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Always Sweating, Difficulty Sleeping. What To Do?
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Thanks for your concerns. The first thing that needs to be ruled out are secondary causes of excessive sweating, such as hyperthyroidism, diabetes. chronic neurologic conditions, chronic infections like tuberculosis or hematologic problems including lymphoma. After these and perhaps others are ruled out by further history, physical examination and basic investigations, then we may have a diagnosis of exclusion called primary hyperhydrosis, a condition in which sweat glands overact in the absence of a heat stimulus. It has been associated with an excessive function of the small nerves that guide the function of the glands. If this is the condition, there are several medications that can be tried as a first line agent for such patients, such as oxibutinin, benztropine and glycopirrolate. Some patients do respond. In others, especially those devastated by excessive generalized sweating and social lifestyle interference, some surgical procedures can be considered, the most common and effect an thoracic ganglion sympathectomy.
Hope that helps as a guideline, I would probably see a neurologist as a first start.
Yours truly,
Dr Brenes-Salazar MD
Mayo Clinic MN
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