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[Mary G]

I just wanted to give the heads up for amiltrytline - Lyncola, we have discussed it before.

My problem was migraine aura and loose bowels.   I have had migraine aura (visual disturbance without headache) and weird tingling sensations for 18 years and more recently, I have been struggling to control it with hormone manipulation so my migraine specialist suggested amiltrytline.  I started on 10mg and have now increased to 30mg and so far, so good, no side effects and I feel much better.

I was reluctant to use ADs (they have had a bad press and as we know, too many menopausal women have been fobbed of with them when they really need HRT) but I now wish I had tried them sooner.   The dose I am taking is too low for anxiety and depression so I'm using it off label as a migraine preventative.  Amiltrytline is often described as an old style AD but it seems to be a real work horse with multiple uses and minimal side effects.

[Peana]

Really interesting to hear your positive experiences of Amitriptyline, something I'll take into consideration for the future. 

I had a good call with the GP this morning, although she was also unsure about whether or not I'd benefit from additional estrogen.  I mentioned that actually this period laid low with covid has given me a chance to slow down and focus on my mental health - I even managed to do a short mindfulness exercise last night.  She suggested that I continue to use this time to try to get back into the habit of CBT / mindfulness as my symptoms have been better this past couple of days.  If I can get back on track with that we'll review my IBS-D and look into trying the fodmap diet.  If I continue to struggle with anxiety we'll initially try increasing estrogen to 75mcg for a month and then review again.

She wasn't worried about my blood results and dehydration, and has put my mind to rest in that respect.  I've done a stool sample in the past year, but if my IBS-D continues to flare she suggested we check that again. 

I'm still a bit in limbo, but I think that trying to find the right course of treatment can take a lot of trial and error, so I need patience.  I also agree with her that if I can kickstart my CBT, that will be very beneficial (I found it great in the past).  I'm feeling a lot more positive than just a week ago, so thanks for your input and listening to me vent!

[Peana]

Just a quick update as I visited the GP today.  She's suggested trying 10 mg amitriptyline as I'm doing everything I can with regards to reducing anxiety via mindfullness, CBT, Tapping, exercise, etc., but my IBS-D is still problematic.  I'll try it later, but as she said it can be drying I'm also going to start on vagifem.  I hate starting 2 things at the same time in case I have side effects and don't know what product is the cause, but I think I'll need to in this case.  Fingers crossed, and thanks for all your help in the past.  I actually felt like I'd done all the right research this time and it was a good appointment.

[Amazing grace]

Good luck peana, I really hope it works for you, nice to see an update too, it's so helpful to others looking for answers when ladies update, take care xx

[Mary G]

Peana, good luck, I hope it works out for you.

10mg is a very low dose and unlikely to cause any drying out of tissues.   I'm on a higher dose than that (50mg) and have no side effects at all. I think you would have to take a significantly higher dose to have side effects.

[Peana]

Thanks, I have suffered with dry eyes, nose, and mouth in the past (although blood results not bad enough to be diagnosed with sjogrens) ,  but hopefully I'll be fine. Thanks for the reassurance.

[Peana]

Just a quick update everyone.

The 10mg amitriptyline helped a little but, although allieviated, my IBS-D was still bad.  Another phone consultation with a different GP led to me increasing my dose to 20 mg and the IBS was so much better - I managed to add beans and pulses back into my diet every other day, and increase my veg intake.  However, at 20 the dryness did start to bother me.  I saw another locum GP a couple of weeks ago as my hot sweats were also back and I was still experiencing occassional light spotting (after 9 months on mirena coil).  He checked with another GP, and as I've only recently had a smear we're going to monitor the spotting and possibly increase progesterone, but in the meantime I've increase to 75mcg estra (which has been great).  He prescribed me some eyedrops, but also suggested that as my IBS had generally calmed down I try skipping the amitriptyline to see if it helped relieve my dry eyes and skin.  I've not taken any since Monday, but now I'm struggling with sleep - grrr!  I'm exhausted by bedtime but then spend at least a couple of hours doing a succession of tapping exercises, guided sleep meditations, yoga nidra for sleep, etc., and then once I do drop off, I'll wake a few hours later, and then I'll wake up early too.  I hate feeling reliant on medication, but I think I'm going to need to take some tonight as I'm getting so tired during the day now.  Any advice? 

For background, I'm physically active during the day and also use a rebounder for exercise, I take magnesium byglycinate, sea buckthorn oil, omega 3, vit D, B-complex, turmeric, andrographis, and rhodiola rosea.  Rather than turn back to the amitripyline I wondered about trying anti-histamines before bed (I'm allergic to sawdust (which is a total pain) and have been cutting wood this week, so I think I might have answered my own question!  I'll try anti-histamines tonight and see how it goes.

I'd still welcome any other advice 

As an aside, the locum GP I saw was a lovely and understanding older gentleman (from how he introduced himself I think he might even have come out of retirement to help with the winter pressure on the NHS).  He made me smile when I said I'd found the vagifem so beneficial and he replied "yes, it can be very good 'down there'". 

[Lanie66]

Hi Peana, catching up on your thread. 

Don't know if this will be of interest to you but I had a period of extreme anxiety, with possible depression
back in August and was prescribed Sertraline.  It was a combination of triggers then one finally pushed me over the edge.  Took 4 weeks for the meds to work fully but they do certainly work!  I'm now on low dose and feel fine mentally.

This is what i really wanted to tell you, in the time it took for them to kick in I tried Tapping and it really helped.  Google it, nothing to lose.  Hope you're more up than down at the moment.

Lx

[Peana]

Thanks for the advice Lanie66.  I've actually been using the 'Tapping Solution' App since Sept and have found it to be very helpful - in fact I'm thinking of finding a therapist to work with to deal with some of my deep seated issues.  I've also been using 'insight timer' to do a yoga nidra or sleep meditation before bed, which has also helped.

I'm back on 20mg Amitriptyline every evening as almost as soon as I'd weened myself off of it, my IBS symptoms resurfaced!  My anxiety also seemed to get worse too.  I'm a bit nervous about sertraline as my sister uses it and initially she had nausea and an upset stomach for a few weeks which I can't face on top of the IBS!  However, I'm due to have a review at the doctors in the New Year, so I'll see what they say about how I'm managing (or not).  I'm substituting Evorel for Estradot at the moment, so I wonder if that's also having an effect as a few folk on here report that their absorption on Evorel isn't as good.

Although the weather is extremely cold right now, we've also had some beautiful sunny days, so I've been trying to work outside as much as possible and/or go for a walk every day (although it's pretty slippy in some places)!  That really helps me too, although I'm still thawing out from spending all morning outside.