Treatment for FIBROMYALGIA besides CYMBALTA, AMITRYPTILINE.

Resolved question:
41 year old Female (1.6 meters 56 kilos) Generally healthy—no colds/flus or fevers for several years. My glands do not appear swollen. I was examined by an infections disease specialist in August. I do not smoke.

In 2008, after the birth of my third child (3 C-sections), I started to have pain in my ankles and wrists. After multiple tests and multiple doctor visits, I was diagnosed with Fibromyalgia.

For about a year, I took Cymbalta. I was very uncomfortable with the “electric shocks” of Cymbalta, so I slowly discontinued use. I was prescribed Amitriptyline and started taking ½ to ¾ of a 25mg pill in late 2010 or early 2011.

In approximately mid-2012, I started to take a full tablet Amitriptyline of 25 mg.

In May of this year, I was feeling really good, and wanted to lower my dosage from a full pill to a half pill. I started to take ¾ of a pill. I would like to note that a series of semi-stressful events took place. It is hard to say if it was the lowered dosage of Amitriptyline or the stressful events--one of which was our family dog was diagnosed with lymphoma and began chemotherapy; however, I became very tired. During the summer I resumed taking a full 25mg of Amitriptyline. I rested as much as possible. I started to have pain in my upper arm bones (both arms equally) and my upper leg bones (both legs equally). Also, I had pain in the back of my legs and under my buttocks.

After resting during summer vacation and having continued tiredness and upper arm bone pain (and thigh bone pain), I decided to try going to a infectious disease specialists to see if my fibromyalgia symptoms were caused by a latent virus or bacteria. I am attaching the blood work dated 14th of August (indicated as: Fecha).

I was prescribed three weeks of Doxycycline (100 mg every 12 hours) and Iron with Folic Acid supplements (100 mg/800 mcg). I also took B-complex vitamins (B1-100mg / B6-5mg/ B12-50mcg). I took all three pills together in the morning with breakfast.

Doxycycline was prescribed for a possible rickettsiosis as indicated by the Proteus 0X19 Positivo 1:160 in “Reacciones Febriles.”

I am attaching my follow-up blood work results—dated 18th of September (indicated as: Fecha)-- after the antibiotics and vitamin supplement treatment of approximately three weeks.

I eat rather well. I avoid junk food and sodas (diet or otherwise). I drink lots of water. I do not eat a large amount of meat. However, I do eat dairy and eggs. My only vices are a cup of coffee with milk in the morning and about four evenings per week I have a beer. I try to sleep at least eight hours/night.

Besides the family dog, we have two cats. I have had cats in my house all my life.

Other symptoms:

I have been rather anxious lately with a marked anxiety about driving in traffic.

• In about 2012 I had a cone biopsy for abnormal cervical cell changes –returned normal.

• Many ovarian cysts

• Dark brown discharge after menstruation

• Slight anal fissure

• Recent increased pain in wrists and shoulders

• Doctors always tell me my colon is irritated; however, the only digestive symptom I have is gas. (no diarrhea, constipation, pain, cramping, etc.)

• I had a blood transfusion in 2001 after the birth of my second child. Placenta-previa caused a lot of lost blood. I am AB- blood type.

• I don’t know for sure the blood type of my children; but I am almost positive I was giving the Rho-gam shot after all three. I can’t remember for sure.

• I have had a slight change in vision. My vision has never been very good; but I have definitely noticed that my vision is blurrier than normal.

My only current medication is 25mgs of Amitriptyline, Iron with Folic Acid, B-complex, and an occasional Tylenol or Tylenol PM.

Submitted: 4 Days
Category: Hematologist

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I went though your reports. They are in spanish, but I could decipher it to my possible extent.
I dont think there is anything severe to bother about. I would recommend not to have a course of empiric antibiotics further without any evidence of infection. However, there is always a possibility of unidentified zoonotic disease (in view of the pets that you have). They may or may not be a reason. I am not sure about it either.
If the physician could find no other obvious reason for your problem, can we work on probably eliminating the unidentified cause ??
I would suggest you to plan some weeks / months off the pet animals if possible and see if your symptoms become better.
Please let me know if you have any additional concerns. Please attach if you have done any scans or imaging.
Regards.

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