Good Morning. Just when you think you have heard it all...

...something surprises you. I've been trying to help a 5-year post-op DSr with her labs and vitamins. She is being scared spitless by here PCP...telling her when she goes a little over the high end of a range she's "toxic". Damn! That is some bogus BS!  The range is a statistic of what the lab considers "healthy" people normal ranges. Totally different from vitamin toxicity. Don't let someone scare you like that, please. 

How many of you medical folks got training in what over the counter vitamins are needed to maintain optimal health? By all means, correct me if I'm wrong about the lab's ranges and such.

--gina
   

The thing is, is the PCP's and NUTS believe it IS toxic to you.  Not too long ago I had a NUT call me about my high D3 level and went on and on and on about what it could do to me. 

I'm sure there are some instances where it could be toxic. 

I went online a few weeks ago looking for college programs for dieticians and nutritionists for bariatric patients - none to be found.....

Good morning Gina, and LWs.  Happy FRIDAY!!!

I am a nurse/nurse practitioner.  Basic training in food pyramid...need 5-6 fruits and veggies a day, if lacking, one multivit a day.  Pretty minimal huh!!  No training in lab ranges for vitamins, except toxcitity more likely with fat soluable vits (A,D,E,K); these are stored in the fat.  Toxicity next to impossible with water soluable vits..C, Bs...we just "pee" excesses out.  That's about the extent of my knowledge re vitamins!!!

Jane

Gina, even I know enough about vitamins to discount what the twit at my surgeon's office said that their daily had everything I needed. HORSEHOCKEY!!!! And that they needed to tell me if I needed to supplement it. I prefer a preemptive strike. Easier to adjust down that up. Took me over three years to fix my extrememly low vitamin D. I'm NOT letting that one slip again.

Thank goodness my PCP leaves me alone when he saw my list. Didn't blink an eye. He's a keeper. :)

I've already told dh that once we get our lab values back we will be tweaking our levels to suit what we need individually but for now, we are both taking the same thing.

Liz

LOL........Gina you know WAY MORE than me about Vits!!  We don't learn about that in basic anatomy classes. 
I'm sure there is very little research done on the longterm effects of consistantly High Vit/Min levels in post bariatric sugery patients since the majority of WLS patients remain on the LOW side of normal or even permanently too LOW. 
That would definitely be a good research topic for some grad student wouldn't it!

Most ranges are developed from testing sick people anyway

Just dropping by to say good morning!

I tried taking calcium citrate pills on Wednesday.  Took 3 doses, the last one being close to bedtime.  Big mistake.  I felt my sleevie wiggling all night and thought I had a Sleevie flu in the morning.  I was going to stay home from work, then figured out that it was the Calcium.  UGH.  Yesterday I had two doses and chews and 1 dose of tablets.  I think I need to build up to all 6 and definitely not at bedtime with my potassium.

My 1 year labs are coming in.  So far everything is looking ok but Iron is still lower than I'd like.  When they're all back I'll post them and get your expert opinion Gina, if you don't mind.  Speaking of expert opinion, has anyone heard whether Randi had her last surgery this week?

Have a fun day everyone!

Lee - I have to take the chews.  The calcium pills make me nauseous.... 

Hope you can get it worked out!

This is timely. I just saw my surgeon's NP yesterday. I won't go into how woefully uninformed she is except to say that she wants me to take Flintstones. Nuff said.
Anyway, she was worried about my Vitamin D level. It is 74. Apparently she has never seen one this high. She doesn't even know what the dangers are of a too high D because she's never had a patient with one that was this high. She wants me to take half the D I had been. Of course I agreed. I didn't tell her that I am aiming for me D to be 100.

You might want to print this article out for her. Here's some paragraphs out of the article published in 2007: 

A consensus is emerging that levels above 50 nmol/L are necessary for proper function of the body’s cells and organs, with a range of 78 to 100 nmol/L necessary for bone health, fracture prevention, and chronic disease prevention.6,8 In determining optimal serum concentrations of 25(OH)D, Bischoff-Ferrari and colleagues found optimal fracture prevention when serum 25(OH)D levels were approximately 100 nmol/L.8

Higher levels can be tolerated without any adverse effects, as lifeguards and sunbathers can have serum vitamin D levels of up to 250 nmol/L without any signs of toxicity.6 According to Holick, exposing the body to sunlight that causes minimum redness to the skin is equivalent to ingesting 10,000 to 25,000 international units (IU) of vitamin D.9 If only 6% of the skin is exposed to sunlight, that is the equivalent of 600 to 1,000 IU of vitamin D.

Some levels will produce toxicity symptoms, however. Vitamin D toxicity appears first as hypercalcemia, with vitamin D levels above 600 to 750 nmol/L, although it can be seen in lower serum levels of 500 nmol/L.1,13

Link: www.todaysdietitian.com/newarchives/tdoct2007pg12.shtml

--gina