RE: Elevated B12 and B6 in 12 month post-op RNY

[Guest guest]

I am finding this to be a problem as well. Any feed back would be great!

Townsend RD,LN Surgical Institute Sioux Falls, SD 57015

Elevated B12 and B6 in 12 month post-op RNYI have a pt.with recent labs as follows: Plasma B6- 117 (normal range-3.3-26.0) Serum B12- 1393 (normal range- 200-1100) Folate- > 24.0 - WNL H & H- 14.1/41.5 - WNLPatient takes daily MVI, weekly Nascobal (B12). I have been trying to research elevated levels of B12/B6 without success. No upper limit toxicity noted. However, I'm concerned that these levels may indicate some other problem in the pathways- My surgeon wants to cut back on pt's B12 supplement. I don't think that's the problem. Anyone have any ideas on this? Thanks, in advance, for the input. Lynne Kurzweil, RDCenter for Advanced Bariatric SurgeryMountainside HospitalMontclair, NJ

[Guest guest]

I have seen the same (elevated B12) in our post-op's and also could not find any research on this. I know this may sound very elemental but I started asking patients when they took their B12 in regards to having their labs drawn. I found that the patients with higher B12 levels took their supplement the same day as they had their blood drawn. I don't know if this really is a correlation or if it's just coincidence.

I have my patients take 2000 mcg per week.

, RD

From: [mailto: ] On Behalf Of melissa mcinerneySent: Thursday, December 22, 2005 8:05 PM Subject: Re: Elevated B12 and B6 in 12 month post-op RNY

I am finding this to be a problem as well. Any feed back would be great!

Townsend RD,LN Surgical Institute Sioux Falls, SD 57015

Elevated B12 and B6 in 12 month post-op RNYI have a pt.with recent labs as follows: Plasma B6- 117 (normal range-3.3-26.0) Serum B12- 1393 (normal range- 200-1100) Folate- > 24.0 - WNL H & H- 14.1/41.5 - WNLPatient takes daily MVI, weekly Nascobal (B12). I have been trying to research elevated levels of B12/B6 without success. No upper limit toxicity noted. However, I'm concerned tha t these levels may indicate some other problem in the pathways- My surgeon wants to cut back on pt's B12 supplement. I don't think that's the problem. Anyone have any ideas on this? Thanks, in advance, for the input. Lynne Kurzweil, RDCenter for Advanced Bariatric SurgeryMountainside HospitalMontclair, NJ

[Guest guest]

This is just my opinion but I would not worry about high levels too much. I see this pre-op as well, we test folate, B12, Vit D and iron pre surgery and for those taking MVI, B complex or other supplements I often see elevated levels. I always show patients their labs and review what they are taking to see if we could make some adjustments. From multiple checks on toxicity (mostly via biochemistry and nutrition textbooks) there is not any real risks with the water soluble vitamins. I would agree with your surgeon that they should just cut back on supplements and then the next time that their labs are drawn have them not take any supplements the day of the test. You can always increase supplements again if needed. Just my 2 cents.

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of melissa mcinerneySent: Thursday, December 22, 2005 5:05 PM Subject: Re: Elevated B12 and B6 in 12 month post-op RNY

I am finding this to be a problem as well. Any feed back would be great!

Townsend RD,LN Surgical Institute Sioux Falls, SD 57015

Elevated B12 and B6 in 12 month post-op RNYI have a pt.with recent labs as follows: Plasma B6- 117 (normal range-3.3-26.0) Serum B12- 1393 (normal range- 200-1100) Folate- > 24.0 - WNL H & H- 14.1/41.5 - WNLPatient takes daily MVI, weekly Nascobal (B12). I have been trying to research elevated levels of B12/B6 without success. No upper limit toxicity noted. However, I'm concerned th! at these levels may indicate some other problem in the pathways- My surgeon wants to cut back on pt's B12 supplement. I don't think that's the problem. Anyone have any ideas on this? Thanks, in advance, for the input. Lynne Kurzweil, RDCenter for Advanced Bariatric SurgeryMountainside HospitalMontclair, NJ

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