I know we are always discussing vitamins - and that they are important.... and I know many you get tested for specific ones..... if your basic blood counts are normal - how does one get the doctor to test for vitamin deficencies? I have the Liza Jane sheets - but again, the doc wants to be the leader.... are there signals in our basic bloodwork that would trigger a doctor to test for a specific vitamin deficiency? Or something the we can say as a patient to request specific imporant tests for those of use with PN - auto-immune issues, etc. based on a certain symtom that we might not think signifiicant to mention? (I know they tested me for B12 a few times over the years because of its relationship to PN) but thats about it as a specific entity.....?

Most doctors do not know how to interpret the results.

Naturopaths may be better, or worse if they want to sell you stuff!

Right now Vit D is getting huge attention. So you can be accurately tested
for that.

The B12 may test normal (if you are sure of the numbers being interpreted)...but its biological activity is really most accurately tested by the MMA test. There is a folate test. A B6 which may not reflect reality.

You can test magnesium/calcium, iron. Normal magnesium in serum does not reflect intracellular however. There is a test for blood serum zinc and a urine excretory one. There is a copper/zinc ratio test.
There are tests for amino acids which are hard to interpret.

there are a whole 'series' of tests that are 'add-ons' to that.
From experience, my Endo ordered various Vit and Mineral extras for calcium asorbtion, Vit-D and Magnesium... I'll look up the test codes and PM you with them [earlier this year]. It all was VERY revealing in what I did and did not have floating around in that blood! Thing is, you have to know what you are looking for to find what you want? Most docs do the basic 'comprehensive blood panels' but not the metabolics, I have found over the ages - and they often are not senstitive to the other needs of those of us who are asorbtion compromised may have. I gets muzzier the more detailed things can get.
I'll get that info to you! - j

Apparently this vitamin testing busines is a hit and miss area. BUN can indiate that there may be a nutrition problem, but getting specific is not a sure thing.

Regarding the B12, even B12, MMA and Hcy, when tested together and at the appropriate time will not catch all cases of deficiency.

Thank goodness the vitamin is safe.

rose

But I don't feel it's comprehensive at this point. I think the doc's agenda was/is a bit different from what our is. His doc did:

#1 - A red blood cell elements test. They analyze packed blood cells for surface-adhering and intracellular content. they looked at the minerals and some toxic metals. On that test, his copper was at the low end and the zinc was on the high end of normal. This was done by Doctor's Data.

#2 - He also ran a blood/serum test for copper/zinc. The serum showed his zinc to be low and the copper:zinc ratio to be high. Just the opposite of the first test. This test was done by The Great Plains Laboratory.

The doc did not know what to make of this. John has very high iron which messes with your zinc levels and his chelation therapy messes with the copper and all minerals to a degree.

#3 - He also did an Organic Acid Profile (urine test)...I can't even begin to understand what all of it means. Thank God most results were normal! The potential problems uncovered by this test were: Low Vitamin C due to either dietary deficiency and/or increased utilization of antioxidant; Decreased pyroglutamic acid (glutathione); Low Pantothenic acid (B5); And Low citric Acid...has something to do with Krebs cycle....I'm clueless about this. This was also done with the Great Plains Lab.

#4 - He also ran a Liver detox profile which show Phase II pathways are underfuctioning. This is usually fixed with glutathione and other antioxidants....so we're seeing a trend here with antioxidants. This was done by Genova Diagnostics.

#5 - He also did a saliva test to check the adrenals....as expected....pretty low functioning....B5 and Vit C are vital to good functioning adrenals.

Some of these labs will only work through a doctor. I think Doctors Data will work directly with the patient though.

A really good nutritionist can be very beneficial in getting an assessment done and will have access to all these speciality labs.

I've been wondering the very same thing about Vit B1 and B6 specifically. What about the total picture rather, than an ad hoc look at B12 and Vit D, which can be very equivocal anyway.

Is it even worth asking for these things to be looked at?

Also what about the phospholipids (such as phosphatidylserine and phosphatidylcholine etc) - how complicated are they to test for? And what are their implications?

At one point, back in 2003, John did meet with a nutritionist who mentioned that you can have your white blood cell analyzed for a good assessment of the B vitamins. This was in response to us telling her that he came down with shingle about 8 months prior. Her comment was that shingles and low B vitamin levels are strongly linked.

We never had any blood cell tests done because John did not have enough white cells and was still transfusion dependent at the time so it was pointless.

Anyways....I just googled on this and found this lab:

http://www.spectracell.com/