Vitamin D Rapid Increase? XPost

At the lab that I have my work done the range is 30 to 80.  She was worried about D toxicity.  I was aiming for 100 but she kind of got me worried so I cut back a bit.  I think I'll do every other day for a week or so then twice a week for a while.
Getting labs done where I go is like pulling teeth.  I would like to get vitalady's full recommended labs done every 6 months but they refuse, saying my insurance won't pay, even though my insurance has never rejected a claim once.  I even went back to a previous PCP because she had been easy going about labs before and she refused, too.  None of the PCPs (there have been at least 3 so far) that I have seen will do them because they think my bariatric surgeon should be ordering them.  And my bariatric surgeon and his staff told me to ask my PCP to do them.  Once I deal with my current issues I plan on consulting a different surgeon but I really don't want to do that while I have ongoing issues going on.
The big issue is that they don't think I malabsorb anymore since my revision, and therefore can't justify frequent labs.  I believe I have at least some malabsorption as evidenced by the fact that I am eating over 2200 calories a day and I can barely break 100 lbs.  I never had that high of a metabolism before so I am sure it's because I am malabsorbing but my surgeon says I'm not.  Although they are starting to acknowledge it now that I am bringing in my food diary and they see exactly what I am eating.  But they still don't think I am malabsorbing vitamins because my levels have been good.  They have been good because I take a boatload of vitamins every day.
I would love to see an Endo but I would need to be referred to one and because I have no issues related to endocrinology they won't refer me.  
It was all a lot easier when I deferred to my doctors and never questioned anything.  I was a good little patient who did whatever they told me to do.  Now that I am educating myself about things they act like I have no right to tell them how to do their job when I ask for tests that they don't recommend for me.  I wish there were doctors around here that understood more about WLS then just doing them, but about their nutritional needs after wards.

i guess i should be thankful that I have medicare - have been on social security disablity since 1999.  Medicare is the best and they cover almost everything.  I can go to whatever doctors I want with no referalls and can have whatever labs the doctors order and as often as they order them.

You say you have no Endocrine disorders?  Do you have a thyroid problem?  ALmost all adult females are hypothyroid and  a large majority don't even know it.  Endocrinologists specialize in thyroid disorders.  If you have hypoglycemia, an Endocrinologist would be the proper doctor to see since they deal with the pancreas, insulin levels and blood sugars.  They also deal with parathyroid.

I can't believe your surgeon can say you aren't malabsorbing?  All Gastric bypass and DS patients malabsorb -  I know your revision changed your procedure but isn't it a combination of the 2 procedures?  Just because they changed the length of your common channel, you still don't have a full GI tract - you don't have a full small intestines - some of them are bypassed causing malabsorbtion of not only food - some do lose this but everyone malabsorbs vitamins for life.

You are like me in that we both need to eat an enormous amount of calories just to maintain our weight.  It took me a year, but I finally gained 20 pounds.  I will admit that I eat alot of foods that I shouldnt but if I didn't eat high calorie foods, I would still be losing.  I also eat at all hours of the day and night.   I also have great labs but that is due to supplementing.  I will say that I do absorb some vitamins - hense - high vitamin A level *(used to deficient) and now stopped vitamin A 8 months ago and can't get my vitamin A level down - normal 38-98 - mine is 119.

B12 shots I need to take 3 times per week, I also take high dose D, lots of calcium and 240mg of tender irons - iron not great since kidney stone surgery this fall and lots a ton of blood - needed a transfusion and can't get levels up but allergic to IV iron, so they are really leary to give it to me unless absolutely necessary.  So, I am still plugging away with the tenders - will increase to 5 per day from 4 if I need to .

I stopped the pancreatic enzymes because they made me absorb foods too well - gained 15 pounds in 3 weeks.   Gastro doctor wants me to go back on them due to fatty infiltration of my pancreas and constant diarhea but I won't take them again right now - don't want to gain anymore weight.  I guess I could go on a smaller dose and they would probably work differently but I am afraid at this point.

good luck and I hope you can find a doctor to help you - I heard there are websites where you can order your own labs - you might look into that if your insurance would pay for it.

That is what ****** me off.  I have Medicare also and they have never not paid for anything.  I have no doubt they would pay for the tests.  They always have in the past with no questions.  All they will say is "I don't believe in ordering unnecessary tests", meaning if I don't have symptoms or a history of abnormal results, they won't order certain tests.
Yes, I have no endocrine disorders.  Thyroid is perfect, no blood sugar issues, everything is good.  I'm not complaining just explaining why I can't go do an Endo.
I don't know why they insist that I have minimal malabsorption.  My intestines are in the DS configuration.  They lengthened my common channel but kept the DS and made my sleeve into a RNY pouch, but I am classified on my medical records as having a gastric bypass and I am treated as one.  So now when I see a doctor I have to try to explain that even though it says RNY, I don't have the Y configuration, I have the switch.  Since the DS isn't performed in Oregon anymore I have yet to find a doctor that has a clue what that is.  My surgeon told me before my surgery that I would have very little malabsorption and that is what he believes.  Personally I feel like even though he used to perform the procedure he seems not to know much about it and I can't even be certain that is what he did.  My surgery is now doing what I thought it was supposed to do nine years ago, if that makes sense.  I almost wonder if I was was measured incorrectly with my surgery and that is why I had so many side effects the first time and the revision corrected that problem.  One of these days maybe I will find out what was done to me.
I eat a lot of high calorie food like fats but I avoid things like candy and bread, junk type food.  I try to make sure that most of the food I eat is healthy.  I do eat a lot more at night then I ever did.  I used to stop eating after dinner but since I have been trying to gain some weight I have started having snacks at night, in fact I would guess I eat most of my calories after dinner.  I am usually too busy to eat much during the day and I could never get in enough calories if I didn't snack at night.  I try not to just eat whatever but to plan what I have and most of the time it is high protein, except the popcorn.  I eat that to add in fiber and carbs plus the extra fat from the butter.
I had an iron infusion a few years ago but now it seems my levels are pretty good just taking the standard dose of iron.
My doctor won't give me pancreatic enzymes because he says it would only help me absorb protein better and he didn't think that was my problem.  He did threaten to give me a feeding tube if I kept losing but fortunately the weight loss stopped 4 months ago and I have stayed the same since then.  He doesn't seem concerned about my weight because I'm not having any issues related to being underweight so he just wants me to continue to try to eat more.  Fortunately I haven't had any issues with diarrhea since my revision.  One of the reasons I had the revision was because I had constant diarrhea, probably due to chronic bacterial overgrowth in my intestines.  I have read that having a blind loop of the intestines is one of the causes of that and it makes me wonder if whatever they did the first time left me with that.  Another doctor had mentioned that to me years ago when I had an auto immune disorder related to the bacterial overgrowth.  It was recommended I get revised 8 years ago because of it but I refused because at that time I was thin and was afraid of regaining, even though I wound up regaining anyway.  Anyway, whatever they did in the revision fixed that problem and I haven't had any bacterial overgrowth since the day of my revision.  For that alone I am grateful I had the revision.
I wish I could order my own labs and have Medicare pay for it but from what I understand if you have that done you have to pay for it yourself.  If you hear otherwise let me know.