Pre-op, should I be trying to raise levels before surgery?

Discussion in 'Vitamins & Labs' started by Manapan, Feb 8, 2018.

  1.  
    Manapan

    Manapan Well-Known Member

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    Hi! I'm still waiting for insurance approval for a DS. I was thinking that it might be a good idea to go into surgery with great vitamin levels so I'm not starting off behind. Looking for advice on whether this is a good idea and whether I'm supplementing enough.

    Based on the ranges given with my labs, I think I need to supplement. My last two sets of labs have showed low levels of iron saturation, and a barely acceptable binding capacity and ferritin level. I keep getting turned away at blood drives for low hemoglobin also. My calcium, vitamin D, and vitamin B12 were at the lowest part of the acceptable range. Protein was under 7 on the most recent one as well.

    I'm taking two multivitamins daily (AM and noon, since they have vitamin C in them for the iron absorption), 324 mg ferrous gluconate twice a day (AM and noon), 1000 mcg B-12 (AM), 500 mg calcium carbonate (it's what I already had and will be replaced with citrate when I restock, PM and bedtime), and 3000 IU D3 (PM and bedtime with the calcium). I also started increasing my protein intake with a protein shake to replace a meal.

    My labs were taken before I added the iron, B-12, and calcium, and at the time I was only taking one multivitamin and 2000 IU D3 per day. Should I add more or change the schedule? Thanks!
     
    hilary1617 likes this.
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    southernlady

    southernlady Administrator Staff Member

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    When is surgery?

    First ask for a redo on the iron panel as you do NOT want to have surgery when low on iron, EVER. If you can, get an infusion.
    Switch to taking 50,000 Dry D3 every day NOW. I was taking it daily for the three months before surgery to raise mine.
    B12, That needs to get up and stay up. You want it as high normal as possible, and even above normal is not an issue. Low B12 causes permanent neurological damage.
     
  3.  
    Manapan

    Manapan Well-Known Member

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    I don't have a surgery date yet, but was told to expect late March or early April. I just really want to get my levels up before my preop blood work gets done. Thanks for the advice! I'll get on that as soon as possible.
     
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    Marquis Mark

    Marquis Mark Well-Known Member

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    Definitely recommend getting your levels up to high end of range, if possible, before surgery. And get an iron infusion. Tell them the pills are brutally constipating and you can't take them. They can't argue with that and should give you an infusion.

    Also recommend getting tested in all DS labs you haven't gotten recently so you know what your baseline level is pre-surgery. That way you'll be able to compare to post surgery. I'm so glad I insisted on doing that. It's been a great reference resource and comfort.

    Definitely agree to start large doses of D (like 50,000/day ) and up the calcium now. Up the protein, too.
     
  5.  
    galaxygrrl

    galaxygrrl Well-Known Member

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    I would check with a doctor. Most of the time the folks on thie board are correct about their medical advice, but I've seen it be off a few times and misinformation posted. This board is wonderful, but get medical advice from doctor, not a bunch of anonymous people on the Internet.

    If you don't need iron yet, I'm not sure why you would take so much. Take is when you need it. One quick google search and I found this

    https://www.healthline.com/nutrition/why-too-much-iron-is-harmful

    This is a great place for support and help learning your new body. Not medical advice.
     
    Last edited: Feb 12, 2018
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    Manapan

    Manapan Well-Known Member

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    Thanks for the advice! I really like how people are candid here.

    I'm actually taking prescription iron as directed. (For once in my life it actually isn't constipating, which is a relief!) The surgeon's office wanted my iron up and gave me the prescription. They're also the ones who added the B12 and suggested adding calcium. My psychiatrist had been concerned about low D levels and didn't want to see them drop below 30, and since they're at 31 and I'm looking at DS I was thinking I should load up.
     
  7.  
    southernlady

    southernlady Administrator Staff Member

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    My doctor had me on the damned green football D2 prescription forever (2007 to Oct 2010), raised levels from out of the toilet to 15. IF I had listened to my doctor, my D would still have been low going into surgery. I STOPPED them and went to the dry D3 BioTech 50,000 a day until surgery in late Jan and by the time I actually had surgery my level was over 50.

    Sometimes listening to strangers online as far as vitamins is beneficial.

    IF your surgery is in the next three months, start taking the dry form of D3 in 50,000. Personally I would take one every day but as long as you take one a week PRE-OP, you should at least hold your own.
     
  8.  
    galaxygrrl

    galaxygrrl Well-Known Member

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    I'm going to challenge you on that.

    You add great value on this board, but you consistantly have given out medical advice on this board that is simply wrong and you need to be more careful and educated in your advice.

    Here is an example on a thread where you gave out the wrong information. You could have really screwed up my calcium had I listened to you. You told me to take the wrong type of calcium. Foruntely, another member caught that mistake.

    http://bariatricfacts.org/threads/will-this-supplement-work-with-the-ds.5987/

    You did that one other time with me too.

    Doctors by all means are not perfect, but taking too much iron is dangerous too and that was my point. Don't just listen to people on the Internet.

    I just think people need to be measured and careful when handing out medical advice.
     
  9.  
    southernlady

    southernlady Administrator Staff Member

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    While calcium carbonate is not the best at all, you can take it. Should you, no, but can you, yes.

    Where did I say she needed to take iron, I said get her iron panel redone...that involves a doctor. IF it under 50 Ferritin, she does not need to go into surgery that low but to get infusions, she still has to deal with a doctor.
     
  10.  
    galaxygrrl

    galaxygrrl Well-Known Member

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    That is not what Dr. Rabkin said to me when I checked with him, nor what others have said. Seems like you are challenging Dr. Rabkin on that. Which is kind of my point in the first place. People need to be careful about handing out medical advice.
     
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    Marquis Mark

    Marquis Mark Well-Known Member

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    Southernlady said, "While calcium carbonate is not the best at all, you can take it. Should you, no, but can you, yes."

    I don't see anything in that statement which advocates for taking carbonate. In fact, she states you should not take it. And I infer nothing where she is "challenging Dr. Rabkin." That, respectfully, is your projection.

    To me her statement just says it won't kill you, but it won't deliver the desired effect as well as other forms will.

    I feel like a bit too much is being demanded of her. Most people on this board share their experience and/or their best understanding, which I think Southerlady does well and generously. Nobody has all the answers. I think it's best to avoid an atmosphere where we shame people away from offering their opinions/advice.

    And most importantly, it's up to each reader to observe due diligence. I've been here a couple of years. I have a sense of who knows what. And I never take anyone's word as gospel. If I did that would be MY bad. I understand this board is a resource, not a repository.
     
    JackieOnLine likes this.
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    galaxygrrl

    galaxygrrl Well-Known Member

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    Did you take the time to read the link I posted above This one - http://bariatricfacts.org/threads/will-this-supplement-work-with-the-ds.5987/

    That is what I was referring too and NOT the post where she qualifies what she said, which I really thought was backtracking. In any event, read the detail of my post and understand what I said.

    As you can see someone corrected her on that thread I linked too.

    As for the Dr. Rabkin comment, he is one of the most respected DS surgeons in the nation. I do think I would trust him over about anyone else on what to take. Sorry, but I trust a well respected DS surgeon. I don't even know what to make of your statement besides its seems like irrational choice to me to take the word of person on the Internet over a respected DS surgeon on what supplement to take after the DS>

    My issue is that many here have handed out simple wrong information on this board mutiple times. And it is our responability to hand out accurate information if possible or just pass on posting.

    I think everyone adds great value here, I just think people need to be accurate in what the post which was my post. It was NOT a personal attack, it was pointing out that we are not doctors and that people are handing out medical advice with little basis for doing so and in fact you suggested taking more iron before surgery which a simple Google search says could be dangerous. Seriously, what studies and scientific evidence are you basing that recommendation on?

    To be honest, I think you are on shaky ground on this arguement and you should let it go. I'm happy to keep on posting "where is your evidence, where is your scientific studies, where is your medical education from to back up your statements" And I will go back to through your posts and find posts where you have handed out advice that is simple not medically sound because I have noticed it in the past.

    As I said, this is a great place for support and learning your new body and you, Southern Lady and others add great value. But honestly, this a bad place for medical advice there is too much misinformation.

    I'm not like DianaCoxDianaCox much :p, and I don't like to stir the pot as much, but everytime I read the wrong advice on this board i just cringe.

    That said, I've gotten amazing support and advice on this board, I just think we all need to be careful.
     
    Last edited: Feb 13, 2018
  13.  
    Manapan

    Manapan Well-Known Member

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    To update, I'm post op now. I had surgery 3/22/18. I tried my hardest to raise those levels before going into surgery. 1500 mg calcium, 40000+ IU D3, 1000 mcg B-12, three multivitamins and three iron supplements daily, and as high protein as the pre-op diet allowed.

    It was all to no avail. For some reason the blood work they did the morning of surgery showed lower levels of everything. Actually to the point that I had iron deficiency and B-12 deficiency anemia and my protein and vitamin D levels were below the acceptable range.

    Now I'm all paranoid that playing catch up on these is going to be insane. I make fluid goals, but not the 90+ grams of protein daily yet. It takes hours to drink a single shake and I'm still on fluids only. I'm taking my vitamins crushed per protocol from the office and having difficulty keeping them down.
     
  14.  
    Munchkin

    Munchkin Full of Fairy Dust

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    Try not to worry too much. The surgery is done and over. You should be able to swallow pills just fine now. Just do the best you can. Most people are never tested for vitamin and mineral deficiencies. Lots of folks are low on something. They just don't know it!
     
  15.  
    Larra

    Larra Well-Known Member

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    First, congrats on getting your DS done. Isn't it great that it's behind you now?
    Next, I agree with MunchkinMunchkin that you have the advantage if knowing that you have deficiencies that need to be addressed. There are lots of people deficient, for example, in Vitamin D who don't know it. Yes, it takes more supplementation to keep up after a DS, but having that knowledge is of enormous value.
    Make sure you take the forms of vitamins and minerals that are easiest to absorb ("dry" D, A, and K, calcium citrate) and follow you labs to see the trends. That will tell you how much of each component you need, which differs from person to person. For example, some people do just fine with 50,000 of dry D daily, some (like me) need 100,000 units, some even more, but none of us would know how much we need without those lab results. And follow your labs yourself. Someone at a doctor's office will just tell you your results are "normal" without noting that they are heading in the wrong direction from prior results. No one cares about this more than you.
     

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