Maximizing Nutrient Absorption: Liquid Vitamins & Supplements for Ileostomates

Because most of us are ileostomates, we aren't able to fully absorb nutrients from our diets. Same goes with vitamins and supplements in pill form like tablets/capsules. When available, I always choose the liquid form. They are much easier or are completely absorbed than ones in solid pill form.
Absorption depends on how long our small intestines are after surgery or more than one surgery.
I have been taking a multi-vitamin including a mineral complex mixed with water. When I don't take it, my energy and mental sharpness isn't the greatest. Many times I lose my clearer face and color in my face that this product gives me.
The product is Beyond Tangy Tangerine 2.0. It tastes great with citrus and peach flavors. It is made from natural sources but doesn't claim to be organic.
It's not cheap at around $58 monthly, if you use 2 scoops of the product every day.
Sometimes, I use only 1 scoop into my cup of water, but not for more than 5 days. I feel the difference in a couple of days.
Hope this is good news for y'all.
To your health,

Sharon (deziner)

Hi Sharon,

You are of course right in that bowel length and/or amount of fully functioning bowel play a key role in what gets absorbed and what does not. But I'm curious to know how much of your small bowel was removed? Reason I ask is I take supplements due to being short gutted, but don't have any reaction if I miss a dose or day's dose of anything. It sounds like you're on the hairy edge of something, rather than your situation being the norm. It would be good if other ostomates chime in. I've got 140cm (55") of small bowel left and I just take a multivitamin (generic Centrum Silver Men 50+), copper, iron, B6 and sublingual B Complex and Vit A. But like I said above........I routinely miss or get busy and forget to take them and there's no adverse effects. I have my micronutrients checked twice a year and am pretty sure I don't need to take some of what I'm taking........but my Docs and dietician frown on my stopping taking them for 30 days to find out what my real deficiencies are. Shhhhh........don't tell them.........but I'm going to do it anyway.

So my point here is if missing a dose of something has a distinct impact on you in any way.........I'd be concerned. Just sayin'.

Regards,

Bob

I'm an ileostomy. I have no problems with tablets, but if they are capsules, then within half an hour, they are fully formed in the bottom of my bag. I can't help on the vitamin side of things as I don't take them. You start with one, and before you know it, your local Mr. Barrett has got you on every vitamin you can think of, and all you're left with is an empty bank. LOL xx

Hi Sharon, I agree with Bob. I think that what you are eating or not eating has a lot to do with absorption issues. Things like breads, oatmeal, bananas, potatoes, proteins, applesauce, rice, tapioca, puddings, peanut butter will help with absorption and make stool thicker. I only have about 3/4 (if that) of my small intestine left and I find the foods I mentioned help tremendously, especially because I find it difficult to drink the appropriate amount of water daily. I also take a multivitamin and B12 complex along with daily meds, and I seem to be doing alright.

I have a problem with multi-vitamins and B6/B12 vitamins - I can't take them - but I think it has to do with my cancer treatments, not having a colostomy. I absorb them and don't release them. I was taking an over-the-counter B6 and B12 supplement, because it was supposed to help with my neuropathy. Not excessive amounts, no doubling up the pills or anything. After developing eye problems (excessively dry, extremely sensitive to sunlight, so I had to wear very dark sunglasses to drive on a stormy, totally overcast day - and even wore sunglasses to work on the computer with the brightness turned down), my doctor finally ordered a whole battery of tests and found that my B6 and B12 blood levels were over twice the recommended upper normal range! A month after I stopped taking the supplements, my eye problems resolved, and my levels finally dropped back into the normal range after about 6 months. I take Vitamin D3 during the winter when I don't get enough sunlight, and fish oil for omega-3's, but I get my B's only from my diet. None of the doctors can pinpoint exactly why this happens, especially since I'm short some intestine, but they finally chalked it up to another side effect of the chemo. Ah, chemo - the gift that keeps on giving - 10 years later!

Hi there ladies and gents, I don't really take any supplements and try to get everything in my food, and that seems to work for me. I have recently started to make smoothies with everything but the kitchen sink in them. If the smoothie is very liquid, it tends to move through me pretty fast. I use a little yogurt and a little milk to add liquid but try to get it so it will just about run off a spoon, almost thick enough to eat with a spoon. Generally, the output is thicker after a thick smoothie, and I feel like I have absorbed a lot of the good stuff. The love of my life and best friend, Kitty, had all her colon and most of her small intestine removed following chemo and radiation for breast cancer. Kitty used a hydration product called "Drip-Drop". This is a powder and contains various ingredients which help the body retain more fluids and to absorb more of the good stuff from the foods you eat. Does anyone use Drip-Drop? The ingredients are sodium, potassium, magnesium, and glucose. I used to use some of Kitty's Drip Drop sometimes, and it could actually make me feel a bit bloated because I was actually retaining a bit too much water! So I know it works. I didn't need to use Drip Drop as much as Kitty needed it because I have virtually all of my small intestine intact. Kitty took all the vitamins as standard for someone with short bowel syndrome. The only problem she encountered was with her potassium levels. This was a continuous problem, and she sometimes had to get an infusion of potassium at the hospital. On several occasions, Kitty woke up at night complaining of muscle pain and cramping in her extremities, arms, and legs. I would massage her arms and legs to ease the muscle pain, but we always wound up in the ER to get a potassium infusion. Is this common with any of you guys with short bowel or borderline short bowel? It was very difficult to get the potassium balanced and to stay at a steady level. Kitty took magnesium and potassium in pill form but did not seem to absorb it very well.

Dinner bell....gotta go...my delicious shrimp will be cold!!!!!

Eamon.

Hi Eamon,

It really depends on the individual. When they short gut you, they try to save as much bowel as possible, so they typically remove the diseased or fistulized sections and end up with a bunch of small pieces that are still good. That brings up the whole issue of scar tissue and adhesions, but that's a tale best left to another day. I doubt they keep track of what piece came from where, so what used to be duodenum, jejunum, and ileum is now a patchwork quilt of pieces from wherever. And each part absorbs something different... so you can see why the whole "who can absorb what" thing is never the same for two people. Your bowel does attempt to adapt over time to what it has and what it needs to absorb... but sometimes it just can't adapt that much. I get the majority of my nutrients from food, and absorption is just barely adequate to maintain me at 185 lbs. If down the road I end up losing any more bowel... or part of it becomes diseased... I'm pretty much f *ked... unless I get a small bowel transplant. And they won't do that unless my liver is so far gone there's no other alternative. Sublingual supplements can be a godsend to some... and are the simplest to take.

Drip Drop is an oral rehydration solution. There's a number of different ones on the market, but anyone can make the same thing at home for pennies. I tried it when it first came out, but by then I was making my own and found all the available ORS's too sweet for my taste. But like everything... your taste buds will get used to it over time... and hydration is one of those really hard things for short gutters. I don't take supplemental potassium, other than what's in my multivitamin. But I do try to eat a banana every day. Getting too much potassium can lead to hyperkalemia... a fancy way to say high blood pressure... so care needs to be taken with potassium supplementation. Most OTC stuff can't kill you... too much potassium can.

Regards,

Bob

Drip Drop has trivial potassium in it and if wasting potassium is a problem for Kitty, it won't solve it. I have the same problem. I don't know what causes it . . . I don't have a colon at all now, but I had that as a problem before that, so it is worse than ever. I manage it two ways. I don't use the Drip Drop because it really only has salt and sugar in it, plus trivial amounts of potassium and magnesium. It will encourage the small bowel to update the fluid you drink, yes, but if she wastes potassium, it isn't going to help her much if she isn't supplementing with potassium in addition. She can try drinking V8 juice . . . in fact, if she adds her Drop Drop directly to V8 juice and drinks that instead of plain water, she might solve her problem with that alone. One cup of V8 has 470mg potassium. (If she finds that plus the DripDrop gives her too much salt, she can get the low sodium V8 juice.) In addition to V8, I get potassium tablets (400mg) that dissolve in water . . . I add one to a serving of applesauce or to a hot drink, no flavor to it. These are easy ways to increase potassium. (I need about 2800mg a day; I am 130 lbs and 5'8" women vary a bit in what they need, but I roughly target that a day.) Cramps show she isn't getting enough of something, though. For food, I also eat avocado (like an apple!) and bananas. But the easy go-to for "extra" potassium is to dissolve a tablet of fizzy potassium into something I am drinking (or eating, like applesauce).

This, though, is all in addition to my basic go-to . . . I drink one liter of water (about four cups) with one scoop of Zero 1000. I buy it off Amazon. It is the same recipe as Dr. Berg's electrolyte supplement. In it, you are getting potassium and magnesium supplemented; I don't think I need to spend a lot of money on sugar and salt, frankly, that is freely available in my kitchen and easy to add to fluids. For rehydration, the recommendation is two scoops, but to just maintain hydration, I use half that, one scoop. One scoop has 1,000mg of potassium in it, along with 1/3 of the recommended magnesium/day. So, I drink two liters of this a day (about 8 cups), so my baseline on any day is 2,000mg of potassium and 2/3rds of my magnesium, just from that. The rest of what I do to close the remaining gap is with V8, fizzy tabs, or regular food (banana, avocado). I don't seem to need to supplement much with salt or sugar, enough of that being in the basic electrolyte drink I use or just from food in general. I make sure to drink V8 in the morning because it has salt in it. Everybody will vary; my problem beyond basic electrolytes/hydration is just the potassium really. The electrolyte drink I use basically takes care of everything without my having to think much about it.

Oh, magnesium. I also use a lotion with magnesium in it . . . from Ancient Minerals, also off Amazon. I rub it onto my knees and feet and lower back, and it eliminates background pain from arthritis/age. The magnesium is absorbed into the bloodstream through the skin, but it also gives localized benefit from the specific absorption site. It doesn't sound like magnesium levels is an issue for Kitty, but I thought I would mention it. She might benefit regardless for other reasons.

BTW, I also don't absorb potassium very well in pill form . . . in my electrolyte water and fizzy drinks, it is always fully dissolved. I also found it to be somewhat irritating to the linings, and so I like to let the water sit at room temperature and fully go into solution. With that, I haven't had any further trouble. I do know that the tendency for potassium levels to drop can create huge problems for someone, really very serious ones, and I am glad that you have gone to the ER to manage it when you have had to do so.

BTW again! I usually get up twice in the night to empty my bag, and I take a big swig of my electrolyte-water when I go back to bed. I try to complete drinking a glass of it by the time I get up in the morning so I don't go from say 10pm to 10am without drinking anything, thus guaranteeing that I start the day dehydrated and behind the curve. Right away when I get up I have a little salt (right out of my hand!), and have a V8 shooter. Then decaf with collagen powder, Bulletproof creamer, some coconut oil (a big mug, another two cups). None of this takes much time to do and I feel good for hours, plus start my day with five cups of fluid under my belt, from two cups overnight plus my decaf plus the V8. Then I casually pick up more fluid throughout the day; I go for a walk and drink a container of coconut water, another 1.5 cups with yet more potassium, around 700mg!, and I have bone broth with dinner, another cup. Then I usually drink my water in addition whenever I feel like it at my desk. I get all kinds of fluid this way without having to think about it very much, and plenty of potassium.

I hope that something here is helpful to you. Everybody varies and everybody's individual problems are unique, so no one solution fits all. But some of these suggestions might be useful. The electrolyte supplement with 1,000mg of potassium is essential for me. Dissolving the DripDrop into a glass of V8 might help. Coconut water helps. The fizzy potassium tabs (400mg, but still) can help. Specific foods can help, like bananas and avocados, for me. I am several months in from my colon removal now, and things are starting to even out. I don't have cramps anymore and I also am starting to do these things more automatically, so I don't have to think about it all the time. I just drink when I get up in the night, do some specific things along with my morning coffee, make my electrolyte drink, and get on with things. Life is slowly starting to feel more normal again without everything revolving around fluid maintenance! I hope that it goes this way for Kitty as well. : )

Drip Drop has trivial potassium in it and if wasting potassium is a problem for Kitty, it won't solve it. I have the same problem. I don't know what causes it . . . I don't have a colon at all now, but I had that as a problem before that, so it is worse than ever. I manage it two ways. I don't use the Drip Drop because it really only has salt and sugar in it, plus trivial amounts of potassium and magnesium. It will encourage the small bowel to update the fluid you drink, yes, but if she wastes potassium, it isn't going to help her much if she isn't supplementing with potassium in addition. She can try drinking V8 juice . . . in fact, if she adds her Drop Drop directly to V8 juice and drinks that instead of plain water, she might solve her problem with that alone. One cup of V8 has 470mg potassium. (If she finds that plus the DripDrop gives her too much salt, she can get the low sodium V8 juice.) In addition to V8, I get potassium tablets (400mg) that dissolve in water . . . I add one to a serving of applesauce or to a hot drink, no flavor to it. These are easy ways to increase potassium. (I need about 2800mg a day; I am 130 lbs and 5'8" women vary a bit in what they need, but I roughly target that a day.) Cramps show she isn't getting enough of something, though. For food, I also eat avocado (like an apple!) and bananas. But the easy go-to for "extra" potassium is to dissolve a tablet of fizzy potassium into something I am drinking (or eating, like applesauce).

This, though, is all in addition to my basic go-to . . . I drink one liter of water (about four cups) with one scoop of Zero 1000. I buy it off Amazon. It is the same recipe as Dr. Berg's electrolyte supplement. In it, you are getting potassium and magnesium supplemented; I don't think I need to spend a lot of money on sugar and salt, frankly, that is freely available in my kitchen and easy to add to fluids. For rehydration, the recommendation is two scoops, but to just maintain hydration, I use half that, one scoop. One scoop has 1,000mg of potassium in it, along with 1/3 of the recommended magnesium/day. So, I drink two liters of this a day (about 8 cups), so my baseline on any day is 2,000mg of potassium and 2/3rds of my magnesium, just from that. The rest of what I do to close the remaining gap is with V8, fizzy tabs, or regular food (banana, avocado). I don't seem to need to supplement much with salt or sugar, enough of that being in the basic electrolyte drink I use or just from food in general. I make sure to drink V8 in the morning because it has salt in it. Everybody will vary; my problem beyond basic electrolytes/hydration is just the potassium really. The electrolyte drink I use basically takes care of everything without my having to think much about it.

Oh, magnesium. I also use a lotion with magnesium in it . . . from Ancient Minerals, also off Amazon. I rub it onto my knees and feet and lower back, and it eliminates background pain from arthritis/age. The magnesium is absorbed into the bloodstream through the skin, but it also gives localized benefit from the specific absorption site. It doesn't sound like magnesium levels is an issue for Kitty, but I thought I would mention it. She might benefit regardless for other reasons.

BTW, I also don't absorb potassium very well in pill form . . . in my electrolyte water and fizzy drinks, it is always fully dissolved. I also found it to be somewhat irritating to the linings, and so I like to let the water sit at room temperature and fully go into solution. With that, I haven't had any further trouble. I do know that the tendency for potassium levels to drop can create huge problems for someone, really very serious ones, and I am glad that you have gone to the ER to manage it when you have had to do so.

BTW again! I usually get up twice in the night to empty my bag, and I take a big swig of my electrolyte-water when I go back to bed. I try to complete drinking a glass of it by the time I get up in the morning so I don't go from say 10pm to 10am without drinking anything, thus guaranteeing that I start the day dehydrated and behind the curve. Right away when I get up I have a little salt (right out of my hand!), and have a V8 shooter. Then decaf with collagen powder, Bulletproof creamer, some coconut oil (a big mug, another two cups). None of this takes much time to do and I feel good for hours, plus start my day with five cups of fluid under my belt, from two cups overnight plus my decaf plus the V8. Then I casually pick up more fluid throughout the day; I go for a walk and drink a container of coconut water, another 1.5 cups with yet more potassium, around 700mg!, and I have bone broth with dinner, another cup. Then I usually drink my water in addition whenever I feel like it at my desk. I get all kinds of fluid this way without having to think about it very much, and plenty of potassium.

I hope that something here is helpful to you. Everybody varies and everybody's individual problems are unique, so no one solution fits all. But some of these suggestions might be useful. The electrolyte supplement with 1,000mg of potassium is essential for me. Dissolving the DripDrop into a glass of V8 might help. Coconut water helps. The fizzy potassium tabs (400mg, but still) can help. Specific foods can help, like bananas and avocados, for me. I am several months in from my colon removal now, and things are starting to even out. I don't have cramps anymore and I also am starting to do these things more automatically, so I don't have to think about it all the time. I just drink when I get up in the night, do some specific things along with my morning coffee, make my electrolyte drink, and get on with things. Life is slowly starting to feel more normal again without everything revolving around fluid maintenance! I hope that it goes this way for Kitty as well. : )

I want to make a point for those of us with ileostomy. Absorption of certain vitamins like biotin is determined by how much of your terminal ileum is left. The more that is resected, the less you will absorb of this and several other vitamins. This resulted in hair problems for me, and I am still trying to correct my absorption.

I have a high output ileostomy, so not only do I suffer from dehydration, but vitamin absorption as well as medicine absorption is problematic for me! I am doing a lot of research.

I know that drinking Gatorade for me works for electrolytes. Every time I have labs drawn at the hospital, regardless of the time of day, mine are within normal limits. But I am taking down this info in the discussion below low in case this stops working.

Perfect post to share my discovery last spring. I had my ileostomy back in 1997 as a 17-year-old kid. I've struggled for years with vitamin intake/energy levels and watery output until a few months ago.

I started taking Athletic Greens every morning without fail. Within a week, I felt better than I have in years. In fact, my output changed from watery to almost paste-like. I am now able to go 4+ hours and sometimes 6-7 hours without needing to empty. The key is very first thing when you wake up, at least 20 minutes before any food, and wait even longer if you love your morning coffee as caffeine can block absorption of some of the minerals.

I did not tell my doctor I was taking this, and he noticed changes on my bloodwork a few months in. Mainly my B12, vitamin D, and inflammatory markers were all better.

Overall, I can feel the decrease in my body's inflammation. I still have bad days, of course, but I will take this product as long as they make it. The cost is about $100 a month, and the results for me have been priceless.

Hi mate,

Where do you buy this supplement online?
Been looking into something to thicken up output and better absorption.

Thanks Joey