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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Green Willow on June 24, 2009, at 22:00:17
I got a prescription for Low dose naltrexone (3mg) to treat RA and things started out with great results for the first 2 weeks. Then, at 2 wks., I began experiencing a racing, pounding heart which would begin about 30 minutes after I took the ldn. It would go on all night, and scare me to death. The pounding would be so severe, that the next morning my chest would just hurt. In the morning I would also feel like I had serotonin reuptake with the feeling that my head was flying off. The doctor told me to lower the dose to 1.5 mg. but the problem continued.
The change that I think may have caused this is that my pdoc had increased my Cymbalta from 60 mg. to 90 mg. a few days before the heart started racing. I was not able to tolerate the 90 mg. so I am alternating 60 mg. one morning and 90 mg. the next.
The first doctor told me to go off the ldn until I figure out why this makes my heart pound. (I get the same heart thingy when I take melatonin.) I have asked all over the place and posted on the ldn boards but no one has any ideas why. I personally think there has to be either a serotonin or norepinephrine thing going one here or maybe the combination is raising my blood pressure alot. I really want to resume the ldn but don't want to take any chances with my heart. In the meantime I am reducing my Cymbalta back to 60 all the time and after a few days maybe I'll try 1.5 mg. ldn again.
There are alot of smart people on this board and I am hoping someone has some ideas. I will be starting with a new pdoc in a few weeks and would like to be heads-up with ideas.
Posted by Phillipa on June 24, 2009, at 23:23:05
In reply to Low dose naltrexone and Cymbalta, posted by Green Willow on June 24, 2009, at 22:00:17
Well I'm not one of the smart ones what is Idn? Thanks Phillipa
Posted by Phillipa on June 24, 2009, at 23:28:14
In reply to Re: Low dose naltrexone and Cymbalta » Green Willow, posted by Phillipa on June 24, 2009, at 23:23:05
OOPS!!!! Low dose naltexone. So for Reumatoid arthritis. Is the dose too high? Love Phillipa
Posted by Green Willow on June 25, 2009, at 20:35:46
In reply to Re: Low dose naltrexone and Cymbalta, posted by Phillipa on June 24, 2009, at 23:28:14
> OOPS!!!! Low dose naltexone. So for Reumatoid arthritis. Is the dose too high? Love Phillipa
Nope, not too high. 1.5 mg. is the absolute lowest dose with any efficacy. GW
Posted by sukarno on June 26, 2009, at 12:54:32
In reply to Low dose naltrexone and Cymbalta, posted by Green Willow on June 24, 2009, at 22:00:17
I can think of a few things here as to what is going on.
It could be the Cymbalta. That's the most logical explanation.
LDN is known - in some rare cases - to aggravate thyroid problems. Some thyroid problems are due to an autoimmune response and LDN boosts the immune system, so that is the suspected mechanism of action there.
Get your thyroid checked and cut back on Cymbalta if you can.
Good luck! :-)
Posted by Green Willow on June 29, 2009, at 20:38:55
In reply to Re: Low dose naltrexone and Cymbalta, posted by sukarno on June 26, 2009, at 12:54:32
> I can think of a few things here as to what is going on.
>
> It could be the Cymbalta. That's the most logical explanation.
>
> LDN is known - in some rare cases - to aggravate thyroid problems. Some thyroid problems are due to an autoimmune response and LDN boosts the immune system, so that is the suspected mechanism of action there.
>
> Get your thyroid checked and cut back on Cymbalta if you can.
>
> Good luck! :-)Fortunately I did have good luck! I was able to go back to 60 mg. of Cymbalta and the pounding heart problem went away when I tried ldn again. I also made another change; I had been taking Singulair at the same time I was taking the ldn and now I have discontinued Singulair totally. I am not certain if the problem was the Cymbalta or Singulair, but the problem did resolve and I have been able to resume the ldn. Yes, I did have my thyroid checked and it was normal.
Posted by tea on December 28, 2009, at 15:36:09
In reply to Re: Low dose naltrexone and Cymbalta » sukarno, posted by Green Willow on June 29, 2009, at 20:38:55
>
> Fortunately I did have good luck! I was able to go back to 60 mg. of Cymbalta and the pounding heart problem went away when I tried ldn again. I also made another change; I had been taking Singulair at the same time I was taking the ldn and now I have discontinued Singulair totally. I am not certain if the problem was the Cymbalta or Singulair, but the problem did resolve and I have been able to resume the ldn. Yes, I did have my thyroid checked and it was normal.
>
>
>
I had that racing heart for a few weeks and I stopped everything- ldn and thyroid meds in the end until it stopped, went on all night and I couldnt sleep. took a few weeks to stop- no idea! I cannot even recall if I was taking ldn at the time it started. Sorry.
I am trying ldn again now, again low dose about your 1.5mg mark. How are you going now?
Posted by Green Willow on December 28, 2009, at 21:29:45
In reply to Re: Low dose naltrexone and Cymbalta » Green Willow, posted by tea on December 28, 2009, at 15:36:09
> >
> >
> I had that racing heart for a few weeks and I stopped everything- ldn and thyroid meds in the end until it stopped, went on all night and I couldnt sleep. took a few weeks to stop- no idea! I cannot even recall if I was taking ldn at the time it started. Sorry.
> I am trying ldn again now, again low dose about your 1.5mg mark. How are you going now?
>
>Presently I am on 3 mg. of ldn and 45 mg. of Cymbalta (I have to dump out half a capsule to do that) and have stayed off the Singular and the pounding heart has stopped. I have noticed that if I have a small amount of alcohol it starts up again. I ended up slowly working up on the ldn and slowly going down on the Cymbalta to get to this dose. Everything seems to work at this dose. Good luck with yours! Green Willow
Posted by tea on December 29, 2009, at 2:14:45
In reply to Re: Low dose naltrexone and Cymbalta » tea, posted by Green Willow on December 28, 2009, at 21:29:45
> > >
> > >
> > I had that racing heart for a few weeks and I stopped everything- ldn and thyroid meds in the end until it stopped, went on all night and I couldnt sleep. took a few weeks to stop- no idea! I cannot even recall if I was taking ldn at the time it started. Sorry.
> > I am trying ldn again now, again low dose about your 1.5mg mark. How are you going now?
> >
> >
>
> Presently I am on 3 mg. of ldn and 45 mg. of Cymbalta (I have to dump out half a capsule to do that) and have stayed off the Singular and the pounding heart has stopped. I have noticed that if I have a small amount of alcohol it starts up again. I ended up slowly working up on the ldn and slowly going down on the Cymbalta to get to this dose. Everything seems to work at this dose. Good luck with yours! Green WillowTHanks for the tip on alcohol. I think I may have been having some alcohol at night at the time of the racing heartbeats.. probably a combo I'd better watch out for. Either that or suddenly my almost non existent thyroid gland(on scan has shrunk to near nothing) decided to kick in out of control:-) My TSH already had risen which it never had before.. which is good as it finally proved I was hypothryoid to the medical profession, LOL., giving me an official no disputable diagnosis..beforehand it was merely a few endos call, low free levels, and the antibodies in blood tests and the scans showing damage. TSH rules with GPs apparently:)
I've given up on docs in general, especially after my accident and the offputting treatment by insurance type docs!
I just asked(via a friend) a leading cardiac researcher who also lectures med students on heart stuff about the racing heart..and he said it wasnt known why it occurred but he'd had it as well sometimes(presumably not for weeks though), and he had no idea why either! That was good enough for me. Also from web searches everyone was saying that no docs could determine why they had these racing beats either.. so save my money and probably get the answer from Green Willow:) Thanks, I'll watch out for the alcohol combo in future. I'll try to read back if I wrote anything about whether I was on ldn then or not. bet I was though.
Posted by Phillipa on December 29, 2009, at 19:35:34
In reply to Re: Low dose naltrexone and Cymbalta, posted by tea on December 29, 2009, at 2:14:45
A really good doc or endo when the patient is finally diagnosed with thyroid problems is supposed to treat the symptoms and not the numbers. Ugg I get so mad sometimes as even here it's only the number they care about. Some feel better on the new standard for TSH 1-2 But others feels better at other numbers higher or lower. I remember when first had the hasimotos TSH went to 22 but wierdly my anxiety was out of sight. Supposed to be tired at that level??? The endocrine system feedback loop is so complicated. Phillipa
Posted by Green Willow on December 29, 2009, at 20:12:46
In reply to Re: Low dose naltrexone and Cymbalta, posted by tea on December 29, 2009, at 2:14:45
Good luck, Tea ~ sorry, I don't know anything about thyroid.
Posted by tea on December 30, 2009, at 2:53:46
In reply to Re: Low dose naltrexone and Cymbalta, posted by Green Willow on December 29, 2009, at 20:12:46
> Good luck, Tea ~ Thanks, u2
>sorry, I don't know anything about thyroid.
That's fine, I do ;) (unless something new is discovered, I don't want to know any more), and I "believe" ldn is a better place to start even IF someone had a slight thyroid problem
Posted by tea on December 30, 2009, at 3:10:25
In reply to Re: Low dose naltrexone and Cymbalta, posted by Green Willow on December 29, 2009, at 20:12:46
> Good luck, Tea ~ Thanks, u2
>sorry, I don't know anything about thyroid.
That's fine, I do ;) (unless something new is discovered, I don't want to know any more), and I "believe" ldn is a better place to start even IF someone had a slight thyroid problem
Reason I said IF is sometimes there may be an overlap, but obviously not always, and most probably not even in the majority of cases.
http://www.elaine-moore.com/MyBlog/Blog/tabid/60/EntryId/153/Default.aspxhttp://eyesee.typepad.com/hyperthyroid_graves_eye/2008/04/the-effects-of.html
Posted by Phillipa on December 30, 2009, at 19:43:15
In reply to Re: Low dose naltrexone and Cymbalta » Green Willow, posted by tea on December 30, 2009, at 3:10:25
So you have hyperthyroidism? Phillipa
Posted by tea on December 30, 2009, at 21:02:10
In reply to Re: Low dose naltrexone and Cymbalta » tea, posted by Phillipa on December 30, 2009, at 19:43:15
> So you have hyperthyroidism? Phillipa
Nope hypothryoid(hashimoto probably, definite TPO and TG antibodies, almost no thyroid gland left on ultrasound and mention of the diseased thyroiditis appearing state on ultrasound I think form memory?).. but TSh stayed in normal range until 2009? Been on thyroid meds since 2001:)
http://www.dr-bob.org/babble/alter/20050612/msgs/520256.html
my aunt was similar and her heart didn't bother her until she was over 60. They fitted a pacemaker but it never got her heartbeat down below 185.. you could see it thumping! beats me. She died shortly afterwards from staph picked up in hospital.. getting the idea of why I avoid hospitals? LOL (aunt also hypothryoid , but on T4 only at 100mg, hence I opted for Armour and T4 as T3 works on the heart andf the T3 did seem to stabilise my irregular heart beats, except when exercising and now maybe on ldn, perhaps with alcohol.. will have to watch out and note what on if happens again?)
Posted by Phillipa on December 30, 2009, at 21:44:17
In reply to Re: Low dose naltrexone and Cymbalta, posted by tea on December 30, 2009, at 21:02:10
I'm 63 also hasimotos thyroiditis but take synthroid. Finally level of both TSH and Free T4 new normal ranges but don't feel better mood horrible. But heart is fine? Are you older also? Love Phillipa
Posted by Jon Y on December 31, 2009, at 16:55:01
In reply to Re: Low dose naltrexone and Cymbalta, posted by tea on December 29, 2009, at 2:14:45
Hi Tea,
Read your post and sympathize. I have a thyroid imbalance too. I was also sick of GPs and tried an NP (Naturophathic Doctor), which is the same as a GP, except they actually listen to your story and sit to work with you to figure out what the heck is causing your problem. My NP diagnosed me like a regular doctor (ran lab tests, etc) but instead of only prescibing meds when the results came back, she made changes in my diet, prescribed herbs/tinctures/vitamins that support my body and condition and, of course, she did prescribe some meds - low dose naltrexone. My symptoms are almost all gone after a few weeks and my thyroid no longer aches like it did. In addition this NP seem far less expensive than my former GPs and I finally feel like I have someone actually helping me heal. I live in Oregon where I think there are more NPs due the fact there's a college in Portland. As you can tell, I am impressed. IMHO I think NPs are the future of medicine. To me it's just the right fusion of eastern and western medical diagnostic methods and treatments. Hope you find a good doc like I did. Best, -J> > >
> > > >
> > > I had that racing heart for a few weeks and I stopped everything- ldn and thyroid meds in the end until it stopped, went on all night and I couldnt sleep. took a few weeks to stop- no idea! I cannot even recall if I was taking ldn at the time it started. Sorry.
> > > I am trying ldn again now, again low dose about your 1.5mg mark. How are you going now?
> > >
> > >
> >
> > Presently I am on 3 mg. of ldn and 45 mg. of Cymbalta (I have to dump out half a capsule to do that) and have stayed off the Singular and the pounding heart has stopped. I have noticed that if I have a small amount of alcohol it starts up again. I ended up slowly working up on the ldn and slowly going down on the Cymbalta to get to this dose. Everything seems to work at this dose. Good luck with yours! Green Willow
>
> THanks for the tip on alcohol. I think I may have been having some alcohol at night at the time of the racing heartbeats.. probably a combo I'd better watch out for. Either that or suddenly my almost non existent thyroid gland(on scan has shrunk to near nothing) decided to kick in out of control:-) My TSH already had risen which it never had before.. which is good as it finally proved I was hypothryoid to the medical profession, LOL., giving me an official no disputable diagnosis..beforehand it was merely a few endos call, low free levels, and the antibodies in blood tests and the scans showing damage. TSH rules with GPs apparently:)
> I've given up on docs in general, especially after my accident and the offputting treatment by insurance type docs!
> I just asked(via a friend) a leading cardiac researcher who also lectures med students on heart stuff about the racing heart..and he said it wasnt known why it occurred but he'd had it as well sometimes(presumably not for weeks though), and he had no idea why either! That was good enough for me. Also from web searches everyone was saying that no docs could determine why they had these racing beats either.. so save my money and probably get the answer from Green Willow:) Thanks, I'll watch out for the alcohol combo in future. I'll try to read back if I wrote anything about whether I was on ldn then or not. bet I was though.
>
>
Posted by tea on January 1, 2010, at 3:27:09
In reply to Re: Low dose naltrexone and Cymbalta » tea, posted by Jon Y on December 31, 2009, at 16:55:01
Thanks Jon. That is really encouraging to hear that what I suspected should work for early or at least not almost destroyed thyroid conditions actually DOES work. I'm so pleaswd to hear it:) My problem is in Australia NP's do not exist and none are trained or recognised. there are naturopaths but not recognised as docs, no insurance, no medicare and can't prescribe meds... We are sooo far behind!
Again, It was really great to hear how you went.
Kind regards, tea
This is the end of the thread.
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