Just wondering...I saw significant improvement in my neuropathy symptoms with Elavil 10 mg in AM and 20 mg in PM which I started in August. I started Hydrochlorothiazide 12.5 mg 3 weeks ago for mild hypertension increasing to 25 mg 6 days ago. Two days after increasing the Hydrochlorothiazide to 25 mg, my neuropathy symptoms returned to pre-Elavil levels. My lytes were checked 10 days after starting HCTZ and were fine. Could the exacerbation of my symptoms (increased burning, tingling, shooting pains, numbness) be related to the hydrochlorothiazide? By the way, so far, it hasn't had a significant effect on my BP. It is my understanding that ace-inhibitors should be avoided with neuropathy, but I wasn't sure about Hydrochlorothiazide.

I use an ACE inhibitor with no problem.

HCTZ is a sulfa derivative. If you are allergic to sulfa, you may have a histamine reaction in the skin, which would be like burning/tingling.

HCTZ also lowers B1 and magnesium in addition to potassium.
Often the blood work does not reflect magnesium levels accurately so you cannot depend on that. Very low and very high are reflected more accurately, but the long in between interval is not really accurate.

Thanks, Mrs. D. I have not taken the HCTZ for 2 days now and my symptoms appear to have returned to baseline. Perhaps a histamine response was the cause of my symptoms. I was even having burning of the tops of my ears, which I've never experienced previously, and perhaps might be more consistent with a histamine reaction. I don't have a history of sulfa allergy, but then again I can't recall ever taking any sulfa meds. Now back to the drawing board on dealing with my mild hypertension. Thanks, again.

I think the beta blockers can be more problematic. Some people get a myotonia from them, and the cold extremity thing they cause also is bad for the nerve endings.

Sulfa and also drugs similar like the diuretics and Celebrex also cause photosensitivity reactions when skin is exposed to UV sunlight. I suspect they are difficult for this reason too. They must go into the skin or their metabolites or whatever.
The allergic reactions to sulfa drugs or drugs with that S group on them, affect the skin dramatically, and in some cases destroy nerves. There used to be a 24hr once a day sulfa called Kynex many years ago that caused deafness and severe allergic reactions. It was taken off the market.