Back into the fold, bad labs.

I have not been signing in here for some time. I was sole care taker of my Mom with Alzheimers and I did not have time to check in here or take care of mysel. fMy precious Mamma died two months ago and I am only just now coming back to life.  I went for lab work because I am not feeling all that great.  I got the results and it seems that I have some work to do to catch up.

Low prealbumin
Low DHEA
Low Vit A
High PTH
Low osteocalcin
low normal  Vit. D
High B-6 (go figure)
low but normal vitamin K


I dont know if I should take extra supplements or just restart the Vita Lady routine recommendations. 

I know I need to up my protein.  It is tuff.  It makes me sick to think of beef, chicken or anything except dairy.   I mean it makes me nauseous to think of eating.  I do it but It is a matter of forcing myself to swallow. 

This has been a really hard time for me.  I dont need a scolding.  I just need a little support and some suggestions from anyone willing.

So sorry to hear about your Mom.

I appreciate your kindness.  It is a real heartbreaker for me.  She was my best friend.

My condolences on the loss of your Mom.

Have you tried to get back to basics with your food intake? To get some ideas, visit MajorMom's Vites, Bites & Exercites daily thread. It helps keep you on track and shows you what others are eating and gives you ideas on what to incorporate in your won meal plan.

Have you tried protein shakes? I hated them at first but now I love my Champion Pure Whey Stack Chocolate. I drink two a day, sometime three, depending on if I can get to my 100-120 g protein a day by food.

High protein foods that are not meat are Greek yogurt such as Fage. I LOVE that stuff! (used to hate it) Cottage cheese is another good one. Any cheese or sliced thin or shaved deli meat is good. And eggs are the most perfect protein that there is. How are your fluids? Have you kept track of them or are you getting enough in?

You've been though so much taking care of your Mom in her need. Now it's time to take care of you. Best of luck and I hope you turn those labs around soon.

Thanks Eileen.  I am with you on the cottage cheese and yogurt.  I love them.  That is what I am living on ...that and cheese of various kinds.  I used to drink the shakes.  I have the stuff to make them.  I will not whine about doing what I must do.  I signed on for this and I am so grateful for the benefits I have already received from the surgery.  My other lab results are wonderful...amazing even. 

I will look into the bites,  vites and exercites and see what folks are doing.  I really cant seem to muster any creativity as far as what to eat.   I feel like I am coming back to Earth after a long ordeal swimming through outer space.  It will take me a little to get back in the swing of it.  I feel like I am immediate post op.  I have forgotten a lot.    Thanks for the support.

(((Rusty)))  I've missed you and I'm so sorry about your mom. Alzheimer's runs in our family too and I know how devastating it is for loved ones and the person going through it. You're a very special person to be able to handle taking care of someone going through that awful disease.

Concerning your labs and vitamins, I would restart Vitalady's basic plan but maybe only take the B-complex 2 or 3 times a wee****il you can get more labs. You want to make sure your B1 is in good shape. I have to take a B1 capsule every day but only take the B-complex once a week.

Instead of only taking 50,000IUs of D3 a day as VL's basic plan calls for, I'd take 100,000IUs for 3 months and retest or reduce to 50,0000IUs at that point.

I don't think vitamin K2 is on VL's basic plan but if your osteocalcin is high, your PTH is high and your D3 is low--you are leaching calcium from your bones. My routine for osteoporosis is 6 does of calcium citrate, a capsule of magnesium citrate and boron tablet with every calcium dose. Also, 4 capsules of vitamin K2 a day, 50,000IUs a day and 100,000IUs M,W & Fri of D3. I'm also on hormone replacements. I was on Fosamax but I'm on a break from it and will have a dexa scan soon to see if I'm holding my own.

Low prealbumin indicates you need better nutrition and protein shakes are an awesome way to get that without all the extra calories. Protein shakes also help with cravings and munchies. :)

I take DHEA everyday too. Not too sure what that is all about though. What have you learned about it?

Hang in there and post often.

--gina
 

You have to be careful taking DHEA - it is an adrenal hormone and people take it that are deficient like me due to adrenal insufficiency or pituitary insufficiency - it also got its popularity years ago when growth hormone was popular for the foutain of youth - and then atheletes used growth hormone - when they discoved that growth hormone showed up on drug tests = they started using DHEA to give them the same effect.

Women have to be careful because high levels of DHEA -S are actually a diagnostic tool for PCOS - and there are alot of side effects like facial hair, deepened voice - many male type symptoms because it affects your testosterone levels.

So, if you are taking it daily - I am not sure the dose -make sure you get your doctor to check your level - both DHEA - S and just DHEA. I dont know how much info they can get off of the DHEA-S if you have been supplementing - that is the test they use to diagnose PCOS - the regular DHEA is the test they use for your adrenals along with cortisol.

My DHEA-S and DHEA are low ,. If your DHEA is high then you are taking too much and need to stop it. I take 50mg daily. I have had a deficiency for years and every time I stop it, a few months later, I get exhausted and sure enough my levels are low.

this last time my cortisol was low too but my stimulation test was normal , so I dont have addison,s it is my pituatary at work

 So sorry about your Mom.  She was blessed to have you there caring for her.  I would say Vitalady's plan would be a good overall hit, or you can just focus on what you're low on and bone up on the supplements.  As for the protein, if dairy is your friend, there's a lot of protein you can get from dairy.  Ricotta cheese and greek yogurt  can really add up.  Try making some custard too.

Rose-

First of all, I'm not a doctor, but I'm studying to become a Registered Dietitian specializing in post bariatric surgery nutrition, so I'm studying this, as well as being just over three years out from my DS. I have experienced some of what I'm about to tell you. Again, not medical advice, but worked for me.

Low prealbumin = possible protein calorie malnutrition. One of the first signs is swelling (pitting or non-pitting edema) in the lower legs. Solution and prevention - *Never* completely take your protein shakes out of your dietary equation, I don't care what the NUT (dietitian who doesn't have a clue about bariatric nutrition) tells you! You can buy unflavored and flavor it any way you want. Lucky Vitamin sells it by the 10 pound bag online.

Low DHEA + not sure what this means. I'll have to look it up.

Low Vit A = night blindness! I had a moderate Vit. A deficiency early out. I was given 25,000 IU dry Vitamin A capsules weekly for 13 weeks, then retested. I still take those capsules today. You can get those through Lucky Vitamin, or Vitalady.
High PTH = osteopenia Just got through dealing with this - totally my fault, because I'm not great about getting all my calcium in (2400 IU daily per my surgeon)., so it was my fault The parathyroid glands are usually silent. High PTH means your body is using your bones for its source of calcium. Ihad a parathyroid study to rule out a tumor, bone scan and Reclast infusion, to try to reverse the osteopenia and keep it from turning into osteoporosis. The osteopenia was moderate, so I do think it is revers able, even though I'm post menopausal at 54. (early menopause puts you at a slightly higher risk of osteoporosis) SOLUTION: If it's really bad, you might have to get infusions. I supplement my Calcium Citrate+D with Liquid Cal-Mag.

Low osteocalcin = brittle bones! see above!
low normal Vit. D = osteopenia and osteoporosis. This vitamin is essential for the body to process calcium. That is why we DSer's take Calcium Citrate+D in addition to our dry Vitamin D capsules.
High B-6 (go figure) -?????
low but normal vitamin K - Increase your vitamin K1 dose. I take 800 mcg weekly, and 5,000 mcg K2 weekly. This is essential for helping your blood to clot. (K1 is usually the one they test for in the series of DS labs)

I will let everyone else talk about the vitamins - will talk about the DHEA - I have been deficient for years.  It is a hormone in your adrenal glands.  You should have a cortisol test to see if that is low also to see how your adrenal glands are functioning.  If that is low, then you need a cortrysin stimulation test to see if they can work at after being stimulated with a shot of ACTH.  IT is a 2 hour test.  THis test is done at an Endocrinologists office.  The endocrinolost will also check your pitiutary because some people have low dhea's due to there pituitary rather than there adrenals - it is called seconary adrenal insufficiency and that is what I have - my cortrysin stimulation test was normal and my cortisol test was low normal.  I am hypopituitary and hypothyroid.

I take DHEA, sythroid, cytomel.  I used to take hormones for my pituitary but I don't need them anymore but I many have to go on them again.

I hope this helps.

I will say that high B6 is very common for all post op WLS patients - jus****ch the vitamin waters if you drink them.  If it is borderline high it is okay but very high, you need to bring it down.