomy patients are at nutritional risk based on their procedure and should be monitored for deficiency after surgery.

Hakaem HA, O’Regan PJ, Salem AM, Bamehriz FY, Eldali AM. Impact of Laparoscopic Sleeve Gastrectomy on Iron Indices: 1 Year Follow-Up. Obes Surg. 2009 Jul 15.

Are Bariatric Advantage products Only for a Bariatric patient?
Our products are specifically designed with the bariatric surgery patient in mind, however many would be fine for those who have not had surgery. It is always best to talk to a qualified health professional before starting any new nutritional product, especially if you have a health concern.