Newby DS'r in vitamin trouble - now with lab numbers

IF my surgeon did my labs, I would only have them pulled once a year NOW and not all the ones I need.

I have a lab slip created from two different surgeons AND the Vitalady list and my PCP handles mine...and he pulls them 2 times a year. *I* adjust my own labs. IF I listened to my surgeon my vit D would be in the toilet and my PTH would be sky high.

Yeah, I got my labs back yesterday in the mail and the PA wrote a note on there and it said...."Great job! Keep up the good work and keep taking that MULTI-VITAMIN every day!"... :ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO:...I shit you not....:ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO:. They are flippin clueless regarding post DSS, just as you guys have always said, you are on your own after the surgery!
 
I've been really bad on the vitamin front lately. Shame on me.

I've been under a lot of stress (my employer announced 50,000 job cuts yesterday, for example, and after 34,000 in 2010 and another 14,000 in 2013, I just can't bear the thoughts of once again defending my team's role to "efficiency" consultants *again* while they yammer on about "streamlining" and "rightsizing" and "rightshoring" and "layers of management" and "spheres of influence"). So, my body probably needs even more vitamins than usual and I've been skipping. Bad Hilary!

This thread is inspiring me to get back on track. Thank you for that!
 
Yeah, I got my labs back yesterday in the mail and the PA wrote a note on there and it said...."Great job! Keep up the good work and keep taking that MULTI-VITAMIN every day!"... :ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO:...I shit you not....:ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO:. They are flippin clueless regarding post DSS, just as you guys have always said, you are on your own after the surgery!
My current PCP DOES have some clue but even he keeps telling me to STOP the extra B12 (can't as all I take is IN my multi) and that I need to drop some of the D. I ignore the advice on both of those.

My first set with this PCP my K was right on the lowest number for normal...his comment then was that doubling the amount I take would be advisable...and that was a so called NORMAL lab value!

That and I get the "she will want copies of these labs", LOL.
 
Another update. Went in yesterday for a pre-colonoscopy screening. While the nurse was doing my blood pressure she kinda wigged out and released the blood pressure and put the stethoscope straight to my heart. She listened for a long time and left the room. She came back with a surgeon who had me take off my shirt and he listened all over. They left then came back and gave me an EKG. I heard them talking outside and they said I had Atrial Fibrillation. They wanted my PCP to come in but he was out for the day. They wouldn't tell me anything other than I needed to see him.

This morning the PCP calls and says I am being scheduled for an electrocardiogram. Is there any possible correlation between this new to me diagnosis (Atrial Fibrillation) and my low blood labs posted at the start of this thread? Are there any additional labs other than the Vita Lady list that I should get based on this news? I am going to do the full list even though it has not been 3 months but just wondering if I should add anything to that.

I remember someone saying in one of my posts that one of my low levels had heart complications. Anyone know off hand which supplement that being low on can cause heart issues. I hope it is just my heart reacting to how creeped out I am about the colonoscopy, that would make anyone's heart miss a beat. Thanks in advance. I'll post updates.
 
Another update. Went in yesterday for a pre-colonoscopy screening. While the nurse was doing my blood pressure she kinda wigged out and released the blood pressure and put the stethoscope straight to my heart. She listened for a long time and left the room. She came back with a surgeon who had me take off my shirt and he listened all over. They left then came back and gave me an EKG. I heard them talking outside and they said I had Atrial Fibrillation. They wanted my PCP to come in but he was out for the day. They wouldn't tell me anything other than I needed to see him.

This morning the PCP calls and says I am being scheduled for an electrocardiogram. Is there any possible correlation between this new to me diagnosis (Atrial Fibrillation) and my low blood labs posted at the start of this thread? Are there any additional labs other than the Vita Lady list that I should get based on this news? I am going to do the full list even though it has not been 3 months but just wondering if I should add anything to that.

I remember someone saying in one of my posts that one of my low levels had heart complications. Anyone know off hand which supplement that being low on can cause heart issues. I hope it is just my heart reacting to how creeped out I am about the colonoscopy, that would make anyone's heart miss a beat. Thanks in advance. I'll post updates.
I have an uncle who has NEVER been overweight, much less obese, great health all his life and he has aFib.
 
Just some reading ... don't have ANY idea if it is valuable/reliable. But how are your mineral/D3 levels?

http://www.medicalnewstoday.com/info/atrial-fibrillation/causes-of-atrial-fibrillation.php

What are the Causes of Atrial Fibrillation?

Atrial fibrillation is closely linked with age. The older we get the higher our risk is of developing it. It is extremely rare for atrial fibrillation to develop in younger patients, unless they have an underlying heart condition. Experts say there are many cases in which the cause of the atrial fibrillation was never found.

Here is a list of the most common causes:

  • Hypertension - high blood pressure.
  • Coronary artery disease - also known as coronary heart disease. Plaque builds up inside the coronary arteries. These arteries supply the heart muscle with blood that is rich in oxygen.
  • Congenital heart disease - problems with the heart's structure which are present at birth. This could include defects to the heart's interior walls, the valves, or blood vessels that carry blood to and from the heart. Congenital heart defects alter the normal flow of blood through the heart.
  • Mitral valve disease - the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart.
  • Cardiomyopathy - a serious disease in which the heart muscle becomes inflamed and doesn't work as well as it should.
  • Pericarditis - inflammation of the pericardium - a protective lining that surrounds the heart.
  • Previous heart surgery - a significantly higher percentage of patients who have had heart surgery develop atrial fibrillation, compared to other people.
  • Hyperthyroidism - the thyroid gland is overactive.
  • Sleep apnea - this is a common disorder in which the patient has one or more pauses in breathing, or shallow breathing, during sleep. Obstructive sleep apnea commonly causes high blood pressure (hypertension), which in turn raises the risk of heart problems and stroke.
  • Alcohol abuse - regular, excessive, long-term consumption of alcohol is closely linked to a higher risk of developing atrial fibrillation. A study carried out by scientists at Beth Israel Deaconess Medical Center showed that risk of atrial fibrillation was as much as 45 percent higher among heavy drinkers than abstainers.
  • Smoking - smoking has been linked to several heart problems, including atrial fibrillation.
  • Excessive caffeine consumption - this could include too many coffees, energy drinks, and or sodas (fizzy drinks). Many sodas have caffeine in them.
  • Atraial flutter - this is similar to atrial fibrillation, however abnormal heart rhythms of the atria are less chaotic and more organized than in atrial fibrillation. Atrial flutter can develop into atrial fibrillation.
  • Several types of chest infections and conditions:
    • Pneumonia
    • Lung cancer
    • Emphysema
    • Chest infections
    • Pulmonary embolism
    • Carbon monoxide poisoning
I don't know whether this site has any value, but ... http://a-fib.com/treatments-for-atrial-fibrillation/mineral-deficiencies/

Mineral Deficiencies
When you have A-Fib, a sensible starting point may be to check for chemical imbalances or deficiencies. A deficiency in minerals like magnesium or potassium can force the heart into fatal arrhythmias.

Minerals, vitamins and herbs have a long and consistently safe track record. Nearly half of the people in the US take supplements every day. A large study published in 2012 found that there wereno deaths linked to nutritional supplements in 2010. (Whereas in an average year, there are roughly 200,000 deaths and over 500,000 adverse events reported due to prescription drugs.)1

Page Contents

Unfortunately a great number of physicians are not well versed in recommending or supervising nutritional support and quite often, will dismiss your inquiries about nutritional supplements.2 You may need to work with your doctor to determine the benefit of supplements for your A-Fib health. (See the FDA’s attack on cherries as an example of the bias you may encounter.)3


Remember: The authors of this website are not medical doctors. Consult with your doctor before adding any minerals or supplements to your treatment plan. They may interfere or interact with the medications you are taking. In addition, you may need closer medical supervision while taking minerals and/or supplements.

Magnesium

MAGNESIUM
“Anyone in A-Fib is almost certainly magnesium deficient.”4 Adequate intracellular magnesium is essential to normal tissue and organ function. Low magnesium is associated with cardiac abnormalities, fibrillation, and vascular and muscle spasms, and is seen in cardiac failure.

While Magnesium (Mg) is one of the main components of heart cell functioning, it seems to be chronically lacking in most diets. “Magnesium deficiencies range from 65% to 80% in general populations in the US and globally.”5 “At least 80% of Americans are deficient in magnesium.”6

Most US adults ingest only about 270 mg of magnesium a day, well below the modest magnesium RDAs of 420 mg for adult males and 320 mg for adult females. This creates a substantial cumulative deficiency over months and years.7 Magnesium used to be plentiful in fruits, vegetable and grains, but decades of industrial-scale farming have stripped the soil of minerals like magnesium. One study found that the nutrient content of crops has declined by as much as 40% since the 1950s. “It now is almost impossible to get adequate amounts of magnesium from food.”8

Most US adults ingest only about 270 mg of magnesium a day, well below the modest magnesium RDAs of 420 mg for adult males and 320 mg for adult females.

Common blood tests are poor indicators of your Magnesium level because Magnesium does its work inside the cell (intracellular), not in the blood. Blood “serum” levels of Magnesium are misleading. They remain relatively stable (at about 1%), even when working intracellular magnesium levels are low. (The body “robs” stored Magnesium to maintain the 1% level in your blood. Not good.)

More meaningful is an intracellular test such as Red Blood Cell (RBC) Magnesium analysis. (Another is the EXAtest” (http://www.exatest.com), unfortunately few doctors provide this test.) The RBC test gives the average level of Magnesium in the cells for the past four months. (A normal lower limit is 33.9 mEq/IU191.) Combined with your symptoms, the RBC analysis should indicate if you’re Magnesium deficient.

Even without the tests, if you have A-Fib you can take for granted that you need more Magnesium.

The Best Way to Supplement Magnesium” with Dr. Carolyn Dean, author ofThe Magnesium Miracle, talks about supplementing magnesium, assuming that most people don’t have diets that can supply enough.(3:04) Published on Aug 16, 2012 by iHealthTube.com.

Foods highest in magnesium content are:

Green vegetables (dark leafy greens)
Whole grain cereals (bran breakfast cereal), quinoa
Nuts, seeds (almonds, cashews)
Beans
Seafood (halibut, mackerel)
• Soy
• Brown Rice
• Avocados
• Dairy

What Kind of Magnesium?
But to insure you’re getting the amount of magnesium you need, it’s often necessary to take magnesium in supplemental form, in addition to foods rich in magnesium. My recommendations of easily absorbed supplemental magnesium are:

Magnesium Glycinate: a chelated amino acid. Look for the label “Albion Minerals.” This is a patented process designed to limit bowel sensitivity. One source is “Doctor’s Best High Absorption Magnesium (200 Mg Elemental)
ir
“.
Angstrom Magnesium: such as “Ancient Minerals Ultra Pure Magnesium Oil 8 oz.”

Another form is Intravenous (IV) Magnesium Sulfate. This is the fastest way to restore normal heart rhythm. It is a recognized therapy worldwide, but not generally in the U.S.9Dr. Julian Whitaker in Newport Beach, CA performs this therapy (www.drwhitaker.com).

Supplement Dosage
A recommended goal is a minimum 600 mg/day, preferably 800 mg. (For example, 200mg three times a day and 200 mg at bedtime.)

It’s prudent to start off with very low doses of oral magnesium such as 100 mg. (Excess magnesium or magnesium sensitivity can cause loose stools and diarrhea which is counterproductive, because of the loss of electrolytes.) Increase the dosage of magnesium every 4-5 days. It may take as long as six months to replenish your intracellular magnesium levels.10Since the kidneys excrete excess magnesium, it’s rare to find cases where magnesium exceeds optimal levels, with the exception of people with kidney disease.

Dr. Carolyn Dean, author of The Magnesium Miracle, recommends putting 1/2 teaspoon of ReMag in 500 ml of bottled water and just “sipping” on the mixture throughout the day. That way you get supplemental magnesium at lower levels throughout the day with less danger of loose stools, diarrhea, and losing electrolytes. (Thanks to Frances Koepnick for this tip.)

Alternatives to Oral Magnesium
If oral magnesium causes bowel sensitivity, an alternative (or an additional source of magnesium) is Magnesium Oil which is applied to the skin and over the heart.

An example is Ancient Minerals Ultra Pure Magnesium Oil which is odorless. (One method is to apply a drop the size of a quarter to the inner arm fold opposite and above the elbow, then wash off in 20 minutes.)

Another alternative treatment is Epsom Salts Baths
ir
—soak for 20 minutes in a bath with 2 cups of Epsom Salts (any brand will do). (Epsom Salt Baths can also cause loose stools.) See Personal Experiences: Epsom Salts Cure. You can also make an Epsom Salts spray—one part Epsom Salts to one part water. Place in a spray bottle and mist the chest. Let it dry on the skin.

See Steve’s Shopping Guide for a Healthy Heart for recommended products and brands (see all of Steve’s Shopping Guides on our sister site, BeatYourA-Fib.com)


Back to the Top


Calcium overload

DANGER OF TOO MUCH CALCIUM!
Too much calcium (Ca) can excite the heart cells and induce A-Fib, especially when magnesium is deficient.11 According to Dr. Andrea Natale, Executive Medical Director, Texas Cardiac Arrhythmia Institute, ‘calcium overload’ is the primary factor in A-Fib remodeling of the heart, i.e., structural changes to the heart, including enlargement of the atria and the development of atrial fibrosis.12

VIDEO 2:Importance of Balancing Calcium & Magnesium“. Dr. Carolyn Dean, author of The Magnesium Miracle, discusses the importance of balancing calcium and magnesium supplementation. She looks at the benefits of both and why you need to have both in the body. (2:30) Posted 11/15/2010 by iHealthTube.com.

A-Fib patients may need to stop or lower significantly their calcium supplements and increase magnesium.13 Aim for a ratio of one part Calcium to two or more parts Magnesium. It’s good to keep track of how much Calcium you are taking in daily, so that you can be sure to take in more Magnesium than Calcium.

A serum calcium test in the 8.6-10.2 mg/dl is considered normal, but one/half of the calcium in blood is attached to proteins (like albumin). A more accurate calcium blood test looks at “ionized calcium” which is calcium not attached to proteins.14 But this is a specialized test and probably isn’t necessary for most people.


Potassium

POTASSIUM
Potassium (K+) is often the second key nutrient A-Fibbers may be deficient in. In fact, magnesium depletion can lead to potassium depletion.15 Low magnesium leads to low tissue potassium, since magnesium is needed for potassium transport into tissue.

Potassium is essential for normal nerve and muscle function and is very important in maintaining normal cardiac function. Potassium helps prevent A-Fib by prolonging the refractory period—the time when the heart is resting between beats. (During this rest period the heart can’t be stimulated to contract, thus leaving the heart in normal sinus rhythm.) When potassium levels are too low, heart cells become unusually excitable, often leading to premature contractions and/or A-Fib.16

Sources of potassium
Foods rich in Potassium include:

Beans (White Beans)
Dark Leafy Greens (Spinach, Chad, Kale, Collards)
Baked Potatoes, Sweet Potatoes (with skin)
Dried Apricots
Yogurt (plain, skim/non-fat)
Seafood (salmon, pompano, halibut)
Bananas
Avocados

But to insure you’re getting the amount of potassium you need, it’s often necessary to take potassium in supplemental form, in addition to foods rich in potassium. Here’s my potassium recommendations.

Supplements Dosage
The recommended dosage is 1600-2400 mg/day. While potassium is available in tablets, the 99 mg maximum FDA dosage makes them impracticable requiring 16+ tablets a day. (Beware: some brands offer 540mg tablets, but the actual dose of Potassium Gluconate is only 90 or 99 mg per tablet.)

Therefore we recommend the powder form. Our favorite is “Now Foods Potassium Gluconate Pure Powder“. Take a total of 3-4 teaspoons a day in juice and divided between 3 meals (approximately 540 mg per teaspoon). You can also consider Potassium Citrate powder using up to 3 teaspoons a day in juice and also divided between 3 meals (approximately 1g per teaspoon). Either form is acceptable. (FYI: Gluconate is neutral PH and Citrate is alkaline, i.e. easier for an acidy stomach.)

As with magnesium, start off low, one teaspoon/day, and increase the dosage every 4-5 days. The goal is to keep the serum blood potassium level at 4.5 but under 5.017 A word of caution—adding too much potassium too soon will make A-Fib worse, not better.18 Too much potassium in blood plasma makes the cardiac cells depolarized and unexcitable, leading to spontaneous activity in other areas of the heart such as the Pulmonary Vein openings.19

Back to the Top


Vitamin D3

VITAMIN D
If you don’t spend much time in the sun or always cover your skin (sunscreen inhibits vitamin D production), you’re probably deficient in Vitamin D. Known as the sunshine vitamin, vitamin D is produced by the body in response to sunlight, and occurs naturally in small amounts in a few foods including some fish, fish liver oils, and egg yolks.

A 2009 study estimated as many as 77 percent of Americans are vitamin D deficient.20Excessive Vitamin D is rare and is not caused by excessive exposure to the sun, or foods containing Vitamin D.

Vitamin D deficiency contributes to the development of both A-Fib and Dementia. (See Boston AF 2011: A-Fib and Dementia by Dr. T. Jared Bunch.) Vitamin D helps the body absorb calcium. A deficiency in vitamin D can cause an imbalance in Magnesium and Calcium, and contribute to heart palpitations.21

As many as 77 percent of Americans are vitamin D deficient.

25-hydroxy Vitamin D Test” or use an in-home Vitamin D test available from the Vitamin D Council.22 Vitamin D deficiency is defined as a blood 25(OH)D level below 20 ng/dL. Normal levels are considered to be above 30 ng/dL.23

[paste:font size="4"]Supplements Dosage

Vitamin D from sun exposure: 5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen.24 Vitamin D is found in supplements (and fortified foods) in two different forms: D2 and D3—both increase vitamin D in the blood. The RDA for adults is 600IU and 800IU for seniors (mostly from sun exposure).

For adults who aren’t getting vitamin D from the sun, the recommended supplement is: 200 IU of vitamin D a day for adults under 50 and 400 IU for adults 50 to 70 years of age. Many doctors are advising their patients to take much higher amounts, such as 1,000 I.U. a day.

Monitoring
You should retest after three months of supplementation. The dose of vitamin D may need to be adjusted based on the test results.

ADDITIONAL READINGS
Frequently Asked Questions: Mineral Deficiencies & Supplements – New category‘Natural’ Supplements for a Healthy Hearthttp://a-fib.com/treatments-for-atr...l-deficiencies/supplements-for-healthy-heart/
Alternative Remedies and TipsAcupuncture Helps A-Fib—Specific Acupuncture Sites Identified
Low Serum Magnesium Linked with A-Fib

Unfortunately a great number of physicians are not well versed in recommending or supervising nutritional support and quite often, will dismiss your inquiries about nutritional supplements.


Last updated: Friday, April 3, 2015
 
As an Amazon Associate we earn from qualifying purchases.
Wow....thanks Diana, I guess I'll check "All of the above". I will share all this and get labs right away to see where I am right now. The info above stated to taper in on the mag and potassium. I did not do that, I just started on the VitaLady starter dosing and have been following that.

Are there any labs I should add at this point or just do the established list and see what it says?

Thanks again for taking the time to post this up for me, I really appreciate it. EW
 
Another update. Went in yesterday for a pre-colonoscopy screening. While the nurse was doing my blood pressure she kinda wigged out and released the blood pressure and put the stethoscope straight to my heart. She listened for a long time and left the room. She came back with a surgeon who had me take off my shirt and he listened all over. They left then came back and gave me an EKG. I heard them talking outside and they said I had Atrial Fibrillation. They wanted my PCP to come in but he was out for the day. They wouldn't tell me anything other than I needed to see him..
That sounds like EXACTLY what happened to me before I was diagnosed, only they sent me to the ER to rule out a PE since I was on birth control and only officially diagnosed it after I wore a holter monitor for 24 hours. Mine was most likely from severe sleep apnea, though. Nevertheless, the whole panicking doctors and nurses thing is pretty freaky. Hope vitamin tweaking can get it sorted out for you.
 
Glad you had it diagnosed because you might be able to get back to a normal rhythm. Good to see your PCP but also make sure you get to see a cardiologist as well. Good luck and hope it's a motivator to re engage with your health!
 
Diana,
I was crunching the numbers in your post above and noticed a big imbalance in my supplimentation. The info you posted above states the being short on Magnesium / long on Calcium can cause A-Fib. The info above recommends 1 part calcium to 2 or more parts magnesium. I am on the VitaLady basic plan right now and that is giving me 1500 mg calcium and 400 mg Magnesium daily. This is almost 4 to 1 reverse of the info posted.

My question is this, how many of you are getting 2 or more times magnesium than you are calcium. Am I reading or doing something wrong here? I go in for an echo cardiogram tomorrow and I think I'll get labs done too. Any additional labs I should get other than the vitaLady lab list? Thanks in advanve. EW
 
I didn't even TAKE magnesium until about a year or so ago. I finally decided my excellent PTH but declining bone density required another tweak, and I figured I'd try that. So I'd look at the lab values for your Mg and Ca and see if they are OK. Other than that, I don't think they would be affecting your heart.
 
Wow....thanks Diana, I guess I'll check "All of the above". I will share all this and get labs right away to see where I am right now. The info above stated to taper in on the mag and potassium. I did not do that, I just started on the VitaLady starter dosing and have been following that.

Are there any labs I should add at this point or just do the established list and see what it says?

Thanks again for taking the time to post this up for me, I really appreciate it. EW

Eric I'm curious about your sodium intake also. Post op I noticed a big craving for salt (really strong flavors in general) in my foods. I was reading the other day that sodium correlates very specifically with potassium (remember the whole Sodium/potassium pump for neuronal firings from high school?) in that if your intake of sodium rises, you need to be damn sure to up your potassium levels to keep the balance. Not doing so could result in dysrhythmias, especially since, as Diana rightly informed you, hypokalemia (low potassium) often results in Hypomagnesaemia(low magnesium). I'm sure you were surprised to see the HUGE difference between the FDA RDA for potassium and what EVERYONE is in agreement is actually required daily. The reason for this is that potassium toxicity can result in instant death...and is actually a popular method for suicide for ER doctors (I knew one). Anyhoo, unlike most vitamins potassium was basically capped at 99mg daily RDA and most vitamin distributers use that number. It's only recently become available at higher doses from US manufacturers, though the rest of the world has allowed much higher doses all along. Here's another article I found today. Please note that the scientific community has been scaring folks to death for decades regarding salt use, and it's literally 95% hog wash. If you are hypertensive, then of course watch your sodium intake. But for most of us....salt is your friend! I just wanted to say that before proving this link for your reading pleasure: http://www.webmd.com/hypertension-h...odium-low-potassium-diet-linked-to-heart-risk . The important take away here is that MASSIVE sodium levels combined with a low potassium level can/will cause an arrhythmia. Therefore, as the study I read the other day suggested, increasing potassium levels is a MUST if you eat a lot of salt in your diet, because it's the RATIO of sodium/potassium that causes problems if it's out of whack. And remember also that it's almost impossible to OD on potassium-you'd need MASSIVE doses because your kidneys remove any excesses detected pretty damn quickly. When those doctors kill themselves they usually hang a bag of potassium IV to overwhelm their bodies natural defenses. Best of luck Eric! You'll be better than fine very soon I'm sure. Just keep on truckin' one day at a time my friend.
:walk:
 
Below is a lab list I put together to help me list and keep track of results. Am I missing anything. So many of these have more than one name or acronym and are also part of a bigger test. I'm about tapped and going cross eyed trying to figure out what is what. Open to any/all suggestions, additions, deletions. Thanks. EW

Lab Range Date Result Date Result Date Result Date Result Notes
Comp.Metabolic Profile
Lipid Profile
Phosphorous - Inorganic
Uric Acid
CBC
Ferratin
Vit. A
Vit. B1 - Thiamin
Vit. B12 & Folate
Osteocalcin
PT
C Reactive Protein
Pre-albumin
Hep Panel Incl. ALT
Magnesium
Thyroid Panel
Iron TIBC % sat
Zinc
Vit. D 25-Hydroxy
Vit. B6 Pydoxine
Serum intact: PTH
Vit. E
Vit. K
PYY
Niacin
LDH
MMA
Selenium
Copper
Homocysteine, Cardio
Cortisol
 

Attachments

  • Blood Lab Worksheet.xlsx
    10.9 KB · Views: 1
On my 8th lab up from the bottom on the list I have "PYY". My PCP says he thinks it should be TYY and that it would take some special orders to get and maybe not even locally.

Questions.......1. PYY or TYY, 2. What is it, do I need it? Thanks for any insight. EW
 

Latest posts

Back
Top