Low Hemoglobin, Ferritin, and Iron 3 years out, anyone else?

[CowgirlJane 14,259]

I am with swim on the Protein. I don't believe the kidney issue is really that big of a concern. My surgeon recommended 60 grams of Protein minimum when i was sleeved. When i was a year out he told me that research indicated it should be 80 for WLS patients. Last I saw he said to do what is working. I think that the point is we don't NEED the super high protein but it makes maintenance easier. Daisy is maintaining fine so I guess she f o under the right balance for her, and I do believe different bodies have different needs....

Truth is there are 3 sources of calories. ..protein fat and carbs. Since carbs fatten me up like a steer for slaughter and I don't want a super high fat diet...well... that leaves protein. I actually think that is why I do well getting lots of protein. . Keeps me from overindulgence of carbs. Not everyone has my same response though.

Does any one know where they would find it goes by height for protein? I'd like to look at the resources. I've not seen them and am always adding to knowledge.

As for kidneys, the only time I've heard of it being hard on the kidneys is for people who are dehydrated (and that isn't on a one time basis type of thing) and those who have kidney disease already. That's again going by research.

If B12 levels are high - as in 2000 is what I've heard, meaning the level is probably more like 1500, one of the reasons for that is leukemia. I can check that.

[swimbikerun 1,045]

Excellent post Cowgirl ... I do have some questions (NERD ALERT ... )

Do you know where he got the 80 from? I've seen another doc in the area who is 80-100 and I'm going where is the research? I don't want to tell people wrong. I try to keep most everything I say to research unless I have a caveat and I'll tell people that.

We get so hoodwinked by media, some not so up to snuff docs, that I want to be on top of my game. No one wants to be sold a bill of goods that don't add up (I've certainly seen that one first hand).

With 3 sources of calories, where would we put veggies and fruit in that? Fruit would be in carbs but as we find out, different levels of good carbs and bad carbs.

Thank you for the post. I really appreciate this. Exchange of ideas is important.

[lsereno 2,525]

My understanding is base Protein needs goes by weight (which roughly correlates to height at average BMIs),

http://www.webmd.com/food-recipes/news/20081107/weight-is-key-to-protein-requirements

http://www.lifeed.ucla.edu/documents/CHS19Protein.pdf

[CowgirlJane 14,259]

fruit and veggies are for sure mostly in the carb group of energy source. (The three macronutrients are Protein, fats and carbohydrates - the sources of food energy or calories).

I do not mean to imply that all carbs are bad for you or that you should eat no carbs! You need them for energy, good health and brain function. If I am eating too low carb, I get brain fog and feel depressed! Never infer that I am an advocate of long term crazy low levels of carbs.

However, there is a big diffference between a diet with salad ingredients (lettuce, Tomato, cukes, etc etc), fresh berries, greek yogurt - all carby food but lower glycemic index lots of good micronutrients as opposed to crackers and Peanut Butter and Pasta and pizza and cold Cereal with milk and the filler crap that is in processed food. Carby food like those examples make me hungry! Frankly, I put milk in that category too. A doctor once told me that cows milk is designed to turn a newborn calf into an enormous steer in a very short period of time and it has that same result on many humans! That really resonated with me because I was raised on dairy products and always thought of milk as so healthy - but it truly fattens me up. Drinking skim didn't help... it's the carbs not just the calories!

I don't know that there is proof or published studies to support that WLS patients need 80g or some magical number. I think it is intuition based on watching hundreds (or thousands) of WLS patients and noting results even anecdotally. I also think it really really depends on the person. Other people I know seem to be able to eat bread, drink milk and enjoy PB&J sandwiches without weighing 300# but I cannot. I was never formally diagnosed as insulin resistant or with PCOS but I suspect both apply to me.

I do not have formal education on any of this - really it is my own experiences. I used to believe in calorie math (calories in versus expenditure) but somewhere along the way I recognized it isn't quite that simple. At least for me, I have alot of baggage around dieting failure based on counting calories so it is an emotional thing too. I stopped tracking calories about 4 months post op because that Protein versus healthy carb balance in my life is what matters and the calories land where they land and I am happily oblivious. What a relief. I never want to count calories or points again, but somehow tallying up protein in my head and not even counting carbs but simply eliminating those problem type carby foods works for me in maintenance.

[sarsar 824]

I am with swim on the Protein. I don't believe the kidney issue is really that big of a concern. My surgeon recommended 60 grams of protein minimum when i was sleeved. When i was a year out he told me that research indicated it should be 80 for WLS patients. Last I saw he said to do what is working. I think that the point is we don't NEED the super high protein but it makes maintenance easier. Daisy is maintaining fine so I guess she f o under the right balance for her, and I do believe different bodies have different needs.... Truth is there are 3 sources of calories. ..protein fat and carbs. Since carbs fatten me up like a steer for slaughter and I don't want a super high fat diet...well... that leaves protein. I actually think that is why I do well getting lots of protein. . Keeps me from overindulgence of carbs. Not everyone has my same response though.

This is an excellent post Cgj! You can research till the cows come home but eventually it just comes down to what works for you. I honestly believe this is true for those of us that have been successful this far. Try something and see if it works, if it does, keep at it. If it stops working change things up a little bit and see what happens.

For me, carbs aren't something I have to keep really low. If I do I feel horrible. I eat more carbs and I have more energy. I also workout a lot so that probably is part of the reason I can get away with eating more carbs. Then again, maybe not. I'm recovering from plastics right now so my workouts are on hold for another month or so while continuing my regular diet (minus the 5:2 which I had been doing for almost a year). It'll be interesting to see if I'll end up having to watch my carb intake more or not. I am keeping protein between 80-100 grams during recovery. Normally I have around 60 or so a day.

[swimbikerun 1,045]

I want to sincerely apologize. I wasn't knocking what you did and if that is how it came across, I apologize. I have been burned (and apparently so have a few others) on doctors who based pretty much everything on the "art" and no science. Trying to get them to justify their science, led me to investigating it, and then finding there were other things they missed that were in the medical research literature.

So I've gotten to where you have that, that has been a problem and proved harmful to me, and then Dr. Oz and all the other guys, I've swung to where I want to see the data behind someones' magic.

Tired of being burned.

[CowgirlJane 14,259]

Swim, not sure who that is directed at but I don't think you have a thing to apologize for. I think "evidence-based" medicine is a good idea. When I first connected with my surgical practice I wanted that. They sent me home with medical studies and abstracts to read.... over time I came to trust their advice and my own body and am less prone to insisting on the research. It would be different if I didn't believe in their competency and integrity the way I do now. It's like when I found a great mecanic 20 years ago.... I still go to him and trust his practical advice. My 15 year old minivan with 180k miles is still reliable and affordable transportation for my college age son....enough evidence for me.

[Jeniluv1978 22]

I'm two years out and next week I will have gotten my last of give Iron infusions! My first time with Abn lab values! Someone asked if you were still losing, I have stall, could it be a contributing factor?