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should i get a new doctor


DJFL77I

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DJFL77I Experienced

so at my last appointment after being recently diagnosed he referred me to a nutritionist...

I wanted to have my vitamins and minerals checked..   he seemed like it wasn't necessary..   I mentioned Iron and b12 to be checked...  He said I was not anemic because of the blood test results from March...  But then I said that was 3 months..

so I got him to test for Iron and vb12...    should it have been more ?????

 


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GFinDC Veteran

It would be helpful if he did a test on Vit D and minerals too.

cyclinglady Grand Master
(edited)

Here is the deal.  Medical is constantly reviewing and changing recommendations.  I just looked up the University of Chicago’s FollowUp recommendations.  It no longer recommends all this additional vitamin and mineral testing:

https://www.cureceliacdisease.org/wp-content/uploads/341_CDCFactSheets7_PostDiagnosis.pdf

Yet others still do:

https://celiacdiseasecenter.columbia.edu/celiac-disease/follow-up/

And this is kind of in the middle:
 

https://www.beyondceliac.org/research-news/new-celiac-disease-guidelines-emphasize-follow-up-care/

Maybe recommendations have changed based on clinical evidence.  Follow-up serological antibodies for celiac disease are still being recommended.  Perhaps if celiac disease is in check (being treated with the gluten free diet),  the vitamins and minerals deficiencies  most likely resolve.   It could be why he recommended you see a nutritionist instead of  running a vitamin panel.  More value.  Maybe in the past, he ran panels and patients opted to supplement and continued a gluten-free junk food diet.  Maybe he prefers (as I do) that you eat a nutrient rich diet that is gluten free.  Then there is no need to supplement.  It is a win-win situation by seeing a nutritionist.  
 

Of course, you could have another illness, that can cause malabsorption, but that is another topic.
 

If he checked you for anemia (low hemoglobin) and you were fine at diagnosis, chances are you are not going to develop anemia unless you are not adhering to the diet.  You would have symptoms of anemia.  Like  extreme fatigue and you can not catch your breath (that was me).  Even if you were a little anemic, it usually resolves fast.  My anemia resolved within months of the diet (well I have a genetic anemia, but that too, is another story).    I was directed to take a bottle of iron pills for three months.  That is because my anemia was so severe that every doctor I saw recommended blood transfusions.  My ferritin (iron stores) literally improved from a 2 to a 25 in three months and then went over 50 in six where it has remained above 50 ever since my diagnosis.  I stopped the iron after three months.  I was able to absorb my iron needs from food.  
 

Vitamin D is important.  Researchers are finding it helps with COVID 19.  (Anything to boost the immune system seems to be beneficial and that includes  sleep.) But do you need it checked?  It is summer.  I live in Sunny California.  My doctor knows I am a cyclist.  I have a year round little tan despite wearing sunscreen.  He knows I do not wear sunscreen on a daily basis (wear a hat).  I get plenty of sunshine that can manufacture lots of Vitamin D.  Sure, it dips down in the lower range in the winter (still in range), but bumps up high in the summer (I looked at my history....see keep your medical records).  Now, if I lived in New York City, worked in a high rise, and exercised in a Yoga studio, my doctor might be checking my Vitamin D levels.  

I am still monitored for bone scans.  Do you need one?  Are you old, little and post menopausal like me?  
 

So, it is all about context.  What is good for me, might not be good for you.  If you have a good working relationship with your doctor who is willing to talk to you and is open to discussion and learning,  you might consider keeping him.  

Edited by cyclinglady
DJFL77I Experienced

ya im in s florida..  so vD all year round i guess

Awol cast iron stomach Experienced

I was not checked for vitamin/ mineral deficiency after diagnosis that I know of. I had been diagnosed vitamin D deficient 8 years prior to my gluten intolerance diagnosis. I am in the Midwest so unlike you CA girls. I get some cold dark days here come winter time. I often have a vitamin D supplement in the cupboard.

I was sent to a nutritionist. She went over some of the areas I needed to focus on as gluten-free foods were not fortified the same as gluten containing foods. She knew I regularly took a multi vitamin as I knew the B's, Mg, and vitamin D are possible areas I needed to pay attention to. She suggested some things I could sub  to bake with etc. Sweet potato was one that she suggested I consider.

Our meeting was a one time thing and didn't require follow up as I had previously been someone who had past work experience/ interest  in nutrition/ biology before diagnosis.

She said to focus on getting the nutrients from whole foods, but in my case taking a multi vitamin was fine to support my nutrient intake and confirmed ( as I knew) would not cause me to go over the rda. 

Good luck 

 

 

 

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