[One of the occasional series of posts about my typical day.]
Or, Annual Physical update the 2nd (and hopefully final :)
What I didn’t mention before was that the day of my annual I was near the tail end of my period. It wasn’t bad enough that we couldn’t do my pap smear (yes, this 400lb 42-year-old woman has a sex life) but it did mean my urine sample had a bit of blood in it. Which necessitated going in to give another urine sample a week later. So my urine tests were all a week behind my bloodwork and pap. Which is probably why the THIRTEEN PAGES of full test results didn’t arrive for another week after the initial, “Here’s the summary of your results” letter I wrote about here (and that letter arrived a couple days after a phone call to discuss my vitamin B12 & D levels.)
Then WellRoundedMama made a few excellent suggestions about vitamin D & TSH. I started to write a reply, and dug in the file box for last year’s even longer test results for comparisons, and … well … my reply was getting onto all sorts of other stuff and, really, getting to post length. So, here ’tis.
| Vitamin D |
July 2007 | Nov 2008 | Desired Range |
| Results | 23 pg/mL | 28 ng/mL | 15-75 pg/mL 30-150 ng/mL |
No, that “desired range” isn’t a typo. Last year’s lab results were in pg/mL, this year’s are ng/mL. This year’s also includes a note that between 20 & 29 ng/mL is “a relative insufficiency”.
I’ve been taking 1000 ius of Vitamin D a day. Now I’m alternating between 1400 and 2400 in prep for going up to 2400iu / day.
| Thyroid | July 2007 | Nov 2008 | Desired Range |
| TSH Result |
3.22 uIU/mL | 2.67 uIU/mL | 0.40 – 5.00 uIU/mL |
| Free T4 Result | 0.8 ng/dL | — | 0.6 – 1.6 ng/dL |
I’ve read that some endocrinologists are pushing to lower the “normal” upper range for TSH to 4.5 or 3.0, but I seem to be moving in an okay direction here. I do have hypothyroidism in my family background, which is why she checked the Free T4 last year.
| Vitamin B12 | July 2007 | Nov 2008 | Desired Range |
| Results | 282 pg/mL | >1000 pg/mL | >247 pg/mL |
This is the biggie, for me. From what I’ve read, the 247 is indeed a very low value, and I’ve felt considerably better since I began treatment. Initially I was given a shot of B12, to get me to a “normal” level, and I’ve been taking OTC vitamins since then. I gradually increased to 3000mg a day, which is admittedly huge. Here’s the thing, though: If I forgot to take them, or if I just put them off til noon, I would feel very tired and a bit sick.
Until last Friday.
Last Friday I was fixing dinner in the kitchen and saw a familiar pile of vitamins. The exact pile, in fact, that I take each morning. I’d gotten them out, put them down, and hadn’t taken them. And I felt fine.
Part of why B12 deficiencies tend to develop gradually is that the body can use its “reserve supply” in the liver. I think I’ve finally got enough B12 built up in my liver that I can manage without the pills for a day without feeling dead. Don’t worry, I am still taking them daily! (And our “in case of earthquake” supply of canned food & bottled water includes B12.) But I am experimenting with dropping to 2000mg/day.
Otherwise…hm…my fasting blood glucose reading was 85 this year, 91 last year. And my BUN/creatine ratio was slightly high both years (21 and 22) despite both the BUN and creatine values being fine. Frankly I think it means I’m a bit dehydrated, or at least I am when I haven’t had breakfast….
Update: A primer on deciphering blood tests is here.
Living ~400lbs 
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