Question:
Tuberculosis Medication- Harmful to WLS Recipients?

I got a positive reaction to my TB test in November, had a chest x-ray in December (which was negative)... still I carry this little germ around (no, I have NO IDEA where it came from) anyhow- The Doctor is putting me on Isoniazid for 6 mos/ as well as Pyridoxine (a fancy term for a B6 supplement). Concerns for the TB meds is it affecting my liver (You can be succeptable to Hepatitis while on this drug)- and the B6 is to be used in conjunction with the Isoniazid- but I have my concerns for my liver and our malabsorption issues. Anyone out there dealt with this? Any suggestions? My surgeon moved to So-Cal....    — Karen R. (posted on July 1, 2003)

July 2, 2003
Anyone? Anyone have any ideas at least on my absorbtion of the B6?
   — Karen R.

July 3, 2003
Sorry I have to keep bumping this up; but 10,000 members and I am the only "Typhoid Mary"?! I feel soooooooooo dirty!
   — Karen R.

July 3, 2003
I don't have TB (don't know anyone who does - at least, anyone who KNOWS they have it), but I have worked in the medical profession, and TB is making a resurgence. You are probably not so alone as you feel. As far as your absorbtion question - sorry, I don't have any answers there... could you call your surgeon, even if he's moved, and ask him?
   — johanniter

July 3, 2003
Whether you have had WLS or not, every drug carries a risk. you have to balance the risk vs. benefits. talk to a bariatric surgeon even if not your own, and perhaps an infectious diseases Dr. As for my self an RN and WLS person, I would definately take the medication after taking mre tests to determine that I am in fact really positive. I just had my tb test and on the form from the hospital it said for those with malabsorption syndromes, or recent gastrectomy (I know not exactly what I had but a little similar) a positive test was an induration (bump) > 5 mm in size at the site of the test.
   — **willow**

July 3, 2003
I am working with an Infectious Disease Doctor, and my test was positive. I guess I will try and get ahold of the GI unit at UCDMC and see if another Doc can help me out.
   — Karen R.

July 3, 2003
I don't have the answer to your question, but wanted to reassure you that the rate of positive TB tests is much higher than you'd think, especially among health care workers and those who've been frequently hospitalized. My partner is a nurse and gets tested at least annually...she's surprised each time it comes back negative because a postitive result is so common. If you are positive for it, by the way, you can't take some meds (such as Remicade, I believe) unless you have been treated for the TB, so take the Isoniazid if you can. And don't feel alone! You're not! Cheers- Lisa
   — gamboge

July 7, 2003
I wanted to post this reponse to my question (I got from a response to me from member at OSSG Gradutes- in case any one stumbles across my original question in the database, if they should encounter TB such as I have!) Karen- "In my research it said that any one having had gastric bypass surgery for rapid weight loss with a positive TB test has a higher risk of developing active TB. Can you believe it? I had never even seen the phrase "gastric bypass surgery" except when researching wls. <LOL> My research also said that gastric bypass patients were at a higher risk to have stomach problems with taking Isoniazid. You're also in the catch-22 position - if you start the antibiotic & you find you cannot tolerate it, if you do develop active TB- you may not respond to treatment because your form of TB can mutate once you start taking the drug & not complete it. Also, by taking the drug there is no guarantee that you won't develop active TB. Okay, that's all the confusing news. I was frightened when this happened to me. There seemed to be no good news. My doc recommended I give it a try. He felt strongly that it was worth the risk. I did. I took it for 9 months (just stopped this past May). I had no stomach problems and my liver was checked regularly & it is fine. Also, if you take the drug, you should avoid alcohol & fish (something to do with the liver). I hope this helps. There are no definitive answers. I wound up taking the risk. I decided I wasn't going to let myself stress out over it. Yeah, every time I got a cold I worried a little and every movement in my tummy was paid close attention to. I know each of us responds so differently, but know this, you are not alone." I left off her name, for privacy reasons.
   — Karen R.