Parathyroid problems and Low vitamin D

Has anyone on here had this problem? I am having a scan on monday on my neck and I am so scared!!!I just got my iron levels up now this happens!!!!!

Hi I hope Michelle is around to give you some advice on this.....low Vitamin D is becoming a problem for many of us the longer post-op we become.  I've dealt with it also, and with supplementing feel much better. The parathyroid/low Vit D/calcium absorption all play in the scheme of things together.  Have you had a bone density done?

I had many parathyroid scans over the years but all negative,  Maybe yours will also. I do have Hashimoto Thryroid which is hypothyroid. So I take Levothroid for that.   Just got my results back from Vit D see Dana post Off Track Once Again...I put the info there if your interested. I was "0" a yr ago and perfect now. Taking well over at least 5800 IU's of "Dry D3"daily since last Sept put me right at perfect numbers.

Hey! What is your blood calcium level?  Vitamin D?  PTH? How much calcium do you take a day total?  What form?  How often and how much at one time? Elevated PTH doesn't have to mean a parathyroid tumor (which are 98% benign).  I had one but had it before WLS though I had it removed after WLS  Elevated PTH could be a sign that your body isn't getting enough calcium and in order to compensate for that - your parathyroid glands are stealing calcium from your bones to keep your blood calcium normal. Your vitamin D levels need to be up to absorb calcium.  Having a vitamin in the low normal range just isn't good enough.  You want it on the higher end of normal.   Also, you might want to have them check Vitamin K which helps with absorption too. Best wishes, Kathy

Kathy, Thank you so much for responding. I don't know what my calcium is. They just called me and said my vitamin d was very low and I needed a scan Quick!! So they got me an appointment monday . I will post after the visit. I feel better now knowing I might not have tumors. THANKS SO MUCH!!!

Actually, only about 100% of us will have this issue at some point. Some will fall lower than others because no one tests these levels, basically.

That said, get all the copies of labs you can, from pre-op til the rest of your life. Maybe I can help you, but I'd need to know if I smack it with a hammer or a sledge hammer, you know?

Primary hyperPTH is not common, esp in us. However, secondary hyperPTH is expectable and preventable.

D and PTH are like a see saw, with calcium in the middle. When the D is low, the PTH is up. As you bring the D up into normal then high normal ranges, the PTH will go down into normal then low normal ranges, hopefully. And the serum calcium will settle about mid range.

That's just about all we can do for ourselves, at least til I learn more about vit K2.

After that, it's to them to give you the right meds. Um, the Rx vit D is not the right one for us. If they want to give you Actonel or something, you have to be your own best judge. I've taken it for 5 yrs and they say I've gotten all I can get from it. 5% increase in bone mass over 5 yrs.

I fixed my vit D & PTH several years ago, right after I got the first PTH test! But the desired ranges keep changing!

But remember, I'm not asacred of no vitamins! I just take whatever I need to slap my lab levels into the target ranged the docs want.

Michelle, Why isn't RX vit d right for us? I'm a Pharmacist and would love to know. Are you talking about Rocaltrol (calcitriol), Drisdol (ergocalciferol)?

Yes. D2, in oil. First, any of the WLS, except band or sleeve will malsbrob at least part of their fats/oils. Proximals prolly get like 30%, I get maybe 5% (distal RNY) and DS stats say they get 20%, but I think far less.

So, no oil.

Then to use vit D, our bodies are looking for D3. That's the form it recognizes. D2 would normally convert to D3 over by the liver. BUT the food/pills do not go there, so conversion does not happen for us. Our converter is bypasses.

So, we take the vit D IN the D3 form, dry powder in capsules.

The same is so for A. Beta carotene cannot convert to retinol, the only form the body recognizes. I know ppl eat a ton of BC because you cannot OD on it, but you also cannot USE it to save your eyes!

Then vit E. 8 forms of it. dl-alpha is the usual gold soft gels. And we cannot convert to d-alpha, the only form the body recognizes. Of those, the d-alpha tocerpherol succinate is #1, that's powder in the capsule.

So, A, D, E, always a problem for us, RNY or BPD or BPD/DS OR any other operation that messes with the intestine. (or Crohn's, etc)

Even when delivered inthe dry "final" form, we still end up with megadoses, cuz something is still lost in translation for many of us.

Now, all that said, vit K is usually included in that group. BUT I don't see much vit K deficiency. BUT the more I read, the more I think we might need to cover that, as well. For myself, I'm taking a low dose vit K1 and a low dose vit K2 (MK-7 form). Both dry, of course. But other than saying "it doesn't convert", I am still in kindergarten on that one!

You can probably give the above more of a medical explanation when you check it. I have a gazillion studies/articles, some easy reads, some way too technical with molecule chains and such. Way over my head.

Michelle, Thank you for the info. I didn't realize we didn't absorb drugs in oil form efficiently. Do you know if the intestines of a proximal RNY adapt to this over time? I've heard that they grow and change. I seem to be absorbing alot of stuff. I've re-gained 40 lbs.

Welllllll, it'd be more accurate to say that we don't absorb any reliable oils/fats. Of any kind, not just drugs and vites. So, BONUS! Butter on your corn!

Minus: no fat solube vites, either. ANd not a reliable portion of the good fats we want, like the omega family. We use Coromega for those (oil in a non-oil form!)

So, that's part 1 of the issue. Part 2 is the exact FORM of the vites.

So, beta carotene does not become retinol (what your body wants), so you supplement your A in the dry retinol form

D2 (the rx version) does not become D3, the only one the body recognizes, so you supplement in the dry D3 form

The regular form of vit E that your mind sees when I say that is dl-alpha tocerpherol (in oil), and our bodies are looking for d-alpha tocerpherol (succinate), which again is dry, as in powder in capsules.

And you can put a big question mark for vit K, because I only know we don't get full absorption of it , but not so much about which form is best for supplementation. I'm taking both K1 and K2, as they appear to do two whole different things for me. But I can't speak with any degree of knowledge on that.

It isn't JUST the intestinal rearrangement that is the problem, but the whole digestive process is bypassed, as well. And that is where the conversion would have taken place. I realize that some docs insist proximals are not malabsorptive, which only means to me that they're not checking labs at 5 yrs or beyond. And most do not check A or D even pre-op!

But, if you force your body to try to find what it needs in food, the intestine willl lengthen and thicken to TRY, even tho it cannot replace the rerouted part. So, hence the regain, but nutritoinal crash that proximals see, anyway.

Labs are not the entire story, but they are a preliminary view of what's happening, esp if you chart them yourself and point out the trends to your medical ppl.