Q. Kindly advise whether my report is all right after bariatric surgery.

Answered by
Dr. Bharat Patodiya
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 10, 2016 and last reviewed on: Oct 29, 2020

Hi doctor,

I am a 25 year old male. I had gastric sleeve surgery around 1.5 years ago. I have lost around 55 kg till now and now, my weight is 68 kg. I have not followed the dietary recommendations and vitamin and calcium supplements prescribed by the doctor for quite a long time. Now, I am in poor health. I have attached my CBC report. It shows vitamin D and folic acid deficiency along with a high lymphocyte count. I am also suffering from scalp folliculitis for a few years. There is no other recent infection or disease that could cause the high lymphocyte count. My diet is extremely poor and I am taking very less amount of water. A preliminary detailed analysis of the report would be appreciated before my scheduled visit to the hospital later this week.

#

Hi,

Welcome to icliniq.com.

My first step is to congratulate you for a definite action towards your health as the bariatric surgery. Also, you have achieved a great weight reduction with it which needs appreciation too.

I understand that you have not been following the diet and just accept the fact and move forward in life. But, I could not understand the term poor health. Is it low, lean muscle mass or weakness or fever or not achieving the desirable body shape?

I did analyze your blood report (attachment removed to protect patient identity), which does show vitamin D and folic acid deficiency, with apolipoprotein-A and lymphocytes being high.

With poor compliance to diet, vitamin A, D, E and K deficiency are expected. So, the same to the folic acid. It can be easily corrected with supplementation.

High apolipoprotein-A is surrogate of cardiac disease marker and can be raised in inflammatory stress to the body such as your current state.

For lymphocyte being high I will not worry at present as the absolute value is less than 5000. I suggest repeating a CBC (complete blood count) after two to three weeks. If it is still high or increasing, then we will evaluate.

Scalp folliculitis can be an indirect representation of your body inflammatory state and also can reflect vitamin A and D deficiency. Though depending on state, you may need antibiotics.

You will do well with dietary supplementation and regular exercise. Take help of a dietician who can incorporate healthy food choice according to your preference.

Yes, adequate water is highly recommended.

For further information consult a general practitioner online --> https://www.icliniq.com/ask-a-doctor-online/general-practitioner

Thank you doctor,

I am so grateful for the prompt and detailed response. I fully intend to change my lifestyle and take the necessary supplements, exercise and dietary modifications as prescribed by the doctor. Yes, by poor health I mean what is expected by not following the prescribed stuff after a bariatric surgery along with weakness, body pain, low muscle mass, etc. I just wanted to know if the report is normal for a person in my current state. The report also shows high chloride level and uric acid. What about the iron levels? I have had significant hair loss since the surgery, but not sure if it is due to deficiency or male pattern baldness that runs in the family.

#

Hi,

Welcome back to icliniq.com.

The report is quite expected for your age. Rather, I will motivate you that you do better than many of your age.

High chloride level could be due to high salt containing food intake and is only borderline high, it will normalize with healthy eating.

The same goes with uric acid. Non-vegetarian diet also increase the uric acid, but it is not significantly higher and do not worry about it.

  • Your hair loss is likely due to male pattern, because it manifest in your age. I suggest that you can start application of Minoxidil 5% twice or 10% once. You should add multivitamins in your diet.
  • Also, you can do DHT level (dihydrotestosterone). If high, then specific inhibitors can be added. This is a very powerful way to reduce male pattern baldness.
  • Also, monthly session PRP can be tried (platelet-rich plasma). Also, take a professional trainer advise to achieve your health goal.

For further information consult a general practitioner online --> https://www.icliniq.com/ask-a-doctor-online/general-practitioner


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