Some Lab numbers

browneyes65
on 7/25/15 5:47 pm - IN

My Vit d3 is high   90 (30-80) been taking 2 50,000 a week will probably go to 1. My Serum Iron was 72 (30-160) range. I'm waiting for my Nut to get back to me with results and what she reccomends. I had a blood count done and Iron studies, what do I look for to check for Anemia and what do you do to make better if I had it?

Cicerogirl, The PhD
Version

on 7/25/15 10:38 pm - OH

Actually, for someone with a RNY, your Vit D is fine where it is as long as it didn't jump a huge amount from what it was before (which is why it is important to keep track of your numbers from one lab draw to another) or as long as you didn't just recently significantly increase your dose. For gastric bypass patients, the recommended level is 75-80 nmol/l, so you are just slightly over that.

If you cut your Vit D dose in half, as you have proposed, your level will plummet drastically.  Cutting it in half is way too much to cut out. If you want to drop it down, you will need to get pills in a smaller dose so you can drop it just a bit... But not from 100,000 per week to only 50,000 per week when your level is just barely above the "reference" range for people with normal anatomy. 

As far as the iron goes, you need more information than just the serum iron level. In order to diagnose anemia, you need to know your ferritin and transferrin/TIBC (Total Iron Binding Capacity), red blood cell count (RBC), hematocrit (Hct), and hemoglobin (Hg) levels, too. The normal diagnosis for anemia is actually based in your hemoglobin level not your serum iron level. Just having a slightly low serum iron level doesn't mean much in its own.  If your other lab values indicate that you are anemic, you will likely just need to increase your iron supplementation.  If your levels drop to severely low levels, though, you may need to have an iron infusion (IV), but adding oral iron is the first step.  

Your nutritionist should probably not be the one recommending changes in iron supplementation if you are anemic.  A doctor should do that.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

browneyes65
on 7/26/15 8:56 am - IN

So far I have the TBIC number 267 and RBC count 4.06 HCT 37.4 The labs ordered were Complete blood count and Iron studies. I noticed I bruise easy,

Cicerogirl, The PhD
Version

on 7/26/15 9:08 am - OH

All of those are on the low side, so it is likely that you need to increase your daily iron dose, but -- because of the way these things interact -- your doctor is the one who needs to advise you based on the remainder of the labs.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Grim_Traveller
on 7/26/15 6:58 am
RNY on 08/21/12

What Lora said. One set of numbers means nothing. If your D has gone form 10 to 30 to 50 to 90 over the last two years, you may be taking way too much. If it has gone from 150 to 120 to 110 to 90, you may be just right, or even a little low.

And you need all those other numbers to figure out iron, and also keep track over time. Have they stsyed the same, or been falling, or climbing?

Some things like D or B12 can rise or drop fairly quickly. Iron most frequently drops slowly, and goes back up even slower, so you need to watch it carefully.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

browneyes65
on 7/26/15 9:00 am - IN

I don't know why they say follow your Doctors or Nut who I see and she tells me what to adjust in vitamins then because she told me I will probably have to start taking 1 50,000 weekly, what am I suppose to think anymore, it seems that they would know this.

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