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Absorption of vitamin B12 is a complex process that relies heavily on a healthy, intact gastrointestinal system. Contact time in the stomach and upper region of the small intestines is particularly important, thus individuals who have undergone bariatric surgical procedures may be particularly prone to deficiency. Deficiency of B12 can lead to conditions such as anemia, nervous system dysfunction, and cardiovascular disease. The only lactose-free sublingual B-12 available. Sublingual (under-the-tongue) supplementation of B12 has been shown to provide good protection against B12 deficiency, and can be an excellent alternative to or addition to periodic injections.

Nutrients that make up our Chewable Calcium Citrates are:

• Calcium Citrate \u2014 Repeatedly shown to be the most bio-available form of calcium. Calcium Citrate does not require an acidic environment for absorption, so it is an excellent choice after weight loss surgery. This form of calcium may protect against kidney stones, so it is safe to recommend to at-risk patients.
• Magnesium Chelate \u2014 Magnesium is important for bone health and supports calcium absorption. The amino acid chelate is easy to digest and is not likely to be irritating. Magnesium is also an important nutrient for cardiovascular health.
• Vitamin D3 \u2014 This natural form of vitamin D is readily converted to the active form needed for bone health. Vitamin D is needed both for calcium absorption and utilization. It is especially important to DS/BPD patients who have malabsorption of fat soluble vitamins.
• Vitamin K \u2014 Vitamin K plays an important role in bone health. Vitamin K is needed to synthesize osteocalcin, a major protein in bone. Low levels are associated with bone loss in men and women.

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Iron is an essential mineral that relies heavily on adequate contact with stomach acid for absorption in the digestive tract. For this reason, many patients who have undergone gastric bypass surgeries develop iron deficiency. In a state of iron deficiency, it is best to supplement iron separately from other minerals to reduce competition for absorption. Calcium, for example, can impair the absorption of iron. Our chewable iron is made from a special very soluble form that has almost no iron taste \u2014 in fact, most people who taste it cant believe it's iron at all. This formula also contains vitamin C and FOS, which have been shown to support iron absorption.

This Chewable formulation contains all natural forms of vitamins. We use the most bio-available forms that are easy to digest and proven to absorb well. We use USP designated elements to address dissolution and disintegration. We use a micro-encapsulation process to eliminate the after taste commonly found in other multi-vitamin chewable formulas.

Some of the nutrients that make our multi-formula unique are:

• Calcium Citrate repeatedly shown to be the most bioavailable form of calcium in numerous scientific studies.
• Chromium Picolinate (Nutrition 21) this patented form of chromium has been demonstrated to support healthy blood sugar and cholesterol levels, and help maintain lean body mass.
• Natural forms of vitamin D, vitamin E and Beta-carotene natural forms are the best absorbed and utilized by the body. We use only water-miscible fat-soluble vitamins.
• Citrus Fruit Peel Extract and Citrus Bioflavonoids plant antioxidants that support tissue healing.
• Vanadium a trace mineral that may help to support insulin sensitivity.
• CoEnzyme Q10 recognized as an antioxidant that may help to promote cardio vascular health.
• Contains comprehensive B complex.