Lab pros needed!

I'm new at the whole labs thing so I could use some educated eyes looking at my lab results...please. :)

I'm about 4 months out and these are my 3 month results.  I've copied & pasted b/c that's all I knew how to do.  Hope this is legible. 

Oh...and my A, E & K results are all pending still.

Here goes...

		Before DS		Post-DS
	Ref range	DATE		DATE
CALCIUM-RELATED		4/18/11		8/17/11
PTH, intact	10-65
Calcium	8.5-10.4	9.2		9.1
Vitamin D, 25-hydroxy	32-100	19		25
Osteocalcin	4.9-30.9
IRON
Iron, Total	35-175	40		36
Iron, binding capacity	250-400	344		328
Iron, % saturation	15-50	12		11
Ferritin, Serum	10-291	37		36
VITAMINS/MINERALS
Folic Acid	> or = 3.1			9.6
Serum Folate	>5.4	>20
Carnitine, total	31-67
Carnitine, free	25-55
Carnitine, esters	3.8-19
Amylase	21-101
Copper	70-155
Magnesium	1.5-2.5
Phosphorus	2.5-4.5
Selenium	110-160
Zinc, P	60-130			65
Vitamin A	38-98	65
Vitamin B1, Thiamine	87-280	107
Vitamin B6, plasma	2-26
Vitamin B12	200-1100	220		1978
Vitamin D, 25-hydroxy	32-100	19		25
Vitamin E	3-15.8
Vitamin K1	.28-1.78
LIPID PANEL
Triglycerides

So it won't let me copy & paste the rest for some reason.  I'm typing out the rest...

Lipid Panel
Triglycerides              167    89
Cholesterol, total      172   133
HDL Cholesterol         31     38
VLDL Cholesterol                 18
LDL Cholesterol         108    77
Chol/HDLC ratio                   3.5

Renal Panel
Glucose                         96     95
Urea Nitrogen (BUN)  11       
Creatinine                       .8     .74
BUN/Creatinine ratio              10
Soduim                          137   141
Potassium                      3.9    3.7
Chloride                         101    107
Carbon Dioxide              27       26
Albumin                            3.7    4.1
Globulin
Albumin/Globulin ratio

Hepatic Function
Protein, total                   7.2     6.5
Bilirubin, total                   .6       .7
Alkaline Phosphotase  76       98
AST                                   20       37
ALT                                    21      66

CBC
White blood cell count     9         8   
Red blood cell count    4.38     4.59
Hemoglobin                   11.5     11.9
Hematocrit                       38       40.8
MCV                                   87       88.9
MCH                                 26.3     25.9
MCHC                              30.2     29.2
RDW                                14.4      16.9
Platelet Count                 327      303
Absolute Neutrophils                  4.8
Absolute Lymphcytes                  2.7
Absolute Monocytes                      .4
Absolute Eosiniphils                     .1
Absolute Basophils                        0
%Neutrophils                                 60
%Lymphcytes                                 34
%Monocytes                                     5
%Eosiniphils                                    1
%Basophils                                      0

Other
TSH                                2.31         4.112
A1c                                                   5.5
PreAlbumin
MMA
LDH
UIBC
Cortisol
C Reactive Protein
Homocysteine
PTH Intact Calcium
Creatinine

So...my B12.  Can that be right?!!  How is it so high?  Should I move down to 1 suplingual a day or should I cut it out altogether?

I'm taking Proferrin for my Iron & I'm taking it twice a day; once in the morning with my other morning vites (multi, calcium, A, etc) and once at bed time.  I am breaking it in half before swallowing.  Any advice on this?

I have been taking 1 50,000IU dry D3 a day.  I will be upping it to 2 a day.  I'm taking one with my lunch vites.  Is it ok to take my other dose at bedtime with my Proferrin?

What else do you see?

Thanks SO MUCH for your help!  :)

Are you following Vitalady's basic plan except for the Proferrin?

--gina

Yes. :)

What I would do if these were my labs:

Take the B12 5 days a week instead of 7.

Keep going with everything else on the basic plan plus and additional D3 for 3 months and see if they'll retest D. If it's up near 100 on the next labs, cut back on the D3 to 50,000IUs a day.

If vitamin A comes back near the top of the range, cut back to 75,000IUs and if it holds at the top of the range on 75,000 for 6 months, cut back to 50,000 and so on until 25,000IUs a day holds steady.

I would start drinking low sodium V8 to pull the potassium up a bit and talk to the doc or dietitian about it.

Milk thistle might help the liver enzymes come down. I currently take 600mg a day.

I would take the Proferrin away from other vitamins and minerals to give it the best chance to absorb and I'd take both pills together.

--gina

Good morning Kathy, I am pretty new at this myself but I can offer some suggestions.

How many mg of Calcium are you taking a day?  I see you mention adding another 50k D3, which is good because 25 is pretty low, and increasing your D3 will help your calcium since it's 'trending' down.  I don't really like to say trending down without at least three data points, but it is down from your pre-DS labs.

Your Iron looks OK but not super.  I know a bit about iron, hopefully someone will add more info then I have.  First your Total Iron is low, generally I try to aim for the median in the range of the listed reference range.  Your total iron is 36 when the median would be closer to 105.  You may want to add another proferrin tab in the morning since you're taking one at lunch and at night.

Also, are you eating enough red meat?  I read the redder the meat the more Heme iron is in it, which is more of what our bodies need.  Iron from plants is good too, but not the best.

Lastly on the iron subject, I don't know if this is possible for you, but maybe you could try a different type of iron, or in the morning try one type of iron (Ferrus Sulfate or something) and then keep the proferrin for noon/night.

Oh, make sure you are taking the right dose.  Lots of times packages state two tablets per dose - If you think you're taking a whole dose when you take one tablet you're only getting half as much as you think you are.

I see your Zinc is low, you may want to supplement that, or further supplement it.

Your B12 is high, I don't know if that's good or bad, you could drop down to 1.5 doses a day, rather than two.

Your protein looks good (Albumin).

Past that I don't know.. I hope this helped.  If I misspoke someone please correct me!
Justin

Would 5000u sublingual vit D3 be similar to 50000u vit D oral?

I read that oral vitamins are less bioavailable at 20% versus 50% sublingual.  Would you recommend oral as well as sublingual?

I take 5000u sublingually.