Hi I'm new. May need vitamin infusions but does a hematologist or endocrinologist order? My pcp wants to refer me

[jeannieb]

Hi my name is Jeannie and I am about 20 yrs post op DS. I am low on blood levels for Vitamin A D E and K even with oral supplementation and have just been diagnosed with secondary hyperparathyroidism. My primary care dr is more than willing to gtive me a referral to be seen but there are no DRs in this area who have done DS and my surgeons nurse and office from 18 yrs ago has not returned my calls. For anyone who has had this issue and gotten infusions were you referred to a hematologist or an endocrinologist? I honestly just want to get it taken care of
Currently I am taking three BARIATRIC advantage ADEK a day
Iron sulfate 625 mg and vitamin C
20,000 units of Dry Vitamin D ( i literally had night blindness my vitamin A went so low)
a multivitamin
and about 2000 mg of calcium citrate

I am having trouble finding the vitamin list for this site Any assistance would be appreciated

 

[Larra]

Hi again, Jeannie! I'm glad you found your way here. There are some folks here who know a lot about vitamin supplementation for the DS. I would suggest you post your most recent labs here, the relevant ones anyway, and I bet people will have some suggestions. For iron infusions, you will probably need a hematologist, but for the other stuff, I would suggest a GI doc, as they often know a lot about bariatric surgery even though they don't perform surgery.

And just off hand, I would ditch the aDEK's and go with separate dry D, A and K. Most of us take at least 50,000 dry D daily (I take 100,000) and you may need to start with a hefty amount to get caught up. And probably at least 25,000 dry A. Your secondary hyperparathyroidism should gradually resolve once you get BOTH your D and your calcium up to par (don't let some surgeon operate on your parathyroid glands! They aren't the problem, it's your D and calcium).
And, how are your protein and albumin levels? Often, if these are low, it's even harder to catch up on the other stuff.

 

[JackieOnLine]

Hello and welcome, Jeannie!

I would suggest you post your most recent labs here, the relevant ones anyway, and I bet people will have some suggestions.

Larra is right, post your lab results.

 

[southernlady]

Hi my name is Jeannie and I am about 20 yrs post op DS. I am low on blood levels for Vitamin A D E and K even with oral supplementation and have just been diagnosed with secondary hyperparathyroidism. My primary care dr is more than willing to gtive me a referral to be seen but there are no DRs in this area who have done DS and my surgeons nurse and office from 18 yrs ago has not returned my calls. For anyone who has had this issue and gotten infusions were you referred to a hematologist or an endocrinologist? I honestly just want to get it taken care of
Currently I am taking three BARIATRIC advantage ADEK a day
Iron sulfate 625 mg and vitamin C
20,000 units of Dry Vitamin D ( i literally had night blindness my vitamin A went so low)
a multivitamin
and about 2000 mg of calcium citrate

I am having trouble finding the vitamin list for this site Any assistance would be appreciated

Welcome jeannieb
Start reading here: https://bariatricfacts.org/forums/vitamins-labs.16/
20,000 Dry D3 isn't even close to near enough. You need to follow the Vitalady list. But first post your most recent labs with ranges, what you take BY brand and dose and your schedule.

Staring dose for DSers for D is a a dry D3 50,000 every day. Your lab value needs to be at LEAST 80. https://bariatricfacts.org/threads/vitamin-d-webinar-by-dr-keshishian.5845/

 

[Spiky Bugger]

Jeannie,

Last time I checked (a couple of months ago), I learned that the facility that makes the INJECTABLE Vit A and D was in Puerto Rico, badly damaged during the hurricanes, and still not operating. I mention it because they may be the source for infusions, too.

Of the few things in my life that ARE okay, Vit A and Vit D are doing okay. I order from Amazon (I’m sorry, but
I do) and usually get:

+/- 50,000 units of DRY Vitamin A mad by BioTech Pharmacal ($8.08/100)

150,000 units of DRY Vitamin D-3 50,000 made by Nivagen ($17.50 /100), Zahler ($19.95/120) or BioTech Pharmacal ($24.38/100).

I take a sublingual Vit K which is expensive, but I splurge on me now and then. That keeps me CLOSE TO okay on blood clotting time, but I take extra if I’m having surgery.


Also...go to THIS page https://www.parathyroid.com/hyperparathyroidism-diagnosis.htm

And scroll down to the section entitled...
High Parathyroid Hormone Levels in Patients with Intestinal Absorption Problems, Such as Gastric Bypass Surgery, Celiac Sprue, and Crohn's Disease.

Dr. Norman explains some of our needs very well.

Sue

 

[southernlady]

I learned that the facility that makes the INJECTABLE Vit A and D was in Puerto Rico, badly damaged during the hurricanes, and still not operating. I mention it because they may be the source for infusions, too.

I know Dr. Ayoola is getting injectables for HIS patients. I’ve heard a compounding pharmacy can do it but not all will cooperate.

 

[Spiky Bugger]

I know Dr. Ayoola is getting injectables for HIS patients. I’ve heard a compounding pharmacy can do it but not all will cooperate.

Then maybe I should ask my source...or Ayoola. I didn’t, because my labs showed those Vitamins in range.