Iron deficiency anemia post VSG!!

A small percentage of VSGers have issues with B12 and/or iron. Many, many people in North America have low Vitamin D, surgery or no...

That's why you need to get regular labs after surgery to make sure you aren't in that category and to start supplements if you are.

Another thing that happens rarely with VSG is not being able to absorb protein as well. This can happen in particular while you are on your PPI. Being on a PPI does interfere with the absorption of certain nutrients including calcium, which is why we're supposed to take more calcium than a non-altered person.

I'm not on any PPI anymore since I got rid of my band.  Does that mean I don't need to supplement extra calcium?  I would like to know my protein and albumin levels, I will ask him to add them on to my next set of labs in 1 week.  That will check the calcium level, too.  I don't know if he'll order a Vit D level...

No, you still need to supplement calcium. The PPI can make everything worse, but even without it, we don't have as much stomach acid as we used to. Osteoporosis is a known complication of partial gastrectomies.

Basically we all need 2x the adult dose of a multi-vitamin and 1500 mg of calcium. Then some need B12 and some need iron and some need both.

This should have been explained to you during the NUT consult Dr. Aceves patients get and also in the material they sent you home with. I'm really surprised you slipped through the cracks somehow as Dr. Aceves is pretty thorough on these things.

The Vitamin D is not really surgery-related. It's just something that a lot of people in North America struggle with. I was deficient pre-op so I take 50,000 IUs every Monday.

So, if on my Chem 20 my calcium level is normal, does that mean I'm getting enough calcium?

I worry about my compliance with the more and more things I add to the regimen.  I've tried to do the whole calcium and Vit D thing in the past and just didn't like it...I know, it's bad to admit.

I don't remember having a consult with a nutritionist there, but maybe I did and just don't remember it.  I certainly don't remember all this info about deficiencies!

I do eat a lot of dairy.

When I was asking about my labs, the calcium was not just "calcium" - what I mean is, I was told to also get a PTH (I think?  Sorry, its early and I am still  uncaffeinated ) to see where the calcium was coming from (if it was actually from supplementation or bone leaching).

My computer crashed with all that information on it, I will see if I can dig it up today.

That's part of the gold of staying around here, and lurking this, the main, and the lightweight boards for me - that I keep up on the "what ifs" of labs.

Because me?  My ferritin, B12, and protein even took nose dives on my yearly labs. 

Actually, almost everyone has normal calcium levels. It's very important for your heart to have enough calcium in your blood. So, if you aren't getting enough calcium, your body will strip it out of your bones.

To know if you are getting enough calcium you need to look at 3 things:

(1) PTH - you want it to be low. High PTH means your body is working hard to get calcium out of your bones

(2) Vitamin D - you want it to be high. If it's low and PTH is high, then it's a sign of calcium deficiency. If it's low and PTH is low, that's a sign of Vitamin D deficiency.

We are just learning a lot about Vitamin D and we are finding out that the old standards were okay if all you cared about was avoiding rickets. But for optimal health, we need more Vitamin D than that and we can't get what we need from the sun, like we've been told for years. At least not if we live in North America and / or use sunscreen.

(3) Serum calcium. If it's high and PTH is high, that's the clincher. But even if it's normal, if PTH is high, then you should take more calcium.

Andrea,

I asked for evidence that B vitamins were important in iron absorption as you claimed. 
So I'm not sure why you posted all that unnecessary stuff about permicious anemia, which as nothing to do with iron deficiency.  Iron defeciency causes microcytic anemia from poor heme synthesis.  B12 deficiency causes a macrocytic anemia, and it's more common in the elderly who make less IF. 
I think you got your apples mixed up with your oranges. 

I was diagnosed with prenecious anemia at age 42, which has been managed with monthly b12 injections. I had VSG surgery 12/09 and have added sublingual b12 along with the daily vitamins and
calcium supplements.
Have you talked with Dr Aceves about your problems?
Wishing you the best.

I haven't let them know yet.  Thank goodness mine isn't pernicious anemia.  That didn't rule you out from getting the sleeve?  I don't remember talking about vitamin supplementation before surgery.  I'm going to look through my stuff from then.