normal lab values

I've posted this before, but for those that haven't seen it, or need a refresher, here it is again.

It's always a good idea to get a copy of the lab report when you have labs done. Doctors will sometimes tell you your labs are good when they really aren't, plus if you see the numbers yourself you can track trends. Like if you get your iron tested today and it's still in the normal range but it's dropped a lot since you had labs done three months ago, you'd want to start taking more iron. Docs usually don’t tell you if it's dropped, just that it's normal now.  I think they may not have time to compare current labs to prior labs.

I have a spreadsheet I use to track my results.  I’d be happy to send anyone a copy if you want.  Of course you can devise your own system, as well.  It makes it super easy to compare current labs to past labs and see right off if something is going up or down.

You can get a copy of your lab report from your doctor’s office or from the lab that does the tests.  When I get a copy from my lab (which is usually quicker than getting it from the doctor’s office, at least for me), I have to show ID to prove I’m me and I have to sign a form giving them my permission to release the records (even though they are just releasing them to me).  Legally they can charge you a small fee for making a copy for you if they want to, but neither my lab nor my doctor’s office ever do.

So look at your lab report. They are really easy to read and you don't need any special medical knowledge to read them. Your lab report will list the references ranges and on mine, if something is high or low, they have it in bold type and put a big H or L next to it so it's easy to spot.

Many people think these “reference ranges" are the “normal" or “healthy" ranges.  That’s not quite true.  They are actually just the averages of the lab results from a bunch of apparently healthy people that were tested by the lab.  So if a lot of the seemingly healthy people tested happened to have low vitamin D, then the reference range may be lower than what is actually needed for optimal health.

With most labs, the reference ranges will be close enough to a healthy range.  With two tests, though, that is not the case.  You want to pay close attention to those two.

It will say something like 211-911 for B12 and you really want your B12 to be about 900-1000, but it's OK up to at least 2000. Below 550, people tend to get symptoms like depression and fatigue. Below 400, people can get permanent nerve damage in their hands and feet.

It will say something like 30-80 for vitamin D but you really want your D about 80-100.  Lower than that, we are at increased risk for things like osteoporosis, heart disease and some cancers.  It can safely be higher than 100.  If your D is really low, you want to pay close attention to your PTH and calcium levels.  If your D is low, you won’t absorb calcium well, no matter how much you take.  When that happens, your PTH usually goes up so you start leaching calcium from your bones to keep the calcium level in your blood good (because your heart won’t work right if the level of calcium in your blood gets too low).

Keep in mind that doctors don’t always know that the reference ranges don’t indicate the healthy ranges.  I know because someone that works for a lab explained it to me, but I think the natural thing to think when you look at the lab report is that those are the healthy ranges to be in.  Which is not always the case.

Most other things, besides B12 and D, like iron and ferritin and protein, etc, you want near the top of the normal range.

Your PTH, you'd rather have near the bottom of the normal range.  High PTH suggests you aren’t getting enough calcium and are leaching calcium out of your bones.

Calcium is better around the middle of the normal range.  If your calcium is on the high side, strange as it may seem, that’s often a sign that you need more calcium.  It can be an indication that you’re leaching calcium from your bones because you’re not absorbing enough calcium.

This is all true for all people, not just those that had RNY.  We do not need different lab values than “normal" people.

 I am 4 months out this week, so I had my 3 month check up 2 weeks ago.  I also had my gallbladder out last month, so in covering all of that with my surgeon I figured mabe he forgot to mention lab work. I brought it up to him and he said that he doesn't order lab work after RNY.  I was pretty surprised, especially after reading this forum for months and seeing that everyone has labs done.  He basically said they never find anything wrong so it's a waste of money, and if there are any issues or problems you (the patient) would know it.  I can see his point, but on the other hand I don't want to think I am doing everything right and then end up sick because there was something else I should have been doing but didn't know any better.  I have an appointment today with my PCP to discuss this and get labs done.  Has anyone else been told that labs are not necessary?

He doesn't order lab work?  Well, if he doesn't order it, then of course he never finds anything wrong.  If he did order it, I just can't believe he would never find anything wrong when nutritional deficiencies are so common.  Many deficiencies don't cause symptoms until they are very, very bad, when permanent damage might have been done.  For instance, you might not notice your vitamin A level is too low until you start to lose your eyesight.  I'd like to catch it before I begin to lose my vision, since I enjoy being able to see.

No labwork?? That sounds unbelievable.  What about malabsorption.  This is a well known side effect of RNY.  I think you would be very wise to have your PCP send you for the proper labwork. What are the checkups like with your surgeon?  Oh you are doing great??  How would he know unless he does labwork?  OMG!!

My surgeon doesn't order lab work but the endocrinologist he asks me to see certainly does.  She's the one who tracks all those details and copies him on her reports.

Thanks so much for this info Kelly. I'm going to keep it in my file of papers for reference after my sugery. My primary care doctors office is in the same medical group as my surgeons and I can access all my medical records online. I love it! Prior to that I drove my doctors office crazy asking for copies of my lab results. 

 Kelly....just want you to know that I always read your posts and do appreciate when you post this information about labs.  I always intend to print it out and always forget.     I hope you have been able to sleep better...  Take care.......