WLS Labs

On November 11, 2009, in General Nutrition, by Andrea

A few suggested biochemical monitoring tools for nutritional status

Serum thiamin – B1 (thiamin)
Normal range: 10-64 ng/mL
Postop deficiency: Rare, but occurs with RYGB, AGB, and BPD/DS

PLP – B6 (pyridoxine)
Normal range: 5-24 ng/mL
Postop deficiency: Rare

Serum B12 – B12 (cobalamin)
Normal range: 200-1000pg/mL  (Andrea’s ideal is around 1200-1800)
Postop deficiency: Common with RYGB in absence of supplementation, 12-33%

RBC folate – Folate
Normal range: 280-791 ng/mL
Postop deficiency: uncommon

Ferritin – Iron
Normal range: Males 15-200 ng/mL, Females 12-150 ng/mL  (Andrea’s ideal is 200)
Postop deficiency: common with RYGB for menstruating women (51%) and patients with super obesity (49-52%)

Plasma retinol – Vitamin A
Normal range:  20-80 mcg/dL
Postop deficiency: common (50%) with BPD/DS after 1 yr, <= 70% at 4 yrl may occur with RYGB/AGB

25(OH)D – Vitamin D
Normal range: 25-40 ng/mL (Andrea’s optimal is 80-100)
Postop deficiency: Common with BPD/DS after 1 yr; may occur with RYGB; prevalence unknown

Plasma alpha tocopherol – Vtiamin E
Normal range: 5-20 mcg/mL
Postop deficiency: Uncommon

PT – Vitmain K
Normal range: 10-13 s
Postop deficiency: Common with BPD/DS after 1 yr

Plasma zinc – Zinc
Normal range: 60-130 mcg/dL
Postop deficiency: Common with BPD/DS after 1 yr; may occur with RYGB

Serum albumin – Protein
Serum total protein

Normal range: albumin 4-6 g/dL; total protein 6-8 g/dL
Postop deficiency: Rare, but can occur with RYGB, AGB, and BPD/DS if protein intake is low in total intake or indispensible amino acids

Information taken from the ASMBS Nutritional Guidelines for the Surgical Weight Loss Patient

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7 Responses to “WLS Labs”

  1. marylaw says:

    Wonderful information, Andrea, and so needed! Congratulations on this new endeavor. I know it will help many pre- and post-ops.

  2. Patti says:

    I’m so excited about this site. I know that you will be extremely helpful to me.

  3. beka says:

    Just an add, cuz I can get geeky about labs… albumin & prealbumin levels are indications of nutritional status. Prealbumin is an even better indicator of malnutrition, though I’ve only seen it used on really sick patients with multiple chronic & acute illnesses combined.

  4. Ruby says:

    Thanks for this! I am so glad you have put up this site. I am going to do my first set of labs soon so I really like this list.

    I am also going to ask them to test my PTH levels. This seems to be a good way to spot a calcium deficiency without doing the bone density test anyway.

  5. Lynn B says:

    I’m kinda shocked that all WLS surgeons don’t have a maditory lab list. I have been very lucky, my doctor runs so many labs – some I’m clueless about – on a yearly basis.

    WBC, RBC, Hgb, Hct, MCV, MCH, MCHC, RDW, Plt Ct, Glucose, UreaN, Creat, Na, K, CI, HCO3, AnGap, Albumin, Calcium, Phos, Iron, calTIBC, VitB12, Folate, Ferritn, TRF, PTH, VITAMIN D 25 HYDROXY.

    I get the results online and my nut looks them over but as I’ve learned from talking with Andrea – what the nut is concerned about and what she should be concerned about are two different things. All of my levels are in the normal range so she says I’m doing fine. All of my levels are at the very LOW end of the normal range and that concerns me. Thanks to Andrea I have a little more knowledge and can supliment myself to the levels I am comfortable with. Another thing to keep in mind is that I am banded and do not malabsorb anything so ALL WLS patients really need to be aware of their own numbers and how to bring them up to where they need to be.

    Keep up the good work!

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