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Old 05-25-2012, 08:06 PM #1
Idiopathic PN Idiopathic PN is offline
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Default Gabapentin, Synthroid and Nortriptyline

As you may have read my previous posts, I am on Gabapentin and Synthroid.

I had my follow-up consultation today with the neurologist who did the skin biopsy. I did not want to expect too much today but you must understand that in my heart, I was hoping that he would say something encouraging or worth pursuing.

Well, it was a let down, he just emphasized the negative result of my skin biopsy and he did not want to pursue any further tests. He said that whether my result was normal or abnormal, I will still hve to treat my symptoms.

He gave me another medicine - Nortriptyline. I know this is an anti-depressant medicine. This is supposed to be taken as complementary to the Gabapentin.

I am so hesitant to take this combination because of adverse side-effects. As it is, Gabapentine alone makes me so drowsy and sleepy. To add Nortriptyline will maybe makes me a zombie .

To add to all this, I have my unstable thyroid function. My last thyroid result was normal after 6 months of being low, but even then, the normal was still "below normal" level. And I read that Nortriptyline may result to exogenous thyroid.

I am stressed because I found out today that the Gabapentin and the Synthroid
I am taking all this time are with Gluten. I have been on gluten-free diet for a month now and yet all this time, I am ingesting gluten!!!

Does anyone have (had) a good experience with the combination of Gabapentin and Nortriptyline? Or is it better to be taken only either one of them. I was given with the lowest dosage for Nortriptyline. Doctor said that if the combination works, we will slowly taper down the Gabapentin.

Will appreciate your inputs.
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Old 05-25-2012, 11:49 PM #2
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Interaction with thyroid is considered a minor type:

http://www.drugs.com/interactions-ch...=1463-0,1734-0

I think it is worth considering, as it may be more useful than
the gabapentin. But that decision is yours and your doctor's.
Used in a low dose, may not be problematic.
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Old 05-26-2012, 05:26 AM #3
Idiopathic PN Idiopathic PN is offline
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Default

Quote:
Originally Posted by mrsD View Post
Interaction with thyroid is considered a minor type:

http://www.drugs.com/interactions-ch...=1463-0,1734-0

I think it is worth considering, as it may be more useful than
the gabapentin. But that decision is yours and your doctor's.
Used in a low dose, may not be problematic.
Thank you Mrs.D.
You mean Nortriptyline may be more useful as a "stand-alone" treatment than being combined with Gabapentin?

It just makes me so concerned about the effect of all the medications that affect the central nervous system.

What could be the long term side effects of Nortriptyline in our body?

Thank you.
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Old 05-26-2012, 07:43 AM #4
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I am only saying that the nortriptyline may be more effective than the gabapentin. (new meta analysis of gabapentin found it only effective in about 30% of cases).

For that reason it is worth trying it. If it works well, you could consider tapering off gabapentin to see which is doing more for you. People all vary in responses to drugs, so one has to try them to see.

More on nortriptyline:
http://en.wikipedia.org/wiki/Nortriptyline

Usually low doses of this drug work for PN.
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Old 05-26-2012, 11:24 AM #5
Idiopathic PN Idiopathic PN is offline
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Quote:
Originally Posted by mrsD View Post
I am only saying that the nortriptyline may be more effective than the gabapentin. (new meta analysis of gabapentin found it only effective in about 30% of cases).

For that reason it is worth trying it. If it works well, you could consider tapering off gabapentin to see which is doing more for you. People all vary in responses to drugs, so one has to try them to see.

More on nortriptyline:
http://en.wikipedia.org/wiki/Nortriptyline

Usually low doses of this drug work for PN.
Thank you so much Mrs.D!

As you know, I am open to every medication available in the market, just to help me with the pain. I just have to get more information from experts like you - and for people who have actually used it.

Thanks for your time.
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Old 05-26-2012, 11:26 AM #6
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When you first start, there may be some sedation. That usually wears off in a week or so. The doctors give it at night for that reason.
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Old 12-16-2013, 08:31 PM #7
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Default gabapentine

am on gabapentine alone. Have been for years. Current dose is 300mg 2 times daily and 600mg at night.TER
Quote:
Originally Posted by Idiopathic PN View Post
As you may have read my previous posts, I am on Gabapentin and Synthroid.

I had my follow-up consultation today with the neurologist who did the skin biopsy. I did not want to expect too much today but you must understand that in my heart, I was hoping that he would say something encouraging or worth pursuing.

Well, it was a let down, he just emphasized the negative result of my skin biopsy and he did not want to pursue any further tests. He said that whether my result was normal or abnormal, I will still hve to treat my symptoms.

He gave me another medicine - Nortriptyline. I know this is an anti-depressant medicine. This is supposed to be taken as complementary to the Gabapentin.

I am so hesitant to take this combination because of adverse side-effects. As it is, Gabapentine alone makes me so drowsy and sleepy. To add Nortriptyline will maybe makes me a zombie .

To add to all this, I have my unstable thyroid function. My last thyroid result was normal after 6 months of being low, but even then, the normal was still "below normal" level. And I read that Nortriptyline may result to exogenous thyroid.

I am stressed because I found out today that the Gabapentin and the Synthroid
I am taking all this time are with Gluten. I have been on gluten-free diet for a month now and yet all this time, I am ingesting gluten!!!

Does anyone have (had) a good experience with the combination of Gabapentin and Nortriptyline? Or is it better to be taken only either one of them. I was given with the lowest dosage for Nortriptyline. Doctor said that if the combination works, we will slowly taper down the Gabapentin.

Will appreciate your inputs.
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Old 01-20-2014, 11:13 AM #8
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Default synthroid

Quote:
Originally Posted by Idiopathic PN View Post
As you may have read my previous posts, I am on Gabapentin and Synthroid.

I had my follow-up consultation today with the neurologist who did the skin biopsy. I did not want to expect too much today but you must understand that in my heart, I was hoping that he would say something encouraging or worth pursuing.

Well, it was a let down, he just emphasized the negative result of my skin biopsy and he did not want to pursue any further tests. He said that whether my result was normal or abnormal, I will still hve to treat my symptoms.

He gave me another medicine - Nortriptyline. I know this is an anti-depressant medicine. This is supposed to be taken as complementary to the Gabapentin.

I am so hesitant to take this combination because of adverse side-effects. As it is, Gabapentine alone makes me so drowsy and sleepy. To add Nortriptyline will maybe makes me a zombie .

To add to all this, I have my unstable thyroid function. My last thyroid result was normal after 6 months of being low, but even then, the normal was still "below normal" level. And I read that Nortriptyline may result to exogenous thyroid.

I am stressed because I found out today that the Gabapentin and the Synthroid
I am taking all this time are with Gluten. I have been on gluten-free diet for a month now and yet all this time, I am ingesting gluten!!!

Does anyone have (had) a good experience with the combination of Gabapentin and Nortriptyline? Or is it better to be taken only either one of them. I was given with the lowest dosage for Nortriptyline. Doctor said that if the combination works, we will slowly taper down the Gabapentin.

Will appreciate your inputs.
Ok, need to know if you are taking the generic form of Synthroid? there is a big difference between the generic and the name brand, cost difference is that great. Generic has more side effects, and does not work as well, or come in as many strengths as the name brand. I'm Hypo Thyroid. And had been under treated for years. SEE an ENDO not your PCP for treatment. Your Thyroid is the master gland in your body and controls all other glands.

Had to get off mine for 2 weeks for a ENT test, and the joint and muscle pain was out the roof in 2 days.

As to the Gabapentin or lyrica about the same drug, I react badly to them. Could be some genetic to as my elder son has the same reactions for his PN.
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Old 01-20-2014, 12:28 PM #9
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Originally Posted by Libby100 View Post
Ok, need to know if you are taking the generic form of Synthroid? there is a big difference between the generic and the name brand, cost difference is that great. Generic has more side effects, and does not work as well, or come in as many strengths as the name brand. I'm Hypo Thyroid. And had been under treated for years. SEE an ENDO not your PCP for treatment. Your Thyroid is the master gland in your body and controls all other glands.

Had to get off mine for 2 weeks for a ENT test, and the joint and muscle pain was out the roof in 2 days.

As to the Gabapentin or lyrica about the same drug, I react badly to them. Could be some genetic to as my elder son has the same reactions for his PN.


There most definitely is a difference between the generic and the brand name Synthroid.

My endocrinologist originally had me on the generic. He has me get a blood test every 4 to 5 months for throid. Eventually, he said I needed to get my medication for my throid increased. I informed the doctor I had read that the generic for Synthroid should never be used. There is quite a difference.

I asked my doctor to write a new scrip using Brand Name Only....Synthroid, which he did and asked him Not to increase the prescription; but to see if using Synthroid instead of generic made a difference.

After three months, the doctor had me get more blood work. Using the Synthroid.....I Did Not Need to Increase my prescription. Since using Synthroid and not generic, I have been on the same prescription without an increase for the past couple of years.



Gerry
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Old 01-21-2014, 07:22 AM #10
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Default Not that the thyroid--

--doesn't have widespread control over metabolic rates and organ efficiency, but the pituitary is generally referred to as the master gland, in that it's hormonal signals control the thyroid and other glands.
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