looking for bloodwork advice

[Trevvian]

I'm planning for an appt with my GP. I'd like to have a full blood workup & check the levels of key things that tend to be wonky in MS patients. So far, I have Vit D, zinc & magnesium on my list. Anything else I'm missing?

No idea if this is appropriate on the forum, but I'm going to go ahead & call out JimmyLegs if available. I know you've posted your suggestions somewhere, but I can't find it right now. Even a link to an old post with tests & levels would be helpful.

I *think* if I can justify my request, my doc will order whatever I ask for.

I'd like to ensure my food & supplements budget is well-spent. Right now, I'm on the gratitude diet but could tweak it some.

Thank you in advance for any advice

[NHE]

I'm planning for an appt with my GP. I'd like to have a full blood workup & check the levels of key things that tend to be wonky in MS patients. So far, I have Vit D, zinc & magnesium on my list. Anything else I'm missing?

You might consider putting vitamin B12 on the list. A deficiency in vitamin B12 can cause permanent neurological deficits.

[jimmylegs]

hey there,

i need some details on what the gratitude diet looks like for you personally. a complete food/fluids/supplements/medication diet diary for three typical days (two at work, one day off) would help for specifying priority tests and clarifying results interpretation once you've had the tests done.

i'll keep an eye out for updates!

[Anonymoose]

C'mon jimmylegs! Give him your dream list!

Jimmylegs is the expert but I would say ask for as much as you can. There are so many interactions with foods, meds, disease, and nutrient use/absorption that it's hard to anticipate all of the possible deficiencies/imbalances. And you begin to feel guilty calling your doc to ask for new tests. That's why I now pay out of pocket for a lot of my tests. It's expensive! I would add tests for some of the nutrients that interact with what you already have listed. Folate will automatically be tested with b12. Add calcium, calcitriol (they say calcitriol and 25OH don't impact each other a lot but my calcitriol is now high and my 25OH is low and plummeting. How could they not be connected?!) and copper. If you experience fatigue, add iron and ferritin (I never thought of those until jimmylegs recommended them...not only did she find the source of my short term fatigue issues and some weird numbness, she found the cause of my scalloped tongue). Some of those may be frivolous but to me the more info you have, the better. And if some levels are normal, you don't have to retest them unless you are high dosing things that compete with their absorption or you are increasing levels of one nutrient that uses the normal level nutrient to do its job.

My doc will test anything I ask for...I'm thinking most will.

[THX1138]

Trevvian, beware of the magnesium test/doctor telling you your Mg level is fine, normal, good, or anything of the sort. Md's typically know next to nothing about magnesium and nutrients - they receive on average 23.9 hours of training in nutrition in medical school.

People with ms are magnesium wasters and the typical Mg test (serum) will not help.

The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for "normal" results.

http://www.ncbi.nlm.nih.gov/pubmed/20170394


THX1138

[jimmylegs]

lol anon! my dream list link is right there in my signature. every post.

[Trevvian]

Thanks to all for the helpful replies. Here's the requested details on my diet. The gratitude diet may be a family term that's not widely used: 'thank you Lord that I have food to eat. I did the best I could with what I have, now you take it from here.' It just means I'm eating cheap.

It's easier to provide a weekly shopping list: I pretty much get the below & combine ingredients differently depending on what meat I have. I make 3 dishes, portion them out & eat the same 3 things all week.

9 to 10 eggs
1 1/2 to 2 pounds of meat. I rotate between beef, pork & chicken
2 to 4 cans of tuna
1/2 to 2 cups of mayo
1 can of cream of something soup
1 head each of broccoli & cauliflower
1 package of fresh crimini mushrooms
1 or 2 tomatoes
1 onion
16 ounces of cheddar cheese
4 ounces of cream
6 to 8 servings of assorted frozen veggies. Almost always spinach, the rest rotate between peas, carrots & mixed
Occasionally I get fruit
1/4 c flax seed

I drink 32 ounces of water daily, 36 of diet coke and 24 of coffee. (Bad. I know. No doubt the aspartame caused my MS)

Supplements & meds:
With breakfast:
1 woman's daily multi vitamin
Tecfidera
1 sublingual Vit B12

With lunch:
2000 iu vit D
200 mg alpha lipoic acid
1000 mcg chromium picolinate


With supper:
Tecfidera
300 mg gabapentin
200 mg alpha lipoic acid


Bedtime:
1000 fish oil
5 mg melatonin

I know the diet ain't ideal, but it's cheap and I don't have to cook daily.

I'm willing to change it as long as I have good reason and I can achieve it. Now's a good time anyway to rethink it, with the MS dx & having recently lost over 60 pounds.

I'm sure I've got some deficits.

Thanks again for your help...and throw the whole wishlist at me. I've hit my outta pocket max this year & who knows what the coverage for next year will be! My plan years start in March.

[Anonymoose]

Hi trevvian,

Sorry for "him-ing" you in previous post.

Do you have any symptoms/annoyances? Gabapentin for neuropathy or spasticity? That info might help narrow the field too. I wonder if any deficiencies have been linked to tecfidera yet...

[Trevvian]

No worries on the masculine pronoun, though that would make my choice of vitamin seem suboptimal, I suppose.

I have obnoxious tingling & painful paresthesias, hence the gabapentin. And bone crushing fatigue, hence only taking it after work, as it's very sleepifying for me. FATIGUE, as in being able to sleep for 16 hours, or realizing after a short walk that if I don't SIT down, I'll FALL down. I was pretty active until the summer flare that got me diagnosed, so pretty sure that's an MS thing.

I've also had a series of random viruses this fall & winter and my hair is falling out. But I'm blaming the Tecfidera for the last two as they didn't appear with the flare, but after I started the Tec in August.

hey ho, this is a fun journey, no?

[jimmylegs]

CRAZY I guess I almost lost this post I just spent forever writing :S glad I snagged it to the clipboard! here it is, round two:

OK this is info I can use

consider making a bag of frozen mixed fruit a regular purchase. perhaps you could alternate between eggs and oatmeal at breakfast?
a bag of apples wouldn't do any harm either.

the beef pork and chicken rotation sounds good. any chance of working some other seafoods into the tuna rotation? like frozen salmon, or tinned oysters or clams?

that's a lot of mayo - how does that factor in? tuna salads?

broccoli and cauliflower, mushroom, tomato, onion, flax = awesome!
re the frozen mixed veg, glad to see spinach in there. better option than peas and carrots, although the last two are nice for variety ever consider yams / sweet potato? so nutritious and anti inflammatory

the dairy ration sounds ok

DITCH THAT DIET COKE too much phosphorus. ties up nutrients. how do you feel about herbal teas?

you're off grains and legumes entirely by the looks of it - smart to reduce processed flour products. but on the whole food front, you could be throwing out the baby with the bath water to some extent. ever pick up brown rice and/or wild rice?

anyway. I won't comment on the supplement regimen now except to recommend a solid 1 week washout before you go for any nutrient testing.

as for tests, you have mentioned serum 25(OH)vitamin d3, serum zinc and serum magnesium. couldn't hurt to also test serum ferritin and serum copper. and serum cobalamin, just to see how your supplement is doing. be sure to get your own copy of results

[jimmylegs]

EEK VIRUSES AND ALOPECIA - defs test serum zinc and serum ferritin

[Trevvian]

Yikes! No, I really don't eat Mayo by the cupful. I meant 1-2 T to 1/2c. ;)

Thank you so much for the helpful advice; I'm quite amazed at the time you spend helping others. Very helpful on the supplement washout especially. I never would have thought of that.

I would LOVE to add oatmeal; I sort of nixed it when I was losing weight & have been afraid to add it back. I have steel cut oats in the cupboard calling my name. And I will see about the fruit too. Mmm, I sense some warm-apple-cinnamon-topped goodness in my future!

And about that Diet Coke...yeah, I'm embarrassed to admit it, but that's the result of months of cutting back from...gulp...over a gallon a day. Still in progress.

When I actually have my computer instead of my mobile, I'll go through the whole thread, type up my test request list & post it for feedback. Then I'll start the washout & start hydrating my veins cause this is gonna be a lot of blood work.

Thanks again,
Trevvian

[jimmylegs]

phew re the mayo! lol

no probs re the help

STEEL CUT OAATTSSSS love it.

i'll keep an eye out for your updated list - ttfn!

[Anonymoose]

Trevvian,
I think you will find this thread to be of interest. http://www.thisisms.com/forum/tecfidera ... 23005.html tecfidera and anemia.

I don't take tecfidera but have resolved a lot of numbness, excessive hair loss, and fatigue issues with iron supplementation in just a month or so...thanks to jimmylegs.

Jimmylegs, will iron deficiency show in ferritin numbers if it is early and not chronic?

[jimmylegs]

heya anon yep serum ferritin is sensitive enough to be a useful indicator of iron depletion before progression to the more serious iron deficiency anemia.