Vit D couldn't hurt.

Standard screening tests include liver and kidney function tests, CBC, hemoglobin/hematocrit, fasting glucose or HbA1c, urinalysis. Some ofthese depend on your age and history, and how long it has been since you were screened.

With your history of HCV, be sure the liver enzymes are in there (ALT, AST).

I agree Vit D would be good. Maybe B12, depending on your age and if you had been previously tested.

Jan

If worried about inflammation - you could also do a cal protectin stool test. 

Another blood test to check is iron.

Hi, I was wondering if anyone has experience a hi number in their bloodwork for b12? The normal range is 150-914 and mine was 2800. I take b12 everyday and a b complex, but everything that I read was the normally our body just flushes too b12 out of our system. With the Jpouch is it common to have some off results with certain blood work results? Just wondering if anyone knew. Thank you for your help!!

I'm going in for tests tomorrow.  I have an ileo.  But I have been so fatigued and wore out after an eight hour shift.  It just came on like one minute I was ok next I wasn't.  

She is checking all the above plus some while I am having it done.  I sure hope it explains it.  

I was just feeling good for several months and then "bam"  somebody flipped a switch.  I do work outside but not in the sunlight but I have been doing that for a few months.  Gets hot here early. 

We will see.  My fingers are crossed it's something simple. 

Richard. 

Sue-

it may just be lab error, but you might want to cut back on the B12 supplements. You just don't need that much, and you don't seem to have an absorption problem. The high value isn't caused by your J-pouch.

I think I remember my GI telling me that everyone has a reserve or deposit of B12 that if normal would last for 2 or 3 years without the need to absorb any therefore depletion can creep up on you slowly if you're not absorbing it. He went on to say that us Pouchers cannot absorb much as it's primarily done in the Ileum which we no longer possess. I have an injection every 2 months & my levels are slowly increasing, 300 last time, were 120 some 2 years ago.

Jan, my HCV is still undectable & AST & ALT are normal but GGT is 70 (range 5-40) as they were last year, PCR, Albumin etc normal. I believe this is an indication of my alcohol consumption, 1 litre beer & 2 glasses wine every day. The obvious thing to do is cut back (reluctantly, I love a lunchtime beer & wine with my meal). I had a liver biopsy in 2002 which revealed minor scarring & I have no right side pain or stitch which I had experienced prior to HCV treatment. Yours & others thoughts will be much appreciated. I mean is 70 worryingly high,.  it's remained the same over 1 year. I haven't spoken to my GI yet about it, I think I know he'll say, give up the booze which will p me off.

Paul

You are correct that B12 is absorbed in the ileum and we retain a store that is enough to last years. But, we do still have our ileum. It is only the colon and rectum that is removed. Some people may have some ileum removed if they have a lot of backwash ileitis damage. It is the terminal ileum that important for B12. This is the distal several feet. The pouch itself takes only 6-12 inches, and should absorb nutrients unless there is pouchitis, or there is a very high output. Another factor is if you take a proton pump inhibitor chronically.  You need stomach acid to absorb B12. So, it is not that all j-pouchers have trouble absorbing B12, but some do. I developed B12 deficiency after about 18 years with a j-pouch. But, I also am over 60 (it is more common as we age). My husband is deficient also and has his colon.

In regard to the extremely high B12 level, it could be lab error, or you are just taking way more supplement than you need. My B12 went way high when my doc prescribed 1000mcg a day. I now just take it twice a week, and it is in the 300-500 range.

Paul, your GGT isn't too bad, especially since it is stable. Hopefully, you are abstaining from alcohol for a minimum of 24 hours before your lab tests, as it can artificially elevate the value beyond whatever liver inflammation there might be. Still, reducing your daily intake would be a good idea (2 drinks per day is recommended for the average male, and you are drinking twice that).  Even reducing a little could make a difference.

Jan

Thank you, yes it's time to cut back, might give me more energy too! I only abstained for 12 hours so all in all I must be in good shape. How lucky I am.

Paul

As for high B12, by IBD GI specialist said in J pouches, weirdly high numbers can show lack of B12 absorption. I'd have to ask for the explanation again, but that's what he said. He put me on supplementation when he saw my high number. 

RachelRaven,

My blood tests also came back with extremely high B12 level. I would be interested in an explanation as to how this may indicate lack of absortion, if you get a chance to ask your GI Specialist.  Also, what is the name and dose of your B12 supplement?

Thank you!

Laura