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| Suggested Lab Tests ~~~~ This is a list of lab tests that various gastric bypass patients have found to be very helpful in diagnosing their special circumstances. This is not comprised by medical experts, but rather gleaned from experience. |
| COMPREHENSIVE METABOLIC PROFILE (sodium, potassium, chloride, glucose, BUN, creatinine, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) ~ (Nc, K, C1, CO2, Glu, BUN, Cr, Ca, TP, Alb, Tbili, AP, AST, ALT). LIPID PROFILE (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio [Fasting specimen], Tchol, Trig, HDL, Calc, LDL) ALT (SPGT) GGT LDH PHOSPHORUS-INORGANIC URIC ACID CBC (HEMOGRAM/PLT/DIFF) THIAMINE (B1), PYRADOXINE (B6) B-12 & FOLATE (also, HOMOCYSTEINE and METHYLMALONIC ACID as part of this picture) IRON, TIBC, % SAT FERRITIN (completes the iron picture and VERY important) VITAMIN A & D (25-hydroxy) THYROID PANEL (T3u, T4, FTI, TSH) SERUM INTACT PTH (parathyroid) MAGNESIUM RBC ZINC PRE-ALBUMIN CORTISOL ***** In addition, it is recommended that you get a yearly DEXA bone scan because of the heightened possibility of osteoporosis after gastric bypass surgery. This is best done in the same month every year as well. |
| HIGHLY RECOMMENDED Be proactive in your post gastric bypass health care and track all of your blood work levels. You are looking for any levels that are declining from one test to the next, even if they are still in the proper range. Many times you can make corrections necessary in your diet to prevent the levels from getting too low. It is also important to keep an eye on levels that are going up and to have an understanding about whether that is a warning or no concern to you. Check out the books link here to find the names of some recommended books on vitamins/minerals and lab tests to aid you in your journey to a healthier you. |
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| Possible Diagnosis codes: 244.9 hypothyroidisn 250.0 diabetes mellitus 265.0 Beriberi 265.1 Other and Unspecified Manifestations of Thiamine Deficiency 266.2 cyanocobalamin deficiency (B12) 268 vitamin D deficiency 268.2 metabolic bone disease 269.2 hypovitamininosis 269.3 zinc deficiency 272.0 hypercholesterolemia 275.4 calcium deficiency 276.9 electrolyte and fluid disorders 280.9 iron-deficiency anemia 281.0 pernicious anemia 281.1 other B12 deficiency anemia 281.2 folate deficiency anemia 285.9 anemia, unspecified 401.9 essential hypertension 579.3 short bowel syndrome or post-surgical malabsorption 579.8 intestinal malabsorption |
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| Why test the Homocysteine? Elevated Homocystein levels are considered to be a risk indicator for cardiovascular risk. Elevated homocysteine levels can be caused by vitamin B12 deficiency. Evidently the homocysteine levels rise significantly long before the B12 stores drop to the level associated with classical B12 deficiency. Links to some sites where I obtained my information: http://www.aafp.org/afp/20030301/979.html http://www.quackwatch.org/03HealthPromotion/homocysteine.html http://www.vegansociety.com/ |
| Why test the Ferritin? This seems to NOT be on the general list for surgeons/PCPs when they are testing for various deficiencies. I am at a loss to explain why. "To confirm a diagnosis of iron-deficiency anemia, physicians usually measure ferritin, a protein that binds iron; ferritin levels are low in iron deficiency ..." From www.stopgettingsick.com. "A blood test can also measure the amount of ferritin, an important iron-storage protein. Low ferritin levels indicate chronic iron deficiency." From: http://www.somersetmedicalcenter.com/11254.cfm "The lower the ferritin level, even within the 'normal' range, the more likely a patient is iron deficient." From: http://www.nlm.nih.gov/medlineplus/ency/article/003490.htm |
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| Why Do The PTH Test? From: http://labtestsonline.org/understanding/analytes/pth/test.html How is it Used? PTH is ordered to diagnose the cause of a low or high calcium level. PTH is used to differentiate between a parathyroid and non-parathyroid problem and to diagnose a parathyroid tumor. Calcium should be monitored at the same time as PTH: It is not just their levels in the blood that is important, but the balance between the two and the response of the parathyroid to changing levels of calcium. Usually doctors are concerned about either severe imbalances in calcium metabolism (that may require medical intervention), or in persistent imbalances (taht indicate an underlying problem). Calcium - PTH Relationship a.. If calcium levels are low and PTH levels high, then PTH is responding as it should. Depending on the degree of hypocalcemia, your doctor may investigate the low calcium further by looking at your vitamin D, phosphorus, and magnesium levels. b.. If calcium levels are low and PTH levels are normal or low, then PTH is not responding and you probably have hypoparathyroidism. c.. If calcium levels are high and PTH levels are high, then your parathyroid gland is producing inappropriate amounts of PTH and your doctor may order x-rays or other imaging studies to check for the cause and severity of hyperparathyroidism. d.. If calcium levels are high and PTH levels are low, then your calcium regulation system is functioning but your doctor wil do further investigation to check for non-parathyroid related reasons for your elevated calcium. |