What labs does/did your doctor order?

i just did my six month labs and they just did the standard CMP and CBC. Did your surgeon look at other tests? My dietitian would like to see the following and I am wondering how common these tests are for bariatric patients, especially around the six month mark? Thanks in advance.

Iron
Ferrintin
Transferrin

Total iron binding capacity (TIBC)

Copper
Ceruloplasm

parathyroid hormone (PTH) serum

25 hydroxy vitamin d
Zinc plasma
B12
Thiamin
methylmalonic acid(MMA) test Homocysteine

Folate
Vitamin a (plasma Retinol)
Vitamin E (plasma alpha tocopherol)
Vitamin K (phylloquinone)

This is a good list of blood tests that I found a while ago, though I'm not sure how up-to-date it is.

http://www.pamtremble.com/wp-content/uploads/2011/08/Bariatr ic_Lab_Test_Recommendation_May20101.pdf

This is great, thanks!

Curious as to the Cortisol test. I have wondered if it's true what they tell us in the T.V. advertisements about "stress raising Cortisol blood levels, and increased Cortisol levels, in turn, causing increased body fat." I wondered if that was just a bunch of pablum to try to get us to buy their product (which supposedly lowers the level of Cortisol in the blood, in turn shedding belly fat). ???

This is the current list for DS patients who are one year out, per PacLap. I'm not sure what merit there would be in any certain one for RNY patients, but I would think the lists overlap a bit (no pun intended):

* * * * * *

Diagnosis: INTESTINAL MALABSORPTION, STATUS-POST BARIATRIC SURGERY ICD-10 Codes: K91.2, Z98.84, Z09 *FASTING* Please Draw the Following: ? CBC ? COMPREHENSIVE METABOLIC PANEL ? COPPER ? CERULOPLASMIN ? FASTING LIPID PANEL ? FERRITIN ? FOLATE ? IRON ? MAGNESIUM ? PHOSPHORUS ? PTH, intact with Calcium ? NIACIN (Vitamin B3) ? SELENIUM, SERUM ? THIAMINE (Vitamin B1), WHOLE BLOOD ? TSH ? VITAMIN A ? VITAMIN B6 ? VITAMIN B12 ? VITAMIN D, 25 HYDROXY ? ZINC, PLASMA Note: VITAMIN A REQUIRES 2 ML FROZEN SERUM VITAMIN B6 REQUIRES PLASMA ? FOIL WRAPPED VITAMIN B3 NEEDS TO PROTECT FROM LIGHT

* * * * *

Thanks so much!

At six months, PacLap does something similar to yours for both the DS and VSG; at one year the DS gets the full monty that batwingsman posted, and similar to what Julie posted, both appropriate for the malabsorbing procedures. For the annual VSG, they call for CBC, Electrolytes, Renal, Liver, Lipids, TSH, B12 and Iron, which is appropriate for the minimal nutritional impact that the VSG has.

After a year, or into the maintenance phase, it is not at all unreasonable to do a more extensive set to get a handle on what your specific needs are. There are three major influences on our supplementing needs - 1) our personal intrinsic quirks (my wife is chronically short of potassium - that's not WLS or diet, it's just her), 2) the impact of our WLS (minimal with the VSG. greater with the RNY and DS) and 3) your personal dietary habits. Initially after surgery, we aren't eating much nutritionally other than protein, so need to supplement more than later. After we get into maintenance and (hopefully) establish better dietary habits, the need to supplement is less, but by how much is the question, so it is useful to do some more extensive studies for a while determine what you really need. If you are working with an RD who wants to get a jump on this and help you tailor your diet earlier, that's great - I always worked to get as overall nutritious a diet as I could within the caloric limits appropriate for my weight loss rather than the fad diets that many seem to use in a futile effort to "improve" their WLS result, and that certainly made the transition to maintenance a lot easier.

With VSG there will probably not be much change in six months. Even with DS or RNY, the body normally has enough reserves for the first year. As long as you are taking your supplements, you will probably not become deficient for a very long time, if ever.

I give a minimum of 14 vials of blood every time.