Nsaids , Clomid and testosterone replacement therapy post op after gastric bypass surgery

[LarrySm88 5]

I quit Testosterone Replacement Therapy, after 2 years on it.

I was not on steroids !!!! Its testosterone replacement therapy, it makes a man at 40 years old, feel great, high sex drive, etc..

It is not pills and 5 different steroids going to you stomach. Its one low dosage intermuscular injection per week.

I do not drink alcohol, or smoke nicotine.

I quit cold turkey, ["weaned off, TRT with very low dosage weekly shot"], 5 weeks before my successfully , gastric bypass surgery , I am still currently off TRT probably forever.

I am 40 years old, ex powerlifter.

I am currently 6'3" 299 lbs , i lost 48 lbs as of today in 3 weeks.

I only choose gastric bypass surgery because my insurance covered it 100%, i knew it was not reversible, going in.

I was told I could continue TRT for life 4 weeks after post op. but now I read No NSAIDS and no Steroids , and they are to opposite things ???? because they can? cause ulcers in the new smaller stomach, and around the staple line.

That being, said I am prepared to quit TRT forever !!! But I don't understand why ? It makes no sense.

I know for a fact my natural testosterone will come back in a few months, being off TRT, I am not worried about that.

*****These are some things that I cant understand and it makes no sense to me , during 4 week post operation. *******

NSAIDS is an appreciation for "NONSTEROIDAL anti-inflammatory drugs" but then it says you CANNOT take Steroids' either ?????

Can someone please explain to me how that makes sense ? One is NON STEROIDAL and one is STEROIDALl ??????

Now on to the Clomid brand name drug name is clomiphene , it can be taken by men or women, i have read many posts about women using Clomid post operation to get pregnant !!! there doctors said it was fine but , as I did further research Clomid is a NSAID !!!!????? how does that make sense ???

Clomid taken by men post cycle therapy off TRT will help a man boost testosterone 200% i have done it before in the past it works bringing back natural testosterone levels. The Clomid comes in crushable form pills and liquid too, obviously because , after gastric bypass surgery, your body does not absorb medication like it did before.

This is a serious post for people who know what they are talking about please respond with personal stories or any knowledge or insight that you have would be appreciated thank you.

[LarrySm88 5]

Sorry for the long post above lol

thanks for your response , in a nutshell I'm just trying to understand how women are allowed to use clomid to become pregnant after gastric bypass ? and its a NSAID ?

and i don't understand why testosterone injections of a intermuscular is not allowed ? Non Steroidal and steroidal ??

so non steroidal and steroidal are both not allowed it doesn't make sense.

I guess my question is are there any seasoned gastric bypass patients that have done trt with out staple line ulcers?

I see you got MINI gastric bypass ?? i never heard of that ? whats the difference between the 2 ?

Edited March 18, 2021 by Bigross88

[The Greater Fool 1,937]

Talk to your medical team.

There are lists of "don't take this list of drugs" and "these drugs are OK". Not every surgeon agrees with either list. Mine didn't.

Everyone is different. We have different medical issues, different sensitivities, different tolerances, different likes and dislikes, different beliefs. Different differences. We need to take all of these things and more into consideration.

Drugs are always a risk v. reward thing. Are the possible negative effects worth the probable positive effects? Whether you can or should take any drug is up to your medical team and ultimately your personal choice. Inform yourself, talk to your team, make a choice, monitor carefully.

I take drugs from the "do not take" list daily. I know the possible side effects and I monitor carefully.

As an example, every pain medication known to humanity carries side effects AT LEAST as bad as NSAIDs. Of course, living in constant pain also has some negative effects.

The first 6 weeks you are healing so some things have a higher risk during this period. Talk to your medical team.

After the first 6 weeks, well, talk to your medical team.

Tek

[LarrySm88 5]

thanks

[LarrySm88 5]

12 minutes ago, OAGBPal said:

Oh got it Thanks for explaining for me, man! I can't answer the questions about the NSAIDs but that does sound weird?

So the mini gastric bypass isn't really very 'mini' at all, but that's the name it has. It's getting increasingly popular in Europe, the Middle East, SE Asia and Australia.

Instead of dividing your intestine and making two "holes" (one in the small intestine, one in your pouch), they take a loop of the small intestine and staple it to the pouch instead.

Here's a diagram:

I chose the mini gastric bypass because:

- On average, we lose more weight than sleeve or roux-en-y/traditional bypass
- On average, we regain less
- On average, we have fewer complications than roux-en-y bypass
- On average, we tolerate foods better than both sleeve and roux-en-y bypass
- It's easily revisable (just move the place on the small intestine where it meets the pouch) or reversible (close the hole in the intestine, sew the pouch back into the remnant stomach)

The downside is there's more problems with GERD/heartburn, but there's a stitch now that some surgeons do that prevents it. I had severe GERD before and I don't have it now.

I'm really, really happy with the MGB so far.

Edit: ALL three surgeries are great and there's large variance in outcomes. So you can get a great result with ALL of them. I just knew myself ... and wanted the most help I could get

wow that's great i don't even think mini bypass was an option for me . i initially wanted the sleeve , but my insurance only covered gastric bypass 100%

was the mini out of pocket?

sometimes i get depressed thinking mine can not be reversed, not that i want to reverse it, its a mind game i play with myself i guess.

plus going through the surgery and diet and everything on top of trying to recover my natural testosterone is tough mentally

i start thinking i cant eat, i cant drink alcohol, I have no sex drive , but I'm down 50 lbs looking good. its a crazy mind game, I'm mentally tough ill be fine.

[LarrySm88 5]

haha that's awesome news. you and i are different i was using test replacement so its going to take awhile for it to come back, but i have done it before and i know what to expect.

clomid would make the recovery much eaiser.

it did before. i forgot to mention i was on trt prescribed by a doctor and closely monitored everything was fine i was bench pressing 405 lbs, but my health now is most important now that I'm 40 years old , i have two young kids i want to see grow up. my dad died at 62 , i refused to let that happen to me.

[RickM 1,747]

A couple of comments to fill things in here.

It's not really a matter of steroids vs. non-steroids, but rather what a drug or class of drugs does to the stomach as a side effect, NSAIDs are merely the most common that are sited as being problematic for bypass patients. The issue is that the part of the intestine where where the stomach pouch is connected is not resistant to the stomach acid, so that anastomosis there is quite vulnerable to ulcers, so any med that can cause some stomach distress is generally to be avoided. Some of the osteoporosis drugs are avoided for this reason, too. This presumably applies to the MGB as well, as it uses a similar connection. The duodenum, the part of intestine immediately downstream of the stomach and is resistant to the acid, is bypassed along with the remnant stomach.

These various meds can sometimes be used in limited times under certain circumstances under medical supervision, but it's a risk/reward trade off between doctor and patient. The sleeve based procedures are generally more tolerant as they don't have that marginal ulcer issue, but many docs still restrict them owing to their bypass experience, (and the sleeve is probably less tolerant than a normal person, while being more tolerant than a bypasser.)

Your bypass can be reversed, (that is sometimes one of its "selling points" but it's not commonly done as it's a pretty complex job; not all surgeons will do it. It is usually reserved for times when there is no other option in treating some problem, rather than just buyers remorse. I have seen it done a couple of times in cases of intransigent ulcers, where no other treatment worked. It can also be revised to a duodenal switch, but that's even more complex than a reversal (they have to reverse it first, then sleeve it, and redo the intestinal rerouting. It is usually done when weight loss was inadequate or with excessive regain, or for other RNY complications such as the intransigent ulcers or bile reflux.

You weren't offered the MGB as it doesn't fit the "standard of care" for WLS in the US - insurance doesn't normally cover it and the ASMBS hasn't approved it, though it has been further developed and used more commonly elsewhere. The next procedure that's likely to gain approval here is the SIPS/SADI/Loop DS

[LarrySm88 5]

Thanks

[LarrySm88 5]

Has anyone on here continued using TRT after surgery? Did u get bad ulcers ? Did you not ?

[LarrySm88 5]

11 hours ago, RickM said:

A couple of comments to fill things in here.

It's not really a matter of steroids vs. non-steroids, but rather what a drug or class of drugs does to the stomach as a side effect, NSAIDs are merely the most common that are sited as being problematic for bypass patients. The issue is that the part of the intestine where where the stomach pouch is connected is not resistant to the stomach acid, so that anastomosis there is quite vulnerable to ulcers, so any med that can cause some stomach distress is generally to be avoided. Some of the osteoporosis drugs are avoided for this reason, too. This presumably applies to the MGB as well, as it uses a similar connection. The duodenum, the part of intestine immediately downstream of the stomach and is resistant to the acid, is bypassed along with the remnant stomach.

These various meds can sometimes be used in limited times under certain circumstances under medical supervision, but it's a risk/reward trade off between doctor and patient. The sleeve based procedures are generally more tolerant as they don't have that marginal ulcer issue, but many docs still restrict them owing to their bypass experience, (and the sleeve is probably less tolerant than a normal person, while being more tolerant than a bypasser.)

Your bypass can be reversed, (that is sometimes one of its "selling points" but it's not commonly done as it's a pretty complex job; not all surgeons will do it. It is usually reserved for times when there is no other option in treating some problem, rather than just buyers remorse. I have seen it done a couple of times in cases of intransigent ulcers, where no other treatment worked. It can also be revised to a duodenal switch, but that's even more complex than a reversal (they have to reverse it first, then sleeve it, and redo the intestinal rerouting. It is usually done when weight loss was inadequate or with excessive regain, or for other RNY complications such as the intransigent ulcers or bile reflux.

You weren't offered the MGB as it doesn't fit the "standard of care" for WLS in the US - insurance doesn't normally cover it and the ASMBS hasn't approved it, though it has been further developed and used more commonly elsewhere. The next procedure that's likely to gain approval here is the SIPS/SADI/Loop DS

If you don't mind me asking , in your 10 years with the sleeve have you ever had a stomach ulcer ? and if you did have an ulcer at some point.

1, they can heal themselves.

2. there is medication someone can take to heal the ulcer.

3. dying from sepsis is the worst case scenario which is extremely rare according to my doctor and dietitian ?!! thanks so much

Edited March 19, 2021 by Bigross88

[RickM 1,747]

No, haven't had any ulcers from it (and neither has my wife who is pushing 16 years out on her DS - sleeve plus intestinal rerouting - and she is an occasional NSAID user.)

I believe that ulcers can heal themselves given time and gentle diet, but they are usually helped along with medication, usually a PPI such as omeprazole and a coating med such as Carafate or Sucralfate, which are sorta industrial strength Pepto Bismol that coats the inside of the stomach between meals to protect it.