XP Lab Results for the Gurus Out There

Ok, I got my labs back. The B6 has to be repeated because the specimen was hemolyzed.
My only concerns are the ferritin, while normal, is down from Oct. 09. Could this be because I had an iron infusion last year?
My protein seems to be dropping. I get about 125 grams a day.
My B12 and vitamin D are doing great, up a great deal since Oct. 09.
My B1 is high. What would cause that and what should I do?
My liver enzymes are elevated. That has been the case pretty much for several years. I will follow up with my pcp.
The rest of my labs are normal. Let me know if there are any others that you want to see.

Name FERRITIN, SERUM
Standard Range 11-264 ng/mL
10/14/2010 239
1/20/2011 196

Name Standard Range 10/14/2010 1/20/2011
HEMATOCRIT 36.0-46.0 % 46.2 40.6
PLATELET COUNT 150-400 K/cu mm 353 327
WHITE CELL COUNT 4.4-11.0 K/cu mm 9.8 6.9
RED CELL COUNT 4.00-5.20 M/cu mm 4.97 4.22
HEMOGLOBIN 12.0-16.0 g/dL 15.6 13.9
MCV 80.0-96.0 fL 93.0 96.1
MCHC 33.4-35.5 g/dL 33.7 34.4
RDW 11.5-15.0 % 14.6 12.7

Name Standard Range 9/4/2008 1/20/2011
IRON SERUM 40-150 ug/dL 88 70
IRON BIND CAP SERUM 225-410 ug/dL 365 304
% SATURATION TRANSFERRIN, SERUM 20-50 % 24 23

Name TOTAL PROTEIN, PLASMA (LAB) ALBUMIN, PLASMA (LAB)
Standard Range 6.1-7.9 g/dL 3.5-4.7 g/dL
10/14/2010 7.1 4.4
1/20/2011 6.7 4.0

Name VITAMIN B12, SERUM
Standard Range 180-914 pg/ml
11/24/2010 622
1/20/2011 1183

Name VITAMIN B1, WHOLE BLOOD
Standard Range 70.0-180.0 nmol/L
1/20/2011 197.0

Name VITAMIN D 25 HYDROXY
Standard Range 30-80 ng/mL
10/14/2010 42
1/20/2011 74

Name PREALBUMIN,SERUM
Standard Range 17.0-42.0 mg/dL
1/20/2011 19.0

Opps, I forgot about the calcium level. It dropped a lot, too.

Name	Standard Range	10/14/2010	1/20/2011
CALCIUM, PLASMA (LAB)	8.6-10.2 mg/dL	9.7	8.9

I read a post Vitalady made to a lady on her grads board, and she basically said to keep with Proferrin ES even if you're getting iron infusions. Proferrin ES is heme iron and it sort of like eating liver or something. It's not like other iron supplements. It really helped raise my ferritin, iron serum, hemoglobin and hemotocrit.

The calcium worries me because I don't see where they ran your PTH (parathyroid hormone). Your calcium, vitamin D and PTH go together. You want your calcium around 9.2, PTH around 30 and vitamin D around 100. How much calcium do you take? I'm thinking you might need to increase it.

I don't see where they tested your vitamin A. You might want to ask to have that run, and if you're bruising easily, your vitamin K1.

--gina

I will check out the Proferrin ES.
I am only taking 1000mg of calcium a day per my doctors instructions.  I was told that I no longer was malabsorbing so I didn't need extra.  Does this mean I am still malabsorbing?
I did request my PTH to be drawn.  I think some labs haven't come back so maybe that was one of them.   My PTH was 46 in Dec. 09.
How much calcium should I take?
What do you think about my protein?  I am concerned that is is dropping in 3 months when I am getting in 125 grams a day.

Here is my vitamin A and K1.

Name Standard Range 1/20/2011
MISC REF TEST NAME   Vitamin K1, serum
MISC REF TEST RESULT   0.50 ng/mL
NORMAL RANGE   0.10-2.20 ng/mL
REFERRAL LAB NAME    

Name Standard Range 1/20/2011
RETINOL (VITAMIN A) 0.30-1.20 mg/L 0.51
RETINYL PALMATATE < 0.11 mg/L 0.06
INTERPRETATION (VIT A)   Normal

Even normal folks need extra calcium. If you're close to a proximal RNY or VSG configuration now, I'm thinking at least 1400mg of calcium citrate a day. If your PTH comes back higher than 46 you can be sure you are leaching calcium from your bones and your body is struggling to keep you organs supplied. If that's the case, you may need more calcium than that and you might need some magnesium oxide to help with constipation as well. Keep the dry vitamin D coming in at 5,000 to 10,000IUs a day. You might want to schedule a bone density scan if you haven't had one in a year or so.

I think a couple of protein shakes might help to bring the protein and albumin back up. If you can absolutely not drink protein shakes, try more eggs and Greek yogurt, but protein shakes would be better.

--g
 

I did ask my pcp about a DexaScan so that should be scheduled soon. I will add one more 500 mg calcium for now.  It does include magnesium but I ordered some extra any way because I have problems with constipation.  I will keep the D where it is for now.
I already have 3 protein drinks a day.  Should I up that to 4?  I actually would rather drink my protein then eat it for some reason.  I do eat at least 25 to 30 grams a day along with my shakes.

I think 4 shakes should do it. They are whey protein isolate, right?

Not usually.  I use Body Fortress.  I buy whey isolate when I can get a good deal on them.

I think Body Fortress is a whey isolate blend. Not a thing wrong with that.

Good.  I guess I'll add a fourth.  Good think I like them.