9 month Post Op Bloodwork - chronic fatigue, muscle weakness

I'm 9 months post op. I've lost 100 pounds. I have chronic fatigue and muscle weakness half the week which lasts all day long. Feels like im spaced out and out of it all day. I'm certainly vitamin deficient even though all my supplements were approved by the nutritionist at the bariatric office.

Does anyone which exactly is causing this chronic fatigue, muscle weakness, etc?

Here is a screenshot of what is low
https:/prnt.sc/jfxr6u

Total Glutathione level is 97
Iron Bind.Cap.(TIBC) is 219
Threonine 48.1
Vitamin A 19.9

Here is a screenshot of what is high
https://prnt.sc/jfxr5i

Vitamin B12 1826
Testosterone 1209
Glutamine 999
LDH 336
Serine 216.9

Any thoughts about the glutamine level being so high? is that something for me to be concerned?

Also my total Testosterone is high, 1209 but my free Testosterone is low at 4.5. How is this possible? Should i see a urologist about this? My libido since surgery has changed and not the same, thats why i threw those tests in there too.

Any other feedback or guidance would be greatly appreciated, thank you.

Since I don't know your history, what you're taking (vitamin-wise) and what labs you had drawn, it's hard to provide feedback or guidance. I assume you're a man (testosterone testing) otherwise I would say you might be anemic (I know men can develop iron deficiency anemia but I don't think it's as common as for women). Did they check your ferritin? Most of us start with Vitalady's prescribed vitamin regime for the DS since most doctors don't give good enough guidance on the DS and then supplement based on lab results. Do you have a good primary care doctor who you're working with on your labs? You say you know you're vitamin deficient - how do you know?

Hello,

Yes im a male.

And two months ago i went to see a hematologist to see if i have anemia and i do not. My levels are borderline low, but not low enough to have any type of anemia.

Yes i checked my ferritin level and it's normal (170).

I saw my nutritionist two months ago and she reviewed and approved my supplements, which are the following

ProCare Health Once-A-Day Multivitamin which has:

Vitamin A- 10,000 IU- 200%
Vitamin C- 130mg -220%
Vitamin D- 3000 IU -750%
Vitamin E- 60 IU - 200%
Vitamin K- 120mcg 150%
Thiamine - 20mg- 1333%
Riboflavin- 12mg- 710%
Niacin - 40mg - 200%
Vitamin B6- 12mg-600%
Folic Acid- 800mcg - 200%
Vitamin B-12- 1000mcg- 16,670%
Biotin - 600 mcg- 200%
Pantothenic Acid- 20mg -200%
Iron -45 mg- 250%
Magnesium- 200mg - 50%
Zinc- 15 mg- 100%
Selenium - 100mcg- 140%
Copper- 2 mg- 100%
Manganese- 2 mg- 100%
Chromium- 100mcg- 80%
Molybdenum- 75 mcg- 100%

I also take

Vitamin B12 Liquid Drops 3000mcg - guess ill stop taking this since my B12 levels just got really high

NovaFerrum 125 Liquid Iron Supplement

Bariatric Advantage - Iron Capsule 45mg

Bariatric Advantage - 500mg Calcium Citrate Chewy Bite

Dr Mercola Vitamin D spray - 5000iu

Probiotic supplement

Fiber gummies

Anything wrong with these supplements?

Something is not working since im chronically fatigued.

You'll likely go deficient and maybe even die taking those vitamins. Buy Biotech vitamins. They are much higher in quantities of what we need than "special" bariatric vitamins.

ADEK are really important for us.

I take 100K of A
150 K of D
800 IU of E
1000 IU of K1
and a couple of K2s per day in addition to everything else.

I take a really high quality multi. I know people on here that take centrum...but I found that I feel much better if I take vitamin shoppe vitamins (high potency). I take a B complex, and calcium.

Scott

ok, so what multivitamin should i take then specifically? please provide a link so i can try that instead of the procare multivitamin im currently taking.

so in addition to your multivitamin, you also take a sepeate A, D, E and K1, and k2 supplement every day? and all of those are from bio tech?

please list exactly which products you take because im interested in trying them and provide links, thx.

Your problem is that you are depending on designer bariatric vitamins and DSers need SO much more than even the ones with "DS dosages". Surgeons and nutritionists do not go the extra mile to learn what a typical DSer truly needs. They just sprinkle a little extra "this and that" and even the most compliant patients like you wind up with problems. This was me about 11 years ago getting malnourished on a bariatric vitamin that my surgeon sold at the office, sprinkled with a little extra calcium and D in substandard amounts.

Have you had your D checked lately? I have money on it being low. Most of us supplement at least (minimum) 50,000 iu (yes, fifty thousand) daily of dry (not oil based) D3. Many are up to as high as 200,000 iu daily, and no - they do not get toxic on it. A is another common one to get low, and our starter is 25,000 iu daily.

hello,

yes my vitamin D is low (24.7) this was the same as it was the last time i did the same bloodwork 3 months ago. In addition to the Vitamin D in my multivitamin (3000IU) I also take a weekly Vitamin D supplement of 50,000IU, but it's a gel based capsule that i get through a prescription. Should i take it daily then? I took it weekly because i wasn't sure if it was needed every day, but i guess i should try doing that then? And i should switch it to a dry capsule?

And yes my Vitamin A is low, should i also take another dry capsule of another 20,000IU of that daily? I could try that as well.

There it is! What did I tell ya?

First of all, the gel D is dispursed in oil, and we malabsorb 80% of all fats we consume. That means that you're really not getting anything from that oil capsule. The good news is that the "Dry" D3 we need does not require a prescription. You can get it on Amazon amongst many places. I just scored this bargain the other day: https://www.amazon.com/Bio-Tech-D3-50-50-000-200/dp/B00IAQUJ H0/ref=sr_1_1_a_it?ie=UTF8&qid=1526411457&sr=8-1&keywords=bi otech+d3-50+50%2C000+iu

Next, not only were you prescribed the wrong D, but at much too low a dosage. Many of us take a "maintenance dose" of 50,000iu of the dry D3 daily, not weekly. When my levels got down to 12 (taking advice from the surgeon's staff), I bumped all the way up to 100,000iu for six months, and it finally started moving. Some take as much as 200,000iu daily just to keep level. Your doc will have a heart attack over it, because this could get toxic in a normal person, but you are NOt normal and your D lab proves it.

thx for the link im going to buy that. do you think i should stick with 50k daily, or take two of those per day to get 100k?

In my own experience, I got little movement on 50 from my lowest. Six months on 100K (2 pills) got me into normal ranges, then I backed down to 50k.