1636 replies to this topic

[ForLyla]

K but if I take it a few hours apart from the cymbalta then it should be ok right?

[fishinghat]

Yea, I would think so.

[ForLyla]

Thanks FH. POLLY I'm having difficulty swallowing for the first time today which is very odd that it would start after taking the ppi. My symptoms are terrible today. I did have a fair amount of chicken for dinner last night so maybe that's why. I dont seem to do well with meat. The last time I had an attack like this, it took approx 3 weeks for the ppi to fully work.

I wonder if this med is making my reflux worse but it's too early to tell. Then again, I haven't been quite as strict with my diet.

[Polly38]

Hi Lyla. How are you doing today?

I'm wondering if I have a hiatus hernia. I have been reading about them today and they can cause breathing issues where the stomach pushes up into the diaphragm! I feel so uncomfortable when I'm sat at work and have to keep getting up to walk around as sitting at a computer all day is not the best Gor posture.

Unfortunately, the ultrasound I'm having on Friday won't show it if I have. I will have to ask for another endoscopy and they won't do it if I've had one in the last 3 months🙄. Am going to speak to the doctor on Thursday- he's going to be well fed up of me!

Lyla - did you say that you have a hiatus hernia? I can't remember.

Thanks.

Polly

[ForLyla]

Yes I do have a mild one. Wouldn't they have seen if you had one 3 months ago? Its doubtful that you suddenly developed one. Your stomach symptoms seem fairly in line with acute withdrawal.

My symptoms have gotten worse since I started on the ppi's. Seems awfully strange but like I said I've only been on them 4 days and not even full doses so they havent really had a chance. I remember it taking at least 2 or 3 weeks before my symptoms cleared up before. I'm still waiting for the axe to drop but I'm super surprised I haven't gone into hell from taking the ppi. Hats off to HAT. What a godsend!

[Polly38]

Oh OK, thanks. It really feels like I may have one. I still don't understand what 'acute' withdrawal means as I weaned off this really slowly. How long is it likely to last, do you know? I've been off for nearly 3 months now

[ForLyla]

Polly it's impossible to tell. Do you have any symptoms aside from the stomach ones? How long has it been again?

[Polly38]

No, just stomach issues and not being able to take a deep breath in, which can be one of the symptoms of a hiatus hernia, when it is pressing on the lungs. I was on Duloxetine (Cymbalta)for 4 weeks and took 4 months to wean off. Have been off for 3 months. The stomach issues have been going on for months but not sure exactly how long.

[fishinghat]

So far so good Lyla, I am keeping my fingers and toes crossed for you.  lol

[invalidusername]

This is one busy forum - I am having trouble keeping up!! With 80 posts already today... I have never known the forum this busy for a long time!

 

Polly - the eustachian tube, and dysfunction thereof, will not affect breathing - or at least not in the manner in which you are experiencing. 

 

I have a hiatus hernia, and I often forget about it. I am not on any medication for it and my breathing is fine. I do have some bloating from time to time of which I am unsure of the origin, but it is perfectly bearable and not all the time. Might be linked, but I am as sure as anything, not going near a PPI just for that...

 

Charcoal tablets are meant to help a lot with bloating associated with hh's... might be something to try...

 

I had no idea I even had one until a year ago when I had a scan. And according to the doctor, it is quite big, and like Lyla said, it wouldn't have just happened at that size, it would have been over time. So I just hope it doesn't get worse with age!! But stress will aggravate too... 

[invalidusername]

Some great info here;

 

https://www.hernia.o...hiatus-hernias/

[ForLyla]

Polly if you have no other symptoms then it doesnt really sound like you have anything to worry about with a long lasting withdrawal. Just looks like it set off some stomach issues for you. Something as common and simple as gastritis and reflux (which go hand in hand) could cause those symptoms. Are you literally having trouble breathing or just the sensation of breathlessness? Have you seen an ENT? Blood tests?

IUN probably about 75 of those posts came from me asking FH questions lol.

[Polly38]

Hi Lyla

It's a weird feeling (the breathing issue). I feel like I have to keep taking a deep breath to get air into my lungs. It is worse today and there is some anxiety with it, and feeling hot at times. I really don't know how much more I can take😫. I am trying not to focus on it, but it's hard. Does this sound like withdrawal?

I have had every blood test going, which have all been normal. I haven't been referred to a pulmonologist but will ask to be once I have seen the gastroenterologist.

Polly

[invalidusername]

You'd think in this day and age the facility to diagnose would exist. 

 

I've joined you the last 3 days with stomach issues would you believe! Might be the stress I had on Monday, but I had got horrible intestinal discomfort. Lower than abdominal area, but is quite uncomfortable today. Trying to ignore it... not easy...

[ForLyla]

Polly I remember the breathing issue was super common in the benzo withdrawal threads I was in. Obviously no one can say for sure but it's likely just linked with your stomach issues.

My baby has been super fussy and sleeping terribly since she had her one year shots. Lack of sleep for me is the absolute worst for symptoms. Feeling so out of it today but when I put a positive spin on it, I'm quite better than I was at this time last year. I guess that's something to be thankful for . Just wish my laryngeal reflux symptoms would get better! Had a slice of cheese today and that's all it took!

[ForLyla]

FH I woke up this morning to heart pounding and feeling jittery. Could possibly be due to a lack of sleep but wondering if perhaps it would be better to take the lansoprazole at night instead of morning. I feel like it will more likely affect absorption when I take it before the cymbalta. Really hoping its not the case where it's starting to affect it.

[gail]

Hello Lyla, I just wanted to say Hello! The answer to your question will be answered by our Fisherman shortly.

[fishinghat]

Hi Lyla

 

That is a reasonable idea. I wouldn't panic yet though. It could just be a minor withdrawal swing. What dose are you on now? 

[ForLyla]

Hi Gail how are you?

 

Thanks FH. I think starting tomorrow I'll take it again in the evening. The last couple of days I've felt almost faint and would kind of black out when I stand up suddenly. I went to check my blood pressure on one of those machines and sure enough it was a fair amount lower than usual. I wonder if that could be a side effect of the ppi. 

[fishinghat]

The FDA says that 2.88% report low blood pressure with lansoprazole. That is pretty low.

[ForLyla]

I'm starting to worry a lot about this. I think it's interacting with the cymbalta the longer I stay on it - causing the anxiety, heart pounding, low blood pressure, lack of sleep. Starting tomorrow I'll take it in the evening again but may have to jump off if this gets any worse. 

[fishinghat]

Strange, heart pounding, anxiety, and lack of sleep go with changes in your serotonin but that normally causes high bp not low. Our bodies are so complicated. Time will tell.

[ForLyla]

FH do you think it could be the ppi affecting the absorption of my poison? Maybe it just needed to build up in my system?

[fishinghat]

It is hard to say but I can not rule it out. If you can continue on it for a couple days you will find out if it is the ppi or just a normal swing in withdrawal symptoms.

[ForLyla]

FH Ya heart pounding, shaking, agitation, super dry skin (even more than usual withdrawal skin), vision changes... definitely the ppi. However, it started when I switched up the time to morning instead of evening so I'm going to try it in the evening for a couple more days. Could just be coincidence after switching the time. Its going to be very difficult to determine what's good or not now because I've likely set myself back for a good month or two.

Here are my theories:

1. Ppi's increase histamine levels which also increase symptoms.
2. Many people in withdrawal comment that they start feeling better from withdrawal when their stomach problems begin. Either having high stomach acidity improves our symptoms somehow or it's a natural response to healing from this injury. Stomach problems are almost a good sign that the end is near but then you have another potentially dangerous condition on your hands.
3. Its affecting the absorption of the meds. I feel more comfortable taking it in the evening because the cymbalta enters my system without impunity for a good 6 hours before I take the ppi. Seeing as the ppi only lasts 12 hours then I'm good to go again in time for my next cymbalta dose.

On the plus side, my acid reflux is better for the time being. Its nice being able to eat a slice of bread again without feeling like my throat is on fire and the pulsing ear pain. I knew the risks. In the chance that it clears up my acid reflux problem and I can eat again, it would have been well worth it.

[fishinghat]

1. PPIs, Proton-pump inhibitors, act by irreversibly blocking the hydrogen/potassium adenosine triphosphatase enzyme system (the H+/K+ ATPase, or, more commonly, the gastric proton pump) of the gastric parietal cells. They do not effect histamines.

 

List,
Omeprazole (Over-the-counter drug (OTC) in the USA)
Lansoprazole (OTC in the USA)
Dexlansoprazole
Esomeprazole (OTC in the USA)
Pantoprazole
Rabeprazole
Ilaprazole (not FDA-approved as of July 2019

A different acid controller called H2 antagonists are competitive antagonists of histamine at the parietal cell's H2 receptor. Histamine released by ECL cells in the stomach is blocked from binding on parietal cell H2 receptors, which stimulate acid secretion; therefore, other substances that promote acid secretion (such as gastrin and acetylcholine) have a reduced effect on parietal cells when the H2 receptors are blocked.

List,
cimetidine
ranitidine
famotidine
nizatidine
roxatidine
lafutidine

Many antihistamines help fight anxiety but those primarily effect the H1 receptors.

Hydroxyzine, (Vistaril, Atarax) - is an H(1)R antagonist, is very effective against anxiety in most people but some get no help from it at all.

Diphenhydramine is a histamine H(1)R antagonist in the brain.

H2, H3 and H4 receptors are primarily involved in allergies, immune response, acid control and other issues.
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2. My notes from the posts indicate that most stomach issues appear toward the beginning of the withdrawal and they start to fade as the emotional symptoms develop into severe stage. There are certainly exceptions to this and I will agree that as the stomach issues decrease there is some improvement in symptoms probably due to the reduction of stress on the brain. Any reduction in stress would help.
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3. The interference of Cymbalta or other medication absorption is a more serious issue for sure. Whether you are using a ppi or an H2 antagonist the CYP enzymes used by each of these varies and may or may not match the CYP enzymes used to process Cymbalta. In addition, genetic variations in the structures of the CYP enzymes is fairly common with some estimates that as much as 10% of the population may have one or more mutations. Lastly, change in pH (acidity) by any acid controlling drug will have an effect on absorption al be it small.
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[ForLyla]

FH the problem is that as stomach acidity changes, even if that affects absorption in the smallest way, it makes a big difference for me! My symptoms have been scary the last few days.

Many of the people I talk to get the worst stomach symptoms in the beginning and at the end. When acidity is high, the mental withdrawal symptoms are better and when its low they are in a bad state. I've talked to so many people that are years in that say they feel fine apart from the stomach problems.

This really sucks either way. I was beginning to be hopeful that I was going to make it out of this mess. I'm not so certain that the ppi will even clear up my acid reflux issues but may even make them worse with rebound symptoms when I stop them. So now I'll be stuck with chronic acid reflux and be setback again for god knows how long. Weeks? Months? I hate living in this hell! 3 years in 10 days and theres no way out of it. Feeling super discouraged again . I guess I should just accept this as my new life.

[gail]

Hello Lyla,

Having a rough time, but it will diminish with time.

Yes, accept this as your new life, for the moment. FOR THE MOMENT, NOTHING LASTS, IT WILL FADE WITH TIME AND PATIENCE. LOVE

[ForLyla]

Thanks Gail. There's no way this is all coincidence. I'm starting to believe that there is some kind of supernatural power that's testing me and putting me to the ultimate test. There's no way it's coincidence all these crazy scenarios I've been put into, especially the last one after the virus. 

[ForLyla]

I'm going to stop the ppi starting today. I just cant take it anymore. I'm in a severe wave right now - the kind of wave I felt last year when I was out of my mind. My anxiety is through the roof, akithisia, heart pounding etc. I woke up this morning feeling like my heart beat was shaking the bed. I only feel like that when I'm in an acute like stage of withdrawal. Unfortunately the ppi experiment failed, although not surprised but still disappointed. It does affect absorption, although it seems to be at a smaller rate than the other ppi. The other one was like missing 3 doses in a row and this one is like reducing your dose by 20%. It will catch up with you. I'd rather get throat cancer than descend into full blown withdrawal hell again.