Razbry's back with labs and questions!

[razbry]

Hello again to all you awesome people...especially those of you who SAVED MY LIFE two years ago! I've been doing pretty good. I recently had some labs done, which indicate I probably should tweak my vits. I'm asking for suggestions from those of you who are experienced. Here are the labs:
WBC: 5.5
RBC 3.45 (L)
Hgb 11.5 (L)
Hct 35.3

Albumin 3.0 (L)
Alk Phos 117 (H)
SGPT 40
SGOT 38
Bili .4
BUN 16
Ca 8.55 (L)
Chloride 104
Creatinine 1.04
Glucose 70
Potassium 4.4
Sodium 138.5
T. Protein 5.6 (L)
Magnesium 2.2
Phosphate 4.3
PTH, Intact 66 (H)
FTSH2 1.63
Vit. D, 25 <4
Vit A 43
Vit B1 16
Vit B12 1842 (H)
Vit B 6 29.6 (H)
Vit E 9
Zinc 68
Copper 77

I also had a 24 hour urine Ca done, which was only described to be as lower than normal.


I had my Dexa Scan and I've moved my spine from osteopenia to normal, my femoral neck is still in Osteoporosis BMD .57 and my Total Femoral still in Osteoporosis BMD .66 (the femoral neck and total however are improved over two years ago).


This is what I'm taking:

Prescription Medication/Vitamins & Minerals

Prescription

• Levothyroxine 212 mg (1/day) (mornings – 30 minutes – no food)
• Lansoprazole (Prevacid) 30 mg (1/day)
• Sertralin HCL (Zoloft) 250 mg (1/night)
• Lorasepam .5 mg (1/night) Also, up to .5 mg Lorasapam/during the day as needed (not used very much)

Schedule

Upon rising

1 Levothyroxine 212 mg
(No food for ½ hr)

Early Morning

1 Copper 5 mg
1 Strontium 300 mg

Mid Day

1 Lansoprazole 30mg
1 Vit. A-25,000IU
1 Stress B-50
1 Vit B12 5,000mcg rapid dissolve (every other day)
1 D3 50,000 IU
1 Vit. E 400IU
2 Calcium Citrate*
1 Multi Vit. - Centrum
1 Zinc 50mg

Evening

2 Vit A 25,000IU
1 Vit C. 1,000 mg
1 D3 50,000 IU
1 Vit. E 400IU1
2 Calcium Citrate*
1 Zinc 50mg
1 Folic Acid 5 mg

Bed Time

2 Calcium Citrate *
1 Vit A 25,000IU
1 Magnesium Citrate
1 Vit. K1 1,000 mcg
1 Vit. E 400IU1
1 Boron 3 mg
Sertraline HCL (Zoloft) (250 mg)
Lorasepam (.5 mg)

*Each cap contains 300mg of elemental Ca

1 protein (whey) shake/day (30 grams protein each)
Syntrax Nectar:

(I don't take Iron...it makes me sick. I have had Iron infusions in the past)

My MD recently prescribed Calcitrol. The only thing I've noticed is that I have had increased bowel movements (at night) and a weight loss of about 4 lbs. I'm nearing the end of my 30 day trial before Ca levels are rechecked. I've also requested that the MD add on Iron/Binding, Vit. K1, Selenium and osteocalcin..

So tell me any thoughts that come to mind...but this is what I'm hoping for:

* Suggested tweaks to my vits. Am I putting my vits together right?
* Thoughts on Calcitrol
* Thought about bone building meds. I know my MD is going to press me to do something.
* Am I missing any vital labs?
* Should I take more protein?
* Any thoughts on long term use of Lansoprazole? I've had 3 endoscopes...so far, so good.

I'm 5'6" 125 lbs Age: 60 Coming up on 13 years post op. duodenal switch biliopancreatic bypass

This past winter I went up to about 145lbs...this current weight loss (gradual over the summer) concerns me (Can you believe it? Life is weird). I'm also having some muscle twitching and "pulls". I'm thinking about upping my Magnesium.

Thank you to anyone who responds. Your thoughts are probably much more enlightened than my MD.

[newyorkbitch]

Where is your ferritin, TIBC?

You need more calcium.

You need to eat more protein.

[razbry]

My MD "forgot" to order those tests, so I'm going in to get them done next week. Could you be more specific about how much more Ca I need and when I should take it? Thanks

[newyorkbitch]

Take Citracal Max, 2 tabs 4 x per day

That's 2520 mg per day

[Simba]

Dec 2, 2014 21:32:07 GMT -5 razbry said:

Hello again to all you awesome people...especially those of you who SAVED MY LIFE two years ago! I've been doing pretty good. I recently had some labs done, which indicate I probably should tweak my vits. I'm asking for suggestions from those of you who are experienced. Here are the labs:
WBC: 5.5
RBC 3.45 (L)
Hgb 11.5 (L)
Hct 35.3

Albumin 3.0 (L)
Alk Phos 117 (H)
SGPT 40
SGOT 38
Bili .4
BUN 16
Ca 8.55 (L)
Chloride 104
Creatinine 1.04
Glucose 70
Potassium 4.4
Sodium 138.5
T. Protein 5.6 (L)
Magnesium 2.2
Phosphate 4.3
PTH, Intact 66 (H)
FTSH2 1.63
Vit. D, 25 <4
Vit A 43
Vit B1 16
Vit B12 1842 (H)
Vit B 6 29.6 (H)
Vit E 9
Zinc 68
Copper 77

I also had a 24 hour urine Ca done, which was only described to be as lower than normal.


I had my Dexa Scan and I've moved my spine from osteopenia to normal, my femoral neck is still in Osteoporosis BMD .57 and my Total Femoral still in Osteoporosis BMD .66 (the femoral neck and total however are improved over two years ago).


This is what I'm taking:

Prescription Medication/Vitamins & Minerals

Prescription

• Levothyroxine 212 mg (1/day) (mornings – 30 minutes – no food)
• Lansoprazole (Prevacid) 30 mg (1/day)
• Sertralin HCL (Zoloft) 250 mg (1/night)
• Lorasepam .5 mg (1/night) Also, up to .5 mg Lorasapam/during the day as needed (not used very much)

Schedule

Upon rising

1 Levothyroxine 212 mg
(No food for ½ hr)

Early Morning

1 Copper 5 mg
1 Strontium 300 mg

Mid Day

1 Lansoprazole 30mg
1 Vit. A-25,000IU
1 Stress B-50
1 Vit B12 5,000mcg rapid dissolve (every other day)
1 D3 50,000 IU
1 Vit. E 400IU
2 Calcium Citrate*
1 Multi Vit. - Centrum
1 Zinc 50mg

Evening

2 Vit A 25,000IU
1 Vit C. 1,000 mg
1 D3 50,000 IU
1 Vit. E 400IU1
2 Calcium Citrate*
1 Zinc 50mg
1 Folic Acid 5 mg

Bed Time

2 Calcium Citrate *
1 Vit A 25,000IU
1 Magnesium Citrate
1 Vit. K1 1,000 mcg
1 Vit. E 400IU1
1 Boron 3 mg
Sertraline HCL (Zoloft) (250 mg)
Lorasepam (.5 mg)

*Each cap contains 300mg of elemental Ca

1 protein (whey) shake/day (30 grams protein each)
Syntrax Nectar:

(I don't take Iron...it makes me sick. I have had Iron infusions in the past)

My MD recently prescribed Calcitrol. The only thing I've noticed is that I have had increased bowel movements (at night) and a weight loss of about 4 lbs. I'm nearing the end of my 30 day trial before Ca levels are rechecked. I've also requested that the MD add on Iron/Binding, Vit. K1, Selenium and osteocalcin..

So tell me any thoughts that come to mind...but this is what I'm hoping for:

* Suggested tweaks to my vits. Am I putting my vits together right?
* Thoughts on Calcitrol
* Thought about bone building meds. I know my MD is going to press me to do something.
* Am I missing any vital labs?
* Should I take more protein?
* Any thoughts on long term use of Lansoprazole? I've had 3 endoscopes...so far, so good.

I'm 5'6" 125 lbs Age: 60 Coming up on 13 years post op. duodenal switch biliopancreatic bypass

This past winter I went up to about 145lbs...this current weight loss (gradual over the summer) concerns me (Can you believe it? Life is weird). I'm also having some muscle twitching and "pulls". I'm thinking about upping my Magnesium.

Thank you to anyone who responds. Your thoughts are probably much more enlightened than my MD.

13 yrs PO that is great, congrats
-Get rid of your B-50 everyday or do take 1/2 a day
-with your thyrorid medication you need a Fe panel (Fe, ferritin, TIBC, %Sat) as thyroid medication is not absorbed correctly in anemic patients, with your H&H on the lower end you need Fe either RX proferrin forte or infusions, as you know both Fe and Ca interfer with thyroid medication, caution here, for non DSers the time is 4 hours apart of Ca and Fe for thyroid medication or you would have to titrate accordingly, I had a thyroidectomy 1 year PO, DS, and I take my Ca or Fe 2 hours apart from my thyroid RX and 2 hours apart from each other since as a DSer we have a short gut.
-I dont see a prealbumin, but your albumin and TP are low, you need to consume more protein if you cant get in more with food, take in a couple more of good protein shakes a day
-Is your Vit D below detectable range? or is that a typo? did you have a 25 OH Vit D?
-as a dser you should have a 24 hr urine for stone risk analysis
-yes you need a Vit K1 ordered
-your Ca is low add more Ca citrate, you can consume ca citrate on an empty stomach, with food etc, try to get in 1-2 more batches a day
-your 24 hr Ca is low, with your low serum Ca, and your high intact PTH you really need an ionized Ca, i will assume you see an endo who RX's your calcitriol, minimally you need a 24 hr creatine also with your 24 hr urine Ca
-with your issues I would also ask for osteocalcin, bone specific alk phos, c-teleopeptide and n-teleopeptide
hope you are feeling better soon, run that by your dr and see what s/he thinks so you can work together

[razbry]

Simba...thank you so much. What an excellent response. I'm taking it to heart. Any other thoughts from the rest of you?

[razbry]

Hi Again to Simba. I'm seeing my MD with your list of suggested tests. I did have a "full" Vit. D test done.
< 4 Vit D,25-)H, D2
62 Vit. D 25-OH, D3
62 Vit. D, 25-OH, Total (normal range (30-100)

To me it looks like I'm getting enough Vit D, and I don't need the Calcitrol (which according to literature is like Vit D).

I'm not seeing an endo. Would you recommend it? My MD has been pretty careful in monitoring my Thyroid meds.

I've already upped my Ca and protein and downsized my vit B. I'm hoping that my bones will improve, my weight loss slide will end, and I will feel a little stronger. Perhaps (when I get my Fe levels) I'll get a infusion or meds for that.

Anyway, thank you again. So so appreciate the time you took to help me.

[Simba]

hello razby,

if you have a question specifically for me please pm me or I will miss it, I sent you a PM as this was reading like war and peace.

[razbry]

OK. I just wanted to share my latest adjustments to my vit/mineral intake. It helps me stay focused and perhaps it will help someone else.

Schedule

Middle of the night
1 Levothyroxine 212 mg (prescription)
(No food for ½ hr)
1 Vit. K1 1,000 mcg
1 Vit. K2 (MK7) 150 mcg

Middle of the night
1 Copper 5 mg
1 Strontium 300 mg

Early Morning
2 Calcium Citrate*
1 Vit. A-25,000 IU
1 Vit. E 400 IU
1 D3 50,000 IU
1 Stress B-50 (Every other day)**
1 Vit B12 5,000mcg rapid dissolve (Every other day)
1 Multi Vit. - Centrum Silver
1 Lansoprazole 30 mg (prescription)

Fit In
2 Calcium Citrate*

Early Evening
2 Calcium Citrate*
1 Zinc 50 mg
2 Vit A 25,000 IU
1 Vit. E 400 IU
1 D3 50,000 IU
2 Vit C. 500 mg each
1 Folic Acid 5 mg
1 Magnesium Citrate 500mg

Fit In
2 Calcium Citrate*

Bed Time
2 Calcium Citrate *
1 Zinc 50 mg
1 Vit A 25,000 IU
1 Vit. E 400 IU
1 Boron 3 mg
1 Calcitrol .25 mcg


*Each cap contains 300mg of elemental Ca

**Stress B-50:
• Thiamine HCL 50mg
• Riboflavin 50mg
• Niacin 75mg
• Vit B6 50mg
• Folic Acid 2,000mcg
• Vit B12 100mcg
• Biotin 500mcg
• Pantothenic Acid 50mg

2 protein (whey) shakes/day (30 grams protein each) Total Protein intake (includes food) 80 – 120 grams







Total Daily Vitamins/Minerals

• Copper 5 mg
• Zinc 100 mg
• Strongtium 300mg
• Boron 3 mg
• Magnesium 500 mg
• Vit K1 1,000 mcg
• Vit K2 150 mcg
• Calcium 3,000 mg
• D3 100,000 IU
• Vit A 100,000 IU
• Vit C 1,000 mg
• Vit E 1,200 IU
• Vit. B 12 2,250 mcg
• Vit B6 25 mg
• Folic Acid 5 mg
• Thiamin HCL 25 mg
• Riboflavin 25 mg
• Niacin 35 mg
• Biotin 250 mcg
• Pantothenic Acid 25 mg

Plus one Centrum Silver Multivitamin

Read more: weightlosssurgery.proboards.com/conversation/45401?page=1#ixzz3O9WB31va

[newyorkbitch]

You need to make sure your protein is 120g minimum every single day.

[razbry]

Thanks NYB. I'm working hard at it. I've also become very organized. I have all my protein/vit/mineral info in binders for easy reference, and all my labs have been logged on my computer. I want to stay focused this New Year...and beyond!