Can anyone help with Vit routine? My Doctor doesn't care.

Okay, it's probably harsh to say that my doctor doesn't care-- let's just say that she doesn't seem concerned that my vitamin levels have been falling and I am on the low end of a lot of tests... and I am really wondering if she is requesting all the needed tests.

I've had a hard time with Vitamin D.  Two years ago I had vague health symptoms-- fatigue, depression, general feeling of unhealth, splitting nails, headaches, etc.  My same doctor cheefully tried to tell me that I was starting pre-menopause (I was 38).  Then another doctor discovered that I had a Vitamin D level of 6.   With 10,000 iu dry Vitamin D3 per day, I climbed back up to 36 (low normal).  My normal doctor declared this a wonderful level and that I should continue supplementing at 2000 iu dry D-3 a day.  (I did 4000).   All my weird symptoms vanished.  However, last year, my Vit D 25-Hydroxy was only 33 (my doctor didn't mind).  This year it is 30 (She still doesn't mind.  It's over the low setting of 25.) 

Last year my B-12 was 240 (reference is 239-931).  My doctor said everything was fine.
This year my B-12 is 234.  My doctor suggests that I supplement with 100 mcg per day.  That would actually be cutting my normal supplementation in half. ???

Now I'm wondering about the rest of my labs because I'm seeing a lot of low readings.

WBC  5.1   (REFERENCE 4.5-11) 

RBC  3.88  (REFERENCE 3.9-5.03)

HGB  11.5  (REFERENCE 12-15.5)

HCT  33.6  (REFERENCE 34.9-44.5) ***My doctor notes MILD ANEMIA, but no action plan.***

MCV  86.8  (REFERENCE 81.6-98.3)

MCH 29.6  (REFERENCE 27-32)

MCHC 34.2 (REFERENCE 32-36)

RDW  14.8 (REFERENCE 11.6-14.8)

FASTING GLUCOSE  72 (REFERENCE 75-100) ***She notes LOW, no other notes.***

Cholesterol  174  (REFERENCE 0-200)  *** She notes GOOD***

HDL CHOLESTEROL  78 (REFERENCE 40-60) *** She notes HIGH***

LDL CHOLESTEROL  88 (REFERENCE 0-130)

TSH  2.45  (0.465-4.68)

URINE COLOR-- YELLOW
URINE CLARITY-- CLEAR
URINE GLUCOSE-- NEGATIVE
URINE BILIRUBIN-- NEGATIVE
URINE KETONES-- NEGATIVE
UR SPECIFIC GRAVITY-- <=1.005  (REFERENCE 1.010-1.020) ***She notes LOW***
URINE OCCULT BLOOD-- NEGATIVE
URINE PROTEIN-- NEGATIVE
URINE UROBILINOGEN-- NEGATIVE
URINE NITRATE-- NEGATIVE

Sorry about the long post and lab read-outs.  I'm just worried.  Any suggestions?  I can't really get another doctor for at least 8 months.  And, yes, she is familiar with RNY patients. 

Sorry-- I accidentally posted this before I could also thank anyone *****plied ahead of time.  I really appreciate anyone taking their time out to read this and post any suggestions or answers.

There aren't any levels there on iron or calcium or much of anything..Your cholesterol is good (I have a history of high and your's is lower than mine)..If your red blood count is low, you can go with the iron and such...how do you feel. If you feel run down, hit it with iron and B12..

But I'm not a vitamin expert either..Better to wait for someone with more experience in labs..

Hmmm.  The higher the good cholesterol, the better.  I guess we are both doing good there.  I was slightly anemic a year ago (lowest of the low acceptable numbers last year) and she never ordered iron or calcium then either.  I don't understand her.  Literally hundreds of RNY patients are getting care at this hospital now.  I can understand if she didn't know what to look for or what labs to run 5-7 years ago but today...?

I fixate on the LDLs since mine are about three times what yours are..but the ratio is still really good for me, I think that's why my PCP hasn't jumped on it. She knows my motivation is to stay off of ANY medication.

I agree with MacMadame...she's not ordering enough blood work. Can your surgeon ask for the blood work, cuz they generally know what to ask for? I get 14 to 17 vials drawn by my surgeon each July and my PCP and I review them in October...then she re-orders any that we think are off and need work..This last time, I got my results from the surgeon and compared all the levels. The only one I was concerned with (and changed my vitamins accordingly) was D..So we're testing that again in January..

If that's all that's being tested, you definitely aren't getting all the necessary labs.

Also, the range for Vitamin D that says anything over 30 is okay is out-of-date. You really want to be at least 55 and over 70 is better.

Here's the list of labs that I get:

http://lapsf.com/Annual%20Lab%20Orders%202008a.pdf

Thanks for posting your list of labs!  I feel like calling and asking my doctor why she has never ordered even half of those for me.  :)

If that's all they did on you for labs that's awful!  You need to find someone who is going to take this seriously, she may know about RNY patients but she's not doing enough. 
I don't have my labs in front of me right now (I'm at work), but I know some of the labs I've had that I don't see above:
B's (besides 12), Iron, ferritin, zinc, Vit A, carotene, D, I know there's more but I can't think of any right now.
Did you have any of those done?  What vit's do you take?  I take a boatload everyday and still have to double my D, add more zinc and start beta carotene.
I know on 'Yahoo groups' there is a list of the labs you should be getting, not sure if there are lists on OH or not, if you want the name of the yahoo groups that can help you let me know.

Gotta go back to work,

Edie

When I come up for insurance renewal and can switch doctors, I think I'd better.  I like this doctor.... she just seems so complacent with seeing me on the low (or slightly lower than the lowest) "acceptable" reading on each of these.

I take 4000 iu of dry D-3 a day, generally split once in the morning and once at night.
3 multi-vits, 1 in the morning, 1 at noon and 1 at night.
Now I am taking sub-lingual liquid B-12 in the morning.
2 calcium (citrate).
1 iron, at noon.

Nothing else except for what's generally in a woman's multi-vitamin.

Thanks for taking time to reply to me! I appreciate it!

If you email me to my email [email protected], I can send you my thoughts on this and the labs list.