labs

[Guest guest]

In a message dated 6/17/2002 9:11:23 PM Pacific Daylight Time,

gayu_pwc@... writes:

> .

>

> I was wondering if any of you had ordered some

> supplements from douglas lab on your own?

>

needs.com has them. their 800 number is on their website, but not all of

their supplements are on their website. call them about the products in

which you are interested . (no affiliation with needs, etc.)

[Guest guest]

hi

vitamin shoppe.com carries some douglas lab products and runs monthly

specials. i am not sure if they carry the dhea .

somish

[Guest guest]

I buy from Vitanet. They seem to be the least expensive source I

have found. Here is a link to them:

http://store./vitanet/douglaslabs.html

Lynn

> Hi everyone

>

> I want to order some supplements from Labs.

> But I was told that they sell supplements only to

> doctors.

> My doctors' office carries the supplements, but they

> are 1 hour away and I am too tired to drive that far.

>

> I was wondering if any of you had ordered some

> supplements from douglas lab on your own?

>

> Thanks

> Gayathri

>

>

> __________________________________________________

>

[Guest guest]

We check lab at 6 months, 12 months, and annually after that. We routinely check:

CBC, CMP, lipid panel, pre-albumin, vit A, vit B12, vit D25-OH, ferritin, folate, iron/TIBC, ionized calcium, PTH, magnesium, and urinalysis.julielewrd <jlewis@...> wrote:

Our nurse practitioner and I are going through our notes from ASBS and realized that we may be ordering too many labs post-op. What kind of labs do other clinics order at months 3, 6, 9 and annually? We would appreciate any suggestions. Thanks , RD, CD

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE__________________________________________________

[Guest guest]

Question for the group:

After much reading it appears that there is no "gold standard" for Vitamin B12 status and that just measuring serum Vitamin B12 may not detect subclinical deficiencies. Just curious to take a little poll to see what various labs are using. serum MMA? serum homocysteine? serum Vitamin B12? holo-transcobalmin?

Thanks for your responses.

Laschkewitsch RD LD

Legacy Obesity Institute

Portland OR

-----Original Message-----From: [mailto: ]On Behalf Of Hillary MausbachSent: Monday, July 11, 2005 6:19 AM Subject: Re: labs

We check lab at 6 months, 12 months, and annually after that. We routinely check:

CBC, CMP, lipid panel, pre-albumin, vit A, vit B12, vit D25-OH, ferritin, folate, iron/TIBC, ionized calcium, PTH, magnesium, and urinalysis.julielewrd <jlewis@...> wrote:

Our nurse practitioner and I are going through our notes from ASBS and realized that we may be ordering too many labs post-op. What kind of labs do other clinics order at months 3, 6, 9 and annually? We would appreciate any suggestions. Thanks , RD, CD

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

We use both serum B12 and MMA at 6 mo and then annually.

Jeanne Blankenship, MS RD

UC Medical Center

[Guest guest]

Do you find some elevated MMA without seeing low B12? If so do you treat with just oral B12 or do you treat as a significant deficiency, giving IM B12?

Thanks for the reply.

-----Original Message-----From: [mailto: ]On Behalf Of jeanne blankenshipSent: Tuesday, July 12, 2005 9:55 AM Subject: Re: labs

We use both serum B12 and MMA at 6 mo and then annually.

Jeanne Blankenship, MS RD

UC Medical Center

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

We see elevated MMAs, especially when serum levels are trending down...300's.(Green, et al define this as subclinical deficiency.) MMA is earlier in the metabolic pathway so it will elevate prior to decreases in B12. We treat with 500 mcg of oral unless the PMD or patient prefers IM. With the latter, you rely on patients keeping appointments for follow-up appointments. IM B12 will be reflected with serum increases quickly -- but that does not equal storage or improved status.

Jeanne

[Guest guest]

Well we got the ID Doc here to finally say he would see Zachery. The ID doctors

here only work out of hospitals so it has been a little bit of a challenge.

So this Dr. wanted Zacherys medical records from our last ped. So I ordered them

to me but I knew what blood work he had done because they had given me a copy.

It wasn't much just a blood and urine culture and a chest xray.

Well I got his records in the mail yesterday and low and behold they had done a

whole series of blood values! And many were off, which makes me think why the

previous ped just kept telling me that Zachery was just anemic.

So here are the values and I was wondering if anyone can make heads or tails of

this! I searched the files but didn't find anything and I couldn't find to much

info on the net that would link these values together.

WBC= 12.6 High

Hemoglobin=11.2 Low

RDW=14.7= High

MPV= 7.3 Low

Segmented Neutrophils= 72 High

Lymphocytes= 19 Low

Absolute Neutrophil= 9.0 High

Sedimentation Rate= 31 High

Any insight would be helpful!

[Guest guest]

In a message dated 9/26/06 9:10:05 PM, meling333@... writes:

Catecholamines

Dopamine

36 H 0-20

Norepinephrine

985 H 80-520

Epinephrine

23 10-200

Suggest pheo unless you are eating or taking stuff that will increase NE.

Normetanephrine

0.91 H 0.00-0.89

Metanephrine

..30 0.00-0.

Prob no pheo

1mg Dex supression test

aldo

63.3

upright 4.1-31.0

ACTH

2 L 6-58

Cortisol

1.7 L 6.7-22.6

You took the dex and got good ACTH suppression but aldo did not suppress so you dont have GRA.

Vasopresson

0.5 0.0-4.7

Serum Osmolality

288 280-303

Urine Osmolality

274 50-800

K

4.4 3.5-5.2

Na

136 134-143

What do you think Dr. Grim?

All Lytes etc OK.

Looks like you have PA or one type or another in early stage (K not low).

ita

[Guest guest]

Eating what stuff or taking what would increase norepinephrine?

All I take is sprio100mg, atenolol 50mg,synthroid 25mcg,vytorin 10/10

1/2 of 25mg HCTZ.

I have a tight chest and always feel so stressed out. Lately I have more palps

and irregular heart beats. Blood pressure dosent seem to be controlled as when I

stand up bp just keeps

going from a sitting of

123/88 P 77 to standing of 125/92 P 103 in about 5 minutes which puts me into a

sweat, feeling faint I am off my feet alot because of this.

4/28 Normetanephrine

0.37 0.00-0.89

Metanephrine

0.24 0.00-0.49

8/17 Normetanephrine

0.57 0.00-0.89

Metanephrine

0.17 0.00-0.49

9/14 Normetanephrine

.91 H 0.00-0.89

Metanephrine

.30 0.00-.49

These all seem to be going up as time marches on.I have palps chest pains and a

tight feeling in my chest like I am going to have a heart attack one day. MY

diastolic cannont be controled on what I am taking. ita

Catecholamines

Dopamine

36 H 0-20

Norepinephrine

985 H 80-520

Epinephrine

23 10-200

Suggest pheo unless you are eating or taking stuff that will increase NE.

>

>

> >

> > Normetanephrine

> > 0.91 H 0.00-0.89

> > Metanephrine

> > .30 0.00-0.49

> >

> >

> Prob no pheo

>

> >

> > 1mg Dex supression test

> > aldo

> > 63.3

> > upright 4.1-31.0

> > ACTH

> > 2 L 6-58

> > Cortisol

> > 1.7 L 6.7-22.6

> >

> You took the dex and got good ACTH suppression but aldo did not suppress so

> you dont have GRA.

> >

> > Vasopresson

> > 0.5 0.0-4.7

> > Serum Osmolality

> > 288 280-303

> > Urine Osmolality

> > 274 50-800

> > K

> > 4.4 3.5-5.2

> > Na

> > 136 134-143

> > What do you think Dr. Grim?

> >

> All Lytes etc OK.

>

> Looks like you have PA or one type or another in early stage (K not low).

> > ita

> >

> >

> >

>

[Guest guest]

In a message dated 9/28/06 3:41:38 PM, meling333@... writes:

Eating what stuff or taking what would increase norepinephrine?

Many cold remedies containing neosynphrince may increase catecholamines depending on what assay they use. So be sure you tell the health care team about any herbs etc you are eating. I also assume they have asked you about licorice.

May your pressure be low!

C.E. Grim, B.S., M.S., M.D.

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

[Guest guest]

In a message dated 11/28/06 1:22:00 PM, meling333@... writes:

Hi Dr.Grim

Do ACE inhibitors actualy lower norepinephrine? I been on Benezapril 5mg for 6 weeks.My Norep was 995 range 80-520

in Sept. Now it is 445

No good studies. One problem with plasma NE is that it can vary over 10 fold in seconds and one needs to control everything that is going on to get a good estimate and do it several times.

I have faxed all the paper work

again for the 3rd time to dr. Schambelan's office yesterday at their request again. This has been going on for 2 months now.

Nothing glowed on the MRI last week either. ita

You might want to remind them that Dr. Grim wanted him or whoever in his group he recommends to see their group.

May your pressure be low!

Clarence E. Grim, B.S., M.S., M.D.

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

[Guest guest]

When we talked to our hemeatologists they suggested Ferritan vs iron as a better measure for detection of deficiency so we do that. I am curious to know how often you see deficiencies in Mg - we do not routinely check that nor B1 and I am curious to hear what you see. We have gone back and forth with making B1 routine but my understanding is the test is not that sensitive and you can often see (and we often do see) clinical symptoms with normal thiamin levels. Lastly we routinely do HgbA1c for anyone with hx of metabolic syndrome of diabetes.

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of jbach11Sent: Thursday, August 09, 2007 9:37 AM Subject: Labs

Just wanted to see what other facilities out there are routinely testing, as far as labs after gastric bypass surgery. We currently check the following:CBCElectroylytesBUNCreatinineGlucoseCalciumMagnesiumCholesterolTriglyceridesT. BIliT. ProteinAlbuminAlk PhosASTALTSerum IronTIBCSerum FolateB12B1Is there anything else that we should be testing on a regular basis? Thanks!

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

Serum calcium does not adequately represent calcium status hence we also do a Serum ionized calcium, serum PTH and 25 Hydroxy Cholecalciferol for all our bypass patients as a protocol. In addition to blood glucose, insulin is also on our list as insulin resistance is more common than frank diabetes in our patient population Would like to know what others are following as well. Regards Payaljbach11 <knbach@...> wrote: Just wanted to see what other facilities out there are routinely testing, as far as labs after gastric bypass surgery. We currently check the following:CBCElectroylytesBUNCreatinineGlucoseCalciumMagnesiumCholesterolTriglyceridesT. BIliT. ProteinAlbuminAlk PhosASTALTSerum IronTIBCSerum FolateB12B1Is there anything else that we should be testing on a regular basis? Thanks!

Fussy? Opinionated? Impossible to please? Perfect. Join 's user panel and lay it on us.

[Guest guest]

CBC with differential, CMP, Lipid Panel, Iron, Ferritin, B12,

Folate, B1, B6, Copper, Zinc, Calcium (and possibly PTH), Vitamins A

and D (25-hydroxy). Sometimes also A1C.

Ava

> jbach11 <knbach@...> wrote:

> Just wanted to see what other facilities out there are

routinely

> testing, as far as labs after gastric bypass surgery. We currently

> check the following:

>

> CBC

> Electroylytes

> BUN

> Creatinine

> Glucose

> Calcium

> Magnesium

> Cholesterol

> Triglycerides

> T. BIli

> T. Protein

> Albumin

> Alk Phos

> AST

> ALT

> Serum Iron

> TIBC

> Serum Folate

> B12

> B1

>

> Is there anything else that we should be testing on a regular

basis?

> Thanks!

>

[Guest guest]

Hello, Why are you testing for albumin and what would you do with it if it were low? Literature does not support the fact that albumin distinguishes between well nourished and poorly nourished individuals. It is prognostic of length of stay and surgical outcome, but not necessarily nutritional status. Many hospitals no longer even include it as a screening tool. Kathy Shattler, M.S.,RD P.S. Insurances will not pay for Hb A1C without a diagnosis of impaired glucose tolerance, diabetes or pre-diabetes as a medical necessity. marchjo <marchjo@...> wrote: CBC with differential, CMP, Lipid Panel, Iron, Ferritin, B12, Folate, B1, B6, Copper, Zinc, Calcium (and possibly PTH), Vitamins A and D (25-hydroxy). Sometimes also A1C.Ava> jbach11

wrote:> Just wanted to see what other facilities out there are routinely > testing, as far as labs after gastric bypass surgery. We currently > check the following:> > CBC> Electroylytes> BUN> Creatinine> Glucose> Calcium> Magnesium> Cholesterol> Triglycerides> T. BIli> T. Protein> Albumin> Alk Phos> AST> ALT> Serum Iron> TIBC> Serum Folate> B12> B1> > Is there anything else that we should be testing on a regular basis? > Thanks!>

[Guest guest]

Low albumin levels can indicate malnutrition and protein

malabsorption; high albumin levels can indicate dehydration. We will

always test total protein, albumin, and sometimes prealbumin, in RNY

pts.

Ava

> > Just wanted to see what other facilities out there are

> routinely

> > testing, as far as labs after gastric bypass surgery. We

currently

> > check the following:

> >

> > CBC

> > Electroylytes

> > BUN

> > Creatinine

> > Glucose

> > Calcium

> > Magnesium

> > Cholesterol

> > Triglycerides

> > T. BIli

> > T. Protein

> > Albumin

> > Alk Phos

> > AST

> > ALT

> > Serum Iron

> > TIBC

> > Serum Folate

> > B12

> > B1

> >

> > Is there anything else that we should be testing on a regular

> basis?

> > Thanks!

> >

>

>

>

>

>

>

[Guest guest]

, please post responses or forward to me. I'm going through the

same thing and I'm trying to convince my surgeon that we need to test

these pre/post-operatively. Thanks!

, RD, CD

jlewis@...

Labs

Can anyone who is checking B1, B6, Copper, Zinc and Vitamin A levels on

post rny or lap bands give me any reasoning or articles as to why???

We are currently not testing these levels. Thanks! Crandall, RD

[Guest guest]

ASMS is releasing the nutrition education tool in the next couple of months. I covers much of this information. There is a one-day nutrition course the Friday before FNCE in Philadelphia that will summarize the research behind the information in the paper. If you need information, please look on the ASMS website for course registration, etc.

Jeanne Blankenship, MS RD

Bariatric Surgery Nutrition Course

September 29, 2007

7:30 – 8:00 am Continental Breakfast and Networking

8:00– 8:05 am Welcoming Remarks, Program Overview and

Introduction to the ASBS Nutrition Education Tool

Jeanne Blankenship, MS RD

Course Director

8:05 – 9:00 Macronutrients and Weight Loss Surgery:

Are high protein diets really the answer?

Liz Goldenberg, MPH RD

9:00 – 9:30 A Primer on Pre-Surgical Weight Loss

Parrott, MS RD

9:30 – 10:00 am Body Composition and Energy Requirements following Surgical Weight Loss Procedures

Jeanne Blankenship, MS RD

10:00 – 10:30 am Break

Vitamin and Mineral Considerations:

Research and Evidence

10:30 – 11:15 am Part 1: Water Soluble Vitamins

Parrott, MS RD

11:15 -- 12:00 Part 2: Fat Soluble Vitamins

Margaret Furtado, MS RD

12:00 – 1:00 pm Lunch (Open for sponsor presentation)

1:00 – 1:40 pm Part 3: Minerals and trace elements

Liz Goldenberg, MPH RD

1:40 – 2:20 pm Laboratory Assessment of Nutrition Status

Jeanne Blankenship, MS RD

2:20 – 2:50 pm Break

2:50 – 3:30 pm Nutrition Assessment and Support for Surgical Weight Loss Complications

Margaret Furtado, MS RD

3:30 – 4:30 pm Case Study Roundtables

Facilitator: Parrott, MS RD

4:30 – 4:55 pm Ask the Experts

Panel Discussion/Question and Answer Session

4:55 – 5:00 pm Closing Remarks

Jeanne Blankenship, MS RD

-------------- Original message from " " <jlewis@...>: --------------

, please post responses or forward to me. I'm going through thesame thing and I'm trying to convince my surgeon that we need to testthese pre/post-operatively. Thanks! , RD, CDjlewismemorialsb (DOT) org -----Original Message-----From: [mailto: ] On Behalf OfcrandallcarrieSent: Monday, August 13, 2007 1:49 PM Subject: LabsCan anyone who is checking B1, B6, Copper, Zinc and Vitamin A levels onpost rny or lap bands give me any reasoning or article

s as to why??? We are currently not testing these levels. Thanks! Crandall, RD

[Guest guest]

You mean ASBS not ASMS, right?

Amy Long Carrera MS, RD Clinical Dietitian Northridge Hospital Medical Center & Center for Weight Loss Surgery Northridge, CA Amy.Long@... 818-885-8500 x4034

From: [mailto: ] On Behalf Of jbship@...Sent: Monday, August 13, 2007 11:54 AM ; Cc: Subject: RE: Labs

ASMS is releasing the nutrition education tool in the next couple of months. I covers much of this information. There is a one-day nutrition course the Friday before FNCE in Philadelphia that will summarize the research behind the information in the paper. If you need information, please look on the ASMS website for course registration, etc.

Jeanne Blankenship, MS RD

Bariatric Surgery Nutrition Course

September 29, 2007

7:30 - 8:00 am Continental Breakfast and Networking

8:00- 8:05 am Welcoming Remarks, Program Overview and

Introduction to the ASBS Nutrition Education Tool

Jeanne Blankenship, MS RD

Course Director

8:05 - 9:00 Macronutrients and Weight Loss Surgery:

Are high protein diets really the answer?

Liz Goldenberg, MPH RD

9:00 - 9:30 A Primer on Pre-Surgical Weight Loss

Parrott, MS RD

9:30 - 10:00 am Body Composition and Energy Requirements following Surgical Weight Loss Procedures

Jeanne Blankenship, MS RD

10:00 - 10:30 am Break

Vitamin and Mineral Considerations:

Research and Evidence

10:30 - 11:15 am Part 1: Water Soluble Vitamins

Parrott, MS RD

11:15 -- 12:00 Part 2: Fat Soluble Vitamins

Margaret Furtado, MS RD

12:00 - 1:00 pm Lunch (Open for sponsor presentation)

1:00 - 1:40 pm Part 3: Minerals and trace elements

Liz Goldenberg, MPH RD

1:40 - 2:20 pm Laboratory Assessment of Nutrition Status

Jeanne Blankenship, MS RD

2:20 - 2:50 pm Break

2:50 - 3:30 pm Nutrition Assessment and Support for Surgical Weight Loss Complications

Margaret Furtado, MS RD

3:30 - 4:30 pm Case Study Roundtables

Facilitator: Parrott, MS RD

4:30 - 4:55 pm Ask the Experts

Panel Discussion/Question and Answer Session

4:55 - 5:00 pm Closing Remarks

Jeanne Blankenship, MS RD

-------------- Original message from " " <jlewismemorialsb (DOT) org>: --------------

, please post responses or forward to me. I'm going through thesame thing and I'm trying to convince my surgeon that we need to testthese pre/post-operatively. Thanks! , RD, CDjlewismemorialsb (DOT) org -----Original Message-----From: [mailto: ] On Behalf OfcrandallcarrieSent: Monday, August 13, 2007 1:49 PM Subject: LabsCan anyone who is checking B1, B6, Copper, Zinc and Vitamin A levels onpost rny or lap bands give me any reasoning or article s as to why??? We are currently not testing these levels. Thanks! Crandall, RD

[Guest guest]

Yes, for some reason I couldn't type correctly today! I can't get the change from ASBS to ASMBS to work for my fingers....

JB

--------- RE: Labs

ASMS is releasing the nutrition education tool in the next couple of months. I covers much of this information. There is a one-day nutrition course the Friday before FNCE in Philadelphia that will summarize the research behind the information in the paper. If you need information, please look on the ASMS website for course registration, etc.

Jeanne Blankenship, MS RD

Bariatric Surgery Nutrition Course

September 29, 2007

7:30 - 8:00 am Continental Breakfast and Networking

8:00- 8:05 am Welcoming Remarks, Program Overview and

Introduction to the ASBS Nutrition Education Tool

Jeanne Blankenship, MS RD

Course Director

8:05 - 9:00 Macronutrients and Weight Loss Surgery:

Are high protein diets really the answer?

Liz Goldenberg, MPH RD

9:00 - 9:30 A Primer on Pre-Surgical Weight Loss

Parrott, MS RD

9:30 - 10:00 am Body Composition and Energy Requirements following Surgical Weight Loss Procedures

Jeanne Blankenship, MS RD

10:00 - 10:30 am Break

Vitamin and Mineral Considerations:

Research and Evidence

10:30 - 11:15 am Part 1: Water Soluble Vitamins

Parrott, MS RD

11:15 -- 12:00 Part 2: Fat Soluble Vitamins

Margaret Furtado, MS RD

12:00 - 1:00 pm Lunch (Open for sponsor presentation)

1:00 - 1:40 pm Part 3: Minerals and trace elements

Liz Goldenberg, MPH RD

1:40 - 2:20 pm Laboratory Assessment of Nutrition Status

Jeanne Blankenship, MS RD

2:20 - 2:50 pm Break

2:50 - 3:30 pm Nutrition Assessment and Support for Surgical Weight Loss Complications

Margaret Furtado, MS RD

3:30 - 4:30 pm Case Study Roundtables

Facilitator: Parrott, MS RD

4:30 - 4:55 pm Ask the Experts

Panel Discussion/Question and Answer Session

4:55 - 5:00 pm Closing Remarks

Jeanne Blankenship, MS RD

-------------- Original message from " " <jlewismemorialsb (DOT) org>: --------------

, please post responses or forward to me. I'm going through thesame thing and I'm trying to convince my surgeon that we need to testthese pre/post-operatively. Thanks! , RD, CDjlewismemorialsb (DOT) org -----Original Message-----From: [mailto: ] On Behalf OfcrandallcarrieSent: Monday, August 13, 2007 1:49 PM Subject: LabsCan anyone who is checking B1, B6, Copper, Zinc and Vitamin A levels onpost rny or lap bands give me any reasoning or article

s as to why??? We are currently not testing these levels. Thanks! Crandall, RD

[Guest guest]

I have read this article but it does not mention zinc and copper - why would RNY patients experience deficiencies??? Also in terms of the B1 and B6 - is the reasoning that these vitamins are absorbed in the duodenum or due to the malabsorption from the RNY. Has anyone read or reviewed the book Micronutrition for the weight loss surgery patient - might this be helpful?? I noticed it is not written by a credentialled person is it a reliable source?? Thanks! Crandall, RDjbship@... wrote: ASMS is releasing the nutrition education tool in the next couple of months. I covers much of this information. There is a one-day nutrition course the Friday before FNCE in Philadelphia that will summarize the research behind the information in the paper. If you need information, please look on the ASMS website for course registration, etc. Jeanne Blankenship, MS RD Bariatric Surgery Nutrition Course September 29, 2007 7:30 – 8:00

am Continental Breakfast and Networking 8:00– 8:05 am Welcoming Remarks, Program Overview and Introduction to the ASBS Nutrition Education Tool Jeanne Blankenship, MS RD Course Director 8:05 – 9:00

Macronutrients and Weight Loss Surgery: Are high protein diets really the answer? Liz Goldenberg, MPH RD 9:00 – 9:30 A Primer on Pre-Surgical Weight Loss

Parrott, MS RD 9:30 – 10:00 am Body Composition and Energy Requirements following Surgical Weight Loss Procedures Jeanne Blankenship, MS RD 10:00

– 10:30 am Break Vitamin and Mineral Considerations: Research and Evidence 10:30 – 11:15 am Part 1: Water Soluble Vitamins Parrott, MS RD 11:15 -- 12:00 Part 2: Fat Soluble Vitamins Margaret Furtado, MS RD 12:00 – 1:00 pm Lunch (Open for sponsor presentation) 1:00 – 1:40 pm Part 3: Minerals and trace elements Liz Goldenberg, MPH RD 1:40 – 2:20

pm Laboratory Assessment of Nutrition Status Jeanne Blankenship, MS RD 2:20 – 2:50 pm Break 2:50 – 3:30 pm Nutrition Assessment and Support for Surgical Weight Loss Complications Margaret Furtado, MS RD 3:30 – 4:30 pm Case Study Roundtables Facilitator: Parrott, MS RD 4:30 – 4:55 pm Ask the Experts Panel Discussion/Question and Answer Session 4:55 – 5:00 pm Closing Remarks Jeanne Blankenship, MS RD -------------- Original message from " " <jlewismemorialsb (DOT) org>: -------------- , please post responses or forward to me. I'm going through thesame thing and I'm trying to convince my surgeon that we need to testthese pre/post-operatively. Thanks! , RD, CDjlewismemorialsb (DOT) org -----Original Message-----From: [mailto: ] On Behalf OfcrandallcarrieSent: Monday, August 13, 2007 1:49 PM Subject: LabsCan anyone who is checking B1, B6, Copper, Zinc and Vitamin A levels onpost rny or lap bands give me any reasoning or article s as to why??? We are currently not testing these levels. Thanks! Crandall, RD

[Guest guest]

" First Principles of Gastroenterology " at

http://gastroresource.com/GITextbook/en/chapter7/7-9.htm reviews the

anatomy of the normal GI tract and where nutrients are absorbed. If

you check that against a copy of an RNY surgical report, you'll see

exactly what was done to the GI tract and why vitamin and protein

deficiencies can occur post-op.

You'll find hundreds of articles regarding vitamin deficiency after

RNY at www.pubmed.gov.

See, for example, Pires LV, s LM, Geloneze B, Tambascia MA,

Hadad do Monte SJ, do Nascimento Nogueira N, Santos de Sousa G, do

Nascimento Marreiro D. " The effect of Roux-en-Y gastric bypass on

zinc nutritional status. " Obes Surg. 2007 May;17(5):617-21.

or

Kumar N, Ahlskog JE, Gross JB Jr. " Acquired hypocupremia after

gastric surgery. " Clin Gastroenterol Hepatol. 2004 Dec;2(12):1074-9.

or

Clements RH, Katasani VG, Palepu R, Leeth RR, Leath TD, Roy BP,

Vickers SM. " Incidence of vitamin deficiency after laparoscopic Roux-

en-Y gastric bypass in a university hospital setting. " Am Surg. 2006

Dec;72(12):1196-202.

Regarding the earlier post: we, too, check albumin, total protein,

and prealbumin as a reliable indicator of protein malnutrition,

malabsorption and/or dehydration.

Steve Huntington, PhD, RD, LD

>

> I have read this article but it does not mention zinc and copper -

why would RNY patients experience deficiencies??? Also in terms of

the B1 and B6 - is the reasoning that these vitamins are absorbed in

the duodenum or due to the malabsorption from the RNY.

>

> Has anyone read or reviewed the book Micronutrition for the

weight loss surgery patient - might this be helpful?? I noticed it

is not written by a credentialled person is it a reliable source??

>

> Thanks! Crandall, RD

[Guest guest]

-

How do you treat zinc deficiency?

-- In

, " steve.huntington "

<steve.huntington@...> wrote:

>

> " First Principles of Gastroenterology " at

> http://gastroresource.com/GITextbook/en/chapter7/7-9.htm reviews

the

> anatomy of the normal GI tract and where nutrients are absorbed. If

> you check that against a copy of an RNY surgical report, you'll see

> exactly what was done to the GI tract and why vitamin and protein

> deficiencies can occur post-op.

>

> You'll find hundreds of articles regarding vitamin deficiency after

> RNY at www.pubmed.gov.

>

> See, for example, Pires LV, s LM, Geloneze B, Tambascia MA,

> Hadad do Monte SJ, do Nascimento Nogueira N, Santos de Sousa G, do

> Nascimento Marreiro D. " The effect of Roux-en-Y gastric bypass on

> zinc nutritional status. " Obes Surg. 2007 May;17(5):617-21.

>

> or

>

> Kumar N, Ahlskog JE, Gross JB Jr. " Acquired hypocupremia after

> gastric surgery. " Clin Gastroenterol Hepatol. 2004 Dec;2(12):1074-9.

>

> or

>

> Clements RH, Katasani VG, Palepu R, Leeth RR, Leath TD, Roy BP,

> Vickers SM. " Incidence of vitamin deficiency after laparoscopic

Roux-

> en-Y gastric bypass in a university hospital setting. " Am Surg.

2006

> Dec;72(12):1196-202.

>

> Regarding the earlier post: we, too, check albumin, total protein,

> and prealbumin as a reliable indicator of protein malnutrition,

> malabsorption and/or dehydration.

>

> Steve Huntington, PhD, RD, LD

>

>

> >

> > I have read this article but it does not mention zinc and copper -

> why would RNY patients experience deficiencies??? Also in terms of

> the B1 and B6 - is the reasoning that these vitamins are absorbed

in

> the duodenum or due to the malabsorption from the RNY.

> >

> > Has anyone read or reviewed the book Micronutrition for the

> weight loss surgery patient - might this be helpful?? I noticed it

> is not written by a credentialled person is it a reliable source??

> >

> > Thanks! Crandall, RD

>