Why do I feel worse in the mornings?

[carolm]

HI All,
Even though I am in remission (or at least all indications are that I am) I still feel 'rough' in the mornings. Aching all over, sometimes a little queasy-- just not well, until about 9:30 or so, then it seems things smooth out, I start getting hungry, I ache less, etc.

This has always been my pattern, just to varying degrees. What happens during the night that I can go from feeling very good when I go to bed to feeling lousy in the mornings? If I could improve this it would have such a positive impact on my outlook.

If you have an idea please chime in.

thanks so much,
Carol

PS-- I stopped eating potatoes because I found I ache a lot more the next day after I eat them, but I can't see anything else in my diet (which is limited to about 12 foods) that would be contributing to food related problems. Rice cakes are my only grain right now.

[janetcg2424]

I don't have the answer but I just wanted to chime in that I also feel that way. I usually can't eat anything for at least 2 hours after waking up, and experience stomach churning until mid-late afternoon most days. By evening, I feel almost normal, and usually feel very good at bedtime. In the morning, I'm right back to feeling yucky again. It would be great to know if there is a reason for this!

[Polly]

HI Ladies!

Have you tried taking an antihistamine before bed?

Polly

[carolm]

Hi Polly,
I was hoping to hear from you. At this time the only thing I take at night is 10mg of Amitriptyline. In fact I moved it up and take it earlier in the evening because it can also make me feel 'slowed' in the morning, like things just can't get going. I do think it helped. Once in awhile I'll take a Zantac in the evening if I think my stomach needs it or if I ate something acidic.

I used to take 25mg of Benadryl every night prior to LC just because it helped with my other allergies and I thought helped me sleep. I stopped that during my first big flare because I was on Entocort and because I was taking everything down to the bare bones and eliminating anything extra. I have had a random night or two in the last couple of months that I've taken 25-50mg Benadryl because I felt I was having an allergic reaction to something I ate--like a stuffy nose, etc. But I've not taken it on a regular basis. I could again, though. I'm not opposed to it.

What are you thinking Polly? That most likely it's inflammation due to an allergic or mast cell reaction?

Carol

[tex]

Hi Carol,

I have a hunch that Polly may be right on target. But in addition to that, I may be all wet here, but when I look at the list of possible side effects associated with amitriptyline, I can't help but wonder if it might be the source of your symptoms, especially since you take it at night. As you probably recall, amitriptyline is a powerful antihistamine, suggesting that some other attribute of the medication might be overwhelming the antihistamine-associated therapeutic effect, to cause the symptoms that you are experiencing. Or conversely, the symptoms might be a sign of an insufficient dose. Dosage is sometimes/often critical with many/most drugs in that category.

Abdominal or stomach pain
agitation
black, tarry stools
bleeding gums
blood in urine or stools
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in consciousness
changes in patterns and rhythms of speech
chest pain or discomfort
chills
cold sweats
coma
confusion
confusion about identity, place, and time
continuing ringing, buzzing, or other unexplained noise in ears
convulsions
cool, pale skin
cough or hoarseness
dark urine
decrease in frequency of urination
decrease in urine volume
decreased urine output
difficulty in breathing
difficulty in passing urine (dribbling)
difficulty in speaking
disturbance of accommodation
disturbed concentration
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
double vision
drooling
dry mouth
excitement
fainting
false beliefs that cannot be changed by facts
fast, slow, or irregular heartbeat
fear or nervousness
fever with or without chills
flushed, dry skin
fruit-like breath odor
general feeling of tiredness or weakness
headache
hearing loss
high fever
high or low blood pressure
hostility
inability to move arms, legs, or facial muscles
inability to speak
increased hunger
increased need to urinate
increased ocular pressure
increased sweating
increased thirst
increased urination
irritability
lack of coordination
lethargy
light-colored stools
lip smacking or puckering
loss of appetite
loss of balance control
loss of bladder control
loss of consciousness
lower back or side pain
mental depression or anxiety
muscle spasm or jerking of all extremities
muscle tightness
muscle trembling, jerking, or stiffness
muscle twitching
nausea and vomiting
nightmares or unusually vivid dreams
overactive reflexes
painful or difficult urination
passing urine more often
pinpoint red spots on skin
poor coordination
pounding in the ears
puffing of cheeks
rapid or worm-like movements of tongue
rapid weight gain
restlessness
seeing, hearing, or feeling things that are not there
seizures
severe muscle stiffness
shakiness and unsteady walk
shivering
shortness of breath
shuffling walk
sleeplessness
slow speech
slurred speech
sore throat
sores, ulcers, or white spots on lips or in mouth
stiffness of limbs
stupor
sudden loss of consciousness
sweating
swelling of face, ankles, or hands
swelling or puffiness of face
swollen glands
talking or acting with excitement you cannot control
trouble in speaking
trouble sleeping
troubled breathing
twisting movements of body pain or discomfort in arms, jaw, back, or neck
unable to sleep
uncontrolled chewing movements
uncontrolled movements, especially of arms, face, neck, back, and legs
unexplained weight loss
unpleasant breath odor
unsteadiness, trembling, or other problems with muscle control or coordination
unusual bleeding or bruising
unusual tiredness or weakness
unusually pale skin
upper right abdominal pain
vomiting of blood
weakness in arms, hands, legs, or feet
weight gain or loss
yellow eyes and skin

And these are only the most common side effects.

Amitriptyline Side Effects

Tex

[ldubois7]

I have the same issue Carol. I used to be a morning person, but it takes so long to feel good that I'm more of a later day person now.
I get slightly queasy some mornings, too....I eat the same 6 foods, so I wondered if it was histamines .....but, antihistimines make me gassy so I avoid them.. :(
I'd like to learn how to feel better if anyone has some knowledge.

[carolm]

Tex,
Whew-- thankfully I don't have but one or two side effects on that list, like loss of appetite and a general feeling of tiredness. I have had times in the past 4-5 months that I've felt good for a long stretch of time, that I wondered if I still needed the Amitriptyline everyday. I guess one way to see what would happen is to drop it down to 5 mg and see if my gut motility stays steady. My GI doc (when it was first prescribed) told me that in times of stress it was okay to take 15mg and I'd say it helped a lot with motility issues but I can't recall if I thought I was better overall on 15mg than on a typical day or not. Usually I was taking 15mg because my husband was in the hospital and we were in for a long haul -- so it really wasn't a typical, routine week to measure.

So where the Amitriptyline is concerned I think these are my choices: Increase to 15mg for a week and at another time drop to 5mg for a week and see what happens. I've never taken more than 15mg because Amitriptyline does kick my butt. I'm generally not too med sensitive but I swear even 25 mg would make me sleep all day.

The other variable to try is to add Benadryl back in at night and see what results come out of that. Right now I take Claritin in the morning with Zantac but that's about all in the H1 and H2 categories.

Do you think a week is long enough or should I test these out for a longer period of time?

thanks so much for your help,
Carol

[tex]

Linda,

Remember that virtually every one of us feels rough in the mornings while we are either reacting or recovering, so we automatically do better later in the day, by default. And many of us find that even after we recover, while our mornings improve significantly, for some of us they may never quite return to their original "bright-eyed and bushy-tailed" status, though for many of us they may be close enough, for all practical purposes.

I'm inclined to feel that when someone is still having rough mornings, their diet may be less than optimal (including supplements, medications, etc.), or, they are still in the healing process and simply need more time to return to a more normal state.

Origainally, I was a morning person, and I typically got up at 4 to 5 am, and started doing the paperwork for the days orders, so that I would be finished before 8 am so that we could begin filling those orders. But once my symptoms began, it was a different world. When I was reacting, I truly felt as though I had been hit by a truck when I dragged out of bed each morning. I felt rough as a cob most mornings. Now that I've been in remission for roughly 10 years, I find that if I get up early, I can be a dynamo of productivity (if I'm in the mood), but if I get to bed late, and get up late, I typically am at my best later in the day.

I'm sure the difference in how I felt "back then", and how I feel now (in the mornings) can be attributed to healing. But it took years to complete that transition.

Tex

[ldubois7]

Thanks, Tex! I am doing better with each passing week, but it's like dragging my feet through mud....slow and laborious.

It doesn't help that we got 7 more inches of snow today, to add to the 18 inches outside already! It's been a crazy winter in the east!

[tex]

Do you think a week is long enough or should I test these out for a longer period of time?

I'm not really qualified to offer an opinion on discovering the correct amitriptyline dose, because I'm not familiar with the details of adjusting to it. Hopefully Polly or someone else may have some insight on that issue. Of course we typically respond very quickly to antihistamines (if we're going to respond to them), so a week should be more than adequate for reaching a condition of homeostasis with conventional OTC antihistamines. I'm not sure that would be the case with a tricyclic antidepressant.

Tex

[carolm]

Linda, I used to have horrid nausea in the mornings even after most of my LC symptoms were gone. I think that's where the bulk of the inflammation was for me- in the upper GI tract. I decided I'd had enough of meds and I wanted to try acupuncture. Luckily I was a quick responder. Seriously after the second session my nausea was gone (but I was afraid to trust it. ) . After the 3rd and 4th sessions I was feeling much stronger, the nausea was really gone and my motion sickness was vastly improved. I continued with follow up treatments for a few more months tapering to every 2 weeks, then 3 weeks, etc. I think my last treatment was about 1 year ago.

Like you, I used to be a morning person but LC has changed that. Now my goal is to see if I can get a grip on these latest aches and nuisance symptoms. As usual Tex and Polly have given me something substantial to think over. If you aren't taking an antihistamine at night you may want to try it. What have we got to lose?

Hang in there,
Carol

[Leah]

Interesting question Carol and I'm sure that Tex and Polly are on to something. I always think "drugs" when things are a bit questionable. I was thinking that there must be something just in the fact that we are in a lying down position for hours when we sleep that makes a difference. I'm feeling pretty good these days and able to eat many things. During the day , I rarely even have gas…. but when I wake up each morning, I am full of it ( luckily, I get rid of it easily and my husband is already out of bed by that time!). I just always accepted this since it's such a small thing. My energy/appetite is fine But, what you are feeling???? Your experiment sounds like a plan. If you don't notice a difference after one week, you might want to extend it to two weeks.

Good luck
Leah

[carolm]

Tex, thanks.
I'll look up the half-life for Amitriptyline and that should help me to know when I should be see effects from a reduced dose. I would think I would see effects from an increased dose within 3-5 days and would want to continue it to determine if the results are solid.
It's not a med to take lightly--but I have to say I was glad I had it last year when my husband was in and out of cardiac units.
I may start with adding Benadryl first however. It might be cleaner that way before I start adjusting the Amitriptyline.

Thanks so much,
Carol

[carolm]

Thanks Leah.
I wasn't thinking of the meds effects but then I was running out of ideas. That's why I value this board and everyone on it. I have taken Amiptriptyline for about 1 1/2 years and maybe it has run it's course. Certainly I was questioning a few months ago if I still needed it. Maybe I should have listened to that intuition more closely. Anyway, we'll see what my plan brings. I have nothing to lose by trying.

Carol

[coryhub]

I always feel worse in the mornings but get to feeling better after I go to the bathroom once or twice in the AM. It's nothing like how bad I used to feel a few years ago. Mornings when I do feel good I try to clean house and shop because I never know when I might get the next bit of energy. I try to take advantage of a good day. I'm going to toot my horn here and say I am doing fantastic since eliminating many, many, many food items. I feel pretty damn good these days. I go potty more than an average person but it's not an emergency state. I am down to no pills but a multivitamin and a calcium pill. If your are a newcomer - do not give up. Eliminating foods (gluten especially) takes time. It's a lot of new information, and plenty of lifestyle changes but it's so worth it!