Good morning friends. A few weeks ago I posted about fatigue and nausea and I received really helpful replies suggesting I may need to take Tramadol at regular intervals in the day to avoid nausea and fatigue which may be mini-withdrawals between doses. For the last 2 weeks I have been doing this. Until now I have been taking 50mg Tramadol at lunch and 100mg at night. I tried added a morning dose of 50mg. I still have no issue with restless legs, but the fatigue and feeling sick is persisting. I even tried 100mg in the morning and it saw me through to the night time dose but I do not have a single day where I dont feel so sick and exhausted. The mental fatigue is awful. I am really feeling ill. Changing how I take the Tramadol seems to make no difference. I have a demanding job and it is really affecting my capacity. Does anyone know why I would be feeling so sick and exhausted? I am taking 100mg Tramadol at night, 50mg at lunch time, 225mg Pregabalin at night and 75mg Trazadone at night. Thank you in advance for your consideration. Hope all you good people are well.
I am feeling so sick: Good morning... - Restless Legs Syn...
I am feeling so sick
Did the nausea start the same time as when you commenced Tramadol? Some people experience nausea with opioids. It may well be that the meds or the combination of meds is causing your symptoms. You won't know unless you go off them (under doctors supervision of course).
Or the nausea/fatigue may be symptomatic of something else.
I experience profound daytime fatigue on pregabalin (300mg).
Hi Amrob. I recall experiencing the nausea when I started Kratom and then again with Tramadol. And the same with the exhaustion. It seems particularly bad at the moment. I do agree, it may be opiates. But I am also interested in your experience with Pregabalin? I reduced the Trazadone to see if it could be that and there was no change. So it may be the Tramadol and Pregabalin? Thanks for your reply. Appreciated.
Pregabalin has been particularly helpful in controlling my PLMD. At the same time, i do experience considerable side effects and after having been on it for the best part of nine years, i'm keen to try something else. For the past five or so year, I have also experienced chronic daytime fatigue lasting between one to three hours a day, especially after exertion (but it's not chronic fatigue syndrome). Several specialists that i've seen, believe that this may be attributable to the pregabalin, but i haven't been able to come off it given that i've tried nearly everything except methadone, and have difficulty tolerating most medications. And as debilitating as it is, daytime exhaustion is preferable to having non- restorative sleep.
Hi Gary, maybe try dividing the Pregabalin dose instead? 50x3. Your RLS and sleep are fine so keep doing the tramadol and trazodone at night only. You can also try treating the symptoms - pure peppermint oil for nausea and putting your head down for 20 minutes when the fatigue strikes. You don’t even need to sleep, just calm yourself with deep breaths and relaxing thoughts. It’s no small feat coming off the DAs. You deserve a round of applause. Congratulate yourself. Be good to yourself. Your dopamine receptors will only improve with time.
Your story is very similar to TeddiJ on here. Maybe read about her experience after more like 30 years on the DAs. Last I heard she literally only needs 1/8 sheet of Suboxone.
Hi there. Thanks for your reply - and practical advice. I will try splitting the Pregabalin - good idea. I will try that today. And as for being good to myself - I am not sure I do that well. I will try the napping and see how that goes - thanks for that advice. It was TeddiJ who advised me to go on Kratom when I stopped the DA cold turkey after 20 years. Her advise to try Kratom was a life saver. It has been just over 2 years since I stopped Pramipexole and to be honest I feel like I have never recovered from that. I have felt ill ever since and grappled with terrible fatigue, depression, exhaustion and burnout. I have felt so burnt out ever since. Thanks again. Appreciated. All the best.
As part of being good to yourself, and now that you can put a line through RLS, you should do some analysis of your health in general. What you think is drug induced fatigue and nausea might be some other easily treatable condition. I had an overgrowth of something called Candida Albicans and had all the same symptoms you do. It was confirmed by blood test. But my allergist knew when he looked at my tongue which was “coated” with a whitish substance. I felt like I was being poisoned and no doctor had a clue but my allergist. Actually, the tongue is kind of a window to your health so maybe start there 😅. If it turns out you’re healthy as a horse and it’s no doubt the Tramadol then maybe continue to follow Teddi’s road and ask doc for Suboxone. Tell him he “can’t just abandon you to your pain and suffering.”
I will check my tongue - thanks!
Hi again! I followed your suggestion and took 1 Pregabalin this morning and have taken another one at lunch time. I haven't felt this well for a long time - no exhaustion, nausea or feeling sick! It has been amazing! I felt so ill yesterday and even after taking my regular night dose of all my tablets I felt so sick. I had a bad night. Woke up and decided to try taking Pregabalin in 3 doses. I have felt so well. I will try this for a few days - I hope it is a solution. Thanks again mate. So appreciate it.
Can’t take credit. That’s what Jools did to stop her nausea from opiates.
Hey, I hit a dead spot around mid day today and lay down for a nap. I felt brilliant after. I am not a lie down person - I tend to just battle on. But the nap worked. Thanks again.
That’s my secret to survival. It ALWAYS gives me a second wind. There’s an older gentleman on here somewhere who has been taking Tramadol for quite a long time. As a result of posts on here he added about 50mg of ferrous bisglycinate to his regimen and for the first time was able to lower his tramadol from 400mg to 200mg. He tried so hard to go lower, doubling his dose of iron, but it was just not possible.
After your traumatic event were you put on an SSRI? You indicated that the RLS started a few months thereafter, but I have a guess that it may have been a drug the docs put you on and since you are pre-disposed to RLS it really made your RLS take flight. Then of course came the DAs, instead of stopping the offending drug, and then the DA eventually down-regulated your receptors to a very painful point. Normally, once stopping a DA, your receptors slowly crawl back to baseline. Tramadol and Kratom both have a tendency to slow that crawl down. In conclusion, I think in reality you have mild RLS, and will return there eventually.
Anyways, my point is, think about trying the ferrous bisglycinate. I use 50mg on an empty stomach about an hour before bed and it stops my RLS in one hour for one night.
Here are more people it is helped despite many of them having healthy ferritin levels. The thing is, the RLS brain is very dependent on our free circulating serum iron (which is not ferritin) and when serum iron plummets at night, which it does in all humans, our RLS goes bonkers. The oral iron taken at night replenishes that serum iron.
See third reply in post:
healthunlocked.com/rlsuk/po...
Thanks for your detailed advice. I have read the posts on iron - I may give it a go.
Why not? The risk and cost are low while the benefit can be quite high.
For the fatigue during the day you could try ritalin or adderal. Taken in the morning it will wear off by night. For nausea - Granisetron or zofran.
Hi Sue. Thanks for reaching out - I appreciate it. I will take a note of those meds. Interestingly, DesertOasis above, suggesting taking Pregabalin during the day so I tried that today. I took 1 this morning and I have had a 2nd one at lunch and I have had no exhaustion, nausea or withdrawals. Its amazing! I feel great! I hope this lasts. I will try it out for a few days to be sure it is helping. Thank you again for your reply. All the best.
That's great and it probably means you don't need pregabalin at all or a lot less unless you have daytime symptoms, because it's half life is 6.3 hours so it will be mostly gone by nighttime.
Interesting Sue. My Doc gave me the Pregabalin as a start to weaning off the Tramadol - but he did say a low dose of Tramadol and Pregabalin together may be best. So I have been going along with taking the two. However its definitely the Tramadol that is controlling the rls - not the Pregabalin. When I try to reduce the Tramadol, the RLS comes back - so the addition of the Pregabalin has not helped. So yes, maybe I don't need it at all. I did find through that the Pregabalin really helped calm the heart palpitations down from the Trazadone and it did help me sleep better.
Hi Gary, I read you have heart palpitations from the tramadol. So did I, and they did not settle. Tried for weeks-months. It made me ask for other medicines and ended up (after several years) on buprenorphine. However, I also suffer from fatigue and brain fog and I suspect the opioid(s), even at the low dose I am taking. As we are all different, we can only share our experiences. And you'll have to find out which one of your meds is causing the fatigue. Or is your sleep still poor? That can also be the cause. Keep on looking and trying, but stick to changing one thing at a time.
Hi Lotte. Thanks for your reply. I appreciate all the concern from members of this group. I think I agree - my issues may be a reaction to opioids. I have had consistent exhaustion and nausea and heart palpitations problems since stopping Pramipexole and the meds I have taken for the rls since stopping Prami are Kratom and Tramadol. So I reckon its my body's reaction to opiods. The Pregabalin really did help with the heart palpitations but it came with serious memory difficulties which I find so distressing because my brain has always been my greatest asset. Regarding sleep - it is so hard because I did not sleep well before starting rls (I experienced trauma which stopped me sleeping). Taking Tramadol, Trazadone and Pregabalin at night did help me sleep, but something is causing crippling fatigue in the day. I am beginning to think this combination is causing bad side effects. However when I try to reduce any one or take them at different times, my sleep deteriorates and the palpitations get worse. Its so confusing at times.
I hear you, Gary! Same here. The continuing fatigue, increasingly coupled to lethargy I find indeed crippling. And like you, my brain used to be my greatest asset. So much crippling that I am currently contemplating to stop the very effective medicines and try to do without. If only to find out whether it is indeed the opioid causing it.
I have just been rederred to a kind of revalidation (waiting list 6 mo+) where a team of multiple doctors will look into my situation to see whether they can be of any help. I hope they come up with something better, but if not, that I will get support while stopping and also in evaluating what ensues. I tried methylfenidate before, but it helped only a little for short periods (4-5h) and when taken frequently (2-3 times daily), it made me restless and uneasy. Apparently I am sensitive to medicines. 😕.
Any other idea?
Hi Lotte. I really hope those doctors can spot something for you. That is an opportunity and I hope it goes well. I share your sentiments about coming off everything. With the confusing cause of rls and the awful side effects of meds, and taking multiple meds at once, this becomes so confusing and like you I have often thought about ditching everything and starting again! At this stage I am bewildered with no clarity on anything! As a lot of us are it would seem. All the best Lotte!
I had overwhelming nausea and vomiting when I started Buprenorphine. It stopped all RLS so I was determined to find a solution.I restarted cannabis, 0.3ml of cannabis oil with 20% THC. It stopped the nausea completely.
I then reduced the cannabis slowly after about 4 weeks.
You can buy it from Lyphe or Sapphire Clinics in the UK. It will take about a month to go through registration etc.
Thanks Joolsg. I appreciate your reply. Have a look at my reply to Sue above. I have had a look at Sapphire clinic - it is only 1 hour from me. I ahve kept this in mind from the time you first mentioned it to me. In the mean time I am hoping changing the Pregabalin dose may help. All the best!
The only problem with this is that cannabis is on the black list for serotonin syndrome according to some researchers, and GaryHB is already taking two serotonin agonists, that’s a lot of serotonin in the system which is sure to aggravate nausea since serotonin is responsible for appetite and nausea. Serotonin syndrome exists on a spectrum. I can’t use cannabis because of being very sensitive to serotonin syndrome.
Its likelt that the tramadol is making you ill. It does have a few nasty side effects. Tramadol is often used to induce sleep.
Could you come of it altogether slowly weening down?
Your doctor may be able to suggest a different medication.
I've read that some people get relief with acupuncture.
Thanks for your message. Unfortunately, Tramadol has been the best for stopping my RLS. I have no RLS at all since being on it. Other meds have not been effective. It is so difficult! All the best.
Glad to hear your sleepiness has gotten better. Have you ever considered that you may not need the pregabalin at all? Tramadol alone does the trick for me. RLS is completely gone except for an occasional flare up after consuming hidden Sucralose (that is a huge trigger for me) and/or rainy, humid days.
All drugs have side effects but Lyrica’s are nasty. Maybe talk to your doctor about it. All my best to you.
You may be 100% right and I might try that. How do you take your Tramadol? Does it cause any side effects for you? It causes terrible insomnia for me so I have to take Trazadone to help with that. Pregabalin did help me sleep better too, but I am not keen to take tablets I dont need so maybe Pregabalin needs to go. Thanks for reaching out to me. All the very best.
I take 1 50mg in the morning after breakfast; one around noon and one after dinner. Bedtime I take one plus I do take 50 mg trazodone at night along with 400 mg magnesium glyconate. I added the mg about 6 months ago and it really helps me sleep through the night better.
I have no side effects from tramadol (thank, God) and I even reduced the amount I take as my Dr prescribed the max (400 mg per day) but I found it made me tired and I was scared of being on that much. So I went to one 50mg dose rather than 100mg dose 4x per day as she prescribed.
Now my sister took one once for back pain and got nauseated and threw up! So we are all different but I’m so grateful that tramadol works for me. It’s truly been a Godsend!! Keep me posted on what you do.
Ok interesting! So you take it evenly through the day. I was not doing that and I think I was getting bad withdrawals during the day. So I started taking 1 50mg at lunch time and 2 50mg at bed time as well as Trazadone, about the same dose as you. Thanks for your insight and for replying - it gives me lost to think about.
That’s a lot of serotonin inducing medication and serotonin is responsible for appetite and nausea. In my experience, it can also make you tired. Look up serotonin syndrome, might give you some ideas about the way the drugs affect you. You might have to drop the Trazodone at the very least.
Thanks for your message. The Tramadol causes terrible insomnia for me - hence why I take the Trazadone. So I can't just take the Tramadol. But I hear what you are saying about serotonin syndrome.
I have taken Tramadol for my back pain before and I find it doesn't 'agree' with me. I still have taken it when I need it as it helps with the pain, however it does make me tired and it CAN make me feel sick, can give me a shocking headache, and on 3 occasions has made me actually throw up.
The tiredness I can't get around, all I can do is take a half dose, but the feeling sick, headache and vomiting I can get around my making sure I never ever take it on an empty stomach. That's a real no-no for me and is a guarantee of trouble for me.
Ok I will watch out for that - thanks.
Cannabis has been found to offer relief from nausea and because it works on the serotonin pathway which is different from the opioid - could be helpful. Also can help reduce RLS symptoms.
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