normal lab values after RNY

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'd love it if you could send me the sheet you use! Thanks Kelly.

I'm emailing it to you.

I have this spreadsheet (thanks Kelly!) and I entered all my labs since surgery...it is very helpful to see changes in individual ranges....that is how I knew I needed to up my D3 and iron...AFTER MY DOCTORS (2 OF THEM) told my labs were "normal".

I know the last time I had labs done, my ferritin had dropped a lot since the time before.  It went from something like 140 down to 70.  My PCP was telling me that my iron was fine and then I pointed out how much my ferritin had dropped and she said, oh, well that might be a concern then.  They just don't usually compare the current lab report to the previous one, and I think that's important.

comparing labs is the only way to truly know how well you are doing-and where the early indicators are for possible deficiencies.

I've learned more from you about vitamins and labs than I ever did from ANY doctor!  Thanks for all the education you provide to us!

A lot of what I know I learned from other people here, including Michelle (vitalady) and Andrea, who don't post much anymore.

Kelly,

I had my labs drawn today (Almost 18 months out post op) and it says my:
ferrin is 170 up from 116 last draw, is this okay??
Calcium 9.4
vit D 25 hydroxy is 70.5 - I take 3 tabs of (D3 2000iu daily)
Serum Folate 24.00
B12 - 1179 down from 1457 (Idecreased it from 3 subling to 2 since last draw.

Do you have any suggestions for to adjust levels?
Everything else is WNL...:) My cloelstrerol & Hgb A1C continue to go down - WNL limits now..

Your ferritin, folate, and B12 are great, although you don't want your B12 to keep dropping.

Your D need to be just a bit higher, at least 80.

Same here... My iron level on my 4.5 year labs was still technically "normal" (but just barely), but it had been dropping significantly (and consistently) for the past several years.  I was not taking any iron since I had a hysterectomy several years ago, and if I had not started taking any on my own (which I have), and my levels dropped this year as they have been, I would be seriously anemic by the time my next set of labs were drawn.  It was only because I had been watching the change that I was able to catch this.

Lora