post-bariatric hyperinsulinemia and hyperparathyroid
I am 9 years out this week! My top was 312 and I am maintaining at 165.
I've been having a lot of health issues this year...constant migraine headaches, weakness, fatigue, etc.
My surgeon is lousy at this post-care. At the annual he told me that five years ago a test I had done showed that I had PB hyperinsulinemia. I was NEVER informed of that. At this annual this year, He told me I needed to reduce corbs and keep track of what I eat. That was it for follow up support regarding the PG hyperinsulinemia. I had my labs done 10 days ago and his staff still hasn't followed up with me. Also, I texted him at a number we are given. he merely said I needed more vitamin d. That's the last I heard from him.
I decided to follow-up with my primary. He is an excellent doctor. He asys my blood work shows I have hyperparathyroid secondary to severely low iron and vitamin D. He put me on therapeutic D and has scheduled me with a hemotologist to address the thalassemia (iron). I'll be getting an iron drip.
I am so pissed at the bariatric surgeon's nonchalance at my care. This was a problem even in the first few years after the GB when I had a mesenteric hernia and had a very difficult time getting into his office for help. It took several emergency room trips before i finally got the surgeons attention and the mesenteric hernia was discovered. I really suffered a lot of pain until that was fixed.
Anyhow, I'm wondering 2 things,
1) Does anyone have hyperinsulinemia and hyperparathyroid? what were your symptoms? How did you get well?
2) Has any ever successfully switched surgeons and transferred care to another bariatric surgeon? if so, how did it go? was the new surgeon receptive? Who did you switch to? Who should I avoid?
It sucks that you cannot rely on your WL surgeon to be doing the right things by you, can you consider changing to a different WL surgeon for future follow-ups?
That said, I am no doctor, medical professional or expert...But I can contribute what I experienced and you might be able to see a correlation or ?? it with your doc for more help...
My 6 yr follow-up blood work came back with my parathyroid way out of wack (the previous yr my Vit D was extremely low)...My surgeon was concerned about the parathyroid and was going to send me to back to my GP for a specialist referral - but 1st he just wanted to ask some questions about what was different in the last year from my previous year in terms of vits & supplements...I told him I had added the Vit D (as we discussed) and that I had also added Mag Oxide to my supplements because I had heard thru the "grapevine" that it would help with regularity (constipation & regularity is a continuing battle)...He never explained the workings of this but he did say that the Mag Ox might be what was throwing off my parathyroid results - he had me do a 6 week trial w/out the Mag Ox in my supplement and re-do of blood work, low and behold my results returned to normal, he then followed up again 3 months later for the same retest with me continuing to stay off the Mag Ox, blood work is still looking good and of course in about 6 months I will go for my annual and we will check again...
Don't know whats on your vits and supplements plan but could be something to look at or at least talk to a professional about...Good Luck, hope you get some resolution...
Alesia : start 249 / surgeon's goal 138 / current 142
hyperparathyroid - means high parathyroid, right? . That one gets high when body start pulling calcium from your bones. That may mean that you either do not get enough calcium or enough Vitamin D
Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). The parathyroid hormone regulates calcium and phosphate levels and helps to maintain these levels. Excessive PTH secretion may be due to problems in the glands themselves, in which case it is referred to as primary hyperparathyroidism and which leads to hypercalcemia (raised calcium levels). It may also occur in response to low calcium levels, as encountered in various situations such as vitamin D deficiency or chronic kidney disease; this is referred to as secondary hyperparathyroidism. In all cases, the raised PTH levels are harmful to bone, and treatment is often needed.[1] Recent evidence suggests that Vitamin D deficiency/insufficiency plays a role in the development of hyperparathyroidism.[2] Lithium is associated with an increased incidence of hyperparathyroidism.[3]
as for the first: hyperinsulinemia
New Data on Weight Gain Following Bariatric Surgery
Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.
The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.
Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.
“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss," said Dr. Roslin.
http://www.lenoxhillhospital.org/press_releases.aspx?id=2106
Hala. RNY 5/14/2008; Happy At Goal =HAG
"I can eat or do anything I want to - as long as I am willing to deal with the consequences"
"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."
Your situation sounds very similar to mine.
I had my DS 10 years ago. Went from 286 down to 160 lbs (post-tummy tuck). About 7 years ago the weight started creeping back up until I was at 226 lbs around 3 years ago. I finally got in to see an endocrinolgist 2 years ago and she found out that I had hyperinsulinemia (post-prandial hypoglycemia) which accounted for the weight regain and overall crappy feeling. The only thing that would help me lose a few pounds was going very low carb - which seems to work by keeping your insulin from spiking.
I asked her about taking Metformin, (a cheap generic diabetes medication that lowers insulin), and while she was originally reluctant as she didn't want it to lower my glucose levels too much, she agreed I could try it. I started with 500 mg once/day for a month or so. I went through a period of adjustment (diarrhea, etc.) but that passed for me quickly. It's been a miracle for me - I stopped gaining weight! Then we increased it over 8 months or so until I ended up taking 2000 mg /day. I take one 500 mg tablet with each meal. I am now back down to 161 lbs - it came off a lb here, a lb there. Best thing is, I can eat carbs in moderation again! (I still can't go crazy on them, or sugar, or I feel sick.)
I also went through the chronically low vitamin d and iron battles with my doctor. Finally was sent to a hematologist 4 years ago who agreed to give me an iron infusion every 12-14 months. Unfortunately they will only do it once my ferritin and hgb get so low I can barely function. I also give myself Vitamin D shots in my thigh every month. Now that I am on top of these issues, my health is great. (Except for chronic almost daily migraines - I'm still trying to sort those out.)
best of luck to you,
suzanne
