Vitamin & lab advice needed

Hi everyone! It's been 4 years since I had the DS and I recently just went in for my lab work.  I'm hoping to get some advice from the vets here.  Everything looks pretty good to me, but I did note that my Osteocalin was a bit low.  How can I make sure that my bones and bone density continue to be good? I'm only 27 and I'm concerned that I might have to deal with bone issues earlier than I'd like. I take 12 Citracal petites a day. I've seen some talk on her about a DEXA scan - would insurance even cover this for me since I'm only 27? They denied the Osteocalin lab saying it was investigational.

I didn't see a result on my labs for Vit K - am I overlooking it? 

Do you take just K1, K2 or both? I currently only take K1 and I'm curious if I should be taking K2 as well.

Thanks everyone for any help!

https://docs.google.com/file/d/0B2Bt4HyCaev1RlFXS2lpZXM1X1k

Insurance usually covers labs if they are coded properly. They might even cover the osteocalin if your doctor resubmits it with a different code. 

They should cover dexa scans every other year since you are at high risk for bone loss. Your surgery program should help figure out how to submit it properly, PCPs aren't as well versed in that aspect.

K is not tested very often, partly because k is one of the few vitamins absorbed in the large intestine. I insisted on having mine checked and it was low, and so can hinder calcium absorption, just as low D can. Ask them specifically to test for it.

Was your pth high? If so, it means you are leaching calcium from your bones, which is further proof you need your vitamin k checked and dexa scan.

K is not very common. K2 is better, but most is packed in oil, which you won't absorb as well. Vitalady has a dry K if you need it.

K2 can help calcium absorption. Here is a random article that explains a little bit about it. I'm not
completely sold but if your OK with the cost (higher than regular K) it seems like it could help.

http://articles.mercola.com/sites/articles/archive/2012/12/16/vitamin-k2.aspx

You might have to appeal if your insurance company won't cover a Dexa scan but it should be only a
matter of showing your DS puts you at risk of calcium deficiency.

Lower is better for osteocalcin as long as you're still within range. It's like PTH in that lower is better for PTH as well. I take vitamin K2 and my dietitian watches my osteocalcin. We think we found the sweet spot for me; I take 2 of Vitalady's 150mcg capsules in the morning with my vitamins and 2 in the evenings. I've brought my dexa scan up from osteoporosis to osteopenia.and need to get another scan soon to see where I am. Take a look at Vitalady's web site. The capsules are dry not oil based and very tiny.

--gina

I can't open your google file with your blood work so I will answer just your post...

Osteocalcin is a bone marker, bone formation, is should be low, if increase you could have increase bone formation, turnover.  It is also Vit K dependent, so you should get your Vit K tested, not a usual deficiency but you should check it.  My Vit K was below detection, and I was severely deficient.  (this was not due to the DS, as it was before, with the band, yes I was malnutritioned with the band).  Osteocalcin is NOT investigational and is a bone marker.

Age is not a restriction for DEXA, check with your insurance.  I have one every 12 months for years.  I am chemically sterilized so I have not had my period in 10 years.   Every one of my bone markers are abnormal yes all 5 specific bone markers, but I am a high risk for osteoporosis, my DEXA is abnormal, both parents osteoporosis, white female, thin  there are women in their 20's who due to CA etc are in premature menopause, and DEXA is paid for them, so age is not the issue, it has to be medically necessary.  What i can tell you, your bone markers,  will be positive years before your DEXA, but most drs including endos don't even know what they are, forget about ordering them....

I was just looking at your labs. Looks like you could take a magnesium citrate with every calcium dose and increase that calcium to 6 - 600mg doses a day. You could add the vitamin K2 as well. Increase the calcium to bring that number down a bit--sounds wonky but that's the way it works. I didn't see a PTH level.

If you are taking B-complex I think you can stop or cut back to one a month. You could get a separate B1 capsule and take it every other day to keep it where it's at.

Otherwise, things look pretty good. 

Gina - I could be totally off from what you are getting at but is this about what you are saying? I'm having a hard time trying to figure out where to fit in this K2. Any help is greatly appreciated! 

1st:

3 tender iron 150mg

2 vitamin c 1000mg

2nd:

3 calcium 200 mg

1 vitamin A 25000 iu

1 magnesium citrate

1 vitamin k1 1000mcg

1 vitamin k2 150 mcg

3rd:

2 proferrin

3 calcium 200 mg

2 vitamin A 25000 iu

3 vitamin D3 50000 iu

2 vitamin E 400 iu

1 multivitamin

1 zinc 50 mg

1 biotin 1000mcg

(B-complex once a month)

4th:

3 calcium 200 mg

1 magnesium citrate

1 vitamin k1 1000mcg

1 vitamin k2 150 mcg

5th:

3 calcium 200 mg

1 magnesium citrate

6th:

3 calcium 200 mg

1 magnesium citrate

7th:

3 calcium 200 mg

1 magnesium citrate

Thanks everyone for the help and advice! I’m going to have to check with my doctor about the PTH and K tests because I know they were on my order.  I’m also going to check with my surgeon about the DEXA scan.