Dear Dr. Eskapa,

I know it's likely you don't know the anwer to this question, but I'll give it a shot. Do you think there would be any difference in the effectiveness of Nal if you have had gastric bypass surgery (Roux-en-Y gastric bypass). I had the surgery 8 years ago and my stomach is back to the normal size pouch but my stomach still bypasses the large intestine and goes directly to my small intestine.

I've read that some people who have had GBS process alcohol quicker and that's why we sober up quicker, but I don't think I buy into that, i think I stay drunk just a long as everyone else.

Thanks,
E

Lena and N101CS, forgive me in advance for responding here - the good Doctor and I had this conversation privately. I was going to only pm Providence, but decided there may be others on here who need the info, but don't want to ask publicly.

I had an underactive, and then inoperative, thyroid for three years b/4 it was diagnosed (by my nurse practitioner, not my MD!). Needless to say, my weight during this time went through the roof. I thought the huge goiter on my neck was just more fat padding! After having the thyroid removed, I dieted off some of the weight over three years' time, then hit a plateau. . .and was still unhealthily overweight. With a family history of diabetes, borderline high blood pressure, arthritis, and a job that demands that I stay in shape, gastric bypass became my only reasonable solution. I had the surgery 4 years ago, and it was a life-saver. Felt like I got myself back!

I've been on TSM for 3 months. I had the same initial side effects as anyone else - clearly indicating the naltrexone was effectively absorbed into my system. My experience of drinking is much changed, in that I still get a buzz, but never actually feel or act 'drunk.' No more blackouts, hangovers, withdrawal symptoms, slurring of speech, or erratic drunk behavior. Again, it has to be the naltrexone blocking the opioid receptors. Most significantly, my drinking is down from 70-80 upw to 50 upw, and I'm not even trying to cut back. It's just happening naturally.

I suspect my progress may be a little slower, in the long run, than it might otherwise be. If I could get enough in my prescription, or manage more AF days, I'd probably go to 75mg., rather than 50, just to be on the safe side. But I'm happy with the progress I'm making.

Dr. E. suggested that I crush my naltrexone and take it with a spoon of yogurt or honey, so I did. But really I don't see any difference between when I took it in pill form, and not - and so have gone back to pill form. (That pill is BITTER!)

Until Dr. E. responds, I hope this is helpful.

I also had GB surgery 2 1/2 years ago...which I think is part of the reason alcohol became my addiction...addiction transfer from food to alcohol. Now I'm back to being hooked on both...great I'm 12 weeks into the process and I have seem some changes. I would be interested to see if it would take longer. However, I think I absorb just as well as I did before surgery...although I do know that I seem to require larger doses than normal of almost all my meds....could be some mal absorbtion....I sometimes take 100mgs...I wil be watching for the Dr.'s response.

Ironically, my MD now thinks I may need larger doses of thyroid b/c of the gastric bypass. !!!???

hummmmm.....that is interesting