My labs are terrible for anemia, no vitamin A or Vitamin D, low B 12 low iron I need help

I had a duodenal switch back in 97 or 98. I have become severely deficient in Vitamin A which effected my vision and even though I am deeply tanned from a florida vacation i am very low in vitamin D as well My primary care dr asked me to reach out to ask for help how to treat as he has no experience with this. my dr was in virginia does anyone get vitamin infusions/ Please i don't know where to begin to get helpand I don't want the night blindness to return

Try and find a doctor that will administer injections to get you out of deficit. It maytake more than one. Once you stabilize you will need to take DRY vitamin ADEK supplements and more than you would think you would need.

You need to find a DS doctor right away as you probably have other issues going on. Calcium PTH among them.

I greatly respect your pcp for acknowledging that this was something he didn't know how to deal with. Many would have just given you inadequate advice, instead he made a good suggestion about seeking help elsewhere.

Standard vitamins, and even ADEKs, just aren't enough for us. You need to be taking dry A, D, and K separately. ADEKs sound perfect, but contain so little of each component as to be almost useless. If anything they get people into trouble because you think you are supplementing appropriate, but aren't. Also, they don't allow you to adjust each component separately, based on your labs.

B12 deficiency is ususual with the DS as this is not a fat soluble vitamin. Still, it sometimes happens, and you should be able to use the usual otc stuff to correct this.

Beyond this it gets complex, so I'm going to send you a pm with more info.

Larra

Thanks Larra I actually called Dr Hazem Elariny's office who did my surgery back in 97 or 98. The nurse did not return my call and neither did any of the Drs. I am not thinking they even do the DS anymore but maybe they do. I have been doing internet searches and have found conflicting advice on what is necessary but I went out and bought

bariatric advantage ADEK tablets the high ADEK multis. Planning on taking two a day

Straight Bariatric Advantage Vitamin A 10,000 units. Last year i developed night blindness and found out it was totally from having no Vitamin A My level was down to 6. My problem is I hate taking any pills so i stopped taking it but now am committed to it. I am going to take one of those a day.

I did get B 12 sublingual and will take that.

Also got a womens multivitamin in tablet and will take that, the one website from University of Minnesota said to take two of them a day plus all the other things I am mentioning.

Also got Ferrous sulfate and vitamin C and will take those twice a day and finally calcium citrate and will take 600 mg four times a day.

I am still open to suggestions. My Dr has never ordered an E or K level so I have no idea if that is down.

THe problem with Vit D is I was in Florida for 6 weeks with no sunscreen and a deep tan and I still have not much D I don't understand that at all.

THanks

The bariatric multi are not what you need. You need separate A D E K. I take 100k D and 125k A daily. Your multi won't get close to helping you raise your levels. A regular centrum type multi is a base level, then add the dry versions of other vitamins. Biotech is a big name for those. 50,000 unit D and 25,000 unit A and with your levels I'd suggest starting with numerous of each daily.

What are dry vitamins? ADEK?

Dry vitamins are water soluble. They are capsules filled with powder instead of oil. DS patients malabsorb about 80% of the fats they consume, including that oil, so they are pretty useless to us in that formula and all of the prescription meds for A, D, and K come in that oil.

The funny thing is that you can purchase these dry formulations in megadoses without a prescription at all through Amazon. Biotech is the brand that has everything you need, but there are other brands nowadays.

Now, I'm going to warn you that this will freak the beejeezus out of your doc, but I promise you that none of us ever get too much of these. Maintenance doses for dry D3 are 50,000 iu (but many take up to 250,000 iu trying to bring your levels up). Maintenance doses for dry A are 25,000 iu (but many take 4x that or more when deficient). Your doc will be afraid of you going toxic, but it's just not going to happen. Just suggest if they resist that you be tested in 3 months to see how they are doing. It took me a six months of 100,000 iu to get my level from 12 up to 80-something, barely normal. I continue with 50,000 iu to keep it normal, but when it dips I double it again for several months.

Valerie,

I have read that about mega doses of Vit D3 for gastric bypass patients on a FB Vit D board and I'm working up to it, starting with magnesium and I just added Vit D (oil capsules) and then I'll add the K2 for cofactors (Vit D cofactors I learned about). I just re-started iron infusions & B-12 shots. Do you know if dry vitamins are recommended for RNY Roun-X (or Y I don't remember) gastric bypass patients (I had a banded operation done 25 years ago, weight regain and had a revision to RNY gastric bypass (but weirdly I could eat more immediately after "revision" & didn't throw up anymore after eating like I did with the band) & lost 60-70 10 years ago but have gained it back with dr burnout from health conditions possibly related to deficiencies and thyroid so I stupidly didn't go to drs or treat my thyroid for 2 years and health got progressively worse along with quality of life. I stumbled onto your board researching vitamins. I haven't heard much about the switch. I know I don't want to undergo another revision and I probably need to work on the issue of why/how to overcome emotional reasons I use my weight to protect me (childhood sexual abuse) and then maybe I could loose some of the regained weight.

Oil based D is a waste of time and money. We malabsorb the oil so you'll be flushing it down the toilet and not helping your labs much

As far as I know, Dr. Elariny is still doing the DS, but I have no connection to his practice so I could be mistaken.

I don't think the amounts you are now starting are going to be adequate to get you caught up. What I've seen over the years is that it's much easier to maintain good vitamin and mineral levels than it is to catch up once they tank. Also, if your protein levels are low, that will make it even harder to catch up on all the other stuff.

Just to give you an example, I take 100,000 units of dry D daily. Granted, I don't get any from sunlight because I need to avoid skin cancer, but still, that's a lot. Many people need at least 50,000/day. I suspect you will also need iron infusions, at least to get caught up. Of course, I could be all wet, but there are a lot of DS'ers who need them even without being in the kind of trouble you are in now.