Checking vitamins for the first time 5 years out

No, I don't mean that i have not had any lab work done in the 5 years since my RNY. I mean that there are some things that my surgeon doesn't check that my PCP agreed we needed to check. My PCP has been very good at taking information that I print out for him on various aspects of being a RNY patient, and is always very good about taking my input (e.g., I have been on thyroid hormone and an anticoagulant for so many years that I often can tell when something is not right, so when I ask for my levels to be checked, he checks them, even though I have a machine that checks my INR (how "thin" my blood is) at home).

So today I wanted to get lab work to check my INR, my Vit K level (which we have had problems getting to stay high enough, and which impacts my INR), and my iron level (it had dropped every year for 4 years in a row, so this spring I started taking a supplement). I mentioned that there are a couple of things my surgeon had never checked (e.g., Vit A), and he actually took the time to look at the ASMBS web page to see what vitamins RNYers have trouble absorbing and need to supplement and ordered half a dozen labs that I had never had checked, plus he wanted to double check my Vit D level (which had been so low the first year and so hard to get up) since my depression has increased lately and low D can contribute to depression.

I was so impressed that he took the time to look through all that the ASMBS info!!

Lora

You are very lucky to have such an open minded PCP. So many Dr's out there treat a patient like they are a number much less listen.

I have an amazing PCP now but I had to go thru quite a few to find her.

I wish they would spend more time on bedside manners during medical school, maybe then we could all benefit with better medical care.

So, I wonder when would be a good time to have all these (other vitamins) checked. I surely don't want to wait five years but I think at least one is in order. Do you think you should have done this sooner? Will you post your results when you get them?
Thanks, Deb

If I were doing it over, I would insist on having EVERYTHING run at a year out just because that first year really throws your body for a loop, and I think (and my PCP agreed) that even though some of the tests he ran were things that were not likely to be a problem (e.g., selenium), with the bypass those things ought to be done every 2 or 3 years.

Sure, I can post the results when I get them. For whatever they are worth.

Lora

I get all my labs done about every six months.

Lora, glad you have a dr that will listen to you, I am having probs with that  a  LOT! is there a list of the vitamin levels we should be at? my vitamin D was 22, "they" say it is slightly low, not to worry, now i am WORRIED!!! arent we supposed to be at 80??? i went to the ASMBS but was so confussed i decided to ask you, thanks, Denise

Yes, 22 is much too low for your D level. The ASMBS says it should be at least 80. All of our levels (and some are less stable than others) can drop very quickly, so if they are low to begin with and then they drop, we can be significantly deficient.

I don't have a prepared list of what all the various levels should be to be optimum. Perhaps someone else does. I just make sure that everything we check is above the midpoint on ALL my labs (and significantly higher than that on some (e.g., B12 and D)).

Lora

at  this point i have no clue where to start, i no longer have a bariatric dr, but there are several local, do i call them? PCP, useless on this one,,,,order from vitalady? i dont even know what to order strength wise or how much to take, it was found when i had colonoscopy and egd done, it was really great to see the pouch and stoma is great after 9 years, that was the  good news, I  was thinking  about the local gastric guy, to see if he would take me on for yearly check ups,, any ideas?? with the  foot reconstruction, & knee revision there were a lot of labs, everything else i saw was good including all the b"s,but i do the shot,

Some bariatric surgeons are better than others when it comes to nutritional and supplementation advice. Their specialty is surgery, not nutrition. I would suggest contacting a local surgeon and asking who they use for nutritional follow up for their patients.

At a minimum, you should be taking two adult multivitamins (e.g., Centrum), 1500-2000 mg of calcium citrate (NOT calcium carbonate), and some form of B12 (most people do sublingual or injections) and Vit D. If you are still menstruating, you should also be taking iron with Vit C. Unfortunately, HOW MUCH of the things other than the multi and calcium really depends on your labs, so getting someone (whether a family doctor or a bariatric surgeon) to order a full vitamin work up is going to be really important.

Some people also take things like zinc, extra Vit A, a B complex, etc.... But, again, our labs really dictate what all you need (and I personally don't think it is prudent to waste money on a "bariatric" or RNY vitamin package (where you buy a bunch of different vitamins all together) without knowing what you need. It may be a waste of money if your labs are good for many of the vitamins that are included in such a package. My B vitamins have always been good, for example, so there has never been any need for me to spend money on a B complex or individual B vitamins (other than B12).

Lora

good place to start, thank you:)