I’m stage 4 ckd, and I am experiencing fatigue and lethargy on a daily basis. I find that I have very little energy, and I can barely accomplish anything beyond a couple of small tasks. I also have stage 3 non-alcoholic liver disease, and had open heart surgery in 2019. However, my recent echo gram shows fairly decent function, my electrolytes within normal, but higher Bun/createnine levels. I have been able to walk with the assistance of a Walker around a half mile 3-4 times a week. I am done in afterwards. I take Farxiga, Amlodipine and carvedilol for kidney and heart. One minute I’m freezing, and roasting hot the next. I’m trying to find out how others normally feel from day to day, please? I also take levothyroxine, Atorvastatin, Vitamin complexes for renal function. Plus one 50 mgTramadol a day and one lowest dose alprazolam per day.
Fatigue and lethargy : I’m stage 4 ckd, and I... - Kidney Disease
Fatigue and lethargy
I am curious why you are taking tramadol daily as its pain medication usually used for a day or so for pain not on a daily basis I have taken 25mg a half a tramafol and it knocks me for a loop makes me sleep for about 8 hours. Can u check with doctor why r u taking Tramadol my prescription of tramadol says only take as needed for pain and I only take half a pill as it knocks me out......are you in pain every day ? Please go over your medications with your doctor and pharmacist sounds like the mixture of what you are taking seems a bit heavy to me but im not an expert..
I have a very bad back problem in my L5 region. Surgery is not an option. I sleep in a recliner, as I cannot lay flat for several hours without extreme pain upon awakening. I have had sleep issues for years, plus neuropathy which gives me restless legs. I take the lowest dosage of 50 mg. and only one Tramadol at bedtime, none during the day. If severe, I take two, which is still a low dose. I wish it would knock me for a loop, so I could get decent sleep. It does not make me drowsy, rather it eventually causes me to be able to relax. It’s only one pill, but if I don’t take it, I cannot relax and I go through a series of muscle tightness and twitching legs, because I also have fibromyalgia. It is so frustrating, it’s unreal. Because of my ckd, I have been unable to take Advil, ibuprofen, Aleve, etc. I also have stage 3 non-alcoholic liver fibrosis, so no Tylenol. At the age of 76, my doctor feels that taking the Tramadol is worth relieving my anxiety and joint pain, because I also gave osteoarthritis. It feels like my whole immune system is turned inside out. I would love to be off all meds. I am in pain every single day of my life. I just don’t know any other way around my current routine. Sleeping pills only worked for awhile, melatonin, not at all. I have a high tolerance for some meds. It is what it is, but all of my problems definitely take a toll on my quality of life. I do appreciate your concern, and I thank you for it.
I think you have answered your own question as to why you are so tired. You don't sleep. You are on heavy medications and in pain. And you have many comorbidities which make you tired. YOU been through a lot and your 76. Not sure what you expect.
Here are a couple of things to consider. What is your hemoglobin and hemocrit levels. The cold sensation you feel could be because you are anemic and that too will make you feel exhausted, short of breath and unable to be active for a prolong period time.
The BP med carvedilol is a known drug to cause insomnia. I was on a small dose and could not sleep to save my life. Went off and was sleeping much better. See if there is something else to take.
Talk to your doctor about your polypharmacy. It is a lot, and there seems to be a reason for all of them. But maybe a review would be good.
I was born anemic and my hemoglobin has always been below normal levels. I have had just about every test, by two separate hematologists over the years, including a bone marrow draw, which was inconclusive. I am told I just have low iron stores. I never realized how much damage anemia could do, until my heart specialist informed me that it affects the whole body and major organs. It has contributed to heart and kidney disease. Not only that, I popped ibuprofen like candy because of arthritis and various surgeries. No one ever told me too much was bad. I even discovered my own kidney disease after looking at some lab work and discovering that my GFR was at 32. When I asked my Dr. About it, she took me off metformin, told me to stop nsaids, and referred me to a renal specialist. She never showed any alarm, and never apologized for not catching the decline in function. I have been pretty resentful about this. I have found a new primary when we moved to a new town, who has taken this all very seriously, and I feel he has my best interests at heart. He has referred me to a heart specialist, renal Dr., and an endocrinologist. I have blood drawn every three months and all my doctors are kept in the loop. I plan on having an in depth conversation with the Endo when I see him later this month. I started having sleep issues in 2000, long before I was on any blood pressure meds, or learned about my ckd. One Friday night, I could not sleep until 6:00 AM. That was the start, and I have been plagued with it ever sense. After many months and years of fighting with it, I gave up, and decided to stay up until I got sleepy. Sometimes, I am awake for 36 hours straight, then I sleep for 12-14 hours, which starts the cycle all over again. I have finally developed a time period where I go to sleep around 5-7 AM in intervals of around 2-4 hours until 2-4 in the afternoon. I have done better since I gave into the situation and quit worrying about it. Sorry to be so long-winded, but no one really understands. Friends and family are well-meaning, but all the unwarranted advice on things I have already tried become frustrating, and people can be very judgmental without the slightest conception of what I’m going through. Thankfully, I have a husband who has the patience of Job and does not judge me. He has been my rock, Thank you for reading my book.🤔😏
Yes, I agree. You need a review of your meds and their interactions with one another. I was having terrible insomnia until I found out one of my meds was causing it. The same with restless leg syndrome.
I have restless legs also, which I think is related to the neuropathy that I experience.
Suggest you only take tramadol at bedtime as it will make you extremely tired your age is a factor im 72 and have cancer and kidney failure I'm exhausted after dialysis treatmemts 3x a week but that is the norm for patients s like me my suggestion do go over your meds and the time of day u should take them that can be a major factor too the time of day ......I pace myself I know my most energy is in the morning therefore I do more tasks in the morning and after lunch im usually on the recliner till the next morning.........
Yes, I do take one 50 mg Tramadol at night. That’s all. Maybe I should be accepting of the fatigue, but nothing is getting done in the house. I need outside help with organizing and to start getting rid of stuff I no longer care about. Also, a housekeeper. I don’t have the energy and need help. I don’t know who to call and I have trust issues with strangers. I know I would feel much better if I could find someone to help me get my house in order. My husband and I moved into our house a year and a half ago, and it still looks like we just moved in. We are both tired and somewhat depressed. Our kids talked us unto moving closer to them, but we are realizing that the main reason they wanted us closer was to make things more convenient for them, when we start to have major problems. I believe they still think we are in our 40’s and capable of doing all the things we always did and are of very little help, except to help with moving. Then they basically cut us loose. Apparently, we went wrong somewhere, because they have their own lives, and we don’t see them very often, except on special occasions. They talk to us with respect, they just have no time for us. Moving again is out of the question. This last move really took a toll. I hope I don’t sound like I’m having a pity party. It is what it is. Just a fact of life. This situation probably adds to my fatigue also. I’m spilling my guts, so I guess it needed to come out.
I've taken tramadol for pain, and it did nothing for me, either in relieving pain or helping me to sleep. You have several co-morbidities and that can make you tired. I can only do 2-3 things a day, if they don't take much energy. Most of our meds also can cause fatigue. Another thing to consider is to make a new routine about sleeping. Try some yoga or meditation before bed. Also. if you can't sleep until early am then do so and sleep in. There is no rule that says we have to sleep at night. Another thing, what do you eat at night? Can it be something that will keep you from sleep. In the past I've tried Nyquil and Unisom to sleep. You might try those if you haven't. Good luck and if you find a way to not be so tired let me know.
I must be in denial, thinking my fatigue was just from meds, and not from ckd factors. I do intermittent fasting. 12/12, with a light meal at the end of my eating period. I think it’s beneficial. Kidneys don’t have to work as hard. I have resigned myself to sleeping as long as possible when sleep does come. I definitely feel better when I have days that I sleep for 5-6 hours straight. I am guilty of being on my iPad for too long at night. It revs up my mind, and I can’t turn off the thoughts, so meditation would probably relax me. I’ll give it a go.
Well, i didn't say because others did but yes, meds can have an effect on it too. You have a lot going on, meds, chronic conditions and sleep issues. I try to do the 12-hour fasting too. On the days I'm successful I do feel better. Still tired though. I have CKD, COPD and diabetes and chronic random pain and a few other odds and ends. Who was it said, getting old isn't for sissies.
For sure! Maybe I’m in denial about the fatigue. I keep thinking it’s meds, or that I need to walk more. I have been trying to walk about 3-4 times a week with a walker, but I either hyperextended my big toe, or I’m having an attack of gout, because my big toe looks like Rudolph’s nose, and the top of my foot is red and swollen. Very painful. I had it one other time, and it took 2 or 3 weeks for it to subside. Always something, but it could be worse.
If it is gout or pseudo gout, it can be very painful. You need to get it checked. They might add Allopurinol to your meds for it but may have to give a steroid shot to bring the pain down initially. I also take tart cherry extract and the combination of Allopurinol and tart cherry has kept that at bay.
Well, it hasn’t been determined that it’s gout. I had it one other time. After doing exercises that required standing up on the toes and lowering heels to the floor, the next day or two, I begin to have this pain and swelling in my big toe joint and across the upper foot.
This last time, I had taken a shower, and was applying lotion to the same foot. I have neuropathy, and was moving my toes back and forth and in circles. The next day, this whole thing flared up again. There is also a condition called “turf toe” that people get after stretching or tearing a ligament in the big toe. I’m no athlete, but I may have jammed my foot or put too much stress on it at some point. I know one thing, I will never work it around again like the other day. I will check on the all Purio l, and I will probably call a podiatrist. Thanks for the suggestions.
I had another thought. You might check out sleepfoundation.org. They have some good tips on sleeping. Just a thought.
I’ve been on a CPAP machine with humidifier, since around 1991. After all these years, my sinuses are dried out from the air, and I haven’t been able to use it for a few months, because I was so stuffed up and sore passages to the point it was painful to breathe. Plus, I sneezed all the time. I know that I need it, but I just can’t reconcile with it right now. I can look into the Sleep Foundation.
Have you given any thought to trying the Inspire for sleep apnea?
I will check it out. Thanks.
Yeah, tramadol doesn't do a thing for me either. The only effective pain relief I've ever gotten was from morphine, demoral and the other big hospital meds.
Can’t take morphine at all! It makes me itch like crazy! Oofda!
I just re-read your reply to me. I am sorry that you are on dialysis. I hope that you are not experiencing any major issues from it.
Are you anemic? CKD related anemia is common.
Yes, I was born anemic. It was discovered in high school.I have low iron stores, and have had numerous tests including a bone marrow draw. It has never been determined what the problem actually is. It contributed to my ckd and heart disease. In 2019, I had my aortic valve replaced, plus a double bypass.
If you had anemia before the CKD then the CKD probably made it worse. I take several iron pills a day and can't tackle the anemia.
Anemia has always been a problem. I’ve had to have a couple of units of blood on at least 3 occasion. My doctors specifically told me that my anemia has definitely contributed to my ckd and heart disease. I recently started to take a product by Mega Food called Blood Builder. It has 26 mg of iron, vitamins C, B12 and folate. It also has beetroot and 36 grams of a food blend of brown rice and vegetables. It does not bind you up and make you sick. My doctor prescribed 63 or 65 mg of iron that I took daily for 2-3 months, and it made me very sick. My liver enzymes shot way up to the hundreds, and my digestive system literally shut down. It was WAY too much for me. I quit taking that, but it has taken awhile to get back to normal. Never again. In my last lab work a month ago, my iron stores went up to the very beginning of normal (11.5) for the first time that I can remember. I’m assuming that the new product has helped me.
Fatigue is very normal for kidney disease. I would see about taking the pain pill at night. Sometimes our body just get so use to the drugs we put in them. If you start feeling nauseous and swelling or brain fog you could be in kidney failure so watch out for those .I know getting chills alitnof ckd paients get I use to my mom got them all the times. Prayers lifted that you start feeling better.
Thank you for your input. 🙏
From my understanding Tramadol is a no no for CKD and only should be taken on a very limited basis. It’s in the opioid category and could also cause constipation. I just saw my Rheumatologist for some pain issues and he said he wouldn’t give me anything other than Tylenol. Review your meds w your neph.
Good luck
Thank you. I can’t take Tylenol because of stage three non-alcoholic liver fibrosis. Any ibuprofen is out of the question, of course, so my doctor has agreed to the lowest dose (50 mg) of one Tramadol per night at bedtime. I take nothing during the day.
itching
Stage 3 Fatigue
Seeking advice and comfort, please help. 
Contradicting Dietary Advice
Hopey.H
