1636 replies to this topic

[fishinghat]

Don't take niacin or curcumin (turmeric) when you have gall bladder issues.
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FYI
Glossary -
Cholecystectomy - The surgical removal of the gall bladder, may cause postcholecystectomy syndrome which includes hard to treat depression. More info available on request.
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"so has given me a course of antifungal"
May I ask what drug he prescribed?
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"so has given me a nasal spray"
May I ask what drug he prescribed?
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Ranitidine was actually removed from the market due to containing a cancer causing byproduct. The FDA is allowing its sale again saying it is a minimum acceptable risk.
It MUST be stored in a cool place to reduce the risk breaking down into a much stronger dose of that cancer causing chemical.
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[Polly38]

Hi Hat.

He has prescribed Flucanozole for the antifungal (a 14 day course) and Beconase for the decongestant. I knew about Ranitidine being taken off the market and am a bit wary but only plan on taking it for a couple of weeks to start to repair the damage, as the endoscopy showed that my oesophagus is very inflamed and raw from the acid. Do you think it will be OK just to take them for a couple of weeks?

Polly

[ForLyla]

Guys I'm in real trouble here. Our stomach needs acid to break down cymbalta and the only thing that can cure me of my current condition is a ppi. Unfortunately my doctor has told me that I can't just leave this as is as it can cause serious long-term damage.

So I have to willingly send myself into a terrible wave that could possibly last for several months. Any recommendations as to how I should go about this? I think a short-term ppi would be preferable (pantoloc sodium) but I'd love anyone else's take on this. Should I wait a few more weeks to see if this clears up on it's own first? Also perhaps the further along I am with my withdrawal, maybe the affects will not be as bad.

[Polly38]

Hi Lyla. I've decided to take Ranitidine for the same reason. I can feel that my oesophagus is already quite damaged so am definitely taking Ranitidine and Flucanozole (the antifungal). When you had your gastrophy did they check for candida as there's a chance you could have it - it causes so many symptoms.

Don't beat yourself up about having to take a PPI, if that's what is needed. We can do this together!

Polly

[ForLyla]

Hey Polly thanks for your support. I really appreciate it. I took a ppi in October and it set me back terribly for 2+ months. I took it for 3 days. It's almost as if I had missed 3 days worth of cymbalta. I've been at this for 3 years. Having to deliberately put myself in a long setback is the worst thing imaginable to me right now. I might just take the next few days to think about if I can do this.

[Polly38]

Oh dear, are you nearly off it now? So it may not be so bad. I am off completely.

[ForLyla]

No I've been holding at 25mg for over a year now.

[Polly38]

Oh right, sorry I thought you were almost off. The thing is, if there is damage there, you need to repair it. You could just take it for the shortest amount of time needed. What happened last time you took a ppi? What symptoms did you have?

[ForLyla]

All my acute symptoms came back with a vengeance after just 1 pill. It always starts with the never ending heart pounding, brain fogginess, vision problems, skin gets insanely dry, extreme anxiety, depression etc.

[fishinghat]

Polly

A couple of weeks on the Ranitidine? Probably OK.
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Fluconazole

Short-acting benzodiazepines
Following oral administration of midazolam, fluconazole resulted in substantial increases in midazolam concentrations and psychomotor effects. This effect on midazolam appears to be more pronounced following oral administration of fluconazole than with fluconazole administered intravenously. If short-acting benzodiazepines, which are metabolized by the cytochrome P450 system, are concomitantly administered with fluconazole, consideration should be given to decreasing the benzodiazepine dosage, and the patients should be appropriately monitored.
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It has some interesting and severe reactions with some antidepressants such as....

 

https://www.ncbi.nlm...pubmed/18585543
Life-threatening serotonin toxicity due to a citalopram-fluconazole drug interaction: case reports and discussion.
Consultation-liaison psychiatrists and oncologists should be aware of this preventable and underrecognized interaction. Citalopram should be stopped or substituted prior to the concurrent administration of fluconazole, and in the event of toxicity, treatment with cyproheptadine has a favorable risk-benefit ratio despite a lack of randomized controlled data to support its use.

https://dailymed.nlm...d7-edbfb6248f69
Adrenal insufficiency has been reported in patients receiving azoles, including fluconazole. Reversible cases of adrenal insufficiency have been reported in patients receiving fluconazole.

 

(Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol; but may also include impaired production of aldosterone (a mineralocorticoid), which regulates sodium conservation, potassium secretion, and water retention. Craving for salt or salty foods due to the urinary losses of sodium is common.) Wiki
Do not take with take SSRIs such as fluoxetine or sertraline. There is no mention of incompatibility with Cymbalta. Wiki
Example - Using fluconazole together with sertraline can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. https://www.drugs.co...teractions.html
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Beconase
No significant issues found.

 

[fishinghat]

Lyla

"Our stomach needs acid to break down Cymbalta"

Not true Lyla, it is removed from the body by enzymes in the liver.

"Should I wait a few more weeks to see if this clears up on it's own first? Also perhaps the further along I am with my withdrawal, maybe the affects will not be as bad."

Possible but how much damage could be done by then.

[ForLyla]

How did pantoloc (sodium) affect the the duloxetine absorption? The other OTC acid reducers also had a negative effect on me.

No idea how much damage can be done. I need to see an ENT but it takes several weeks. I'm going away with my daughter on Feb 22 so I'd like to wait until I'm back before hell begins in full throttle again.

[Polly38]

Hi Hat

I think you must have posted information on the wrong tablet as the one I'm taking definitely isn't a benzodiazepine, it's an antifungal.

Thanks.

Polly

[Polly38]

I've just looked them up and it looks like there's 2 meds called the same thing.

[ForLyla]

FH are you fairly confident that lansoprazole wont affect the absorption of duloxetine? You also mentioned that sodium bicarbonate might not?

[fishinghat]

Polly, that article talk about how the Fluconazole causes the build-up of benzos in the body. A bad drug interaction. I couldn't remember if you were taking a benzo as well so I threw that in there to be safe.

[fishinghat]

Lyla, One of the main factors in whether a ppi will cause a problem with Cymbalta is in which liver enzyme (CYP) is used to breakdown the medication. Cymbalta is eliminated by the liver using the CYP1A2 and CYP2D6 metabolism. So if a ppi also uses one or both of these enzymes then not as much enzyme will be available to process the Cymbalta and it will build in the blood steam. when you stop taking the ppi the enzyme is now available to proves Cymbalta and blood levels drop like a rock.

[Polly38]

Thanks Hat.I stopped taking Diazepam last August, and was only on a tiny amount so am not on anything now.

I took the Flucanozole last night and have felt so horrible today. My stomach has been fine but I have felt like I can't breathe at all. I have been at work and have been crying on and off for most of the day. I am so exhausted by all of this and really don't know what to do anymore!

When I woke up this morning my ears and nose weren't so congested and my stomach has been fine. I'm wondering if taking Ranitidine has helped with this as it stopped the acid during the night. I've either had a bad reaction to the Flucanozole or it is Candida die off - I really don't know but I can't take it again whilst I'm at work during the week as it was a struggle to get through the day.

I'd really appreciate your thoughts on this Hat and IUN. Could this breathing thing still be withdrawal as all the other withdrawal symptoms seem to be fading now.

Thanks.

From an exasperated Polly😖

[fishinghat]

It can still be withdrawal but after this length of time is doubtful, could be a reaction to Flucanozole but not die off of Candida, I think the Ranitidine has probably helped your stomach. That will reduce the heartburn and stomach pain but not help the respiratory acidosis or breathing issue. That condition is due to the blood being more acidic not the stomach.

[Polly38]

Thanks Hat. So is there anything I can do about the breathing? I have my asthma inhalers so maybe I do need them.

[fishinghat]

Asthma inhaler will probably not help the respiratory acidosis. The best thing is breathing exercises which you have been doing. I don't mean to be insulting but are you sure your deep breathing is deep enough. When you do deep breathing your belly button should protrude forward as far as possible. This would indicate you are breathing with your diaphragm and moving the extra CO2 out of the bottom of your lungs. The intensity of your respiratory acidosis (if that is what it is) is proportional to your anxiety.

[Polly38]

I don't take that as an insult. Thinking about it, maybe it's not deep enough. How often should I be practising will it take ages to start to get back to normal? I still don't understand what is causing it.

Thanks.

[ForLyla]

Polly my naturopath said to do 2 20 minute sessions of diaphragm breathing a day. Morning and night and for 5 minutes before meals if I'm anxious. I need to do it more consistently. Since I've had the stomach flu, I've noticed myself tightening my stomach inadvertently. Not sure if this has an affect on my reflux.

[Polly38]

Thanks Lyla. I've just done some breathing exercises. Do you do your exercises lying down. I have been diagnosed with hyperventilation syndrome in the past so it has to be that!

[ForLyla]

Ya I lie down. Breathe in elevating my stomach for 4 seconds, hold for seconds and exhale for 4 seconds. This is supposed to help with vagus nerve function.

[Polly38]

Thanks so much! I'll try doing that twice a day. How's your breathing today?

Polly

[fishinghat]

Polly

Hyperventilation syndrome is another name that drs use for anxiety. It is breathing fast and shallow during periods of stress, always a function of anxiety.

Lyla's description of the breathing exercises is right on. If my memory serves me right there is some links in the ebook to you tube videos on breathing exercises. My therapists always said to do no more than 3 or 4 breaths in a row and they can be done every 20 to 30 minutes if necessary.

 

The cause of this is simple.

 

During normal breathing you take in oxygen and breath out carbon dioxide.

 

During stress you breath faster and shallower.

 

This allows carbon dioxide to build up in the lungs and you take up less oxygen.

 

This allows carbon dioxide to build up in the blood and causes it to be more acidic.

 

Acidic blood will not hold as much oxygen causing tissues to be oxygen deprived.

 

This causes you to breath even faster and shallower, worsening the condition.

 

Deep breathing helps remove the carbon dioxide that has built up in the lungs and thus reverses the process.

[invalidusername]

Fantastic description there Hat - 5 stars!! LOL

 

Really easy to follow - and yes, agreed with the breathing; it being called diaphragmatic breathing for good reason. It comes naturally to me as I used to teach Tai Chi back in the day, but so many people don't even know they can breathe with that part of the body. I saw it all the time in my classes where students would just stick their chest out. Proper diaphragmatic breathing should hardly move the chest at all - it is all in the stomach area (or tan tien as we called it). 

 

Has to be done right for the results...

 

Try it laying down and see if you notice your chest move more than the stomach and you will know you are going wrong....

[Polly38]

Thanks both. It sounds like I need to practice, practice, practice! It's really hard to practice at work though.

Hope you're doing OK IUN.

Polly

[invalidusername]

Have a look at this video - seems to be quite good at explaining, or look up qi gong exercises which focus a lot on breathing, which was also related to my Tai Chi lessons..

 

 

I feel like utter crapola today... but thanks for asking my lovely!!

 

IUN