PPIs

[Fiddleman 4,376]

I take B12 sublingual once a week. My bariatric doctor calls it the brain drug. It's important to keep up with B12 and B1 because problems caused by deficiencies are non-reversible. Calcium is another one it's important to take. Deficiency won't show on a blood test, your body will just rob your bones to get what it needs. Lynda

A DEXA scan is accurate enough to determine if a person is deficient or not in calcium, right? Is there another test people can use?

As for b12, I have been wondering if this is something that one should take daily or just when extra energy is needed. I personally haven't noticed a change from taking it versus not taking it, but have gotten to the point where I am inconsistent with taking a dedicated daily b12 supplement. However, I do know a lot of the Protein powders (as well as a lot of food in general) are fortified with it and my multi has some 200% b12 RDA in it. I know that a lot of the b12 energy-based supplements have b12 in it (5 hour energy has more than 8000% RDA). My labs always show b12 levels at surplus (out of range actually), but do realize this could change the further out one gets. Would you think a vet be wise to "stay on top of" the b12 by taking a supplement daily or just when they feel they need the energy boost? Just curious.

[Nicolanz 1,484]

Last time I got blood work was last summer and my Vitamins were all normal, but they found H. Pylori. I'm more concerned with the risk of infections due to suppressed stomach acid. I'm going to make an appointment to see if I'm free of H. Pylori and good with my Vitamins. I switched to an H2 blocker and it isn't working. It would be my luck that I'd be apart of the 8-10% that needs bypass. I think taking a PPI would outweigh the risks of having that done!

The only time I've ever suffered from acid reflux before the sleeve was when I was pregnant. That's it. Now I'm starting to worry about what other long term side effects of the sleeve will be!

[Nicolanz 1,484]

And B12 is separated from Protein that we eat by hydrochloric acid made in the stomach. It is circulated through the body by attaching to intrinsic factor, a protein also made in the stomach. So, with a smaller stomach and depressed stomach acid production, it seems inevitable that we will have pernicious anemia without taking a B12 supplement. I read that in people with a partial gastrectomy, it can take two years to notice the effects of b12 deficiency. I'm getting close to two years and have been feeling crappy lately. I'm back on all my Vitamins. Hopefully that helps.

[swimbikerun 1,046]

No a Dexa scan isn't, but it does tell you if there are significant bone changes. If you have Calcium issues, and I have close to every risk factor known to medicine, then you get it.

There are blood calcium tests (serum and ionized) and urine calcium. The blood one is the quick one but does NOT tell the whole story. The ionized one is good or better, but the blood with the urine one is really going to give you the picture of what is going on. Its due to those that I get the Dexa scans yearly and I can guarentee you I will again after the significant drop in hip % and the risk factors I have.

The problem is getting it done and getting someone who knows the whole deal to be able to read and interpret it. You need Vit. D levels at the same too, helping that out but also kidney function too. Its not just adrenal glands because the kidneys urinate out excess calcium.

You want to be careful - when B12 is high, that can mean leukemias or liver diseases. Its because B12 is released during cytoloysis and/or decreasing clearance by a messed up liver.

I had an internist who flipped at me but I was like you want the medical research? Its there. That's why you want to be careful about the education of the person reading bloodwork.

As for reflux, yes, that's something they're finding out.

Pernicious anemia ... yes but they need to look at all the factors and 99% of doctors, including specialists, wouldn't know how to read bloodwork. I mean read it in terms of the patient and in relation to everything else. Judging the patient and not reading the computer printout that says everything is normal.

Patients who present with medical research and I mean serious research ... docs need to look at. Its not a matter of who has the degree, someones' ego, its about the health of the patient.

Pernicious anemia is called that because you can die from it.

[Nicolanz 1,484]

You're not helping my anxiety, Swim! Lol! You are very knowledgeable, thanks for the info!

[swimbikerun 1,046]

Look, seriously, it is better to find out and get things taken care of than fart around (with all due respect and pardon my language) and have problems. If you know about stuff, you can know what types of help or the like you need, more appropriate & timely care.

That has been my problem, way too many really don't understand the interworkings of everything and the effects it has on the body. Medical school does NOT really teach this sort of stuff and they don't teach problem solving. If you have something of a medical/science background with math/login/CS skills, that is why I can do what I can do & know what I know. I wont say who, but a local in the area who is a nationally big head cheese helped me out long time ago with the medical library. Those ladies at the library have been a Godsend.

If I didn't know what to look for and ask and show people stuff, I wouldn't have gotten some of the care I did. After care can be a huge problem, and its better we know and fix it.

I've had several people with cancer who paid the price for not getting things addressed.

[CowgirlJane 14,260]

Swimbikerun could you start a thread specific to long term supplement issues? I will be honest...I am lost and I know this is important. Did the Calcium issues happen even while supplementing?

[ProudGrammy 8,322]

converting or have converted to RNY because of reflux, so it is def. an issue for some seems it can happen farther down the road, not as an immediate problem.

ok guys

did all/most of you have reflux before WLS?

i never really did (except when i ate too much chocolate or pizza late at night)

i started taking a PPI per my doc right after surgery

indefinitely!!!!

i just took/take it cuz he told me i should/no questions asked

i am now "officially" concerned/spooked about what the future "might" hold

then again, i'm not gonna worry about the "what might happen in life in general"

i don't foresee stopping the PPI - but.........maybe i'll mention/talk to my NUT/surgeon

kathy

Edited May 13, 2014 by proudgrammy

[lsereno 2,525]

........

As for B12, I have been wondering if this is something that one should take daily or just when extra energy is needed. ............

At Kaiser Fremont, we are told to take one per week, must be sublingual.

Lynda

[lsereno 2,525]

I'm thinking of trying to give up the PPI again since my rheumatoid arthritis med has been changed. It may have cause the reflux. Esp. since I now know long term use can lead to osteoporosis. Although I do take Calcium and Vitamin D so maybe that's enough to offset the PPI.

Pre-op, I only had reflux after a lot of margaritas. Something about the sweet and sour mix never set well, even in my pre-op, cast-Iron mega tummy.

Lynda

[swimbikerun 1,046]

Cowgirl Jane - Sure 'nuf on starting a new thread but where would you all like to go? I could put some info I've learned together for you all.

Just - put it in where? Do I need to ask Alex where is the best place?

Btw, I do have sources, my doctors hate it when I quote to them.

[CowgirlJane 14,260]

Just post in vets forum. .I think good reminder as I am sure people lose their Vitamin diligence over time...

[Nicolanz 1,484]

Day 4 of H2 blocker and today reflux seems to be decreasing. I'm going to keep trying to wean myself off. I'll let y'all know how it goes! Hopefully I will be free of the meds completely.

[swimbikerun 1,046]

Great! Over there on the long term supplementation area, I posted about PPI's and Vitamin issues.

[kidrn72 85]

I was taking PPI prior to having my sleeve done due to acid reflux that I tolerated to the point I couldn't swallow. By the time I went in to have my reflux checked I already had a segment of Barrets esphogaus, which is a pre cancer condition. Now I have to always take a PPI for the rest of my life to avoid cancer. I am good about limiting my caffeine to reduce reflux. But I also have to be diligent about my Vitamins and Calcium.