AboutJacqueline Jacques, ND Expertise My expertise is in nutrition and weight loss surgery. I can answer questions related to nutritional care, vitamins, deficiencies, diagnosis, treatment and management. I can answer nutrition questions related to any procedure: gastric bypass (RNY), duodenal switch, lap-band, etc
Experience I have spent seven years working almost exclusinvely in the area of weight loss surgery and nutrition.
Publications Bariatric Times, Beyond Change Obesity, WLS Lifestyles, Nutrition and the MD, OH Magazine
Awards and Honors Health Professional of the Year 2004 - Bariatric Support Centers International
Question I had bypass surgery 7 years ago and have been diagnosed with both osteoarthritis and rheumatoid arthritis which are advancing rapidly. Is there a correlation between the surgery and autoimmune problems? Is is safe to be taking NSAIDS, plaquenil and methotrexate or can such a combination accelerate malabsorption? Are there any rheumatologists in the New York/New Jersey metropolitan area who treat gastric bypass patients?
Answer Judi,
As I am an nutrition expert, I am really not the best person to answer this question. I do not know of any research linking weight loss surgery to autoimmune disorders, but I do know that several of the drugs you mention here can have serious side effects both nutritionally and otherwise. Typically NSAIDS are contraindicated after a gastric bypass. I would suggest that you start with a consult with your surgeon. I would also ask him/her for an referral to a rheumatologist - as many WLS patients have arthritis, it would be likely that they already have someone they work with.
Nutritionally for these drugs, I would be most concerned about iron, folic acid and vitamin C. You are most likely already taking these on a daily basis, but with methotrexate you may need as much as 5mg folic acid to prevent deficiency. This requires a prescription, and would usually be provided by the rheumatologist.
