Pre-Op Surgery Update(jejunojejunostomy)

As promised - new update....

My primary care physician cleared me this morning for my jejunojejunostomy surgery but I still need to be cleared by my endocrinologist. My PTH was extremely high 30 days ago when I saw my bariatric surgeon. I increased my vit D intake to D3-50 50,000 units twice daily in hopes of lowering my PTH. I just got my new labs back. Everything looks great with the exception of my PTH level. Instead of decreasing, it increased. I'm confused and a bit concerned.

Do you think having a high PTH will prevent clearance from my endocrinologist?
Any suggestions on how to lower my PTH?

Thanks for any insight.

How many times a day are you taking calcium? What version of calcium are you taking?

Where you your vitamin D falling? Most people here try to keep it in the high average range. You have to take calcium citrate in addition to D.

Do you add in Magensium Citrate? (not oxide)

Good Morning Scottie:

I'm pleased to get your response and bit of wisdom.

I'm taking 2 calcium citrate 300mg twice daily. I didn't think to increase the normal dosage. I thought my focus just needed to be on Vit D to lower the PTH.

Note: normal labs show my Vit D level low.

I usually take 2 magnesium citrates at 150mg before bed daily but must confess, I haven't been consistent since I refocused on PTH and started prepping for surgery.

Do you think high PTH affects the safety of surgery?

Not sure about the safety of the surgery- That is a medical question.

What I would say is that you probably need to take more calcium citrate. Most people on here take 3 doses a day.

Do you take K2? K2 helps your body absorb calcium.

I can definitely do 3 times a day with the calcium citrate. I only take K1 as suggested by my nutritionist. I'll ask about the possibility of k2. I didn't realize it would help absorb calcium. Apparently I need as much of that as I can get. ?

High PTH is pretty serious. It can mean chronic kidney issues, a parathyroid tumor, cancer etc. -- but with malabsorption WLS, it often indicates that your body is leeching calcium from your bones. This is very dangerous, unless one likes the idea of osteoporosis.

The ASBMS recommends a minimum of 1500 mg of calcium citrate a day for life after a RNY -- to be adjusted by labs and DXA bone scans. I do not remember the amounts for a DS -- but I would have to believe due to increased malabsorption, it would be more. Certainly 600 mg a day -- that you aren't even taking religiously, is clearly not enough. Also, the dosages need to be divided as the body cannot absorb all of it at one time. Most people take 500 mg three times a day to account for this.

I would talk to your doctor about increasing your calcium citrate intake to improve your PTH levels. It's possible, even likely, that is the cause of your PTH issue.

Thanks Kat - great points. I'm on it......?

It's not really an issue for surgery unless they do further testing and see any severe osteo issues.

It's not just Vitamin D for PTH it is a whole range of things but you might focus on more calcium and magnesium. Maybe add K2. It might be an indication that you are leaching calcium from your bones as opposed to from supplements/food.

Maybe switch your calcium type to something like Bone up from Jarrow.

Pete

Thanks Pete

I'll look into it this weekend. I see the endocrinologist on Monday. ?