Birth Control and Meds Question

This may be a dumb question, but as a RNY'r we malabsorb alot of what we eat, this includes meds.  I know we have to take a large amount of vitamins because we "waste" most of them....so how does birth control work?  Do we absorb the whole pill?  Or malabsorb some?  This goes with other meds, Tylenol etc.

Inquiring minds!

Amanda

You must take 2 forms of birth control to guarantee that you won't become pregnant due to the malabsorbtion.  You also can't use time released pills, as they go through your digestive tract and dont' get absorbed properly and you dont' the entire benefit of the medication

I'm worried about the same thing.  I just recently switched to the Nuvaring.  It's pricy, but at least it's working lol

Amanda -

This is not a dumb question at all.  Yes, we can malabsorb some types of medications.  There are a few that actually have greater absorption simply because they hit the intestine faster than normal... but that's not the case with birth control - we'd malabsorb some degree of the birth control meds taken orally.  Nobody knows exactly how much.  Here's an article that might help explain more about how medications are absorbed (or not) after RNY.
http://pamtremble.blogspot.com/2008/04/article-every-wls-patient-should-read.html

Also, just for clarification.... the vitamins we take in pill form are not "wasted".  In fact, you can count on all the supplements we take to be absorb similar to a person without RNY.  The reason we take such large amounts of supplements is because we no longer full absorb vitamins/minerals from food so we have to replace those missing nutrients with supplements.  The vitamins in food have to be separated from the food molecules before the body can use them.  And the intestines have "assigned" spots that do that extraction and absorption for each vitamin or mineral.  Here's a diagram that shows those spots. So if food doesn't pass those assigned spots, the body can't pull the vitamins from the food... so the food just floats on by keeping all it's nutrients without giving us what we need. But the nutrients in supplements are already separated from the food and in a form the body is ready to use immediately and doesn't need a specific spot for absorption.   For instance Calcium has two absorption spots - one in the duodenum and one in the jejunum - both those spots are now gone so we can't count any of the calcium we get from milk or cheese in our daily requirements. But the calcium we take in pill form is going to be absorb as if we were a normal person. 

HTH
Pam

To add to this question, I have PCOS so I take the pill to help this condition (as well as for birth control purposes).

Does the lack of absorption render the pill ineffective to the PCOS?

I haven't gone through the surgery yet (haven't technically started the process yet) and I know that PCOS doesn't get better for everyone after they've had the surgery... I just wouldn't know what to do if the pill stopped helping my PCOS...

8 months after RNY and having horrible, long-lasting, very heavy periods, I finally gave up and went to the OB/GYN.  He brought up the idea of malabsorption of the birth control pills, though he didn't know for sure if that was happening.  So, we decided to try the NuvaRing.  I'm on my 2nd month...so far, so good.  Don't have to worry about malabsorption at all.  And while my period was still 6 days long, only 3 days were heavy...and those 3 days weren't the worst heavy as they had been.