Thank you, mrsD. I carefully read all the info you provided. I have never used grapefruit or orange juice more than 2 8oz cups per day and never with dinner while doing the "mayo diet". Since my amitriptyline is taken at bedtime, levels of the juice in my bloodstream is low. My bigger interaction problem is my fentanyl which is in my system 24/7 without a break. The citrus juices have the effect of intensifying the fentanyl. I am already on a high dose and this could be dangerous.

Also, I have been using high carb meal replacement bars (44g) as I usually don't get to eat 3 meals per day and I know I will be exercising when I use one. Turns out this may be the cause of my imflammation. The sketchers have been off for a week now. Since there has been no dramatic change in the swelling of my feet and ankles, that rules that cause out. It's down to my hypothyroid problems or using those hi carb bars.

I went to my rheumy yesterday and asked about Hashimoto's. He said he doesn't deal with that and I would have to see my regular doctor or an endocrinologist. He said to me that he only handles my enbrel. So now I have an appt with my internist for tomorrow.

Yes, I have the epsom salts cream and it temporarily helps me a little bit at best (as long as I stay off my feet).

Thanks to all your wonderful info, I am sufficiently armed to see my internist and get him to do SOMETHING. I will let you know when I find out what is going wrong: my thyroid or my stupidity. Thanks, Cat