This is kind of my pet peeve right now. I’m 3 years 8 months post-op and the assumption across the board(s) (bit of a play on words there) is that you’re a DS’er – you NEVER have to worry about your B levels. WRONG-O! Yes, we do have intrinsic factor working in our favor. (RNY’ers don’t.) HOWEVER, we have tremendously smaller stomachs AND malabsorption working in our new GI tracts – so (I should have figured this out WAY long time ago) we DO need to be concerned about your B Vitamin levels.
Most DS docs DO NOT require post-ops to test full B-spectrum vitamins in post-op labs. However, more and more of us who are further out post-op started having low B Vitamin problems. Here’s the thing – the new thinking is that *anyone* with a malabsorptive surgery (whether WLS or a gastric cancer type reconstruction) needs to pay serious attention to their B Vitamin levels. For instance – the range (from the lab I use – every lab’s ranges are unique, but within a somewhat reasonable range) for normal B-12 is 211 to 911. The newer research is starting to show that those of us with malabsorptive procedures (remember, we aren’t normies – the range for the lab is for normies – with completely intact, non-adjusted GI systems) is rock bottom is 1400, distal RNY post-ops should be more around a minimum of 2000.
Why didn’t I pay attention to the fact that my number was tanking before my very eyes on my lab tracking form until I was over 3 years post-op? Because public opinion (DS post-op community) was that “We’re DS post-ops, we don’t have to worry about B Vitamin deficiencies, neener, neener, neener!” Total bunk.
My endochronologist and I have been doing some serious digging into this subject, and when I go back next month for my next check-up, he’s hinting that a series of B-12 shots is in my future (my number is in the low 200s – totally sucky). Even though I take four times the recommended dosage of Super B Complex – but the fact of the matter is this: 3 years of malabsorption without supplementation to counter it has done it’s damage. Here’s the thing, though – people think, B Vitamins – no big deal. But it CAN be a HUGE deal. Do some reading (there are some excellent published articles on this very topic! Some incredible web sites out there devoted to further education and advocacy for folks who suffer from problems related to B Vitamin deficiencies) – it will floor you how serious these deficiencies can become! B-12 levels play into anemia issues, B1 levels get severely low enough – you can suffer paralysis! B2 gets low – you’ll start noticing that spices are spicier and the corners of your mouth might crack and bleed. B Vitamins are important. It’s part of the crux of being part of a sub-population where education is garnered because of the things we experience as post-ops (regardless of which type of surgery you have) – we’re kinda like guinea pigs!
By the way, my surgeon gave me a great list of labs to have run, too. BUT – make sure it’s sufficient. My endochronologist and I, along with my PCP, and in cooperation with my surgeon – have been refining my lab list – the “basic” list that most surgeons give their post-ops is NOT as thorough or sufficient as it should be.
And… about your PCP acting kind of stupid about the DS – honey, that’s just the way of it. My PCP is the most amazing, sweetheart, proactive, advocate in every sense of the word. When I was researching WLS she was 1000% behind me and researching with me along the way. Even though she’s a grand 95 pounds dripping wet – she was as convinced that WLS was the ONLY answer for me as I was. However, she does not live my surgery – I do – so it is MY responsibility to remain informed, continue my research, and stay proactive about the stuff that needs done to make sure that I continue to be as healthy as can be.
So – sorry I’m so long winded. Bottom line is this: you DO need to supplement B Vitamins. You don’t necessarily need B-12 injections (unless, you, as a unique individual started out deficient in that area to start with – some folks do!), unless of course your B Vites tank on your labs at some future point in time. I highly recommend you take two super B complex (I use NatureMade – I can get them at Costco easily and inexpensively) daily. Don’t take them in close conjunction with your iron. And of course – my theme song once again: DRINK LOTS OF WATER!