Vitamins

Hello all

First of all, I had my six month check-up yesterday and it went really well. I am down 115 lbs. to date. I did labs and all my levels are great!  My questions is about vitamins.  I know I have asked before, but I am still a little confused.  My surgeon is amazing (Dr. K in Glendale) and he is of the start minimal and work up mentality in regards to vitamins.  I am taking a multi, calcium, D and B.  I specifically asked about the fat soluble vites A and K, to which he replied my A levels are great and there are no accurate ways to measure K, so don't add them at this time.  I will be doing labs again in 3 months and every 3 months for at least the first two years.  He suggested don't add anything else yet, and if my next labs show deficiencies or downward trends we will address it then.  What do you think?  I think he is an amazing surgeon and respect his advice, but want to make sure I don't do anything to hurt my progress.....It is going so well.

Any feedback would be appreciated. 

congrats on your great weight loss, and yes Dr K is amazing.  I also think start off slowly but always test becasue as a Dser it is hard to drag yourself out of the toilet.  One thing in your post is incorrect, Vit K is indeed accurately tested, (Vitamin K1, phytonadione; and a direct functional Vit K assay is osteocalcin gamma carboxylation.   PT, which I see posted here as blood work to be ordered  is an indirect assay and is less sensitive and not to be used for Vit K deficieny, it is used for imminent bleed and not for Vit K deficencies.  Could you possibly have misunderstood Dr K?     As a DSer it is unusal to be deficent in Vits A or K but they do happen, Ca and Vit D and Fe deficency will be most common issues and make sure you are not anemic via an Fe panel.   I would suggest test 3 monhts PO, then 6 months, then 12 months PO.  every 3 months PO for 2 years is unnecessary, but do trend your results. 

I might have misunderstood. I know he definitely said not to worry about A and K right now and all my levels were great. I think one of the reasons iron is not as much of an issue with me is bc i have been postmenopause since age 33 for 14 years. But he does want to see me in 3 months at 9 months post op to check everything again. This was the first labs post op as he did not request them at 3 months. I will do them in 3 months to check trends......thanks for your response. Did you have Dr. K? I couldnt imagine having gone through this with anyone else......he is amazing. 

His philosophy is the medical norm, "don't prevent, treat if they dip too low or too high".  My choice is a preemptive strike, prevent problems before they start.

--gina

I recommend to understand the numbers yourself at the very least.  My doc's staff did not bother to compare previous results to notice any downward trending.  I noticed it myself and adjusted accordingly.

The two main ideas are start high and lower or start at a base and adjust up as needed.
At this point his baseline seems to be working for you so I think you are good to go. 

The issue is to always follow your labs and on that lab schedule you will have plenty of time
to catch downtrends and react to any lows that show up. I had my zinc go low at 9 months
and added extra at that time. I think the same with vitamins A, E, and K although I proactively
added A and K when they trended for mid-normal to low-normal.

This is the typical medical professional take on the issue although I think the minimal approach also
fits in to what I know about Dr. K's overall philosophy too. They are reactive and not very pro-active.
As long as their starting point is good and they review labs regularly there isn't anything really wrong
with that. It's the Docs that give you a bad starting point and then say come back next year that cause
problems.

I agree with your doctor's approach as long as you know that you are at risk and that you own the risk.  

I started with the Vitalady's program but had swallowing (and other) problems and switched to your doctor's strategy.  I know I am taking a risk by doing it.  I have researched exactly where my doses fall short, what kinds of problems ds veterans tend to see and also the symptoms of vitamin deficiencies.  (Every time I get a zit now I freak out!)

I think that some of the people that go with the VitaLady program are also taking as big a risk because they don't own it.  They do not understand vitamins and minerals, they just do what she says.  If I kept on the VitaLady program, I would want to know exactly what the signs of too much vitamins are.  I heard of a lady who increased the already high B vitamins recommended by the VitaLady and then spent a year with poop so acidic that it ruined her life.  (The old "if a little is good, more must be better" mind set.)

We can not be stupid about this.  The bottom line is too many or too few vitamins are dangerous and people's body seem to do vastly different things after surgery.  What is best for one person is poison for the next.  We have to own it and we have only ourselves to blame if things go south. 

Wow.  That felt great to say!  Thanks!