Sufficiently Deficient

Rather than buy myself flowers or take a trip for my WLS birthday, I did what I've done for the last seven years: get a complete blood panel. And this year, like every year since my bowel obstruction in 2007, I find that I lack the necessary vitamins and minerals for good health and general wellness.

On the bright side, my levels are better this year than they were in 2008 when I last discussed them here. My lowest year ever was 2010, when my body was recovering from having Lily. Come to think of it, 2010 was one of my most challenging post-op years, marked by minimal communication simply because I had a hard enough time facing my deficiencies as an individual, much less in a public setting like this where readers can offer their two cents. At that time, my ferritin (stored iron) was -1 and my hemoglobin was 7.8. My B12 dipped dangerously close to 200. I was also seriously deficient in vitamins B1, B6 and D.

To put it lightly, I was miserable. I felt like I was wading through cobwebs. Simple conversations were exhausting because it took every ounce of my energy just to follow along. Exercise was out of the question because the lack of B12 caused coordination issues, and the anemia (caused by low iron and low B12) caused severe muscle cramping and general fatigue. Lacking B1 and B6 meant issues with memory, cognitive thought and mood. Getting out of bed was a feat in and of itself.

We aggressively tackled the deficiencies that year with iron infusions, B12 injections and fistfuls of pills. There were days when managing my health felt like my career. But looking over my most recent set of labs, it seems like the effort paid off.

By the Numbers
Before any of us gets too excited, let me reiterate that I am still deficient in many areas. The good news with this recent set of labs is that it appears that all levels are rising. I'll take whatever good news I can get. Here's where I am at as of Feb. 24, 2012 (date of the bloodwork; bold type indicates levels are within normal range):

• Hemoglobin -- 11.2 (Normal is 11.7-15.5)
• Ferritin -- 3 (Normal is 10-154)
• Total Iron -- 18 (Normal is 40-175)
• PTH -- 116 (Normal is 10-65)
• Vitamin B1 -- 73 (Normal is 87-280)
• Vitamin B6 -- 6 (Normal is 2.1-21.7)
• Vitamin B12 -- 330 (Normal is 200-1100)
• Vitamin D -- 67 (Normal is 18-72)

To clarify, anemia is defined by the amount of hemoglobin. Not enough hemoglobin mean not enough (or small) red blood cells, which means muscles and organs don't get the oxygen they need. Though I am still technically anemic, I'm considerably less so than I was two years ago. And this is the first time that my ferritin level has been a positive number.

PTH is an indicator of whether my body is leaching calcium from my bones. My level indicates I still haven't found the right oral supplement to prevent that from happening.

The B vitamins are all much higher than they were on my last round of labs, but B1 is still lacking. Also, I seem to be among the 10 percent who have brain/blood issues with a B12 level between 200 and 400.

Plan of Action
Lab results alone aren't enough to create a treatment plan, but they are a powerful tool. I will continue my high-dose B-complex oral supplements to boost B1, and I will start monthly B12 injections again to get that number closer to 1000. My Vitamin D level is the best news yet. It means I can go from taking my 50,000 IU supplement twice a week to once a month to maintain.

I have a referral to see a hematologist to discuss the best treatment for my lack of stored iron. He will be the best person to help me determine what's needed in that arena.