No energy and needing new goal totals.

[LivingTheDSlife]

Hi everyone,

I had the DS 4 months ago and the last two weeks I have had my energy levels drop so much idk what I should do to change it, I can't seems to stay awake past 8pm at this point lol, I was fine till this happened with more energy. I am taking b complex, iron, multi vit, calcium citrate. Also I have hardly lost anything the last two weeks. I am aiming for 100-110 protein a day, 40-60 carbs, and 80 fats, what is ideal at this stage as well? My dr keeps giving me r n y goals on totals. I go walking daily for an hour, if I try going to the gym I get a head ache and nausea if I do weights or to much other than water arobics.

 

[DSRIGGS]

You are't taking Vitamins A, D, E or K? You definitely need to be taking A & D. E and K aren't always needed by all DS'rs but low A can do permanent damage to your vision and low D will cause all kinds of issues including lack of energy.

You likely need Zinc and copper as well.

I would also up your protein goal to 150 grams per day and I think some extra carbs wouldn't hurt either.

 

[Clematis]

Don't listen to the surgeon about vitamin needs -- they were trained to be cutters, not nutritionists. (But don;t listen to the nutritionists either. LOL) Look at the Vitalady list for vitamin supplements. When did you last have labs? What were the values?

 

[Marquis Mark]

Could be a lot of things, but those are also iron deficieincy anemia symptoms. How are your iron levels?

 

[DianaCox]

Scott - why would you be recommending 150 g protein to someon at 4 months out, who isn't doing a whole lot of muscle-building exercise? Excess protein gets treated like excess carbs, with a "bonus" of the excess nitrogen having to be excreted by the kidneys.

 

[DSRIGGS]

Scott - why would you be recommending 150 g protein to someon at 4 months out, who isn't doing a whole lot of muscle-building exercise? Excess protein gets treated like excess carbs, with a "bonus" of the excess nitrogen having to be excreted by the kidneys.

Because it seems to me that if she is weak a large contributing factor would be because she likely isn't absorbing enough protein calories. She is going to shit out 40% or 60 grams of the protein that doesn't get absorbed anyway. If the average adult is supposed to get .8 of a gram of protein per Kilo or roughly 0.36 grams Protein/lb and she weighs 200 lbs (I have no idea of her weight just picking a number) then she needs to absorb around 72 grams of protein a day. If she was eating 150 grams of protein (I said target because we often fall short) that would be roughly 90 grams of absorbed protein so I don't think that extra 18 grams of protein is going to be bad for her. In fact with all the stress her body is under that she probably needs it. She is also walking and hour a day so that is almost 500 calories being burned. I think she needs the extra protein.

 

[Charris]

In the beginning of my DS Journey I was NO ENERGY. I couldn't even lift my feet to walk. DR.K told me he wanted me to get some sugar in my system. So he told me to get some low calorie Gatorade G2 and drink it. I'm not saying you should do it just telling you my experience. He wanted me drinking something like so many ounces in a certain time frame. Can't remember the exact instructions

 

[DSRIGGS]

In the beginning of my DS Journey I was NO ENERGY. I couldn't even lift my feet to walk. DR.K told me he wanted me to get some sugar in my system. So he told me to get some low calorie Gatorade G2 and drink it. I'm not saying you should do it just telling you my experience. He wanted me drinking something like so many ounces in a certain time frame. Can't remember the exact instructions

I am not necessarily advocating it, but I ate cream of wheat with a little splenda a little half and half to get some calories in me my fist month because it was really all I could eat. Now it wasn't much at all, like an ounce or two but it kept me from being nauseous (my stomach did not like being empty) and it gave me a at least a tiny bit of energy.

 

[Charris]

@LivingTheDSlife have you made your surgeon aware of your issue? I think that would be a good place to start. They may want you to do lab work

 

[DianaCox]

I don't think you are supposed to count absolute weight in calculating a morbidly obese person's protein needs, i.e., the 0.8 g protein/kg body weight/day. A good deal of that excess weight is FAT, not muscle that needs to be spared. Protein needs should be based on labs (because the unfortunate fact is that no two DSs are the same, because no two people are the same) - some people are going to malabsorb 50% of protein, some 30%, and some may have problems like you did, and malabsorb much more.

If her serum albumin and pre-albumin levels are OK, I don't think taking in more protein is necessarily the answer to her fatigue. I'd look at dehydration, iron, thyroid, perhaps a glucose tolerance test first, before assuming insufficient protein. I'd also look at sleep and psychological issues - this is a time of great change in hormones, feeling comfortable in one's own body, and just plain issues related to getting used to the new normal.

 

[DSRIGGS]

I don't think you are supposed to count absolute weight in calculating a morbidly obese person's protein needs, i.e., the 0.8 g protein/kg body weight/day. A good deal of that excess weight is FAT, not muscle that needs to be spared. Protein needs should be based on labs (because the unfortunate fact is that no two DSs are the same, because no two people are the same) - some people are going to malabsorb 50% of protein, some 30%, and some may have problems like you did, and malabsorb much more.

If her serum albumin and pre-albumin levels are OK, I don't think taking in more protein is necessarily the answer to her fatigue. I'd look at dehydration, iron, thyroid, perhaps a glucose tolerance test first, before assuming insufficient protein. I'd also look at sleep and psychological issues - this is a time of great change in hormones, feeling comfortable in one's own body, and just plain issues related to getting used to the new normal.

Agreed that labs should direct.

 

[Will2014]

No way to know until you have labs done, but it sure sounds like a vitamin/ mineral deficiency to me. Have you looked at the vitamin info on this site? I also haven't heard you say that you ARE taking A,D,E, and K supplements. I lean towards anemia because of your generalized weakness. But remember anemia has several causes, not just iron deficiency. Copper deficiency can cause, as well as certain B complex vitamin deficiencies. Your body is still adapting to the new architecture. It's crying out a need for something. It's your job to find out what. G'luck to you and please keep us posted!

 

[DSRIGGS]

No way to know until you have labs done, but it sure sounds like a vitamin/ mineral deficiency to me. Have you looked at the vitamin info on this site? I also haven't heard you say that you ARE taking A,D,E, and K supplements. I lean towards anemia because of your generalized weakness. But remember anemia has several causes, not just iron deficiency. Copper deficiency can cause, as well as certain B complex vitamin deficiencies. Your body is still adapting to the new architecture. It's crying out a need for something. It's your job to find out what. G'luck to you and please keep us posted!

Yep on more than one cause for anemia. Mine non iron deficiency and even though I absorb better aND don't need creon anymore it is a never ending battle to keep my copper, zinc, a,d,e, and k in or near range.

 

[LivingTheDSlife]

I am taking a bariatric multi vitamin with high A D E K, she just prescribed me a dose of vitamin D that she wants me just taking once a week, and she also added iron ferrochel bisglycinate 36mg daily. I don't know what you needed specific on my labs I printed and am going to attach to the post.

 

[DSRIGGS]

PLEASE DO NOT LISTEN TO YOUR DR ON YOUR VITAMIN NEEDS. IT IS UP TO YOU UNDERSTAND YOUR LABS AND ADJUST YOUR SUPPLEMENTS & DOSAGE APPROPRIATELY.

The Bariatric Advantage Multi doesn't give you enough of anything so you need take all of those elements (A, D, E & K) separately and in the dry form:

• Your K is low so you need to buy Biotech Dry K1 and take 1-2 a day
• Your D is 22 and it should be up around 100 so you are woefully low and that is probably making you feel like garbage. Buy Biotech D3 Dry 50,000 IU and I would 2 a day or 100,000 IU (I take 200,000 IU daily but I would thing 100,000 is a good start for you).
• Being low on D is also why your PTH is getting high (this will cause calcium issues if it gets too high). Get the D up and your PTH will go down.
• Your Iron is also low which is also going to make you feel weak. You aren't anemic yet but you are going to be if you don't get the iron up. You need to get a full iron panel run as well, not just iron. I don't take Iron because my iron levels are fine so somebody who uses iron can help you with what to take.
• Your Albumin and Total Protein are in range but towards the bottom so it wouldn't hurt if you could get those up a little. It isn't bad where your are but you don't want to drop out of range so if you can get the numbers up a tad it will give you a cushion.