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Another "please help with my confusing blood test results" thread

VictoriousSecret
on 5/26/11 7:55 pm

I posted my full results on my blog at http://www.obesityhelp.com/member/victorioussecret/blog/2011/05/26/blood-and-urine-test-results/ and will also post here.  The results are so confusing - any tips about what these levels might mean or what I should do about them would be appreciated.  They certainly tested a lot fewer things than I expected, so if you notice any that are missing, I'd be grateful for your knowledge on that as well. 

 

 I find myself being frustrated that I could so easily get my lab results, but in the last hour on the computer, I couldn't find anywhere to help me easily interpret them.  I want a place where I select my test from a drop down menu and then put my results in the next box, and voila! It says, "This level is high, that may mean _____" or whatever.  Guess what?  That doesn't exist, so invent it and make a bunch of money off the advertising.  And tell me that it's ready, so I can use it!

Urinalysis: (normal range in parenthese after the result)
Glucose - negative
Ketone - negative
Blood - negative
pH - 8.5 (5.0 - 7.5) out of range
Nitrite - negative
Leuk - negative
Protein - negative
Sp. Gr. - 1.020 (1.005 - 1.030)
URO - 1.0 (0.0 - 1.9 mg/ dl)

Blood test results:
Amylase serum - 272 (31 - 124 U/ L) out of range
Lipase serum - 21 (0 - 59 U/L)
Magnesium serum - 2.0 (1.6 - 2.6 mg/ dL)
TSH - 1.020 (0.450 - 4.500 uIU/ mL)
Vitamin D, 25-Hydroxy - 23.8 (32.0 - 100.0 ng/ mL) out of range
Vitamin B1 (Thiamine) plasma - 112.5 (66.5 - 200.0 nmol/ L)

Lipid panel with LDL/ HDL Ratio:
Cholesterol, total - 157 (100 - 199 mg/dL)
Triglycerides - 80 (0-149 mg/ dL)
HDL cholesterol - 44 (>39 mg/ dL)
LDL/ HDL Ratio - 2.2 (0.0 - 3.2 ratio units)
VLDL cholesterol cal - 16 (5 - 40 mg/dL)
LDL cholesterol calc - 97 (0 - 99 mg/ dL)

CMP 14:
Calcium, serum - 9.3 (8.7 - 10.2 mg/dL)
Glucose, serum - 82 (65 - 99 mg/dL)
BUN - 12 (6 - 20 mg/dL)
Protein, total, serum - 6.9 (6.0 - 8.5 g/ dL)
Albumin, serum - 4.1 (3.5 - 5.5 g/ dL)
Bilirubin, total - 0.6 (0.0 - 1.2 mg/ dL)
Alkaline phosphates, S - 85 (25 - 150 IU/ L)
AST (SGOT) - 18 (0 - 40 IU/ L)
Potassium, serum - 4.0 (3.5 - 5.2 mmol/ L)
Sodium, serum - 136 (135 - 145 mmol/ L)
Chloride, serum - 100 (97 - 108 mmol/ L)
Creatinine, serum - 0.60 (0.57 - 1.00 mg/ dL)
ALT (SGPT) - 12 (0 - 40 IU/ L)
Carbon dioxide, total - 23 (20 - 32 mmol/ L)
BUN, creatinine ratio - 20 (8 - 20)
Globulin, total - 2.8 (1.5 - 4.5 g/ dL)
A/G Ratio - 1.5  (1.1 - 2.5)

It's all Greek to me!  I'm supposed to be getting a call from my surgeon's office to set up an appointment regarding my high amylase levels, but no word yet about the other items out of range (except they prescribed me 8 pills of vitamin D).  My vitamin D was low before surgery and they prescribed me the same 8 pills.  That was about 7 or 8 months ago.  So perhaps that is insufficient!  (Told you I was a pale office worker!)

When I'm at the appointment, I'll ask if there are any "in range" items I should be concerned about.  As they say on the boards, you should take action when things are trending low, not wait until they're out of range.

     

Temporarily holding on losing more because I'm gaining!  Pregnant with my first baby (a boy!) due June 2013, after two rounds of IVF.  SO GRATEFUL!

Sharyn S.
on 5/26/11 8:02 pm, edited 5/26/11 8:02 pm - Bastrop, TX
RNY on 08/19/04 with
Amylase serum - 272 (31 - 124 U/ L) out of range ~ rapid weight loss
Lipase serum - 21 (0 - 59 U/L)
Magnesium serum - 2.0 (1.6 - 2.6 mg/ dL)
TSH - 1.020 (0.450 - 4.500 uIU/ mL)
Vitamin D, 25-Hydroxy - 23.8 (32.0 - 100.0 ng/ mL) out of range ~ too low; you need to be taking at least 50,000 units DRY vitamin D daily until your levels increase
Vitamin B1 (Thiamine) plasma - 112.5 (66.5 - 200.0 nmol/ L)

Lipid panel with LDL/ HDL Ratio:
Cholesterol, total - 157 (100 - 199 mg/dL)
Triglycerides - 80 (0-149 mg/ dL)
HDL cholesterol - 44 (>39 mg/ dL)
LDL/ HDL Ratio - 2.2 (0.0 - 3.2 ratio units)
VLDL cholesterol cal - 16 (5 - 40 mg/dL)
LDL cholesterol calc - 97 (0 - 99 mg/ dL)

CMP 14:
Calcium, serum - 9.3 (8.7 - 10.2 mg/dL)
Glucose, serum - 82 (65 - 99 mg/dL)
BUN - 12 (6 - 20 mg/dL)
Protein, total, serum - 6.9 (6.0 - 8.5 g/ dL)
Albumin, serum - 4.1 (3.5 - 5.5 g/ dL)
Bilirubin, total - 0.6 (0.0 - 1.2 mg/ dL)
Alkaline phosphates, S - 85 (25 - 150 IU/ L)
AST (SGOT) - 18 (0 - 40 IU/ L)
Potassium, serum - 4.0 (3.5 - 5.2 mmol/ L)
Sodium, serum - 136 (135 - 145 mmol/ L)
Chloride, serum - 100 (97 - 108 mmol/ L)
Creatinine, serum - 0.60 (0.57 - 1.00 mg/ dL)
ALT (SGPT) - 12 (0 - 40 IU/ L)
Carbon dioxide, total - 23 (20 - 32 mmol/ L)
BUN, creatinine ratio - 20 (8 - 20) ~ high protein diet
Globulin, total - 2.8 (1.5 - 4.5 g/ dL)
A/G Ratio - 1.5  (1.1 - 2.5)

Sharyn, RN

RIP, MOM ~ 5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

VictoriousSecret
on 5/26/11 8:21 pm
Thanks for having a look.  My doctor did prescribe 8 gelcaps of 50,000 mg vitamin D, every 3rd day.  It just seems like that won't last long.

     

Temporarily holding on losing more because I'm gaining!  Pregnant with my first baby (a boy!) due June 2013, after two rounds of IVF.  SO GRATEFUL!

clpeltz
on 5/27/11 8:13 am
You need DRY D3.  You will absorb that MUCH better.  With your malabsorption, the gelcaps (oil based) will not be absorbed as well.

RNY to DS Revision 4/29/2011
Dr. Henry Buchwald


"Think twice.....Cut ONCE"

VictoriousSecret
on 5/28/11 7:39 am
Bought some on amazon.  Thanks!

     

Temporarily holding on losing more because I'm gaining!  Pregnant with my first baby (a boy!) due June 2013, after two rounds of IVF.  SO GRATEFUL!

rbb825
on 5/26/11 9:20 pm - Suffern, NY
I have a book that explains all lab tests that I got ions ago at Barnes and Noble that I find very helpful when I dont' understand something.  By now, I understand most of it but I still refer to it on occasion.

According to the book - a person with elevated amylase levels and normal lipase levels are due to peptic ulcers, inflamation of the salivary glands, inflamatory bowel disease, intestinal obstructions. = It also says it can be a helpful clue to the presense of macroamylaseemia.  I am not sure what that means.  I also know that both amyalase and lipase are elevated in pancreatitis but amylase gets elevated first, so depending on if you have any abdominal pain and it would have to be pretty severe - they would have to repeat both of these to see if they are both elevated at this point.  As time goes on, the amylase goes down and the lipase stays up for a few weeks.  Elevated levels can also be found in alcoholics and pregnant women.

Your urinalysis is perfectly normal - a high PH just means your urine was less acidic that day.  Everything else was perfect in the urine.

Your TSH is great.  Your  B1 could be a little higher, you want it at the top of the range and can actually go over the top with no harm.  Are you taking any vitamin B1?  You should be taking 100mg of vitamin B1 daily besides your multi - if you want, you can start at 3 times a week and start from there.  B1 deficiency is very dangerous, it can cause nerve damage - so you dont' want it to go down.  I developed a deficiency and have had to take 300mg per day for the past 2 years.

Your vitamin D is very low.  I am not sure what 8 pills you are taking but they are obviously aren't doing a thing.  We want our levels to optimally be up around 80-100, anything below 50 is not good.To go with your vitamin D and calcium blood test, you should have had  a PTH test - parathyroid - this determines along with the D and calcium what shape your bones are in - besides getting a DEXA scan.  With a level like yours - you need to get some dry D3 - 50,000 units from vitalady.com and take them 2-3 times per week to start - see how your body reacts to that dose and then you can adjust from there.  Many start right away on daily and I personally feel that is overkill.  I took it 2 times per week at the beginning and in 2 months I went up to 97.  I then dropped back into the 70's so I had to increase to 3 times per week where I maintained for 2 years and was doing great around 100 until about 2 months ago.  On my last test, it came back greater than 150 so I am now back at 2 times per week and I am waiting for my newest results.   I can't imagine how high I would be if I took it daily.

I would increase your protein intake.  6.9 is a bit lower than we would like, ideal is in the low to mid 7's.  By 8 months, you should be getting atleast 90 grams of protein per day, try adding another protein drink per day - that can add as much as 30-35 grams per drink.

You are missing alot of test - CBC, iron, ferritin, tibc, iron Sat%, vitamin A, vitamin B12, folate, vitamin K, vitamin E, vitamin B6, selenium, zinc, copper, phosphorus, PTH, HA1C,

In answer to your first question, yes you can go to a book store like barnes and noble and get a book on blood tests -  mine is called A Manual of Laboratory and Diagnostic Tests.  The only thing is you still  need to be able to interpret them as a weight loss surgery patient.  We dont' always go by the standard ranges.  So, you may not always no when you are "OUT OF RANGE" by our standards but it can give you a guide as to what the tests mean.  I have learned alot from my book.

feel free to ask me questions any time or to PM me.

 

southernlady5464
on 5/27/11 9:03 am
DS on 01/24/11 with
With a level like yours - you need to get some dry D3 - 50,000 units from vitalady.com and take them 2-3 times per week to start - see how your body reacts to that dose and then you can adjust from there.  Many start right away on daily and I personally feel that is overkill.  I took it 2 times per week at the beginning and in 2 months I went up to 97.  I then dropped back into the 70's so I had to increase to 3 times per week where I maintained for 2 years and was doing great around 100 until about 2 months ago.  On my last test, it came back greater than 150 so I am now back at 2 times per week and I am waiting for my newest results.   I can't imagine how high I would be if I took it daily.

Different folks, different strokes...I was taking dry D3 from vitalady one time a day and my D is still in the crapper. So now I take two a day...And by "in the crapper", mine was 35, just inside of normal.

I can't imagine not taking it at least once a day.  So each person is different. You have to find what works for you. You do well with 2-3 times a week. I need 2 each day.

Liz

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 140 | Goal weight: 135






   

rbb825
on 5/27/11 8:38 pm - Suffern, NY
You are right - different folks, different stokes and you also need to check out what surgery people have before commenting.  You had a duodenal switch, so it is normal for a DS patient to take 100,000 units of D3 a day but that is way overkill for us RNY patients which her and I are.  So, before you recommend something you might want to check out the surgery type.

 

VictoriousSecret
on 5/28/11 7:43 am
Thank you so much!  I just placed 3amazon orders and appreciate your time and effort.

     

Temporarily holding on losing more because I'm gaining!  Pregnant with my first baby (a boy!) due June 2013, after two rounds of IVF.  SO GRATEFUL!

beemerbeeper
on 5/26/11 10:18 pm - AL
DS on 09/30/09 with
I'm no lab person but even I know that you need to get your D way up for your bone health.  Try DRY D (VitaLady) 50,000 twice a day.

What the story behind 8 pills of D prescribed is is beyond me. Makes no sense.

~Becky




hazelnut6
on 5/27/11 3:14 am
RNY on 06/22/10 with
They prescribe the 8 pills initially to give the Vit D a boost and get the numbers up quickly.  After that, it will cut back to 1 pill @ 50,000 per week.

Many bariatric surgeons require your Vit D level to be around 60-65  (way above the average of around 35)





VictoriousSecret
on 5/28/11 7:45 am
I thought it was odd too.  Before surgery, they tested my levels, found my D was low and prescribed the 8 pills.  That was maybe a month or two before surgery.  Now 7-8 months later, it's low again, and again, just the 8 pills.  No 1 pill per week follow up.  And this was all through my bariatric surgeon!  I'm glad I have the folks on the boards.

     

Temporarily holding on losing more because I'm gaining!  Pregnant with my first baby (a boy!) due June 2013, after two rounds of IVF.  SO GRATEFUL!

(deactivated member)
on 5/27/11 7:31 am - Woodbridge, VA
A few things:

First, a good resource for labs is
www.labtestsonline.org. It does what you say doesn't exist: click on the lab in the box on the right, and it tells you what the test is, what the results could mean, etc.

Second, you shouldn't be asking your doc if there are any "in range" items of concern - you need to be tracking your lab results YOURSELF to see the trends. Your doc isn't going to do that for you; all they will say is that if it's within "normal" range, then it's fine.

Third, I wouldn't even bother filling that prescription for vit D. Get the dry form from Vitalady, and take it more than once every 3 days, and certainly more than once a week for maintenance once you get your levels up.
cajungirl
on 5/27/11 7:45 am
Did they draw for B-12?  I don't see it.

Your D is way to low.  You need to be taking DRY D-3, large amounts until you get it UP.  I agree with Sharyn on the 50000 IU a day.  You won't find this in a vitamin shop, drug store, etc. look online.  I buy mine from vitalady, I couldn't imagine adding 10 additional vitamins to my current vitamin regimine. 

Proximal RNY Lap - 02/21/05

 9 years committed ~  100% EWL and Maintaining

www.dazzlinglashesandbeyond.com

 

VictoriousSecret
on 5/28/11 7:47 am
Thanks to everyone.  I have saved this thread in my medical records file and am taking steps now.  At 6 months out, I don't want to allow anything to slip into a serious problem area.

     

Temporarily holding on losing more because I'm gaining!  Pregnant with my first baby (a boy!) due June 2013, after two rounds of IVF.  SO GRATEFUL!

Kayla B.
on 5/28/11 7:54 am - Austin, TX
The biggest issue I have with your lab results is how insufficient they are.  Your surgeon drew so few things on you!

Where's your vitamin A?  All your B vites? B 12? folic? IRON?!  Not even a CBC?  What the heck?

I really think you should reconsider making a separate visit to your PCP and asking for more in depth labs.  The lack of blood tests done is actually laughably pathetic.  I have a list of recommended labs to have drawn on my profile, courtesy of Vitalady.
5'9.5" | HW: 368 | SW: 353 | CW: 155 +/- 5 lbs | Angel to kkanne
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