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Suggest Treatment For Palpitations, Joints Pain And Depression
Question: My wife(55) has addison's disease since April. Taking cortef 20 mg, florinef 0.10mg and eltroxin 75mg. The problem is they raise the heart beat so high 140-150 beat per minute that she has to take bisoprolol to reduce the beating. Now the bisoprolol is giving her excruciating muscle and joints pains and depression. Any idea what might help ?
Brief Answer:
The dose of Eltroxin needs to be reduced
Detailed Answer:
Dear Sir, Hi & Welcome.
Thanks for posting your query on Healthcare magic.
I appreciate your concern for your beloved wife.
I have gone through your query.
In addition to Addison's disease she also seems to be having hypothyroidism (underactive thyroid) for which she is being prescribed Eltroxin.
In my opinion the increased heart beat appears to be due to inappropriate dose of Eltroxin. So, accordingly the dose of Eltroxin needs to be adjusted as per the thyroid function tests.
Hope this will help in reducing the heart rate and may be discontinuing Bisoprolol.
Best wishes.
The dose of Eltroxin needs to be reduced
Detailed Answer:
Dear Sir, Hi & Welcome.
Thanks for posting your query on Healthcare magic.
I appreciate your concern for your beloved wife.
I have gone through your query.
In addition to Addison's disease she also seems to be having hypothyroidism (underactive thyroid) for which she is being prescribed Eltroxin.
In my opinion the increased heart beat appears to be due to inappropriate dose of Eltroxin. So, accordingly the dose of Eltroxin needs to be adjusted as per the thyroid function tests.
Hope this will help in reducing the heart rate and may be discontinuing Bisoprolol.
Best wishes.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for your answer. In march when she was in the hospital for 3 weeks she was not on eltroxin. The first day they gave her cortef and florinef the heart pounding started. They did not give her a beta bloker at the time and sent her home with those pills. She couldn't get up at all for 2 weeks. She was in pain and just going to the washroom felt like she ran a marathon. A neighbor of us who is a retired cardiologist suggested bisoprolol.
It worked for a few months but now the muscles pain are awful. The beta blocker seems to be going everywhere in the body including the brain. As for the eltroxin dose it is according to the tests done 2 weeks ago. The worst pill is pribably the florinef for heart palpitatuons.
A few months ago we tried removing slowly the florinef at home as a test over a week weening and the heart palpitations stopped. What a relief! But 2 days later she ended up in hospital again with hyponitremia. Florinef had to come back with bisoprolol. This is an absolute horror story. The pills saved her life in march but now she is not living. In bed until noon in pain and the rest of day in a chair in pain.
I guess the only solution is pain killers. But mixing that with this pill cocktail is scary.
We don't know what to do anymore.
It worked for a few months but now the muscles pain are awful. The beta blocker seems to be going everywhere in the body including the brain. As for the eltroxin dose it is according to the tests done 2 weeks ago. The worst pill is pribably the florinef for heart palpitatuons.
A few months ago we tried removing slowly the florinef at home as a test over a week weening and the heart palpitations stopped. What a relief! But 2 days later she ended up in hospital again with hyponitremia. Florinef had to come back with bisoprolol. This is an absolute horror story. The pills saved her life in march but now she is not living. In bed until noon in pain and the rest of day in a chair in pain.
I guess the only solution is pain killers. But mixing that with this pill cocktail is scary.
We don't know what to do anymore.
Brief Answer:
Steroid induced myopathy.
Detailed Answer:
Dear Sir, Hi & Welcome back.
Thanks for the elaborative reply which I have gone through diligently.
She seems to have developed side effects due to the steroids which are referred to as "Steroid myopathy".
An excess of or exogenous corticosteroids is believed to cause this condition.
The main treatment for steroid myopathy consists of a decrease in the dose of steroid to below a threshold level and/or an alternate-day dosing could also be considered. Instead of Florinef an alternative safe but effective medication can be used. Such treatment should be undertaken with good judgement or sense.
In addition to above, she must undergo physiotherapy with range-of-motion exercises (either passive, active-assisted, or active, depending on the degree of weakness) and stretching exercises should be performed to prevent joint contractures. As a general rule, resistance exercises should be limited to muscles with greater than antigravity strength. Bed mobility, balance activities, transfer training, and gait training should be included to address decreased mobility.
Hope these suggestions could be beneficial to her.
Best regards.
Steroid induced myopathy.
Detailed Answer:
Dear Sir, Hi & Welcome back.
Thanks for the elaborative reply which I have gone through diligently.
She seems to have developed side effects due to the steroids which are referred to as "Steroid myopathy".
An excess of or exogenous corticosteroids is believed to cause this condition.
The main treatment for steroid myopathy consists of a decrease in the dose of steroid to below a threshold level and/or an alternate-day dosing could also be considered. Instead of Florinef an alternative safe but effective medication can be used. Such treatment should be undertaken with good judgement or sense.
In addition to above, she must undergo physiotherapy with range-of-motion exercises (either passive, active-assisted, or active, depending on the degree of weakness) and stretching exercises should be performed to prevent joint contractures. As a general rule, resistance exercises should be limited to muscles with greater than antigravity strength. Bed mobility, balance activities, transfer training, and gait training should be included to address decreased mobility.
Hope these suggestions could be beneficial to her.
Best regards.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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