Lab questions-need answers please!

My PCP did 9 month labs for me.
My cholesterol has skyrocketed again (to 287) so he wants me to go back on statins. I'm putting him off for three months because I don't like the muscle aches I get and my HDL (82) was high, my VLDL (19) is in range and my so were my triglycerides (92).  Even my LDL/HDL ratio is fine (2.3) so only my LDL is bad (187) 

But....here are the labs I have questions about:

Hemoglobin			14.00
Hematocrit			42.50
Calcium, Serum			9.70
Protein, Total, Serum			6.40
Albumin, Serum			4.00
Vitamin D, 25-Hydroxy			71.20
B-9 Folate (Folic Acid), Serum			15.10
Vitamin B12			1879.00
Ferritin, Serum			26.00

My ferritin and protein are within normal limits, but low by vitalady's standards.  How do I raise them?
My B12 is high.  Should I go from one shot every two weeks to one shot a month?
My calcium is within normal limits, but high by vitalady standards.  Should I do something to change it?
Next labs will be in late September at the bariatric surgeon's office.
Thanks guys for your help.
Janet

Janet - Gina can answer better than me, but I can help with a few.

B12 is ok.  Its water soluable so its not toxic.  If you're getting injections maybe space them every 3 weeks to see how that works.  Calcium high is not really good and indicates that your bone stores are being used (I think), so the fix is to take evey MORE calcium citrate.  Protein - more protein shakes... ferritin - Vitalady has some supplements on her site that work well.  Proferrin is one, and I can't remember the name of the other.  Both friendly to our systems. 

 thanks Jody--I guess it's back to the vitalady site for me
Janet

Calcium being high is an issue if Vitamin D is low (yours isn't) and PTH is high. I don't see PTH so it's hard to tell if the calcium is concerning.

One thing to keep in mind that is that ranges are guidelines. Some people are just naturally higher or lower than the norm and that's okay because that's their norm. The way to tell is to look at everything in context and also over time. So, it's not just one value to look at, but a couple of them in context.

 Thanks, I agree not to get too worried unless something is really out of range.  They didn't do PTH-not sure what that is.

Ferritin and iron are usually helped by carbonyl iron and Proferrin, which is heme iron. Vitalady carries both. The carbonyl is her Tender iron, comes in either chewable or capsule. Did you happen to get an iron serum level? Proferrin causes the least intestinal issues but I've found the combo to be effective. I take tender iron in the afternoon and Proferrin at bedtime.

Your vitamin D isn't bad. You might want to increase your calcium citrate and magnesium. If calcium gives you intestinal issues, you might try adding some magnesium oxide. Look for PTH as soon as you can get another script. Vit D, calcium and PTH need to be read together.

While the protein serum is lower than suggested, your albumin is good. You'll need to keep an eye on those.

You might try B12 every 3 weeks and see how it maintains. You might also want to start supplementing folic acid for your folate level. You want it just a bit higher >20.

Did you get vitamin A or any other vites and minerals?

--gina
  

And remember, if you do start the proferrin from Vitalady to break the pill in half prior to taking it. I stood there last night and broke each day's ahead of time to remind me that I put in my pill carrier. LOL

 Great idea.  My DH laughs when I put my weekly meds together each week.  It's a job in itself, isn't it? LOL
Janet

 Gina,
I already take the Tender Iron but I am going to order the Proferrin as well.  I have extra magnesium but haven't been taking it since my bathroom issues have mostly resolved with stool softener.  I'll add one more calcium and the magnesium.  i need to check into folic acid as well.  The only A I get is in my multi.  The PCP didn't test for A and I didn't think to ask.

I'm not as consistent as I should be with afternoon vites but I found that if I program my iphone to tell me to take the meds, I do better.  Thank goodness for technology!
Janet

You might want to reconsider taking a statin.  You might want to try taking a different one than you took - zocor (simvastin) causes the least problems with muscle pain and start with a small dosage.  Also insist on a blood test called CPK.  This is a blood test that checks for a complication from statins that affects your muscles and should be checked every 3months when they do your liver function tests but most doctors dont' do it.  This can prevent the muscle pains that you were having.  They also say that when you get the pains to tell your doctor immediately.  I know several people that it was as simple as switching drugs.  Yes, your HDL (good cholesterol) is very good but your total cholesterol is very high (really bad) and your LDL which is the most dangerous is really high (really bad) and the most alarming and reason to go on treatment.  This number should be below 100 and if you have any heart disease or family history of heart disease, this should be below 75.  My cardiologist wants mine below 60.
So, if you are saying your levels skyrocketed when you went off of them, then you obviously need them and there is a good chance they will continue to go out of whack. 

you are not actually anemic but your ferritin is very low.  You don't have an iron level but with a ferritin like yours, I would definitely increase your iron.  You said you are taking vitalady's tender iron - how much are you taking?  Capsules or chewables?  Before you go to Proferrin which is very expensive - you can go up to 300mg of the carbonyl iron - that is 5 of the capsules.  You can also take them all at one time and make sure you aren't taking them within 2 hours of your calcium or thyroid medication.  If you are already taking 300mg of carbonyl iron, then you need to add Proferrin to the mix.  The proferrin can't be taken with the carbonyl since it can't be taken with vitamin C and the tenders have C in them.  Proferrin can be taken with calcium but not thyroid.

Your protein levels are very low, especially the total protein.  I would add a protein shake daily.  By 9 months, you should be getting atleast 90 grams of protein daily

Your D isn't bad, you might want to increase it a bit - ideally we want to be between 80 and 100

Your folate is bit low - we want to be greater than 24.  I would get some over the counter folic acid - 1200mcg daily

Your B12 is fine.  Ideal is 1500-1800, so yours is perfect.  It can even go up to 2000.  Having high levels, mean nothing since we just pee out the excess.

You are missing so much - iron, iron sat%, TIBC, comprehensive metabolic panel (kidney, liver, etc), vitamin A, PTH, vitamin B1, vitamin B6, vitamin K, vitamin E, copper, selenium, zinc, magnesium, phosporus

It is absolutely essential that you get iron, comp metabolic panel, vitamin A, pth, vitamin B1, selenium, zinc and magnesium at each draw- the others should be done yearly