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Bariatric

Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.

Why this still fits

I had bariatric surgery [type] [time ago] and I've been experiencing increasing brain fog - difficulty concentrating, memory problems, and word-finding trouble. I want to check for surgery-related nutrient deficiencies that could be causing this. Can we run a full micronutrient panel following ASMBS guidelines?

What would weaken it

  • -All micronutrient levels normal on comprehensive testing
  • -Fog pattern identical to pre-surgical baseline
  • -Fog resolves completely on days without food (suggests reactive hypoglycemia only)

Tests and measurements to discuss

Thiamine (vitamin B1) - not on standard metabolic panels

Vitamin B12 + MMA (methylmalonic acid)

What this helps clarify: Elevated MMA confirms B12 deficiency at tissue level

Range context

<0.4 μmol/L

How to use the result

Save the result with date and symptoms from the same week.

Iron panel (ferritin, TIBC, iron saturation)

What this helps clarify: Iron storage marker that can affect energy, focus, and cognition.

Range context

40-100 ng/mL

How to use the result

Save the result with date and symptoms from the same week.

Copper + ceruloplasmin

Vitamin D (25-OH)

What this helps clarify: Patient-facing vitamin D explainer route matching the common 25-OH wording used in lab and search language.

Range context

Lab context

How to use the result

Save the result with date and symptoms from the same week.

Zinc

Folate

What this helps clarify: Essential for methylation and neurotransmitter synthesis

Range context

>20 ng/mL

How to use the result

Save the result with date and symptoms from the same week.

CBC with differential

What this helps clarify: Core blood count panel used to review white cell patterns, hemoglobin, and platelet context.

Range context

Lab reference interval

How to use the result

Save the result with date and symptoms from the same week.

Basic metabolic panel + magnesium

What this helps clarify: Intracellular magnesium - serum levels miss deficiency

Range context

5.0–6.5 mg/dL

How to use the result

Save the result with date and symptoms from the same week.

PTH + calcium (secondary hyperparathyroidism screening)

Peer-reviewed references

  1. 1. HTTPS://PUBMED.NCBI.NLM.NIH.GOV/31742775/ [DOI]
  2. 2. HTTPS://PUBMED.NCBI.NLM.NIH.GOV/37798508/ [DOI]