Labs 2.8 years out

Any input greatly appreciated, thanks in advance.

componant               my value          standard range/ normal       units
________________________________________________________
b-12                              >2000                 >210                247-911       pg/mL
Vit D Deficiency Screen 43    30-75             ug/L
Vit A        .26    .30-1.20             mg/L    
Retinol Palmitate    .03    0.00-.10              mg/L    
Prealbumin    9    15-45              mg/dL    
Parathormone Intact 63    12-72              pg/mL    
Hemoglobin A1C    4.6    4.3 - 6.0                 %
Ferritin        73    10 - 120              ng/mL    
Cholesterol    125    0 - 200              mg/dL
Triglycerides    74    0-150              mg/dL    
HDL Cholesterol    71    50-110              mg/dL    
LDL Cholesterol Calc  39    0-129               mg/dL
VLDL-Cholesterol    15    0-30                mg/dL    
Cholest/HDL Ratio    1.8    0.0-5.0
Hemoglobin    14.5    11.7-15.7                  g/dL  
Sodium        142    133-144               mmol/L
Potassium    3.6    3.4-5.3               mmol/L
Chloride        108    94-109               mmol/L
Carbon Dioxide    24    20-32               mmol/L
Anion Gap    10    6-17               mmol/L
Glucose        68    60-99                  mg/dL
Urea Nitrogen    6    5-24                  mg/dL
Creatinine        0.57    0.52-1.04                  mg/dL
GFR Estimate    >90    >60                 mL/min/1.7m2
GFR Estimate if black>90    >60                 mL/min/1.7m2
Calcium        7.8    8.5-10.4                  mg/dL
Bilirubin Total    0.2    0.2-1.3                  mg/dL
Albumin        2.6    3.9-5.1                     g/dL
Protein Total    5.4    6.8-8.8                     g/dL
Alkaline Phosphatase 71    40-150                       U/L
Alt        38    0-50                       U/L
AST        51    0-45                       U/L
Vitamin B1 WB    141    70-180                nmol/L

Impression: - LA Grade A reflux esophagitis.
- LDS anatomy.
- No explanation for pain identified.
- Normal examined ileum. Suture at the anastomosis
which may be removed at the time of a subsequent
endoscopy with a dual channel scope.
Recommendation: - Discharge patient to home (ambulatory).

Wow... You've got some work to do my friend.  I am 11 mo out.  I know my bloodwork backwards/forwards/right and left.

First of all, your protein intake is in the dumper.  You should have at least 125+ grams of protein a day at this point in your journey.

Prealbumin 9 - This should be at 20

Albumin 2.6 - This should be at 4

Protein 5.4 - This should be at 7

These numbers are not good at all.   You need to start doing protein shakes since you can't eat (which I can sooooooooo relate to).  The kind of protein you need is "WHEY PROTEIN ISOLATE"  you do not need any other type.  Syntrax or Unjury.  You have to get these numbers up.  The only way to do that is to get more protein in.  Syntrax you can use with water, Unjury, some you can use with water, other's I recommend almond milk or coconut milk.  I do not recommend regular milk at all. 

Try 3 - shakes a day

Add 1 FAGE plain greek yogurt w/a protein powder mixed in

That will give you 100 grams of protein before food.

You can also add protein to your coffee in the morning to get an extra 20 or so grams.

You must do this!!! 

These are not enough labs to have done.  When were the last one's you had done.  Your Vit A is also in danger.  You need to supplement separately from a multi.

I am not a Dr, but we have to become our own advocates.

Are you having symptoms other than not being able to eat?

Have you been to a GI Dr to have an Endoscopy done? 

Were these just yearly labs?

MajorMom is our resident expert (yes, I call her that) in labs and vits.  I hope she will pipe in and can help you more.

Yes MM usually leaves me advice for labs. I usually drink premier nutrition from costco it has 30 grams protein, 3 carbs and 150 cals. yes I have had an endoscopy and they found nothing to say it should hurt when I eat just a suture still in there. I am being scheduled for another endoscopy asap, depending on labs she said I may need a TPN.... I hope not. It just hurts to eat and drink or take ANYTHING, I dont know how to explain it other than that it hurts my stomach, makes me nausaus.

Premier is not the best.  It is a blended protein. It is not what you need to bring your levels up.  It is for someone who is not deficient.

It must be "WHEY PROTEIN ISOLATE" by itself in order to bring your numbers up.

There are 2 on the market that I trust.  Unjury & Syntrax .  I was in the hospital for 17 days total, they gave me Beneprotein 100 grams a day.  My #'s tanked.  I know this stuff!

I got out with numbers worse than your's.  My first lab draw after using Unjury exclusively with food also.  Albumin 3.4, PreAlbumin 16, Protein 7.  2 months later (today) I got my new lab results.  They are even better.

You must do this to save your life.   If you do not have protein, then medicines are going to struggle to work to help you get better, whatever the underlying problem is. 

I have ulcers in my esophagus and in my alimentary limb.  It took 2 different Dr's (my surgeon wasn't one of them) to figure out my problem.  Now I'm moving forward.  I don't eat a lot of food like I once did.  I get in my protein no matter what!!!  In fact, drinking another protein shake now.  I had this surgery.  I am committed to making it work!

Do you take anything like Prilosec?  And how often.  What have they given you for nausea?

You need to find a Doctor that will figure out what is wrong with you and causing the pain. Your protein markers are in the crapper and if it doesn't get fixed you are going to die from it. I am surprised that your other labs are as good as they are (not great) because most of them ride on the protein. They will also start going lower. Damn girl, be the squeaky wheel, change doctors,do whatever you have to, this needs to be fixed,yesterday!  Meanwhile will they give you something like Viokase to help hold onto what little protein you have?

Does it also cause pain to drink your protein?

Where are the rest of your labs?  Iron markers? All I see is ferritin.

Thats all I have gotten results for so far... It hurts to ingest EVERYTHING!! :-(

I'm sorry I didn't see this earlier. 

B12 is probaby fine but you might be able to reduce your dose or the number of days a week you take it. I take it 4 days a week instead of every day.

Vitamin D3 needs some work. I'd try 2 of Vitalady's D3 50,000 IUs a day. Maybe one in the AM and one in the PM. Test again in a few months and see if it's working for you.

Vitamin A (palmitate) needs work too. I took 4 of Vitalay's vitamin A (palmitate) tiny capsules a day for several months and got the levels up. Now they stay up and I only take one capsule once a month.

Your protein markers (prealbumin, albumin and protein serum) are getting scary low. If you are having trouble eating or drinking what are the docs suggesting? TPN or more protein shakes?  Once you get your protein markers up, your vitamins should start to absorb in your system better. It's all connected.

Calcium is way low and understandable if you're having trouble taking those horse pills and with your D3 so low. The good thing about calcium is that it can be dissolved in liquid and mixed in with a shake or yogurt, etc. 

Iron hasn't crashed yet but better get ready with a plan. Either you can take supplements or start preparing for infusions. I found that a combo of Vitalady's Tender iron capsules and Proferrin worked well. It took about a year to bring my sluggish levels up. I took 300mg of Tender iron in the afternoons and 2 Proferrin tablets split into 2 pieces at bedtime. Now I take 180mg of Tender iron a day and 1 Proferrin 3 times a week. 

Potassium is getting too low. You might want to ask your doc for a script or how much over the counter would be right for you. I take 900mg a day in over the counter. I should push for a script but haven't yet.

B1 looks good and the liver enzymes, AST and ALT, aren't bad. 

None of this is going to work if they don't get your pain associated with eating and drinking sorted out. I'm so sorry you're going through that and I hope they will address it ASAP. You might want to try to dumping the contents of some of the capsules in shakes or yogurt. I wouldn't try that with a multi or B-complex or B1--blech! 

Please keep us osted on how you're doing. Good luck.

--gina

I have no expertise on vitamins but the one thing that stood out to me was the smoking. I am not going to scold you ;) but that is not helping anything. They can cause ulcers in your stomach, which of course, causes pain. I've seen too many good people have seriously bad side effects to not say anything. Okay, off my soapbox. Sending you good thoughts!