my 6 month bloodwork

So, apparently my 6 month surgiversary was on Sunday and I completely missed it. LMAO!! If it wasn't for Jena sending me a text on Monday, it would have totally passed me by.  

Anyway, I got the results of my blood work and all the levels look good for the most part.  I go to the surgeon for my 6 month follow up next Thursday so we will discuss it all then.  BUT, I would like to share with you all and get opinions on the results and what I should do for some of them.

I was going to try to scan it and copy it into this message, but I'm not sure if I can convert it into word or excel.. anyone know how to do it?  It is a jpg. 

Anywho.. here's a run down. 

       Iron, total  92
       iron binding capacity   230--this says it's out of range (250-450 mcg/dL)  so what does this
                     mean to me?
      % saturation   40

comprehensive metabolic panel w/egfr
      glucose    89
      urea nitrogen (BUN) 11
      creatinine 0.61
      eGFR NON-AFR. American >60
      sodium 141
      potassium 4.2
      chloride 107
      carbon dioxide 25
      calcium 9.1
      protein, total 6.6
      albumin 4.2
      globulin 2.4
      albumin/globulin ratio 1.8
      bilirubin, total 0.5
      alkaline phosphatase 67
      ast 13
      alt 18
      vitamin B1, whole blood 128
      vitamin B6--pending still

CBC
      WBC 6.3
      RBC 3.78 says out of range (3.80-5.10 million/uL)-- my step mom said that as long as my
               hemoglobin and hematocrit numbers were ok, I don't need to worry about this..YES or NO?
      Hemoglobin  12.5
     Hematocrit 36.5
MCV 96.5
MCH 33.0
MCHC 34.2
RDW 13
PLATELET COUNT 207
absolute neurtophils 3906
absolute lymphocytes 1865
absolute monocytes 460
absolute eosinophils 25
absolute basophils 25
neutrophils 62.
lymphocytes 29.6
monocytes 7.3
eosinophils 0.7
basophils 0.4

vitamin D, 25-hydroxy, lc/ms/ms
vitamin D, 25 OH, total 35
vitamin D, 25 OH, D3 35
vitamin D, 25 OH, D2 <4
   There is a note here saying 25-OHD3 indicates both endogenous production and supplementation. 25-OHD2 is an indicator of exogenous sources such as diet or supplementation.  Therapy is based on measurement of Total 25-OHD, with levels <20 ng/ML indicative of Vitamin D deficiency, while levels between 20 ng/mL and 30 ng/ML suggest insufficiency. Optimal levels are <30 ng/ML       Does this mean I need more D?

Vitamin B12 364
   Note says: Although the reference range for vitamin b12 is 200-1100 PG/ML, it has been reported that between 5 and 10% of patients with values between 200 and 400 PG/ML may experience neuropsychiatric and hematologic abnormalities due to occult b12 deficiency; less than 1% of patients with values above 400 PG/ML will have symptoms. 
                Think I need to up my B12???

Thanks for all of your insight on my numbers.  I can't believe it's been 6 months!

Look good!! I was told that my B12 should be at LEAST 700 from Dr Brader so I would up your B12 a bit - but of course ask your surgeon first - my PCP was quite happy with a 300 and Dr BRader doubled my dose... AS far as teh RBC and Binding capacity maybe Pam or Jodi will have better insight into that. You can also e-mail them to Shauna (or bring a copy on saturday is probably your best bet) she is a whiz with labs.

Congrats on your 6 month anniversary too!

Thanks Liz.. I will put them in my bag with my PC stuff and bring them on Saturday too.. I see the surgeon on Thursday so we will discuss as well.  I know the B12 will need to be upped.

Total Iron Binding Capacity (TIBC) means you could become anemic....considering your Hemoglobin/hematocrit (H&H) is ok, it is ok for right now, in my opinion (I had a low TIBC sometimes too)  My surgeon suggested adding more red meat to help - and it did.

I have absolutely no idea about the whole vitamin D thing....mine wasn't tested and it's not something I'm "used to" looking at and analyzing for work and such....so can't help ya there

b12 - yes...I think you do need to up your b12.  How much and what kind are you taking a day?  You can't get "to much" b12 because whatever you don't use, you will excrete - it is safe for the body.  However,  when mine is way high (like over 1000) I notice I can't sleep.  And b12 has is used for "energy" so it makes sense to me that when it's high...I'm bouncy LOL  I know I've seen someone post that their surgeon said they want it over 500?  I could be makng that number up.  Make sure you are getting SUBLINGUAL b12.  We don't absorb the regular pills.

There's also a type of anemia called pernicious anemia which deals with the whole b12 thing...people are misdiagnosed (or rather, UNdiagnosed) with this because your H&H can stay "normal" and yet you are anemic due to the b12 thing.  But I don't think you are in a danger spot right now - definately go over it with your surgeon and don't just take my word for it by any means!

Oh - and b12 is also found in animal meat and such...so while you are upping your red meat intake for the iron...you may be able to eeek out a little more b12 as well.  But, again...the whole reason for supplementation for us w/ b12 is because we don't absorb it well through our intestines.

Congrats on your six months!  I can't believe how far you have come so quickly!!  You are doing a PHENOMENAL job!!!

OP...everything looks good, but like Pam said, you can up the B12.  Congrats. 

My B12 was low as well this time around.  And I have always taken more than she prescribed.
So now she has upped my oral and I get B12 shots every two weeks.

I also eat a lot of turkey, have added liver 3x per month...and I also take a liquid sublingual B12/B Complex.

Anyway...thanks for the advice Pam.  how are you?

Thanks for the great advice nurse Pam!! I currently only take a high potency B-Complex with Folic Acid plus Vitamin C. (as far as the B goes.. I take LOTS of other vitamins including a multi)  I was just told to get the B-complex.  It has only 10 mcg of B12, so I guess that's the problem.  I will add a sublingual B12.  I was always wondering/thinking that I wasn't getting in enough B12, especially given the amount I exercise.

Guess the steak I had planned for tonight is a really good idea.  I know I need to add more animal protein to my diet.

just as a reference I take 5000mcg B12 sublingual daily... lol

If the b complex is anything but sublingual...it's  not doing any good for you as far as the b12 is concerned (b1, however, we can absorb via regular pill form) so I would definately look into that.  They can be tricky to find in sublingual - although I have now been able to find them at Giant just recently and I think I have found them at Walgreens as well.  And GNC definately has their own brand, that's what I used to get first out.

I was originally told 1000mcg sublingual a day.  I then started to take it every other day when my levels were high and I wasn't sleeping.  The last time I ran out, I could only find 5000mcg sublingual - so I took that 2-3x a week.  I haven't had labs done since my one year...but plan to in the next coming months.

Just to add my 2 cents worth I take 2500 mg of B12 daily and have never had a problem with my levels - you have to look for them, tho, because sometimes that dosage is hard to find. But again check with your surgeon first, of course. When I had that lousy cold last week I actually doubled my B12 for those few days and I do think it helped with my energy level and to start feeling better sooner...

I can use all the cents I can get.. thanks for your input!!