18 Month Lab Work

Here are all my labs. Warning, this will be very long. I have this typed into a spreadsheet but since that won't cut and paste well... I typed this in. Comments are noted where appropriate. I'm very, very happy overall with my results. The handsful of supplements I take is paying off. The big observations are: 1. My protein is now is at 7.1 is down about .4 from my last labs. Lab normal range is 6.0 to 8.3. The difference from my last labs, well I've been slacking on my 3rd protein shake each day. And funny, last year, my protein was 7.1 or so and I added that 3rd shake a day and that brought it up to about 7.5. So, it appears that the extra 30 grams of protein equates to .4 on my protein reading. Interesting, eh? I know that 7.1 is in normal range but I like it at 7.5 which is my pre-op reading. 2. My liver enzymes which were checked a couple of months ago AST was back to normal and were better - ALT was down to 70ish from much more than that are now back up. My AST is now 42 (normal range 3-35) and ALT is now 110 (normal range is 3-40). After some high readings (ALT was over 300), I started taking milk thistle (500 mg twice a day). Milk thistle (sillymarin) helps cleanse the liver. My readings improved quite a bit and doc was happy. I just realized that the new bottle of MT was 175 mg per capsule not 500 mg. So, I'm going to go back to 1000 mg a day and recheck with the doctor. I'm trying to avoid liver biopsy. Have an appointment with my surgeon next week to go over results and will consult with him. Lots of post-ops with elevated liver enzymes. 3. My Vitamin D level is finally up to 44. It had been in the 20s which is technically considered normal but our nutritionists now want it to be a minimum of 40. After reading on the vitamindcounsel.com website... I'm going to try to get that up to 50 by adding one more (small) capsule to each day and see how it goes. 4. My calcium and PTH are doing very well. I had a parathryoid tumor pre-WLS and that messed up my calcium levels and bone density. The tumor has been out about 9 months now and my levels are looking good. Next bone density scan will be February, one year after tumor removal. Hope there is some improvement. Kathy Complete Blood Count (CBC) WBC (reference range 3.8-10.8) - 12/07/2004 (Consult): 7.7, 04/29/2005 (Pre-WLS): 5.5, 09/12/2005 (4 Mos. Post-Op): 6.0, 11/28/2005 (6 Mos. Post-Op): 5.1, 05/16/2006 (12 Mos. Post-Op): 6.9, 11/16/2006 (18 Mos. Post-Op): 5.1 RBC (reference range 3.80-5.10) - 12/07/2004 (Consult): 4.62, 04/29/2005 (Pre-WLS): 4.76, 09/12/2005 (4 Mos. Post-Op): 4.46, 11/28/2005 (6 Mos. Post-Op): 4.31, 05/16/2006 (12 Mos. Post-Op): 4.34, 11/16/2006 (18 Mos. Post-Op): 4.23 Hemoglobin (reference range **** 15.5) - 12/07/2004 (Consult): 13.2, 04/29/2005 (Pre-WLS): 13.2, 09/12/2005 (4 Mos. Post-Op): 12.3, 11/28/2005 (6 Mos. Post-Op): 12.3, 05/16/2006 (12 Mos. Post-Op): 12.8, 11/16/2006 (18 Mos. Post-Op): 13.1 Hematocrit (reference range 35.0-45.0) - 2/07/2004 (Consult): 38.0, 04/29/2005 (Pre-WLS): 39.2, 09/12/2005 (4 Mos. Post-Op): 37.4, 11/28/2005 (6 Mos. Post-Op): 36.8, 05/16/2006 (12 Mos. Post-Op): 37.5, 11/16/2006 (18 Mos. Post-Op): 37.6 MCV (reference range 80-100) - 12/07/2004 (Consult): 82, 04/29/2005 (Pre-WLS): 82.1, 09/12/2005 (4 Mos. Post-Op): 84, 11/28/2005 (6 Mos. Post-Op): 85, 05/16/2006 (12 Mos. Post-Op): 86, 11/16/2006 (18 Mos. Post-Op): 89 MCH (reference range 27-33) - 12/07/2004 (Consult): 28.6, 04/29/2005 (Pre-WLS): 27.6, 09/12/2005 (4 Mos. Post-Op): 27.6, 11/28/2005 (6 Mos. Post-Op): 28.5, 05/16/2006 (12 Mos. Post-Op): 29.6, 11/16/2006 (18 Mos. Post-Op): 30.7 MCHC (reference range 32-36) - 12/07/2004 (Consult): 34.7, 04/29/2005 (Pre-WLS): 33.6, 09/12/2005 (4 Mos. Post-Op): 32.8, 11/28/2005 (6 Mos. Post-Op): 33.5, 05/16/2006 (12 Mos. Post-Op): 34.2, 11/16/2006 (18 Mos. Post-Op): 34.7 RDW (reference range 11-15) - 12/07/2004 (Consult): 14.3, 04/29/2005 (Pre-WLS): 12.9, 09/12/2005 (4 Mos. Post-Op): 15.1, 11/28/2005 (6 Mos. Post-Op): 19.3, 05/16/2006 (12 Mos. Post-Op): 13.6, 11/16/2006 (18 Mos. Post-Op): 13.6 Platelets (reference range 140-400) - 12/07/2004 (Consult): 262, 04/29/2005 (Pre-WLS): 295, 09/12/2005 (4 Mos. Post-Op): 303, 11/28/2005 (6 Mos. Post-Op): 240, 05/16/2006 (12 Mos. Post-Op): 292, 11/16/2006 (18 Mos. Post-Op): 221 Mean PLT Vol (reference range 7.5-11.5) - 04/29/2005 (Pre-WLS): 8.4, 09/12/2005 (4 Mos. Post-Op): 9.0, 11/28/2005 (6 Mos. Post-Op): 9.4, 05/16/2006 (12 Mos. Post-Op): 8.9, 11/16/2006 (18 Mos. Post-Op): 8.4 Comprehensive Metabolic Panel (CMP) Sodium (reference range 135-146) - 12/07/2004 (Consult): 137, 04/29/2005 (Pre-WLS): 142, 08/19/2005 (3 Mos. Post-Op): 138, 11/28/2005 (6 Mos. Post-Op): 140, 03/03/2006 (9 Mos. Post-Op): 139, 05/16/2006 (12 Mos. Post-Op): 139, 11/16/2006 (18 Mos. Post-Op): 141 Potassium (reference range 3.5-5.3) - 12/07/2004 (Consult): 4.4, 04/29/2005 (Pre-WLS): 4.5, 08/19/2005 (3 Mos. Post-Op): 4.7, 11/28/2005 (6 Mos. Post-Op): 4.1, 03/03/2006 (9 Mos. Post-Op): 5.0, 05/16/2006 (12 Mos. Post-Op): 4.3, 11/16/2006 (18 Mos. Post-Op): 4.0 Chloride (reference range 98-110) - 12/07/2004 (Consult): 101, 04/29/2005 (Pre-WLS): 103, 08/19/2005 (3 Mos. Post-Op): 102, 11/28/2005 (6 Mos. Post-Op): 106, 03/03/2006 (9 Mos. Post-Op): 105, 05/16/2006 (12 Mos. Post-Op): 104, 11/16/2006 (18 Mos. Post-Op): 105 Carbon Dioxide (reference range 21-33) 12/07/2004 (Consult): 23, 04/29/2005 (Pre-WLS): 27, 08/19/2005 (3 Mos. Post-Op): 30, 11/28/2005 (6 Mos. Post-Op): 25, 03/03/2006 (9 Mos. Post-Op): 19 L, 05/16/2006 (12 Mos. Post-Op): 26, 11/16/2006 (18 Mos. Post-Op): 28 Glucose (was diabetic pre-op - reference range 65-99) - 12/07/2004 (Consult): 132 H, 04/29/2005 (Pre-WLS): 116 H, 08/19/2005 (3 Mos. Post-Op): 105 H, 11/28/2005 (6 Mos. Post-Op): 92, 03/03/2006 (9 Mos. Post-Op): 86, 05/16/2006 (12 Mos. Post-Op): 91, 11/16/2006 (18 Mos. Post-Op): 76 Urea Nitrogen/BUN (reference range 7-25) - 12/07/2004 (Consult): 11, 04/29/2005 (Pre-WLS): 13, 08/19/2005 (3 Mos. Post-Op): 20, 11/28/2005 (6 Mos. Post-Op): 22, 03/03/2006 (9 Mos. Post-Op): 24, 05/16/2006 (12 Mos. Post-Op): 20, 11/16/2006 (18 Mos. Post-Op): 16 Creatinine (reference range 0.5-1.3) - 12/07/2004 (Consult): 0.6, 04/29/2005 (Pre-WLS): 0.7, 08/19/2005 (3 Mos. Post-Op): 0.7, 11/28/2005 (6 Mos. Post-Op): 0.7, 03/03/2006 (9 Mos. Post-Op): 0.9, 05/16/2006 (12 Mos. Post-Op): 0.9, 11/16/2006 (18 Mos. Post-Op): 0.6 BUN/Creatinine Ratio (reference range 6-25) - 12/07/2004 (Consult): 18, 08/19/2005 (3 Mos. Post-Op): 29.8 H, 11/28/2005 (6 Mos. Post-Op): 31.4 H, 03/03/2006 (9 Mos. Post-Op): 26.7 H, 05/16/2006 (12 Mos. Post-Op): 22.2, 11/16/2006 (18 Mos. Post-Op): 26.7 H Calcium (reference range 8.5-10.4) - Had parathyroid tumor (adenoma) - these tests prior to parathyroidectomy - 12/07/2004 (Consult): 10.8 H, 04/29/2005 (Pre-WLS): 11 H, 08/19/2005 (3 Mos. Post-Op): 11.4 H, 11/28/2005 (6 Mos. Post-Op): 10.3 - These tests after parathyroidectomy - 03/03/2006 (9 Mos. Post-Op): 9.5, 03/20/2006 (9 Mos. Post-Op): 9.3, 05/16/2006 (12 Mos. Post-Op): 9.5, 11/16/2006 (18 Mos. Post-Op): 9.8 Protein, Total (reference range 6.0-8.3) - 12/07/2004 (Consult): 7.5 - After 3 month high protein pre-op diet - 04/29/2005 (Pre-WLS): 8.1 H, 08/19/2005 (3 Mos. Post-Op): 7.4, 11/28/2005 (6 Mos. Post-Op): 7.2 - Added 3rd protein shake a day - 03/03/2006 (9 Mos. Post-Op): 7.5, 05/16/2006 (12 Mos. Post-Op): 7.4 - Been skipping my 3rd protein shake a day - 11/16/2006 (18 Mos. Post-Op): 7.1 - Will be adding my 3rd shake back in! Albumin (reference range 3.5-4.9) - 12/07/2004 (Consult): 4.4, 04/29/2005 (Pre-WLS): 4.8, 08/19/2005 (3 Mos. Post-Op): 4.8, 11/28/2005 (6 Mos. Post-Op): 4.6, 03/03/2006 (9 Mos. Post-Op): 4.6, 05/16/2006 (12 Mos. Post-Op): 4.7, 11/16/2006 (18 Mos. Post-Op): 4.5 Globulin, Calculated (reference range 2.2-4.2) - 12/07/2004 (Consult): 3.1, 04/29/2005 (Pre-WLS): 3.3, 08/19/2005 (3 Mos. Post-Op): 2.6, 11/28/2005 (6 Mos. Post-Op): 2.6, 03/03/2006 (9 Mos. Post-Op): 2.9, 05/16/2006 (12 Mos. Post-Op): 2.7, 11/16/2006 (18 Mos. Post-Op): 2.6 A/G Ratio (reference range 0.8-2.0) - 12/07/2004 (Consult): 1.4, 04/29/2005 (Pre-WLS): 1.5, 08/19/2005 (3 Mos. Post-Op): 1.8, 11/28/2005 (6 Mos. Post-Op): 1.8, 03/03/2006 (9 Mos. Post-Op): 1.6, 05/16/2006 (12 Mos. Post-Op): 1.7, 11/16/2006 (18 Mos. Post-Op): 1.7 Bilirubin, Total (reference range 0.2-1.3) - 12/07/2004 (Consult): 0.5, 04/29/2005 (Pre-WLS): 0.4, 08/19/2005 (3 Mos. Post-Op): 0.4, 11/28/2005 (6 Mos. Post-Op): 0.6, 03/03/2006 (9 Mos. Post-Op): 0.6, 05/16/2006 (12 Mos. Post-Op): 0.4, 11/16/2006 (18 Mos. Post-Op): 0.6 AST (reference range 3-35) - 12/07/2004 (Consult): 15, 04/29/2005 (Pre-WLS): 21, 08/19/2005 (3 Mos. Post-Op): 18, 11/28/2005 (6 Mos. Post-Op): 24, 03/03/2006 (9 Mos. Post-Op): 39 H, 05/16/2006 (12 Mos. Post-Op): 37 H - Was over 50 in June in the hospital but came back down into normal range on it's own and along with taking milk thistle (1000 mg a day). Then noticed my new bottle of MT was lower dosage - 11/16/2006 (18 Mos. Post-Op): 42 H Will increase dosage back to original 1000 mg and see if it improves ALT (reference range 3-40) - 12/07/2004 (Consult): 22, 04/29/2005 (Pre-WLS): 39, 08/19/2005 (3 Mos. Post-Op): 24, 11/28/2005 (6 Mos. Post-Op): 51 H, 03/03/2006 (9 Mos. Post-Op): 73 H, 05/16/2006 (12 Mos. Post-Op): 94 H - Was over 300 in June in the hospital but came back down into the 70s on it's along with taking milk thistle (1000 mg a day). Then noticed my new bottle of MT was lower dosage - 11/16/2006 (18 Mos. Post-Op): 110 H Will increase dosage back to original 1000 mg and see if it improves Alkaline Phosphatase (reference range 20-125) - 12/07/2004 (Consult): 50, 04/29/2005 (Pre-WLS): 53, 08/19/2005 (3 Mos. Post-Op): 60, 11/28/2005 (6 Mos. Post-Op): 57, 03/03/2006 (9 Mos. Post-Op): 51, 05/16/2006 (12 Mos. Post-Op): 35, 11/16/2006 (18 Mos. Post-Op): 31 Iron (reference range 35-175) - 08/19/2005 (3 Mos. Post-Op): 77, 11/28/2005 (6 Mos. Post-Op): 56, 05/16/2006 (12 Mos. Post-Op): 47 - Switched from 2 Vitron-C (66 mg each elemental iron (132 mg total) - ferrous fumerate) to 8 Tender Iron (25 mg each elemental iron (200 mg total) - carbonyl iron) - 11/16/2006 (18 Mos. Post-Op): 86 TIBC (reference range 250-400) - 08/19/2005 (3 Mos. Post-Op): 308, 05/16/2006 (12 Mos. Post-Op): 320, 11/16/2006 (18 Mos. Post-Op): 300 % Saturation (reference range 15-50) - 08/19/2005 (3 Mos. Post-Op): 25, 05/16/2006 (12 Mos. Post-Op): 15, 11/16/2006 (18 Mos. Post-Op): 29 UIBC (reference range 110-370) - 08/19/2005 (3 Mos. Post-Op): 231, 05/16/2006 (12 Mos. Post-Op): 273, 11/16/2006 (18 Mos. Post-Op): 214 Ferritin (reference range 10-232) - 08/19/2005 (3 Mos. Post-Op): 121, 11/28/2005 (6 Mos. Post-Op): 154, 05/16/2006 (12 Mos. Post-Op): 157, 11/16/2006 (18 Mos. Post-Op): 141 Hemoglobin A1C (reference range < 6.0) - 08/19/2005 (3 Mos. Post-Op): 5.5, 11/28/2005 (6 Mos. Post-Op): 4.8, 11/16/2006 (18 Mos. Post-Op): 5.1 Lipid Panel Cholesterol (reference range < 200) - 11/28/2005 (6 Mos. Post-Op): 100, 05/16/2006 (12 Mos. Post-Op): 129, 11/16/2006 (18 Mos. Post-Op): 149 Triglycerides (reference range < 150) - 11/28/2005 (6 Mos. Post-Op): 57, 05/16/2006 (12 Mos. Post-Op): 76, 11/16/2006 (18 Mos. Post-Op): 38 HDL Cholesterol (reference range > 39) - 11/28/2005 (6 Mos. Post-Op): 37 L, 05/16/2006 (12 Mos. Post-Op): 51, 11/16/2006 (18 Mos. Post-Op): 66 LDL Cholesterol (reference range 0-100) - 11/28/2005 (6 Mos. Post-Op): 52, 05/16/2006 (12 Mos. Post-Op): 63, 11/16/2006 (18 Mos. Post-Op): 74 Magnesium (reference range 1-5-2.0) - 03/03/2006 (9 Mos. Post-Op): 1.8, 05/16/2006 (12 Mos. Post-Op): 1.8, 11/16/2006 (18 Mos. Post-Op): 1.6 Phosphorus (reference range 2.5-4.5) - 03/03/2006 (9 Mos. Post-Op): 4.3, 11/16/2006 (18 Mos. Post-Op): 3.6 PTH, Intact (reference range 10-65) - Had parathyroid tumor (adenoma) - these tests prior to parathyroidectomy - 12/07/2004 (Consult): 60, 04/29/2005 (Pre-WLS): 122.8 H, 08/19/2005 (3 Mos. Post-Op): 40, 11/28/2005 (6 Mos. Post-Op): 67 H - These tests after parathyroidectomy - 03/20/2006 (9 Mos. Post-Op): 35, 11/16/2006 (18 Mos. Post-Op): 35 T3, Free (reference range ) This test after partial thryoidectomy (no meds) - 03/03/2006 (9 Mos. Post-Op): 2.37 T4, Free (reference range 0.8-1.8) - 08/19/2005 (3 Mos. Post-Op): 1.01 - These tests after partial thyroidectomy (no meds) - 03/20/2006 (9 Mos. Post-Op): 1.10, 11/16/2006 (18 Mos. Post-Op): 1.28 TSH (reference range 0.4-5.5) - 12/07/2004 (Consult): 1.938, 04/29/2005 (Pre-WLS): 0.803, 08/19/2005 (3 Mos. Post-Op): 1.400 - These tests after partial thyroidectomy (no meds) - 03/20/2006 (9 Mos. Post-Op): 3.165, 11/16/2006 (18 Mos. Post-Op): 2.4 Vitamin A (reference range (38-98) - 08/19/2005 (3 Mos. Post-Op): 52, 05/16/2006 (12 Mos. Post-Op): 65, 11/16/2006 (18 Mos. Post-Op): 57 Folate, Serum (reference range > 5.4) - 11/28/2005 (6 Mos. Post-Op): > 24.0, 05/16/2006 (12 Mos. Post-Op): > 24.0, 11/16/2006 (18 Mos. Post-Op): > 24.0 Vitamin B12 (reference range 200-1100) - 11/28/2005 (6 Mos. Post-Op): 1477 H, 05/16/2006 (12 Mos. Post-Op): 1179 H - Increased sublingual B12 - 11/16/2006 (18 Mos. Post-Op): > 2000 Vitamin D, 25-Hydroxy (reference range 20-100) - 08/19/2005 (3 Mos. Post-Op): 23 - (checked many times along with calcium and PTH) Increased to 800 ius Vitamin D (dry) - 11/16/2006 (18 Mos. Post-Op): 44 - Increased to 1200 ius Carotene, Serum (reference range 6-77) - 11/16/2006 (18 Mos. Post-Op): 23 Selenium (reference range 110-160) - 05/16/2006 (12 Mos. Post-Op): 83 L - Added supplement 200 mg/day - 11/16/2006 (18 Mos. Post-Op): 139

Kathy, I am SO impressed by how dilegent you are to track your labs! You are my idol! Seriously, do you have a spreadsheet for this? I'm just wondering if you would mind sending one to me so I can start doing this? This is just awesome. Congrats on your good results! Hugs, Pam

Hey, Pam! I do have a spreadsheet but I'm getting too many columns so I typed stuff back into a list. If you want a copy of list or spreadsheet let me know and I can send it to ya. Yes, I am very diligent in my labs - I did my 3 month intervals the first year (with extras in there due to certain things being particularly monitored) and now go every 6 months. While I trust my doctors, I know that I am my own best advocate. When I have things in a spreadsheet or list, I can look for trends. For example... I saw my iron dropping over the same of the last year or so. My doctor wasn't alarmed but I didn't like the trend. So, I adjusted things a bit on my own and the results were great. My iron went back up so I'm sticking with what I know. Hugs to you, Kathy

I just got my semi annual labs done at my pcp duriing my annual physical. I will be three years out next month. She really isn't up on wls patients. There are several items on the results that are elevated. The doctor wanted me to contact my surgeon to discuss the results. The surgeon wants to rerun the bloodwork before we explore other avenues. Since you seem so well informed I thought you might know why they could be elevated. BUN/Creatinine Ratio 29 Bilirubin,Total 1.7 Vitamin D 67.2 Vitamin b12 942 I take 2 flintsones a day, 1500 mg of calcium citrate, b12 sublingual 1000 mcg. Thanks for your input.. cheryl

Be sure to discuss all of these with your surgeon/doctor! BUN/Creatinine Ratio is often high when one eats a high protein diet or if you are dehydrated. Mine has been elevated too. My doctor hasn't been worried and just tells me to make sure I drink alot of fluids. Bilirubin has to do with the liver and bile ducts. Not sure what specific issue a high level points at. Did your labs say that your Vitamin D was high? 67.2 is not high by my labs standards which is 20 to 100. Vitamin D is in your multivitamins but you can also get it from sunlight. Milk products are often Vitamin D fortified. It may also be included in your calcium citrate since Vitamin D is important for calcium absorption. Your B12 is not high by my labs standards which rates normal from about 200 to 1400 or so. Elevated B12 is not a bad thing. My doctor tells me "Your B12 is high. We LIKE it high." Excess is washed out by the body since the B vitamins are water soluable. In many ways, it is better to be a bit high then low since low can lead to neurological issues. Hope this helps! Kathy

Thanks for your quick response. I will be speaking with the surgeons office tomorrow and see what he has to say cheryl

Hi kathy.. I just wanted you to know i'm very impressed with you and how well you follow your labs.. not only do you do an excellent job following them but you try to improve them as well even if you are in a normal range.. i think i just may follow your foot steps with my labs because like I say i'm very impressed by you.. xoxo