james_edin said:

Six months of eating roughly 1,100 calories a day and my ferritin has halved, which I did not connect to the intake until somebody pointed it out.

Vitamin D levels and micronutrients: an often-overlooked connection. Obese individuals store vitamin D in adipose tissue, making it less bioavailable. As you lose fat, vitamin D can actually increase WITHOUT supplementation.

My trajectory: Baseline 18 ng/mL → Month 6 (with supplement) 42 ng/mL → Month 12 48 ng/mL. Target is 40-60 ng/mL. Adequate vitamin D supports immune function, bone health, and mood — all relevant during weight loss.

PharmacoVig_BOS said:

Vitamin D levels and micronutrients: an often-overlooked connection.

Blood count monitoring for micronutrients: my doctor noticed my MCV (mean corpuscular volume) trending up at month 6: 90 → 96 fL. This flagged potential B12 or folate deficiency.

Sure enough, B12 had dropped from 620 to 340 pg/mL. Started B12 injections monthly and MCV normalized within 2 months. GLP-1 agonists can impair B12 absorption — this is a real clinical concern that deserves routine monitoring.

james_edin said:

Six months of eating roughly 1,100 calories a day and my ferritin has halved, which I did not connect to the intake until somebody pointed it out.

Mine went the same way, slower.

From the other side of the consultation, briefly.

Vitamin and mineral labs to check while on micronutrients — my doctor orders these quarterly:

• B12: Can drop due to reduced GI absorption. Mine went from 650 to 380 — now supplementing.
• Iron/Ferritin: Reduced food intake = reduced iron. Ferritin dropped from 63 to 30. Supplementing.
• Vitamin D: Was already low (22 ng/mL), now taking 5000 IU daily.
• Folate: Stable, no issues.
• Zinc: Slightly low, added a multivitamin with zinc.

Nutritional deficiencies are a real risk when you're eating significantly less. Don't skip your labs!