Some Labs - Your Feedback Appreciated!

[OnMyWay2Thin]

Hello,

This past week I went to my endocrinologist for my thyroid check and he did some labs. This isn't a complete DS lab list but I'm low on some things and would appreciate your suggestions. I go for my DS lab work at my surgeon's in October and am hoping to improve this by then. Here are my results:

Cholesterol, total 171, normal 125-200
HDL cholesterol. 40 low, normal > or = 46
Triglycerides. 134, normal < 150
LDL-cholesterol. 104, normal < 130

CHOL/HDLC ratio. 4.3, normal <5.0
Non-HDL cholesterol. 131

Glucose. 90, normal 65-99
Urea nitrogen, 18, normal 7-25
Creatinine, .53, normal .50-1.10
eGFR non-afr American. 114, normal >60
eGFR African American. 132, normal >60
Sodium, 140, normal 135-146
Potassium, 3.1 low, normal 3.5-5.3
Chloride. 102, normal 98-110
Carbon dioxide. 22, normal 19-30
Calcium. 8.4 low, normal 8.6-10.2
Protein. 6.6, normal 6.1-8.1
Albumin. 4.1, normal 3.6-5.1
Globulin. 2.5, normal 1.9-3.7
Albumin/globulin ratio. 1.6, normal 1.0-2.5
Bilirubin total. .4, normal .2-1.2
Alkaline phosphatase. 52, normal 33-115
AST. 20, Norma l 6-29
ALT. 30 high, normal 6-29

HemoglobinA1c. 5.4, normal <5.7 (I am diabetic, does this number mean I am not anymore?)

TSH. 2.44

T4 (thyroxine) total. 6.2, normal 4.5-12.0
Free t4 index. 2.0, 1.4-3.8
T3 uptake. 32, normal 22-35

White blood cell count. 9.4, normal 3.8-10.8
Red blood cell count. 4.16, normal 3.8-5.1
Hemoglobin. 12.3, normal 11.7-15.5
Hematocrit. 38.1, normal 35-45
MCV. 91.5, normal 80-100
MCH, 29.5, normal 27-33
MCHC. 32.3, normal 32-36
RDW. 15.7 high, normal 11-15
Platelet count. 283, normal 140-400

Iron total. 30 low, normal 40-190
Iron binding capacity. 247 low, normal 250-450
% saturation. 12, normal 11-50

Pending tests are Ferritin, vitamin b-12, and FSH

I'm not sure how much or what type to take of the items I'm low on. I'm also not sure what to do about high levels. I should add, I'm still tired and get weak sometimes standing for too long; I've chalked it up to surgery only being 2 months and a week ago and recovering. Any help would be greatly appreciated!

Thanks,
Kelly

[newyorkbitch]

Was this blood drawn on day 3 of your menstrual cycle? I ask because of the FSH...

[newyorkbitch]

What about PTH? And pre albumin?

[kyal]

Your iron is low and will continue to fall. Are you supplementing? You will likely need an infusion so time to start researching hematologists.

Your calcium is low and without testing parathyroid hormone it's difficult to say why. It is of concern however, particularly if it continues to fall.

No Vit A and D results. These are two of the most important tests for a post op DS patient, along with Iron and PTH.

Your HbA1c looks promising. You may not be diabetic anymore. That's a discussion for your doctor however.

Nothing else stands out as abnormal but I'm sure others will comment as well.

[OnMyWay2Thin]

Thanks for the feedback and questions.

NYB, no, I did not have my period at the time, probably this week. Because it was for my thyroid, I didn't tell him what to test. My DS bloodwork is actually next month. I was just hoping to get a jump on bringing the low numbers up.

Kylal, my surgeon had said to wait for labs to supplement iron. I had been constipated and received iron IV in the hospital so I guess he thought it would be okay. I started iron last night. My full bloodwork is next month so I'm sure the surgeon will test the additional important ones at that time (I'll make sure!)

Thanks,
Kelly

[newyorkbitch]

FSH is follicle stimulating hormone. It must be taken on day 3 of your cycle. It's an indicator of fertility.

[kyal]

Ensure you get calcium repeated and PTH. Also A, D and zinc.

If you were iron deficient before surgery it's not rocket science that you will be even more deficient after.

Who is your surgeon? Most of them aren't amazing with the nutritional/lab advice.

[OnMyWay2Thin]

Actually, it was TSH that was taken, not FSH, that might explain why it wasn't day 3. Does this help, NYB?

Kyal, I'll get calcium repeated and the others taken. How much calcium should I be taking? I was iron deficient before so that makes sense. Surgeon is Dr. David Greenbaum. I just want to get my numbers right!

Do you think these low numbers are contributing to my low energy level and leg weakness?

Thanks!

[kyal]

The iron deficiency can certainly suck the energy out of you. That's where I would start. A lack of vitamin D and B12 are also usual suspects in low energy along with inadequate protein.

You should be taking 2000mg of calcium which is twice the daily recommendation.

What supplements are you taking? Can you list them and dosages so we can see what your taking and give you some recommendations?

[OnMyWay2Thin]

Thanks, Kyal and NYB. Just got in the additional labs.

Ferritin is 207, normal is 10-232
Vitamin B12 is high at 1903, normal is 200-1100
FSH is 5.1, normal for all phases it says (follicular, mid-cycle, and luteal) Not even sure what this means!

Kyal, I take the following supplements. I know I will need to add dry vitamins after I get those labs back, probably, but I was told to wait until the first set of labs.

Morning
CVS Pharmacy Calcium Citrate + D with Magnesium(contains 500 mg calcium, 250 IU Vitamin D, 80 mg magnesium, 7.5 zinc1 copper, 1 manganese)
Baby Aspirin
Bariatric Advantage Chewable Multi-Formula high in Vitamins A, D, E, and K (contains A 5000 IU, D3 667 IU, E 250 IU, K 60 mcg and many other things)
Omeprazole DR 40 MG
Armour Thyroid 60 mg
B12 sublingual with Folic Acid (should I discontinue this due to the high numbers or perhaps, take every other day?)
Isopure, no carb, ready to drink Grape Frost, contains 40 g protein

Lunch
CVS Pharmacy Calcium Citrate + D with Magnesium(contains 500 mg calcium, 250 IU Vitamin D, 80 mg magnesium, 7.5 zinc1 copper, 1 manganese)
Bariatric Advantage Chewable Multi-Formula high in Vitamins A, D, E, and K (contains A 5000 IU, D3 667 IU, E 250 IU, K 60 mcg and many other things)
Bariatric Advantage Dry Vitamin D (Vitamin D3 5000 IU)

Dinner
CVS Pharmacy Calcium Citrate + D with Magnesium(contains 500 mg calcium, 250 IU Vitamin D, 80 mg magnesium, 7.5 zinc1 copper, 1 manganese)
Bariatric Advantage Chewable Multi-Formula high in Vitamins A, D, E, and K (contains A 5000 IU, D3 667 IU, E 250 IU, K 60 mcg and many other things)
CVS Pharmacy Probiotic (one a day vegetable capsules provides 1 billion CFU)
CVS Pharmacy Biotin 10,000 mcg

Night
Bariatric Advantage Iron Chewy Bite (contains 60 mg Vitamin c, 30 mg Iron, 10 mg sodium)

A couple things, I was taking my Calcium wrong and only corrected it about a month ago, I was taking 1 tablet instead of the two required to make 500, so I was only taking 1/2 a dose. I'm thinking if 2000 is required I need to add another dose. How far apart does calcium need to be taken to get the maximum absorption, is it 1 hour, 2, or 3? Just want to fit it in so it counts. I just added iron two days ago so I'm hoping that will start to raise without infusions. What do you think?

All feedback is appreciated!!

Thanks so much,
Kelly

[newyorkbitch]

FSH Is pretty meaningless unless it is taken on day 3 of your cycle. Are you concerned about your fertility?

[OnMyWay2Thin]

Not really, NYB, I just don't want a beautiful surprise like my sister had at my age. Still trying to figure out best birth control but I wasn't even aware what that was so I wasn't checking it. I like your recommendation you gave me a month ago but my doctor said she is not for the IUD. She didn't elaborate only to say she had seen some bad problems. Thanks for your response, you always give good feedback and thought-provoking questions.

[newyorkbitch]

So use hormonal birth control that is not ingested and is not an IUD. Like nuvaring or DMPA.

[OnMyWay2Thin]

sounds like a plan to me. Does that need a backup method?

[newyorkbitch]

Not in my opinion.

Depo (injected) is very effective, safe, and foolproof.

[PeteA]

Try for 3 hours between calcium doses but really I do anywhere from 2 to 3 depending on my schedule.
I can't remember if I read something to back that up or just did a best fit on my schedule.

[OnMyWay2Thin]

Thanks, NYB and Pete, your help is very much appreciated! I'll try for 3,also!

[kyal]

Using the Bariatric Advantage your A and D may come back deficient or lower than pre op. Did you have baseline labs taken? Look for a trend, if it's lower than last time you'll need more.

It's difficult to separate calcium out for maximum absorbability. You would be taking it just about all day at 3 hourly intervals. I take my calcium four times a day, 3 capsules each time. Breakfast, Lunch, Dinner and before bed. I use Vitacosts Bone Booster which has hydroxyapatite calcium which is a more absorbable form than citrate and contains vitamin D and K.

[Deleted]

I with Kyal, Take more calcium, at least 2 hours apart. I get the bigger calciums, the 630's from walmart. taken 4 times a day. My calcuim was 10.2 ( range 8.6 - 10.4) at my last labs. PTH was 21.

I would dump the bairatric advantage vites and just get a good multivite, like Centrum Silver for women (has iron). Also, The K in the Centrum is high enough if you take two a day. I would add Dry vite A and D. Add E if you tested low. I rarely take any E, and mine has been fine. I'll take the E if I see my skin drying up or starting to flake a bit.

[OnMyWay2Thin]

You guys are the best! I will gladly change vitamins if it will help! Actually, I was just about to reorder the multi so I'll make the switch now!

I did get baselines taken and will compare, great suggestion!

Just what would I do without all of you?!?! Thanks so much.

Kelly