This is going to be very boring for folks who read my blog who are not WLS patients. So… those of you who aren’t… might just want to skip this one :)

I got my blood test results back. I went to a new PCP and well… lets just say I won’t be going back. I have an appointment with a new doctor (Hematologist/Internist) on the 14th.

At four years out from the Duodenal Switch, I am in the window when most severe deficiencies show up. Because my body has used up all it’s stores and the malabsorption in my gut can’t compensate.

I’ve been pretty compliant on my vitamins. Previously, I’ve had issues with the Magnesium, Calcium, PTH, Vitamin D balance. Vitamin D regulates the intestinal absorption of calcium, while PTH regulates the activation of vitamin D. In my case too little vitamin D imbalanced my calcium metabolism. So I am on prescription Vitamin D. This has done the trick in the past, although my PTH has never came back “normal”. I’ve simply forced myself to accept my new level of normal.

I am concerned about two main “irregularities” in my bloodwork that haven’t shown up before. My “Iron Binding Capacity” number is elevated. It’s 484 and the reference range is 250-400. I have checked previous years and it’s never been outside the range before. When I read about what this means, it seems like an elevated TIBC indicates an iron deficiency. But we wont know for sure till I get my Ferritin tested.

The other number I am concerned about is Methylmalonic Acid. I’ve never had this tested before and was surprised it was ordered. Apparently this test tests B12 deficiency at the tissue level. An elevated MMA test can mean a B12 deficiency. My number was 272 and the range is 88-243.

What complicates all this is that someone screwed up and didn’t order everything or the lab didn’t test for everything. So to really be SURE about the B12 deficiency… I need to know my B12 level. Which they omitted. Although the MMA test is supposed to be more sensitive then the standard B12. And it looks like I have several of the symptoms of Pernacious anemia. Mostly huge huge issues with fatigue and sleeping. Also.. this type of anemia is supposed to effect the Bilirubin level…although for the life me I can’t find “how”. Is it supposed to be higher or lower? Anyway. I’m thinking B12 shots are in my future.

This B12 deficiency sort of tips me over. I realized by looking at last years paperwork, they did not do my B12, but my Red Blood Cells were large. Another sign. My sister has a B12 deficiency. Another possible link. But she has the RNY surgery. My surgery (the duodenal switch) preserved my lower stomach where the intrinsic factor is made for B12. I had a vertical gastrectomy instead of a transected horizontal pouch made. So if I am missing that factor, it’s not because of my surgery I don’t think. I think I’d be facing this anyway. Which is also sort of depressing.

So my guess is that I have one or possibly two types of anemia. I’m really hoping its just the B12 one and my iron stores are fine. It’s REALLY hard for some DS patients to restore their iron stores.

Here are the “irregular” numbers and the numbers I am VERY proud of. :)

Triglycerides: 104
Total Cholesterol: 102 (non fasting)
Iron Binding Capacity: 484 (range: 250 -400)
Bilirubin: 1.8

PTH: 79H 10-65

Methylmalonic Acid: 272H (Range: 88-243)

The tests that were supposed to be done and were omitted for whatever reason were:

Folate,
Ferritin
Transferritin Saturation
Vitamin B 12
Vitamin D2 and D 25 OH (these were pending and Im still awaiting the results).

So in about 10 days I have an appointment with a new internist/hematologist. Please note that my looser new PCP still hasn’t called me herself and I had the bloodwork on the 23rd. Also note that they exposed the Vitamin A sample to light for more then 30 mins so I might have them retest that too.

I am a little depressed that my body is letting me down again. I like to think myself an over achiever at everything and Im disappointed that things aren’t going perfectly. But… so be it. Knowledge is power and I am going to keep moving forward.

I’m comforting myself that this is why I’m making such slow progress in my running. And that perhaps when I get the iron and vitamins that my body needs, I’ll be able to make faster progress.

I think instead of running this morning I’ll just do elliptical and yoga. Knowing that my body is deficient is making me feel “not strong” which is not going to help dedicate me to running 2 miles without walking.

Related posts:

  1. Iron issues
    2.   So yesterday I went to my new hematologist. ...
  2. Errand Day
    3.   Nothing exciting to write about. Emma...
  3. Running is hard
    4.   Oye. Running is hard. I am in this...