memory loss

[Guest guest]

This was very interesting!!! Thanks for all the sites you send out to us!!!

They are very much appreaciated!

{{{ Greatful Hugs }}}

Helen

          I may never see tomorrow;       there's no written guarantee, And things that happened yesterday                 belong to history!!! {{{Sent With Many Hugs}}}                  Helen

              

[Guest guest]

Hi Lynn,

It could be a possible side effect of the anesthesia. Did your Doc give you a list of genral and rare side effects? Ask and see if you can find out th etype of anesthesia given and get a list of the side effects and make sure you tell your doc. It could be a rare side effect, and they may need that on record for future study

How long your surgery took could also be an answer. Make sure you tell your doctor about your concerns. It could be just post surgery stress of some sort, also. Surgeries really are stressfull on a patient. Worrying alone can make a person firgetful and absent-minded. The medicines and gas the anesthesiaologist give you are also dangerous when given for a long period of time. Everyone reacts to them different. There are so many possibilities to consider. It was my daughter that had the CToma and the surgery, yet I went through so much stress that I became absent-minded, forgetfull, and quite "air-headed". Funny thing is that it has "stuck" with me ever since! LOL

Whatever the possibility is, you should definitely tell your physician so they can look into it to make sure nothing major is going wrong!!

Hang in there! I am here for you!!!!

[Guest guest]

Hi

You are right about the stress before surgery, even if you think you aren't having any, you probably are. A lady I knew underwent a 9 hour surgical procedure, and she found she had a lot of trouble with her memory. She found an article somewhere that said for every hour you are under it takes 1 month of recovery to get everything back. I had 2 surgeries in 3 months, so I guess it took its toll... The Ginko is helping though. Thanks for your input.

Lynn

Re: memory loss

Hi Lynn, It could be a possible side effect of the anesthesia. Did your Doc give you a list of genral and rare side effects? Ask and see if you can find out th etype of anesthesia given and get a list of the side effects and make sure you tell your doc. It could be a rare side effect, and they may need that on record for future study How long your surgery took could also be an answer. Make sure you tell your doctor about your concerns. It could be just post surgery stress of some sort, also. Surgeries really are stressfull on a patient. Worrying alone can make a person firgetful and absent-minded. The medicines and gas the anesthesiaologist give you are also dangerous when given for a long period of time. Everyone reacts to them different. There are so many possibilities to consider. It was my daughter that had the CToma and the surgery, yet I went through so much stress that I became absent-minded, forgetfull, and quite "air-headed". Funny thing is that it has "stuck" with me ever since! LOL Whatever the possibility is, you should definitely tell your physician so they can look into it to make sure nothing major is going wrong!! Hang in there! I am here for you!!!!

[Guest guest]

I havent had any memory loss, but I have trouble forming some words, a problem I didnt have before the surgery. I am usually very articulate, and now have a hard time pronouncing some words. THey want me to have a MRI to see if there was more damage than they thought. I too would be interested in knowing if anyone else has had problems as such after surgery.

memory loss

Has anyone experienced problems with their memory following their surgery? I find it hard to remember small things, like names sometimes. It seems to be getting better, but it is a little worrisome. I am wondering if the anaestetics cause this, but I can't find anything on that.

Lynn

[Guest guest]

Hi - just chiming in again on the memory loss issue. I run the day program services for adults with brain injury here on the Eastern Shore of Virginia. Memory loss of the type you describe is a cognitive symptom of brain injury.

There are a lot of other symptoms with severe injury, but what you descibe would be consistent with a mild injury, such as a concussion. Post-operatively, it is often seen after open-heart surgery in which they mechanically pump your blood for you while they operate. I read recently that up to 25% of all open-heart patients get this - they called it "foggy brain" or "fuzzy brain". Often it is permanent.

At any rate, I share this because memory loss could be a post-op problem if there were some sort of problem with the flow of oxygen to the brain during the op. I've never heard of it outside of the open-heart stuff, but it seems to be in the realm of possibility.

Good to see you back, Audrey, & great news re: no cholesteatoma this time.

[Guest guest]

Hmmmm what was it I have to write??? Oh yeah memory loss! On a more serious note yes I have noted some forgetfulness...like from even going to one room from another and forgetting why!! It has been 8 years since my first op to remove C-toma and being nearly 47 I thought it was just my age. Maybe it is linked I cannot tell for sure but will keep an eye on it....the kids just say I'm going senile...they love me I know. Audrey memory loss Has anyone experienced problems with their memory following their surgery? I find it hard to remember small things, like names sometimes. It seems to be getting better, but it is a little worrisome. I am wondering if the anaestetics cause this, but I can't find anything on that. Lynn

[Guest guest]

i do not have to tell all how i suffer every day, because we all do.

my children keep me going(really give me no choice) i try so hard every day.

but lately i just can not take the brain fog..its more than a fog...i am

getting worse, i forget everything, my children are suffering the worst from

this. they are still young enough to need my assistance with school projects,

they do have to remind me every morning of what they need but by time i find

my way home i forget. my youngest is failing because of me....is there

anything anyone can help me with??? please i will try anything and

everything............thankyou for listening.

i think they will be better of without me...i am just ruining their lives

peace, love SUE

[Guest guest]

SUE,

My son is suffering from the terrible brain fog, too. He, at 16, seems like a

very old man at times. My heart just really, really goes out to you. I wish I

had a wonderful answer for you, and a magic wand! It must be very hard trying

to raise your kids while feeling so awful.

Have you changed any meds lately? I am wondering if you are herxing or maybe

having a problem with yeast, because brain fog, lightheadedness, dizziness

all actually gets worse with yeast.

Please remember that your children need you, and they would NOT be better off

without you in their lives. You keep giving them hugs, ask the school for

help with your child who is struggling academically, and reach out to whoever

can give you support. It is vital that you ask for help in specific ways, or

no one will fall right in to your lap and do what you need done.

Hang in there!

Judie

[Guest guest]

i thank you all for responding.

i do try everything to remember, i write things down and forget where i put

the paper or simply forget to look.

my husband bought me a huge calendar, i either forget to write important

things down or again i forget to look at it to remember.

it seems no matter what meds i take nothing is working, i am getting worse. i

know my kids love me and need me, but for what all they need me for is to

take care of me and poke fun and my fried brain.

in the past i have been on antidepressants i think its time to go back on (i

have been resisting for months now).

again i thank you

peace ,love SUE

[Guest guest]

Have you ruled out an omega 3 fatty acid deficiency?

Monika M. Woolsey, MS, RD

http://www.afterthediet.com

[Guest guest]

how would you r/o omega 3 fa def? which labs would you do? By the way

does anyone ever have a problem with PCPs being able to order certain

labs like b1, vit D, VitA? I have seen some labs come in that I am not

sure if they would be appropriate to use for indicator of vit status

(i.e. carotene level?) I have a hard time giving specifics if the lab

does not know how to order those at times (other than serum vs whole)

> Have you ruled out an omega 3 fatty acid deficiency?

>

> Monika M. Woolsey, MS, RD

> http://www.afterthediet.com

[Guest guest]

Is the patient getting enough Carbohydrates in their diet? I find most

of my male patients only eat meat and cheese for their protein intake

and forget about the CHO's and I find their have the same symptoms of

memory loss at 6 months.

Beth Whelan, MS,RD,LD

Outpatient Dietitian

Harbin Clinic

office: (706) 378-8163

fax: (706) 238-8037

 

Re: memory loss

how would you r/o omega 3 fa def? which labs would you do? By the way

does anyone ever have a problem with PCPs being able to order certain

labs like b1, vit D, VitA? I have seen some labs come in that I am not

sure if they would be appropriate to use for indicator of vit status

(i.e. carotene level?) I have a hard time giving specifics if the lab

does not know how to order those at times (other than serum vs whole)

> Have you ruled out an omega 3 fatty acid deficiency?

>

> Monika M. Woolsey, MS, RD

> http://www.afterthediet.com

[Guest guest]

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA

(eicosapentanoic acid) levels can be checked. However,we recently

ordered a complete " essential fatty acid profile " on our patient

(referred to in a recent message). We found many abnormalities

including alpha-linoleic acid, linolenic acid, DHA, and EPA

deficiencies. In addition to the tube feeding we gave her (Peptinex

DT), which contains soybean oil, we supplemented with Sea Omega

brand fish oil capsules (2 gms 4x daily) until we had repleted the

DHA, EPA as well as linoleic and linolenic acids. I think repletion

was easier in this patient because of the controlled tube feeds, and

other supplementation. By the way the fish oil from the capsules

was extracted and flushed down the feeding tube. Whether you order

specific FA levels vs. the whole profile depends on what you are

after, I suppose. Since this was my first experience with this, the

entire profile was interesting. However, based on our treatment

methodology with only EPA and DHA content of fish oil capsules, one

could argue over whether ordering the entire profile was overkill.

But I think if this comes up again, I WOULD continue to opt for the

entire profile.

I went through a lot of trial and error getting laboratory tests for

nutrient evals. Thiamine is a biggie. Whole blood, vs plasma,

protect sample from light, ETKA as gold standard. I talked with

techs from our lab, as well as techs and MD's from the lab we send

our tests out to (that our lab can't do). Talk with your lab if you

have questions. Do your research, discuss with them what you are

after, and they can suggest how you or the MD write the order for

what you want. By the way, if anyone knows of a lab that does ETKA

levels, let me know--I called 5 labs across the country, including

Mayo, and none did this test.

And specifically, to address your Vit A level and whether carotene

is an appropriate test, what you are after is a 'beta' carotene

level or you can ordered a fractionated carotene level which is a

total carotene broken down into the components, including 'beta.'

> > Have you ruled out an omega 3 fatty acid deficiency?

> >

> > Monika M. Woolsey, MS, RD

> > http://www.afterthediet.com

[Guest guest]

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whole

profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does

ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

[Guest guest]

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whole

profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does

ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE__________________________________________________

[Guest guest]

Serum B12 misses 24-30% of deficiency. When the B12 is less than 300, it can be considered sub-clinical deficiency. Some patients begin demonstrating signs of deficiency in this range. If the homocysteine and MMA (methylmalanic acid) are increased while be B12 is trending down, it is time to supplement.

Jeanne Blankenship

University of California,

Re: Re: memory loss

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whole profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

In my message about ordering a complete " essential fatty acid

profile " , I should have said complete " fatty acid profile. " Sorry

for the error.

> > > Have you ruled out an omega 3 fatty acid deficiency?

> > >

> > > Monika M. Woolsey, MS, RD

> > > http://www.afterthediet.com

[Guest guest]

What dosage are people using to supplement B12? I searched through the archives and found a lot of variation: 500mcg/day, 1000mcg/day, 1000mcg/week, 2500mcg/week. This was only my facilities 2nd surgery, so I have not handled a deficiency yet. Thanks for your recommendations.Jeanne Blankenship <jbship@...> wrote:

Serum B12 misses 24-30% of deficiency. When the B12 is less than 300, it can be considered sub-clinical deficiency. Some patients begin demonstrating signs of deficiency in this range. If the homocysteine and MMA (methylmalanic acid) are increased while be B12 is trending down, it is time to supplement.

Jeanne Blankenship

University of California,

Re: Re: memory loss

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whole

profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does

ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

1000 mcg/day sublingual or monthly B-12 injections.Hillary Mausbach <hillary_mausbach@...> wrote:

What dosage are people using to supplement B12? I searched through the archives and found a lot of variation: 500mcg/day, 1000mcg/day, 1000mcg/week, 2500mcg/week. This was only my facilities 2nd surgery, so I have not handled a deficiency yet. Thanks for your recommendations.Jeanne Blankenship <jbship@...> wrote:

Serum B12 misses 24-30% of deficiency. When the B12 is less than 300, it can be considered sub-clinical deficiency. Some patients begin demonstrating signs of deficiency in this range. If the homocysteine and MMA (methylmalanic acid) are increased while be B12 is trending down, it is time to supplement.

Jeanne Blankenship

University of California,

Re: Re: memory loss

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whole

profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does

ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

Should we be concerned about excessive B12 supplementation? We used to tell our patients to take 1000 mcg/day sublingual B12 but our labs read high at 6 months. So we have decreased our dosage to 1000mcg 1x week.

We discuss vitamins on this listserv so much. Do we ever reach a consistent decision on what is right for our patients? This really concerns me. Some days I feel more confused than my patients.

From: [mailto: ] On Behalf Of jeremiah elizondoSent: Thursday, September 08, 2005 9:45 AM Subject: Re: Re: memory loss

1000 mcg/day sublingual or monthly B-12 injections.Hillary Mausbach <hillary_mausbach@...> wrote:

What dosage are people using to supplement B12? I searched through the archives and found a lot of variation: 500mcg/day, 1000mcg/day, 1000mcg/week, 2500mcg/week. This was only my facilities 2nd surgery, so I have not handled a deficiency yet. Thanks for your recommendations.Jeanne Blankenship <jbship@...> wrote:

Serum B12 misses 24-30% of deficiency. When the B12 is less than 300, it can be considered sub-clinical deficiency. Some patients begin demonstrating signs of deficiency in this range. If the homocysteine and MMA (methylmalanic acid) are increased while be B12 is trending down, it is time to supplement.

Jeanne Blankenship

University of California,

Re: Re: memory loss

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whol e profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

we also use sublingual B12 1000mcg 1x per week starting off. I think the best thing to do is check labs consistently. ( we check q 3-4 months for the first year or until levels are stable) If we notice that 1000mcg 1x per week is not keeping the levels normal, then we change to daily. I'm up front with all of my patients and let them know that this is not an exact science and that some people will be on different doses, but that we supplement according to what they need.

Janelle D. McLeod, RDGastric Bypass CoordinatorPenn State Hershey Medical Center717-531-6321

This message (including any attachments) contains information intended for a specific individual(s) and purpose that may be privileged, confidential or otherwise protected from disclosure pursuant to applicable law. Any inappropriate use, distribution or copying of the message is strictly prohibited and may subject you to criminal or civil penalty. If you have received this transmission in error, please reply to the sender indicating this error and delete the transmission from your system immediately. >>> jlewis@... 9/8/2005 2:28 PM >>>

Should we be concerned about excessive B12 supplementation? We used to tell our patients to take 1000 mcg/day sublingual B12 but our labs read high at 6 months. So we have decreased our dosage to 1000mcg 1x week.

We discuss vitamins on this listserv so much. Do we ever reach a consistent decision on what is right for our patients? This really concerns me. Some days I feel more confused than my patients.

From: [mailto: ] On Behalf Of jeremiah elizondoSent: Thursday, September 08, 2005 9:45 AM Subject: Re: Re: memory loss

1000 mcg/day sublingual or monthly B-12 injections.Hillary Mausbach <hillary_mausbach@...> wrote:

What dosage are people using to supplement B12? I searched through the archives and found a lot of variation: 500mcg/day, 1000mcg/day, 1000mcg/week, 2500mcg/week. This was only my facilities 2nd surgery, so I have not handled a deficiency yet. Thanks for your recommendations.Jeanne Blankenship <jbship@...> wrote:

Serum B12 misses 24-30% of deficiency. When the B12 is less than 300, it can be considered sub-clinical deficiency. Some patients begin demonstrating signs of deficiency in this range. If the homocysteine and MMA (methylmalanic acid) are increased while be B12 is trending down, it is time to supplement.

Jeanne Blankenship

University of California,

Re: Re: memory loss

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whol e profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

We recommend 1,000 mcg (SL) 2 x/wk OR 500 mcg (swallowable) daily. Most patients have normal results with these dosages. We adjust the others as needed.Hillary Mausbach <hillary_mausbach@...> wrote:

What dosage are people using to supplement B12? I searched through the archives and found a lot of variation: 500mcg/day, 1000mcg/day, 1000mcg/week, 2500mcg/week. This was only my facilities 2nd surgery, so I have not handled a deficiency yet. Thanks for your recommendations.Jeanne Blankenship <jbship@...> wrote:

Serum B12 misses 24-30% of deficiency. When the B12 is less than 300, it can be considered sub-clinical deficiency. Some patients begin demonstrating signs of deficiency in this range. If the homocysteine and MMA (methylmalanic acid) are increased while be B12 is trending down, it is time to supplement.

Jeanne Blankenship

University of California,

Re: Re: memory loss

Thank you for all the ideas! His B12 is 235 (our labs normal limits are 180-914) would you start supplementing?

We have not ruled out a efa deficiency - I will mention this to his provider.

We have struggled a little with carbohydrates, he will be bringing in food records so we will be able to talk more about that.

Thanks again!jeremiah elizondo <jer_mail23@...> wrote:

Thank you for all the input on the labs. This is something I have been struggling with.

Jerry jpaulis1 <spaulis@...> wrote:

To check Omega 3 levels, DHA (docosahexaenoic acid) and EPA (eicosapentanoic acid) levels can be checked. However,we recently ordered a complete "essential fatty acid profile" on our patient (referred to in a recent message). We found many abnormalities including alpha-linoleic acid, linolenic acid, DHA, and EPA deficiencies. In addition to the tube feeding we gave her (Peptinex DT), which contains soybean oil, we supplemented with Sea Omega brand fish oil capsules (2 gms 4x daily) until we had repleted the DHA, EPA as well as linoleic and linolenic acids. I think repletion was easier in this patient because of the controlled tube feeds, and other supplementation. By the way the fish oil from the capsules was extracted and flushed down the feeding tube. Whether you order specific FA levels vs. the whole

profile depends on what you are after, I suppose. Since this was my first experience with this, the entire profile was interesting. However, based on our treatment methodology with only EPA and DHA content of fish oil capsules, one could argue over whether ordering the entire profile was overkill.But I think if this comes up again, I WOULD continue to opt for the entire profile.I went through a lot of trial and error getting laboratory tests for nutrient evals. Thiamine is a biggie. Whole blood, vs plasma, protect sample from light, ETKA as gold standard. I talked with techs from our lab, as well as techs and MD's from the lab we send our tests out to (that our lab can't do). Talk with your lab if you have questions. Do your research, discuss with them what you are after, and they can suggest how you or the MD write the order for what you want. By the way, if anyone knows of a lab that does

ETKA levels, let me know--I called 5 labs across the country, including Mayo, and none did this test.And specifically, to address your Vit A level and whether carotene is an appropriate test, what you are after is a 'beta' carotene level or you can ordered a fractionated carotene level which is a total carotene broken down into the components, including 'beta.'> > Have you ruled out an omega 3 fatty acid deficiency?> > > > Monika M. Woolsey, MS, RD> > http://www.afterthediet.com

Stay connected, organized, and protected. Take the tour

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE

__________________________________________________

[Guest guest]

RE: B-12 post Roux

After 3 months post-op, we recommend 500 mcg three times weekly.Angie , MEd, RD

Nutritionist

SIUH Center for the Surgical Treatment of Obesity

256 Mason Avenue

Staten Island, NY 10305

718-226-1300

[Guest guest]

I too would question thiamine def. does this pt have any other

symptoms ex) muscle weakness especially in lower limbs or difficulty

controlling eye movements etc.

Deanna

[Guest guest]

No, he didn't. We ended up giving him 1000mcg IM B12 at his clinic visit, and added 500mcg oral B12 daily coupled with B-complex IM weekly. We are going to check labs and assess symptoms again in 8 weeks.deannamachac <deannamachac@...> wrote:

I too would question thiamine def. does this pt have any other symptoms ex) muscle weakness especially in lower limbs or difficulty controlling eye movements etc. Deanna

Hillary Chrastil, RD, LMNT

Dietitian, Bariatric Surgery Team

VA Nebraska-Western Iowa Health Care System

Omaha, NE__________________________________________________