Vitamin deficiencies?

I am four years out from my RNY.  Last August, I had a great annual exam, with essentially normal labs.

Starting last October/November, I started gaining weight (now about 30 pounds up from what I maintained for three years!).  My periods started lasting two weeks, with extreme cramping.  The entire time, I was taking birth control pills. In addition, my labs started plummeting.  My vitamin D, vitamin B12, and ferritin levels became almost non-existant.  My hematocrit and hemoglobin are fine.  B12 is back to normal on bi-weekly shots, but my D and ferritin are still in the toilet.  I'm taking 3 iron pills a day, and have been since May.  I saw an endocrinologist yesterday who has put me on OTC 10,000 IUs of D3 daily since I actually had a decreased D level on prescription D2 50,000 units a week.  My thyroid is perfect.

Ultrasounds have shown uterine fibroids and adenomyosis, both of which can cause period problems, which is probably the root cause of my ferritin issue.

Does anyone else have any experience with this? I'm just frustrated that everything was fine in August and within a few months, everything tanked.  I'm exhausted all of the time, cold most of the time (it's 100 degrees outside and I wear jeans and pants), short tempered, cry over the most stupid things, have random joint pains, some paresthesias in my hands, random abdominal pains, headaches, and a host of other things.  Surprisingly, even taking as much iron as I am, I am not really constipated in the usual sense.  I sometimes take 15-30 minutes to have a BM, but I usually have two or three a day.

I go for a test to check for adrenal gland issues on Thursday.  It's a long shot, but the endocrinologist wants to rule out Addison's disease.

Before all of this happened, I was taking my double dose of daily multi-vitamin.  My labs have been great since my surgery.  I just don't understand how it could all change so suddenly.  I need to call my surgeon and schedule my annual visit, but between my primary care doctor, the gynecologist, the endocrinologist, and my psychiatrist, I will have had six doctor's appointments/lab tests in three weeks on Monday. He has said in the past that he focuses on surgery and cutting me open (three times now ), and I'm already undergoing all of the lab testing he would normally do.

Was the double dose of multi vitamins all the supplements you were taking?  If so it's surprising you didn't have issues much sooner but it was bound to catch up to you.  The body has amazing vitamin stores and it takes a long time to deplete them and it looks like you reached that point.  No judgment here, I did the same thing after my first WLS.  Took the very minimum and had fine labs for many years then down the toilet.  First thing, if your ferritin is that bad and not coming up you need to see a hematologist about an iron infusion.  Second, get thee to vitalady.com and get some D50.  It is 50,000 units of dry D3 and it is what you will need to get your D level up.  I would send Michelle an email and get her advice.  She is a long time post op and knows more then many doctors do about what our new insides need to keep; running.  It won't be cheap but as you can see, saving money on vitamins has a very high cost.  She can advise you on needed labs and then help you interpret them to get the best supplement schedule you can have.

I learned the hard way that even when things looked okay to most doctors there were things to look out for, downward trends in levels, to keep us healthy.  It is much harder to bring things up then it is to keep them up.  Most doctors are happy if your levels are in range.  Mine don't even say anything when they are below range as long as it isn't by much.  We need to aim for the top of the range on most things, like D and B12.  

Good luck to you and I hope things start getting better for you fast.

Are you sure your labs have been great since your surgery?  Like, you've gotten copies of the lab reports and seen the numbers?

A double dose of a multi is not all the vitamins we need.  Most post ops need a least 10,000 IU D3 to maintain a good vitamin D level - if your D level is very low, you will almost certainly need more than that to get your level up.  What is your D level?  According to the Linus Pauling Institute of Oregon State University, we need it to be at least 80.  To maintain my level, I have to take 50,000 IU D3 three times a week.  That comes out to about 28,000 IU D3 a day, average. 

The reason your level dropped taking 50,000 IU D2 once a week is because D2 has to be converted to D3 in the body and it takes a lot of D2 to make a little D3 and because the prescription D2 is in oil and we malabsorb fats after RNY.  Plus 50,000 IU a week, even if it was D3, would be a pretty low dose.  So it's not at all surprising your level is very low.

How much iron are you taking, and what kind?

Kelly, what brand D3 do you take?

Vitalady Tender D3.

Where do you get them?

vitalady.com

St_Mel, are you also taking your calcium?

most likely your lab work over the years show a steady decline in levels, but nobody told you that... That's why it is important - even critical to always get copies of your results - one - to make sure they test ALL what needs to be tested - and 2. to make sure taht your numbers are not only "normal: but that they are optimum for you, 

i.e. I give myself B12 once a week... if I don't my B12 drops below 800 that makes me really tired (normal B12 list it as 250-900 - I like mine 1000-2000).  and so on. 

You may need iron infusions - just oral iron probably will not help you much at this time..

Adenomyosis is why I ended up having a hysterectomy in 2010.  Like you I had a period, a small break and another one.  Essentially I was ON my cycle more than I wasn't.  I ended up anemic (not diagnosed until after though) and having iron infusions.  I've since had another round of infusions (18 months a part).  They helped TREMENDOUSLY! 

Get to a hematologist and request infusions, with a low ferritin it's almost impossible for us to bring it back up.  Also on the D3 be sure it is dry form....if not you can order from Amazon or vitalady up to 50,000 iu.  Be sure to have your D checked again in 2-3 months to see how it's coming up (or not).

I don't know how old you are but I have had female problems all my life.  We tried an ablation and it didn't help with the bleeding at all, hence why I ended up with a hysterectomy.

Good luck Mel, I can sympathize with what you are going through.