The True LAB Story!

I was anemic before  WLS, but it got substantially worse afterward.  The bottom line is labs are ESSENTIAL!!!!  My anemia brought about pica--I craved and ate cornstar*****essantly (a box a day at the worst) which brought about a 17lb gain, muscle wasting, and extreme fatigue over the last 2 yrs.  I just had my first Infed infusion on Thurs. and I must say I can feel the difference already primarily because the cravings are all but gone.  No matter the deficiency, I believe it can cause us to revert to old habits or crave things we may not have eaten otherwise.  While I don't discount oral vits and minerals, please see a specialist if your labs are off consistently and your doc basically tells you to keep it up hoping for a change.  The sense of failure we feel with even a slight regain can spiral out of control and we may be less at fault, personally, than we perceive.  It wasn't until recently that I realized my eating habits were brought on by deficiencies that had a number of side effects, weight gain being the least of them.  I'm convinced that labs are key to staying on track with loss and maintenance no matter how far out ( I'm 4+ yrs)!

I'm five years post-op.  I have suffered with low iron problems since about two years post-op.  I had depleted iron stores. (Ferritin)  If your doctor is not a specialist, (Hematologist), he may not know   to order or read iron studies. About two years ago I had worked myself  up to 1 1/2 hours of cardio a day and weight training.  I was at my lowest weight.  Suddenly I started experiencing extreme exhaustion, (Sleeping 14+ hours and still tired) dizziness and I was lightheaded.  Doctors measured my Hemoglobin and said that it was normal.  It was taking from the ferritin.  Over the last two years I gained 20lbs!  I'm finally seeing a hematologist who orders IV Iron infusion whenever my ferritin drops below 100.   It measured as low as 7, at one point. I am back to an hour of cardio a day.  I've lost  the 20lbs and feel great.  It's a shame that I had to suffer for so long.  I actually had to demand a referral to specialist.  I was barely functioning. Labs are so important.  I get them every three months now.  The farthur out we are the more complications can sneak up on us.  I am now experiencing elevated PTH due to low calcium.  I wasn't consistent with my calcium as I was focusing on the iron. (you can't take them together and I'd frequently forget.   I'm taking Upcal D now.  Thanks for the reminder.  long term post-ops have a lot to share with others, including doctors.

MOt docs do not launch ppl on iron. I find it odd because we malabsorb iron, regardless of surgery type. OK, bands can't eat enough.

As for your problem with PTH, vit D is the problem. While there is the right form of D in the UpCal D, if you are a DS, you're robably needing 50,000 units/day for awhile, the ropping backto 20,000 or 30,000 once you find your level at 60-70.

When D goes up, PTH goes down. And vice versa. CALcium is sorta stuck in the middle there, but will usually fall into line once PTH rests between 20-40 and D is up around 60-70. The D needs to b te dry form D3, but I'm guessing you know that.

The iron in a multi is sort of a nod, but since it's mixed with calcium and everything else, so the net to us is between zero and not much.

I launch my proximal RNY and bands on 150mg elemental iron and 300mg for distals and DS. But even so, as was said, labs are critical and WE need to get copies and keep a spread sheet, even if it is done by hand. Chart your changes and take action when you see downward trends developing, long before you "feel" sick.

The areas to watch:
protein, albumin and pre-albumin
iron, ferritin and the CBC
vites A, D, E, B1, B12, folate
calcium
PTH
zinc

Those especially are where the trouble will find us. And just a multi or two does not address these specific issues.

RE: 150mg and 300mg iron -- Is that true for post menopausal as well? Deb

Yes. The reason for taking it isn't what you use or lose, but that you cannot get it IN in the first place. The malabsorption is the problem.

It is itrue for men, as well. They are usually quite depleted if no one has been watching for awhile.

Is there a limit to how much you should take at one time? Thanks, Deb

In THEORY, 150mg at one time. However, I take 300mg at once (all 12) and the lab results definitely refdlected the increase. I started with 4, then 6, then 8, then 10, then 12. That was over time and the lab result dictate the increases. Then when I reached 12, my numbers were precisely where I wanted them. I get labs in another few weeks and will see if 12 is holding them where I want them.

Thanks! I've been taking 6-8 at a time and it occurred to me that I might taking too many.  I'm glad I can take it all at once.  Otherwise, I'd have to stay up 24 hours in order to separate the iron and calcium doses. Deb

I totally understand. My husband actually takes 600mg at the same time. I'm thinking that can't be right, but his labs are stellar, not just ok.