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What Causes Chronic Fatigue, Severe Nausea And Increased Migraine Attacks Despite Taking Medication?
Question: I was given the dx of fibromyalgia. I have had issues mounting for about two years as I know what it is. I have severe chronic fatigue, severe nausea despite Phenergan 50 mg po q6, my migraines have increased to 3 times a week, my anxiety and panic are just out of this world. I am bi polar and take Cymbalta 90 mg po, clonazepam 2mg TID, nexium, I have pain in my head neck shoulder hips knees and ankles. The muscle pain in my neck lower back L5S1. My stomach is tight an bloated I need help please? I need help feeling better. I just can't stop all and rest.
Brief Answer:
Consultation
Detailed Answer:
Thanks very much for your question.
You describe diagnoses of fibromyalgia, migraine, nausea, anxiety, panic, and bipolar disorder. Your current medications are Cymbalta 90mg, Klonopin 2mg TID, and Nexium. Your question surrounds your ongoing pain, bloated stomach, and what inflammatory markers mean.
First, fibromyalgia, anxiety, and panic are all effectively treated with Cymbalta. The first thing I would as your doctor would be to increase the Cymbalta dose to 120mg. This is the maximum dose and given your symptoms, I believe you need it increased. I would expect this to help with pain, anxiety, and panic.
Second, regarding your stomach, I would take over-the-counter simethicone for bloating. I would also make sure your Nexium dose is at its maximum of 40mg daily.
Third, if you have elevated inflammatory markers such as ESR/CRP, this could point to an autoimmune disease such as lupus or rheumatoid arthritis, which could also be contributing to your joint pain. You definitely need to follow up the results of these tests with your doctors, as autoimmune disorders require additional treatment.
In the future, for continuity of care, I encourage you to contact me at my direct link below. We receive a significantly higher payment from this website for direct questions, so I prefer this venue in which to work with you. It would be my pleasure to be your personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Consultation
Detailed Answer:
Thanks very much for your question.
You describe diagnoses of fibromyalgia, migraine, nausea, anxiety, panic, and bipolar disorder. Your current medications are Cymbalta 90mg, Klonopin 2mg TID, and Nexium. Your question surrounds your ongoing pain, bloated stomach, and what inflammatory markers mean.
First, fibromyalgia, anxiety, and panic are all effectively treated with Cymbalta. The first thing I would as your doctor would be to increase the Cymbalta dose to 120mg. This is the maximum dose and given your symptoms, I believe you need it increased. I would expect this to help with pain, anxiety, and panic.
Second, regarding your stomach, I would take over-the-counter simethicone for bloating. I would also make sure your Nexium dose is at its maximum of 40mg daily.
Third, if you have elevated inflammatory markers such as ESR/CRP, this could point to an autoimmune disease such as lupus or rheumatoid arthritis, which could also be contributing to your joint pain. You definitely need to follow up the results of these tests with your doctors, as autoimmune disorders require additional treatment.
In the future, for continuity of care, I encourage you to contact me at my direct link below. We receive a significantly higher payment from this website for direct questions, so I prefer this venue in which to work with you. It would be my pleasure to be your personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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