Mrs. Burschman Posted November 14, 2009 Report Share Posted November 14, 2009 OK, so I've had pretty bad diarrhea since September. Why, I don't know. Going to the gastroenterologist on Monday.I've also had a worsening of my POTS symptoms since then. It's almost like I'm not taking my "wonder drug," Paxil, which has been all I've needed to control my symptoms.Do you think it's possible that I don't feel like I'm taking my medicine because I'm not? Could severe diarrhea prevent someone from absorbing a medication?It would be nice if that were the case, rather than Paxil all-of-a-sudden not working, or my POTS all-of-a-sudden getting worse.Whaddya think?Amy Quote Link to comment Share on other sites More sharing options...
iheartcats Posted November 14, 2009 Report Share Posted November 14, 2009 I was told you can lose the effect of the Birth Control Pill if you vomit or have diarrhea. At least I was told that and to be careful with food poisoning, flu, etc. when I was on it (such as if you lose more than '3' days worth you're no longer protected from pregnancy that month).I don't know how much truth there is behind that medically, but it's worth looking into. It'd be awful if you're losing a good chunk of your meds that way. Quote Link to comment Share on other sites More sharing options...
lifesaver Posted November 14, 2009 Report Share Posted November 14, 2009 It sure can mrs B--no doubt about it. Once you see your GI doc and get the intestines under control you will start feeling better--doh. Call the doctor who prescribes the Paxil and tell them what is happening and see if a dose increase would help until things settle down. Quote Link to comment Share on other sites More sharing options...
Mrs. Burschman Posted November 14, 2009 Author Report Share Posted November 14, 2009 Thanks, guys. I don't know why I didn't think of that sooner.Having diarrhea would also make me feel worse because of dehydration and improper nutrients, so I'm probably getting a double-whammy. And when I don't take my Paxil, I get diarrhea. So that makes a triple-whammy.Hopefully, the doctor can figure out what's wrong with my guts and get them calmed down. Bleah. Amy Quote Link to comment Share on other sites More sharing options...
erik Posted November 14, 2009 Report Share Posted November 14, 2009 It seems plausible. A drug like Paxil relies on attaining a "steady state" at a certain level. Even frequent intermittent interruption seems like it could disrupt that and shift the resulting "steady" level lower.I don't suppose you happen to be having any symptoms associated with withdrawal, are you? That might be a clue that plasma levels are dropping out on you.It wouldn't be so meaningful without a prior "reference value" back when it was working well for you, but would a doc be able/willing to measure the "plasma value level" of paroxetine?It is a different topic, but I have a personal fascination/fixation on the Cytochrome P450 stuff that is so key to drug metabolism. If something were going on that tampered with that, it could also mess with the body's ability to attain "steady state". In the case of Paroxetine, it is apparently cleared by the 2D6 enzyme... and is also a potent inhibitor of 2D6. If something increased the activity of 2D6 it could also account for lower paroxetine levels overall. There aren't too many documented substances that do that though, just dexamethasone & rifampin according to one P450 reference chart. Quote Link to comment Share on other sites More sharing options...
Mrs. Burschman Posted November 14, 2009 Author Report Share Posted November 14, 2009 I don't suppose you happen to be having any symptoms associated with withdrawal, are you? That might be a clue that plasma levels are dropping out on you.Well, I can't really tell. The last time I thought I was having "withdrawal" from quitting Paxil, I figured out that it was actually POTS, confirmed by a tilt-table test. I think they actually have a lot in common.Amy Quote Link to comment Share on other sites More sharing options...
yogini Posted November 14, 2009 Report Share Posted November 14, 2009 I would think dehydration would be the biggest problem from so much diarrhea. You would lose the Paxil most likely if it runs right through your system - if you go to the bathroom shortly after you take it. Quote Link to comment Share on other sites More sharing options...
MamaTrain Posted November 14, 2009 Report Share Posted November 14, 2009 Mrs. B-Awhile back I read an article on IBS and it said that since there is like 70% of serotonin in the gut (your "2nd" brain) that low levels of these neurotransmitters can cause IBS issues. I THINK it said too little serotonin causes constipation so maybe you have a little too much serotonin going on. This is just a mere thought mind you! :-) I attended the nutritionist guy I am seeing lecture on digestion and I was shocked at how much a terrible "gut" can affect your health. I'm even more committed to doing his program now than I was before! Have you had any other issues like gall stones? I had my gall bladder removed and it has NEVER been the same since! Hope you get this back on track since you were doing so well on the Paxil! :-)KC Quote Link to comment Share on other sites More sharing options...
erik Posted November 14, 2009 Report Share Posted November 14, 2009 The Gut Is Said to Have A Mind of Its Ownhttp://pn.psychiatryonline.org/cgi/content/full/36/14/16Also intriguingly, whereas standard SSRI doses used to treat depression sometimes trigger nausea, diarrhea, or constipation, lower SSRI doses?less than 20 mg?can be effectively used to treat the nausea, diarrhea, and constipation caused by the irritable bowel syndrome. Quote Link to comment Share on other sites More sharing options...
MamaTrain Posted November 14, 2009 Report Share Posted November 14, 2009 Thanks for link post Erik! Quote Link to comment Share on other sites More sharing options...
kayjay Posted November 15, 2009 Report Share Posted November 15, 2009 hey- this type of bathroom trouble is a huge problem for me during a pots flare. Again I have hyperpots. I do know that at the mayo clinic the neuro checked my hear rate at rest then had me do about 5 squats. He checked me again ( also I got a little out of breath and a little sweaty) anyway this is another way they confirm hyper POTS I don't know why.My point is that I do take a SSRI but without the beta blocker blocking the hormones from my adrenal surges I would have diarrhea all of the time. When I first got sick 11 years ago I lost about 20 lbs from this over time.Just another thought I could be way off base but for me those adrenal hormones trigger bathroom trouble.Another thought can you crush your pills up and drink them with water so your body may have a better chance to absorb them. Good luck - Hope you feel better soon1 Quote Link to comment Share on other sites More sharing options...
erik Posted November 15, 2009 Report Share Posted November 15, 2009 I think there is a liquid version medically available if that would help or be worth a try. Quote Link to comment Share on other sites More sharing options...
Mrs. Burschman Posted November 15, 2009 Author Report Share Posted November 15, 2009 My point is that I do take a SSRI but without the beta blocker blocking the hormones from my adrenal surges I would have diarrhea all of the time. When I first got sick 11 years ago I lost about 20 lbs from this over time.Hey, thanks kayjay! It's something to keep in mind. I would LOVE it if I could find something to use instead of the Paxil -- or just be able to take less Paxil along with something else. I don't like some of its side effects. I will have to ask about beta blockers (once I find a DOCTOR, that is.)Amy Quote Link to comment Share on other sites More sharing options...
juliegee Posted November 15, 2009 Report Share Posted November 15, 2009 Just a thought. many with MCAD suffer with intractable diarrhea. Check out the mastocytosis society website:www.tmsforacure.orgJulie Quote Link to comment Share on other sites More sharing options...
Mrs. Burschman Posted November 15, 2009 Author Report Share Posted November 15, 2009 Just a thought. many with MCAD suffer with intractable diarrhea. Check out the mastocytosis society website:www.tmsforacure.orgJulieI have wondered that, given the interstitial cystitis and junk. Who deals with that? Allergists?Amy Quote Link to comment Share on other sites More sharing options...
juliegee Posted November 15, 2009 Report Share Posted November 15, 2009 Only good ones. You usually have to see a masto specialist for the DX. The world Health Organization recently tackled diagnostic criteria for mastocytosis- still evolving...They plan to tackle MCAD in 2010. Until then, really progressive allergists trained at teaching hospitals are helpful or masto specialists (as hard to find as autonomic specialists.)I was lucky enough to find a great allergist, in my hometown, trained at Mayo. He's a godsend. I consider him my PCP. He writes my prescriptions, not necessarily related to "allergies" as he understands the MCAD affects ALL of my body systems. Find an article from a medical journal (or the TMS website) that describes your issues. Print it and bring it to your PCP. S/He should be able to direct you to help. Let us know what you learn-Julie Quote Link to comment Share on other sites More sharing options...
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