Fat absorption?

I have been away from the forum for a long while, but I need an update as to current medical thinking.  I had the JIB in 1975.  No stomach work, but extreme loss of small intestine.  Good results, several unexpected trials since they didn't know what to expect and actually stopped doing it a year later.

And some of my body's natural functions have "grown back" to some extent over the years.  Yet here I am alive and happy 30 years longer than my doctors had predicted without the surgery.  Last time I was here, I was criticized for not being a real DS.  So as a disclaimer, let me make it clear that what I say should not confuse DS prospects and I am not attempting to affect them in any way.  I merely seek knowledge about shortened bowels, long-term.  And DS folks have the same bowels that I do.

Many of you were told that the shortened bowel only absorbs 20% of fats ingested in the diet.  Great for cholesterol levels, a factor to consider when it's time to expel the remaining 80%.  And, because of this, that gel-cap medications are pretty ineffective.  I have always gone to VitaLady for DRY vitamin D (hard to find locally).

The fat expulsion has improved, I wonder if my gut is absorbing fat better now, and whether the gel-cap restriction is life-long, or more appropriate for new surgeries mostly.

The people here have always been better informed than anyone else in such matters.  I am hoping that some of you have lived with your DS long-term and know about what changes over the decades.

Can you test your theory with oil based D3 capsules and let us know how your labs are in 6 months?  I wouldn't use the prescription oil based D2 but I would test D3. I know many of us maintain on 50,000IUs of dry D3 but I'm not sure if 50,000IUs in oil would be needed or as economical as Vitalady's dry D3.

--gina 

I'm 9 years post op and thanks to the clueless nutritional advice I got from my surgeon and her staff having me take another 400iu when I plunged to 12, it took me over a year to get my levels where they needed to be with dry D3 at 50k iu daily.  Vit A was another fast slipping level and Dry A at 25k iu got me back to a good place, too. I'm hesitant to risk how well I absorb gel D.  Another option for you just came out recently.  Patchmd.com has a D patch, and because it's not going through the digestive tract, the dosage is the same as everyone else.  I know of one DSer that gave it a try and is getting good results.  I'm waiting until my D is gone and I intend to give them a try too.

I just moved to a new state, so I've not looked much yet for a compounding pharmacy that may be able to get me what I need.  What I did find is that Walmart can get the 50k dry D from Biotech.  You don't need a prescription, but you need to ask for it at the pharmacy, and if they don't have a couple bottles, they can order it for you.

Congrats on the longevity there. 

I recently heard on a webinar by Dr. Kesheshian who does the DS that there can be a lot of
extra absorption over time although there are limits. He likened it to using a single muscle
over and over. Eventually that muscle gets stronger (in our case absorption gets better). It seems
to have something to do with the villi that get thicker and more plentiful but since htere is no
stretching in that part of your gut then there is a limit.

Still the gel-cap angle is a crap shoot. I don't even think anyone has tried to replicate those fat absorption
studies since they were originally done. So no new information to prove or disprove the use of gelcaps
at a later date - everything is anecdotal.

Thanks guys.  I have lab results due back next week, but I will stick with what has worked in the past.  50K DRY and maybe increase to daily (now I do a few times a week) if necessary.  I didn't know about the patch, interesting.  Dry D3 is only 25¢ now so it's not worth worrying about.  It can experience increases in cost and still not be a real issues.  It works, and if I have to pay for it out-of-pocket, so be it.

Amazing how little anyone, in the city, bariatric nutritionally aware doctors and specialists, don't seem to know what's going on.  And certainly are unwilling to accept that I do.  Perhaps they don't want their shortcomings exposed or challenged.  The older I get, the more I realize how *I* am the only one who is truly on my side :-(

Thanks, feel free to add more comments.  I will keep checking.

You are so right how you have to look out for yourself. I think people get so caught up in seeing
the same things over and over they stop considering new information and woe to those that don't
fit in their neat little box. Not everyone but enough that it can be a pretty big challenge.

I totally agree that the dry D3 is more economical. I think the patches are more an alternative for those
people that don't seem to get the benefit from the dry D and some people just want to try and reduce
the pills they take but the D's are pretty small anyway.

"And DS folks have the same bowels that I do."

Umm, no we don't. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682245/

But if you are seriously concerned about your present fat absorption, you can have it tested. It's called a fecal fat test, and it involves a strict journaling of your food and analysis of you feces over the course of a few days.

Geez, same thing happens every time I come here.  Someone takes great joy in pointing out that JIB is not DS.  I thought I made a disclaimer, so that no DS prospects would confuse anything I said with DS information.  It is true that there are differences in the exact lengths and locations of the bypass.  It is also a drastic shortening of the small intestine to where only inches remain.  I can only assume that we have some of the same issues in common, but I stand corrected.  I though twice about coming back with my question.

The lack of meaningful challenges tells me that I'm on the right track, that I ought to avoid any "I no longer have much fat malabsorption" thoughts, it's just not worth gambling on.  At this stage in my life, I kinda do what I want (within educated reason) and see what happens on the bathroom scale, with my bloodwork, with the normal spectrum of symptoms, with my other related symptoms (kidney, AFib, anemia).  I am content. What I am doing works, and this is no time to start experimenting.  One thing I have learned with age.  Stay away from hospitals!   Those places will kill you :-)