labs

[Guest guest]

Please someone correct me if I am wrong, according to information I

learned in the BariMD nutrition course, lap-band patients should

still have labs checked because their diet may still be inefficient

after surgery. I believe that there has been reported thiamin

deficiencies resulting in wernicke's encephalopathy after lab band.

Someone asked about the book Micronutrition for the Weight Loss

Surgery Patient. I have it and it is a GREAT reference!

Even though my surgeon doesn't test certain labs unless I beg him to

(I'm usually right and I love it!)I still advise both my lap bands

and RNY to take a bariatric formulated vitamin.

, RD, CD

>

> 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

>

>

> --------- 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]

Get a vitamin D level. If the 25 hydroxy vitamin D (D3) is low, she needs repletion of D. That should help PTH and in turn bring calcium levels down. Bartholomay, LRDManager, Nutrition TherapyMeritCare Health Systems.Bartholomay@...(701) 234-6166Strengths: Arranger, Ideation, Adaptability, Empathy, Maximizer>>> Beth Taschuk <bethhanne@...> 11/3/2009 2:02 PM >>> Good afternoon: I have a patient that had AGB 8/09... Per protocol I instructed her to begin calcium supplements. She reports that several months before her surgery, her PCP advised her to d/c calcium supplements due to her high blood calcium levels. Am I incorrect in thinking that calcium supplements will not raise your blood calcium levels and that calcium levels are regulated by parathyroid hormone? I did check PTH which was well wnl...Any suggestions? She consumes very little dairy and I am concerned about her future bone health.. Thanks so much.Beth Taschuk RD

This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C. Section 2510-2521. This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law. If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer.

[Guest guest]

Just received Vit D level and it is wnl..the only paramenter out of range is thiamine..

Thanks

Beth

From: Bartholomay <.Bartholomay@...> Sent: Tue, November 3, 2009 3:31:06 PMSubject: Re: labs

Get a vitamin D level. If the 25 hydroxy vitamin D (D3) is low, she needs repletion of D. That should help PTH and in turn bring calcium levels down.

Bartholomay, LRDManager, Nutrition TherapyMeritCare Health Systems.Bartholomay@...(701) 234-6166Strengths: Arranger, Ideation, Adaptability, Empathy, Maximizer>>> Beth Taschuk <bethhanne@...> 11/3/2009 2:02 PM >>>

Good afternoon:

I have a patient that had AGB 8/09... Per protocol I instructed her to begin calcium supplements.

She reports that several months before her surgery, her PCP advised her to d/c calcium supplements due to her high blood calcium levels. Am I incorrect in thinking that calcium supplements will not raise your blood calcium levels and that calcium levels are regulated by parathyroid hormone? I did check PTH which was well wnl...Any suggestions? She consumes very little dairy and I am concerned about her future bone health..

Thanks so much.

Beth Taschuk RD

This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C. Section 2510-2521. This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law. If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer.

[Guest guest]

You can actually have free calcium excess despite normal blood serum calcium. Free calcium excess can occur for a number of reasons including inflammation being slightly acidic. You can always ask how her doc came to this conclusion or if she has any calcium deposits, elevated dental plaque, h/o kidney stones or other dental problems. You can easily calculate free calcium if you have a phosphorus level and albumin is normal (Around 4.0)

1. Calculate Predicted Calcium: Phos x 2.5= Predicted calcium

2. Measured Ca - Pred. Ca = Free Calcium Index

Normal range is .5-1.3

Optimal range is less than 0.8

You can also do Calcium to Albumin ratio

Normal is 2.03 to 2.71 Optimal is 2.10-2.3 A high ratio is indicative of free calcium excess (i.e not enough protein bound to albumin and floating in the serum)

I typically use Sam Queen's Basic 100 when looking at Labs, I have another reference at home that I can send to you tomorrow.

Also, you can do urine to see if there is calcium crystals in the urine and ionized calcium

http://www.labtestsonline.org/understanding/analytes/calcium/test.html

Tina Musselman, R.D., C.C.N. Bariatric Surgery Program Coordinator www.stjameshospital.org tina.musselman@... Phone: 708-679-2717 or 708-747-4000 ext. 7444 Fax: 708-679-2048

From: [mailto: ] On Behalf Of Beth TaschukSent: Tuesday, November 03, 2009 2:03 PM Subject: labs

Good afternoon:

I have a patient that had AGB 8/09... Per protocol I instructed her to begin calcium supplements.

She reports that several months before her surgery, her PCP advised her to d/c calcium supplements due to her high blood calcium levels. Am I incorrect in thinking that calcium supplements will not raise your blood calcium levels and that calcium levels are regulated by parathyroid hormone? I did check PTH which was well wnl...Any suggestions? She consumes very little dairy and I am concerned about her future bone health..

Thanks so much.

Beth Taschuk RD

The information contained in this e-mail and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.

[Guest guest]

Hi

I got a call from the on call Dr this morning for my labs, to get my Potassium, Calcium and Sodium levels. My potassium was low at the beginning of the week(3.1) and today the result read 3.3. So they have come up since taking the supplements. I was on 12.5 mg of HCTZ, I am no longer on them. My calcium is now normal(9.6), and Sodium is normal. Magnesium and the rest not back yet.

Now, my Dr did bloodwork to test for HA on Friday. I was also asked to give a urine sample. They did not ask for a clean catch. And this Dr on call told me that it was a "dirty" sample. And that it was full of cells that he would treat me for a UTI, but anyways the lab couldn't test it. I am also ending my period. Was the Dr's office supposed to get a clean catch sample?? (I am not having symptoms of a UTI). What is your opinion on this?

Thank you

[Guest guest]

Always do a mid stream clean catch. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Nov 14, 2009, at 8:07 AM, pscs@... wrote:

Hi

I got a call from the on call Dr this morning for my labs, to get my Potassium, Calcium and Sodium levels. My potassium was low at the beginning of the week(3.1) and today the result read 3.3. So they have come up since taking the supplements. I was on 12.5 mg of HCTZ, I am no longer on them. My calcium is now normal(9.6), and Sodium is normal. Magnesium and the rest not back yet.

Now, my Dr did bloodwork to test for HA on Friday. I was also asked to give a urine sample. They did not ask for a clean catch. And this Dr on call told me that it was a "dirty" sample. And that it was full of cells that he would treat me for a UTI, but anyways the lab couldn't test it. I am also ending my period. Was the Dr's office supposed to get a clean catch sample?? (I am not having symptoms of a UTI). What is your opinion on this?

Thank you

[Guest guest]

For everyone we do CBC, CMP, prealbumin, iron, ferritin, vit B12, Vit A, folate, Vit D, 25-hydroxy, transferrin, intact PTH, beta carotene, phosphorous, hgbA1c, lipid panel, magnesium, selenium, zinc, PTT, calcium, thiamin. If it is a duodenal switch patient, we also check Vit E and vit K inaddition to everything else listed. Hope that helps.

n, 10/18/10, guidryrose <guidryrose@...> wrote:

From: guidryrose <guidryrose@...>Subject: Labs Date: Monday, October 18, 2010, 12:49 PM

Hi,What labs do you currently recommend to be checked for your post surgery yearly follow up?Thank you in advanceRose Guidry RD, LD, RN, BSNETMC Transplant

[Guest guest]

Sheila...would you mind taking a look at my lab report and see what you think??

TSH. 6.96. Ref 0.35 ---4.94

Free T3 was 2.46. Ref. 1.71 ---3.71

Free T4 was 1.21. Ref..0.70----1.48

Thanks bunches..

I also have. Other results I don't understand. I have ordered a couple books

and plan to try to educate myself on gland function. I think that is the only

way to stay ion top of it. DeeDee

[Guest guest]

Hi Dee - your TSH is FAR too high and shows there is something

wrong somewhere, even though your free T3 and free T4 look reasonably OK. I

take it your doctor is not taking your symptoms and signs into consideration

and that no tests have been done to see if you have thyroid antibodies. These

need testing because antibodies see your thyroid gland as public enemy number

one and set about its gradual destruction and during that time, your thyroid

gland will be secreting less and less thyroid hormone. Get those tests

done and if you have results for ferritin, Vitamin B12, D3, folate, magnesium,

copper and zinc, let us have them together with the reference range for each

one done.

Luv - Sheila

Sheila...would you mind taking a look at my lab

report and see what you think??

TSH. 6.96. Ref 0.35 ---4.94

Free T3 was 2.46. Ref. 1.71 ---3.71

Free T4 was 1.21. Ref..0.70----1.48

[Guest guest]

When did you start DASHing? How are you keeping your sodium so low, most have

to work to keep it down to 1500mg. Be sure you are reading every label and

paying attention to portion control.

Are your NA and K numbers from a urine test? (Those are the numbers you want.)

With that said, I agree with your doctor unless something else is going on that

you haven't told us about. Why would you introduce the side effects of

medicines if you don't need them?

>

> Blood pressure was running 160/110 to 170/120 most days. I have been dashing

to extreme and have been consistent 120/80 eating only 500 mg of sodium or less

per day. My kidney doctor said I have salt sensitive kidneys. As long as I keep

my Bp down he will not prescribe spiro or elperone. Anyone else feel lousy even

after having 100 mg sodium in their meal? I asked to start spiro but was refused

because I got my Bp down with diet. As for now he does not plan to follow up

with me.

> On a positive note I have lost thirty pounds! I have been very careful about

calorie counting and still unable to lose weight. This low salt thing is

working.

>

> NA 24 normal 9-23

> Potassium 3.9 Normal 3.5-5.2

> Aldosterone 9.96 normal 0-19

> Renin .84

> These were taken right before I started dash.

> Thoughts?

>

[Guest guest]

BTW, back then my sugars immediately and an hour after lunch would be 60. But corrected when I finally got my body adjusted to a better diet - not a DASH back then - but lower carbs and more veggies

From: dsmemory <dsmemory@...>Subject: Re: Labshyperaldosteronism Date: Monday, March 26, 2012, 3:44 PM

I agree msmith and Lucy. I too went vegetarian years back and wasn't doing something correctly, as my hair started falling out and I felt terrible. Adding more protein made all the difference., your labs look similar to mine (early PA). I too am extremely salt sensitive and am holding my daily intake to around 500 mg. It seems when I go over 500 mg of Na I don't feel very well and my BP is harder to control. Don't forget the potassium side of the DASH diet as you want around 4800 mg. per day. I have been eating low Na and high K for about a year now and have adjusted well.I too eat non packaged foods, no sauces, very little eating out. In addition I have some food allergies to consider. I have become an avid reader of food labels.Here are some ideas of meals for you:BreakfastEggs (I cook mine in organic, non-salted ghee)Fresh FruitSmoothies (if you add protein powder check the

label for additives which are common)Dairy (great if you can tolerate milk - watch out for Na content in cheese and cottage cheese)Oatmeal (not instant - use old fashioned oats if you can tolerate gluten)Juice (watch out for added sugar) I LOVE fresh squeezed orange juiceWatch out for bacon and sausage, breakfast cereals, breakfast bars, baked goods.When I do eat out for breakfast I order 2 eggs over hard, no salt added (scrambled eggs and omelets are sometimes made out of a pre-made egg mix that may have additives in it) and a dish of fresh fruit.Lunch and DinnerProtein Veggies Fresh FruitSometimes brown riceAdded organic olive oil (can't forget that we need some fat in our diet too)Watch out for sodium infused meats. I buy all organic, grass fed (if possible), no sodium added meats.As far as seasonings go, garlic powder is my friend. I love garlic. Also love to use fresh

peppers and onions to cook with.Use your beef or chicken bones to make broth. Use this broth in cooking or to simply have a warm drink on occasion.I also make sure that I have my favorite snacks in supply, should I get hungry mid day:- sliced apples with roasted almonds and raisins- Lara barsReal treats:- Bare Naked juices- Jamba Juice- grilled sliced apples (tastes like apple pie)Dr. Grim is a big advocate of low sodium V-8 juice to add K to your diet. Based on the reviews I have seen on this board regarding medication side effects, I am working my hardest to go dietary route first. I know there may be coming a day when medication is necessary and I accept that. However, if I can hold off as long as possible then I plan on doing so.I actually embrace my way of eating now (wasn't easy at first). The flavors of foods without enhancement are wonderful.Head on over to

www.sodiumgirl.com for great ideas on living in a low sodium world. Her recipes are wonderful.> > >> >> > >> > Blood pressure was running 160/110 to 170/120 most days. I have been dashing to extreme and have been consistent 120/80 eating only 500 mg of sodium or less per day. My kidney doctor said I have salt sensitive kidneys. As long as I keep my Bp down he will not prescribe spiro or elperone. Anyone else feel lousy even after having 100 mg sodium in their meal? I asked to start spiro but was refused because I got my Bp down with diet. As for now he does not plan to

follow up with me.> > >> > On a positive note I have lost thirty pounds! I have been very careful about calorie counting and still unable to lose weight. This low salt thing is working.> > >> > > > >> > NA 24 normal 9-23> > >> > Potassium 3.9 Normal 3.5-5.2> > >> > Aldosterone 9.96 normal 0-19> > >> > Renin .84> > >> > These were taken right before I started dash.> > >> > Thoughts?> > >> >> > >> > > >> > > >> > > >> > > >> TODAY(Beta) • Powered by > > >> Race car driver reviews new Mustang GT> > >> What happens when a driver used to triple-digit speeds takes a classic muscle car on regular roads?> > >> Privacy Policy>

>>

[Guest guest]

Agreed . Milk has about 125 mg Na per cup - easy to gulp down more or can

be hidden in cooked foods. Salted butter has 117 mg per tablespoon. Unsalted

butter has only 2 mg per tablespoon. I use ghee which is clarified butter (no

sodium added). Sauces, soups, dressings mess me up bad too.

> > > >> >

> > > >> > Blood pressure was running 160/110 to 170/120 most days. I have been

dashing to extreme and have been consistent 120/80 eating only 500 mg of sodium

or less per day. My kidney doctor said I have salt sensitive kidneys. As long as

I keep my Bp down he will not prescribe spiro or elperone. Anyone else feel

lousy even after having 100 mg sodium in their meal? I asked to start spiro but

was refused because I got my Bp down with diet. As for now he does not plan to

follow up with me.

> > > >> > On a positive note I have lost thirty pounds! I have been very

careful about calorie counting and still unable to lose weight. This low salt

thing is working.

> > > >> >

> > > >> > NA 24 normal 9-23

> > > >> > Potassium 3.9 Normal 3.5-5.2

> > > >> > Aldosterone 9.96 normal 0-19

> > > >> > Renin .84

> > > >> > These were taken right before I started dash.

> > > >> > Thoughts?

> > > >> >

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> TODAY(Beta) • Powered by

> > > >> Race car driver reviews new Mustang GT

> > > >> What happens when a driver used to triple-digit speeds takes a classic

muscle car on regular roads?

> > > >> Privacy Policy

> > >

> >

>

[Guest guest]

Thank you all! Great ideas and things to keep in mind. Sent from my iPadOn Mar 26, 2012, at 2:48 PM, "dsmemory" <dsmemory@...> wrote:

Agreed . Milk has about 125 mg Na per cup - easy to gulp down more or can be hidden in cooked foods. Salted butter has 117 mg per tablespoon. Unsalted butter has only 2 mg per tablespoon. I use ghee which is clarified butter (no sodium added). Sauces, soups, dressings mess me up bad too.

> > > >> >

> > > >> > Blood pressure was running 160/110 to 170/120 most days. I have been dashing to extreme and have been consistent 120/80 eating only 500 mg of sodium or less per day. My kidney doctor said I have salt sensitive kidneys. As long as I keep my Bp down he will not prescribe spiro or elperone. Anyone else feel lousy even after having 100 mg sodium in their meal? I asked to start spiro but was refused because I got my Bp down with diet. As for now he does not plan to follow up with me