9 months Post Op, chronic fatigue, muscle weakness.

[thelivecity 0]

Hi, im new here on this forum. i got the duodenal switch last aug.

I'm 9 months post op. I've lost 100 pounds. I have chronic fatigue and muscle weakness half the week which lasts all day long. Feels like im spaced out and out of it all day. I'm certainly Vitamin deficient even though all my supplements were approved by the nutritionist at the bariatric office. I saw a hematologist a few months ago and i dont have any anemia.

Does anyone which exactly is causing this chronic fatigue, muscle weakness, etc?

Here is a screenshot of what is low in my bloodwork https://prnt.sc/jfxr6u

Total Glutathione level is 97
Iron Bind.Cap.(TIBC) is 219
Threonine 48.1
Vitamin A 19.9

Here is a screenshot of what is high in my bloodwork
https://prnt.sc/jfxr5i

Vitamin B12 1826
Testosterone 1209
Glutamine 999
LDH 336
Serine 216.9

Any thoughts about the glutamine level being so high? is that something for me to be concerned?

Also my total Testosterone is high, 1209 but my free Testosterone is low at 4.5. How is this possible? Should i see a urologist about this? My libido since surgery has changed and not the same, thats why i threw those tests in there too.

Any other feedback or guidance would be greatly appreciated,

For my supplements i take the following,

ProCare Health Once-A-Day Multivitamin which has:

Vitamin A- 10,000 IU- 200%
Vitamin C- 130mg -220%
Vitamin D- 3000 IU -750%
Vitamin E- 60 IU - 200%
Vitamin K- 120mcg 150%
Thiamine - 20mg- 1333%
Riboflavin- 12mg- 710%
Niacin - 40mg - 200%
Vitamin B6- 12mg-600%
Folic Acid- 800mcg - 200%
Vitamin B-12- 1000mcg- 16,670%
Biotin - 600 mcg- 200%
Pantothenic Acid- 20mg -200%
Iron -45 mg- 250%
Magnesium- 200mg - 50%
Zinc- 15 mg- 100%
Selenium - 100mcg- 140%
Copper- 2 mg- 100%
Manganese- 2 mg- 100%
Chromium- 100mcg- 80%
Molybdenum- 75 mcg- 100%

I also take

Vitamin B12 liquid Drops 3000mcg - guess ill stop taking this since my B12 levels just got really high

NovaFerrum 125 Liquid Iron Supplement

Bariatric Advantage - Iron Capsule 45mg

Bariatric Advantage - 500mg calcium citrate Chewy Bite

Dr Mercola Vitamin D spray - 5000iu

Probiotic supplement

Fiber gummies

Anything wrong with these supplements?

Something is not working since im chronically fatigued.

[shedo82773 1,236]

My B12 was high and atfirst they had me use sublingual every other day. It was still high so now I take it once a week. Do you have excess to your DR or a Nutrtionist they can help you set things up. Each person has different needs. They would be the best one to work out your needs. I have Fibromylgia and losing my weight and being able to exercise has helped me tons. Sorry you are having these problems. Take care.

[Postop 413]

@thelivecityB12 gets peed out so don’t worry if it’s high. Assuming you’re a full DSer, we don’t take sublingual B12 drops. That’s generally for RNYers. We don’t have issues with B12. If the rest of your Bs are good you don't need to supplement them. Subsequent bloods will let you know if you need to add any.

1. What type of A do you take, beta carotene, retinol, palmitate, etc. ?

2. What type of D do you take, D2, D3, etc.? Sprays aren’t good for us. Do you take any pills, what type?

3. What type of Iron pills do you take, sulfate, fumarate, etc.?Do you take it with the C to help with absorption? The liquids aren’t generally effective for us .

4. Are all your pills ‘dry’ and not gel caps?

5. What’s your ferritin level?

6. What are your zinc and copper levels? Do you take them at least 1 hour apart so they don’t cancel each other out?

6a. calcium citrate chews aren’t enough. Only for the first month or two. You need pills. If you PM me your email we can go over all of this in more detail. I can send you a list of some of what I take. At 13 years out it wouldn’t be exactly right for you but it could give you an idea of what type of pills I buy.

7. Do you have your preop bloods? This can help you compare. Even if your current bloods say something is in normal range it may not be enough. (I had this experience with a zinc issue at about 10 mos postop. Once I brought the number back to a pre op level my problems disappeared).

When you tell me some of this information I can help. At a quick glance your A,D & iron are too low. Your A and D are way too low. Both should be a good deal higher than your blood norm suggests.

BTW, who did your DS?

Edited May 12, 2018 by Postop

[thelivecity 0]

1 hour ago, Postop said:

@thelivecityB12 gets peed out so don’t worry if it’s high. Assuming you’re a full DSer, we don’t take sublingual B12 drops. That’s generally for RNYers. We don’t have issues with B12. If the rest of your Bs are good you don't need to supplement them. Subsequent bloods will let you know if you need to add any.

1. What type of A do you take, beta carotene, retinol, palmitate, etc. ?

2. What type of D do you take, D2, D3, etc.? Sprays aren’t good for us. Do you take any pills, what type?

3. What type of Iron pills do you take, sulfate, fumarate, etc.?Do you take it with the C to help with absorption? The liquids aren’t generally effective for us .

4. Are all your pills ‘dry’ and not gel caps?

5. What’s your ferritin level?

6. What are your zinc and copper levels? Do you take them at least 1 hour apart so they don’t cancel each other out?

6a. calcium citrate chews aren’t enough. Only for the first month or two. You need pills. If you PM me your email we can go over all of this in more detail. I can send you a list of some of what I take. At 13 years out it wouldn’t be exactly right for you but it could give you an idea of what type of pills I buy.

7. Do you have your preop bloods? This can help you compare. Even if your current bloods say something is in normal range it may not be enough. (I had this experience with a zinc issue at about 10 mos postop. Once I brought the number back to a pre op level my problems disappeared).

When you tell me some of this information I can help. At a quick glance your A,D & Iron are too low. Your A and D are way too low. Both should be a good deal higher than your blood norm suggests.

BTW, who did your DS?

Hi, im a full DSer, let me answer your questions,

1) the ProCare multivitamin website says "from Beta Carotene & Vitamin A Acetate"

2) procare multivitamin website says "Cholecalciferol)" (D3)

3) I have multiple iron supplements, i have tried the NovaFerrum 125 Liquid Iron Supplement. I also have Bariatric Advantage 45mg iron with Vitamin C. My procare multivitamin also has 45mg of iron in it as well. The procare multivitamin Iron says its "from Ferrous Fumarate". The bariatric iron one is also ferrous fumarate.

4) all dry

5) Ferritin is 170 (normal)

6) zinc is 76 (normal) copper is 83 (normal). These are in my daily procare multivitamin. plus some copper is in my bariatric advantage iron supplement, which i take seperately than my multi

6a) i will PM you. i figured i take enough pills as it is, and chews are much easier to take for me.

7) yes i do, 5 months pre surgery my zinc level was normal, Ferritin level was low (29) Vitamin D was low (19) and its still low.

My DS was done in Mexicali MX by Dr. Dr. Antonio Esquerra (i paid cash)