9 month Post Op Bloodwork - chronic fatigue, muscle weakness

ok thank you

So, a couple of things. You make changes based on your labs.

Usually there is a normal "range" not a single number. Did you just pick
the midpoint or are your lab reports just different?

From the low bloodwork I would just track the iron related numbers to see if
they are trending down. Mine are habitually just low of normal so I just track
that for some new reason they don't tank.

The low calcium is something you might want to add more even though it isn't very low.
Coupled with the fact that your PTH is slightly elevated that might be something you want to address
sooner rather than later just in case. I couldn't tell the total amount of calcium you are taking daily
from your vitamin list. Is it really just 500mg a day or are you taking multiple doses? 1500 split into
3 doses would be a OK for most guys, maybe just a little low.

As for the low A and D you need to increase your doses. I know some D labs still cite 30 as normal
but latest thinking is around 50 or 60 for a more normal D level and you will find people around the boards that advocate around 100. I don't but I've never seen anything that it hurts either.

B12 being high isn't really a problem but you can switch to every other day. You just urinate the excess. Not like B6 where too high can cause problems.

Not sure about the testosterone stuff or the glutamine amino acid. Neither is usually something DS people follow. Are you taking glutamine supplements? Looking at a quick search I would just wonder why?

So, best advice is to track your labs looking for trends so you can address them proactively which you seem to be doing.

As you get further out you may end up looking for cheaper alternatives than your nutritionist has set but if your happy for now and mostly your labs are OK no reason for radical changes.

Pete

Hello,

My iron is trending lower, 3 months ago it was 248, now its 219. What Iron supplement do you suggest? I was taking Iron liquid shots. Guess that didnt work for me. Now im taking Bariatric advantage Iron 45mg, plus i get another 45mg daily from my multivitamin.

As for the calcium, i take 3 calcium citrate chews daily so 1500mg a day. Maybe the chews aren't working and i should switch to a regular capsule?

For the calcium I would first try to add a dose and go to 2000mg a day. Personally, I find no difference in types of calcium but I mostly take citrical max (630mg per dose) mixed with some local CVS generic calcium citrate once in a while. You could stand pat and see if your calcium / PTH stay steady but it wouldn't hurt to add more. You might also add K2 and mag citrate to help with the calcium absorption (note K2 is different from K1 that has to do with blood clotting).

For iron, you might add a heme iron like Proferrin or maybe Biferra which is a combination of heme and non heme iron. Most OTC are non heme iron which are metal based and have the usual restrictions about what you can take it with. A pure heme iron like Proferrin can be taken any time.

Do you take your Vitamin C with your iron? That might help too.

Also keep an eye on your total iron numbers. I was eventually taken off iron because the total iron went too high which can be bad over time.

thank you for the advice. i will definitely try a new calcium supplement and take another dose to get 2000mg a day. hope that works for me.

i have no clue what you mean by pure heme iron. please explain what that is.

Yes my vitamin C is in my multi, and i also take my seperate iron supp. with my multi in the mornings. i then take my calcium supplements in the afternoon and evening.

In my bloodwork my Iron is 61 (normal) and my Iron Bind cap .(TIBC) is low (219). which one is total iron?

The line that is just iron would be your total iron. In theory, for a healthy, standard absorption person, as your total iron stays in the normal range that should allow your other numbers to stabilize A lot of things can change that and the issue for me was I added iron to get my total iron up but it made no difference for TIBC, Hemoglobin, Hematocrit, etc so I had to stop taking the supplements and never had to restart.

Iron supplements break down into heme and non-heme iron. The vast majority are non-heme iron (types like carbonyl, ferrous sulfate base ). They all attach to another metal as part of the process to put it in supplement form ( that is why you compare different types of non-heme based on elemental iron ). Non-heme iron competes with calcium when they are taken together.

Heme irons, like Proferrin, are more closely related to food based iron and have no restrictions on when you can take them. They are more expensive and you can't compare elemental iron totals between heme and non heme iron because the absorption mechanisms are different. There is some research that shows a combination of the 2 might work best (Hence feosol biferra)

In practical terms most people take one or the other. Some people can get their doc to prescribe Proferrin so it may get covered under their insurance. Hit or miss on that for people.

thx for the explanation, i did not know that. i only knew not to take my iron supplement at the same time as my calcium because i know they would counteract each other. since my iron supplement is ferrous fumarate.

so is Proferrin available over the counter or only with a doctor prescription? because it would be easier to be able to take it with my other supplements at the same time. im all about making things a little easier. if at all possible.

i found it on amazon https://www.amazon.com/Proferrin-ES-Polypeptide-Dietary-Supp lement/dp/B00MJPVYZE/ref=sr_1_2_s_it?s=hpc&ie=UTF8&qid=15264 70277&sr=1-2&keywords=Proferrin

should i take this once daily or 2 or more a day?

Now we are out of my area of expertise. Mostly I see people taking two or three a day. Taking it in addition to your current iron I would suggest starting with 2 and see what changes in your blood work.

cool thx