Report, 6 month labs in

Well, I had my 6 month visit, and it was a little unusual. I participated in a shared medical appointment. 5 people including myself saw the baritrician, Dr Cooper, she reviewed our weights, vitamins and what activity we were doing. Also asked if we were having problems like hair loss and constipation and offered suggestions. At the end we had a quick individual exam. No reviewing of labs. As not all of us were at 6 months or had labs available.
As far as I can tell, I need to up my vit d (currently take 5000 units dry d3), iron (1 tender iron most nights of the week) and maybe cut back a little on the b12 ( 5000 sl daily). So glad to see my hga1c below 6  (bye bye diabetes!!). Have had problems in the past with low hdl, and it still remains low.
Thanks in advance for any advice.

protein  6.9    albumin 4.4    calcium 9.4     bili .4    alk phos 54   Ast 15        glucose 86 

chemistries were all normal, if curious will post if needed.

Iron 20   tibc 347     transferrin saturation 6     hgb 9.8  hct 33.1     (Never been anemic in the past)

b12>2000    vitd 35.7  (vit d was 31 preop)

triglycerices 74   chol 139   hdl 40   vldl  15   

tsh 3.47

PTH 48    Folate 806      hemoglobin A1c 5.5

I think you could double your D3 and increase your calcium citrate a dose or 2 a day.

Which Tender iron are you taking? The 25mg chewable or the 60mg capsule? Did they test ferritin to go with your iron?

Your protein and albumin looks pretty good.

You could cut 1 dose of B12 a week.

Did they test vitamin A?  How much do you supplement of vitamin A (palmitate)?

--gina

Thanks Gina!
I take tender iron from vitalady that has 60mg carbonyl iron and 400mg vit c.
I take 2 citrical a day and my multi has another 500 mg of calcium citrate.

No vitamin a level.  vitamin a is 7500 in my multi

no ferritin, but transferrin saturation 6

Yeah, you need to up the D3 a lot.  We need our D above 80 or we are at high risk for things like osteoporosis, heart disease and some cancers.  I'd do something like 50,000 IU several times a week for a couple months, then retest.

And I'd sure up the iron.

You probably don't need as much B12 as you are taking.  The ASMBS only recommends 350-500 mcg sublingual a day if your numbers are good but I'm not sure I'd cut back that much.  But some.

Are these all the labs you had done?  Because I see a ton of stuff missing.  B1, vitamin A, zinc, copper, prealbumin, ferritin, B6, at a minimum.

Kelly

Thanks Kelly.
That was it for the labs. Folate, b12 and vit d were all that were tested. I dont know if that changes at 1 year.
My NUT was the one that recommended that my vit d be above 70 or 80.

Your TSH is a bit high. For effective weight loss, it should be less than 3.0, according to newer standards and my bariatric program. I just had my 6 month labs done and it will be awhile before I get the vitamin levels back. When I do, I'll post them. My lipid panel is crap, which really surprised me.

You are definitely anemic - your hemoglobin is way too low, should be above 12, usually below 9, they give you blood transfusion. Your iron is also super low which leads me to think your ferritin is probably very low - you should probably try to get that tested - it is how much iron you have stored in your blood and is very important. Your saturation is also very low. I would increase your tender irons to 3 per day and make sure you take them every day. You can take them all in one dose and they must be atleast 2 hours away from your calcium and thyroid medication.

There is controversy about high B12 levels. My hematologist says greater than 2000 is fine, you just pee out the excess. I used to have levels like that preop and wish I could get them back but with my malabsorbtion, I just can't do it. If you are concerned with such a high level, take the 5000mcg 5 or 6 days per week and get retested in 2 months and see where your level goes. You want to be around 1500 but it can go up to 2000.

Your vitamin D is very low also. 5,000 units is not enough. You need to get the 50,000 unit capsules of Dry D3 and take them 2 times per week, this should bring up your levels niceley. You want your level to be between 80 and 100. If you want to continue on the 5,000 unit capsules to finish the bottle, take 3 per day - all in one dose.

Your TSH is too high. Are you on Synthroid? If so, you need to have your dose increased and if not, you need to be put on it. The new range for TSH levels put out by the Endocrine Society is .3-3.0. Unfortunately not all doctors use this range. If your TSH is too high, it can slow down your weight loss.

You also need to have vitamin A, zinc, magnesium and selenium done.

You also aren't taking nearly enough calcium. 2 citricals are depending on type are either 400mg, 500mg or 630mg per day. You need to take between 1500 and 1800mh per day. Try getting the maximums which are 315mg per tablet or 630mg per tablets - take 2 tablets 3 times per day and you will get 1890mg per day. The petites you need to take 3 yablets - 3 times per day. It is misleading when you read the bottles - when it gives you the dosage, it is for 2 tablets/

Thanks so much!
I am upping the d and the iron. I was doing twice a day, but will try for 3.

Thanks again!