Teeth!!
Well, that is part of the problem. The prescription vitamin D is D2 in oil. D2 must be converted to D3 in the body and it takes a lot of D2 to make a little D3. And after RNY, we malabsorb fats, and oil is a fat, so we don't absorb vitamins in oil well. I bet you'd see a BIG change if you switched to dry D3, which you would absorb a lot better.
You didn't mention how often you take the D2. The prescription D2 is 50,000 IU D2 in oil. I have to take 50,000 IU dry D3 three times a week to keep my level around 100. I'd probably need 10 times that much D2 in oil, so if I took the prescription stuff, I bet I'd have to take 10 of them a week. I bet you aren't taking that much.
I'd switch to dry D3 ASAP. I bet you'll see a huge change in just a couple months.
As far as ferrous sulfate, that's not absorbed real well in RNY folks either because you need a lot of stomach acid to break it down for absorption but we don't have a lot of stomach acid after RNY. We absorb carbonyl iron a lot better. As an added bonus, it's much less likely to cause constipation.
I suspect a great part of your problem is that you are taking forms of vitamins and minerals that simply are not absorbed well in RNY folks.
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Ah, for some reason I thought she was RNY. But still, everyone needs D3, not D2. It's just the oil that doesn't make a difference.
As far as the ferrous sulfate, if she's taking any type of PPI, then she still likely doesn't have enough stomach acid to absorb it well.
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
OK. Well, it is not surprising your vitamin D level is low. If you switch to 50,000 IU D3 and take that a few times a week, I bet your level would be up to 80 in a month or two.
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Is the product you get from the pharmacy Drisdol? Those green football-shaped things with oily stuff inside? If so, that's D2.
Unless there is something new available by prescription, there is no D3 available by prescription. Even if your doc writes a script for D3, the pharmacy will give you the D2. Legally, they are allowed to make certain substitutions.
If you are getting 50,000 IU D3 by prescription, that's great news and must be a new product. I'd like to know the name of it.
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.