Tired, Achy In The Afternoon

[timphillips]

Hello -

Looking for some thoughts on symptoms I am experiencing in the early afternoon right after I eat lunch. I had been taking Mirapex for 8 years. The daily dosage was 1.0mg until September of 2020 when I went off due to augmentation. I tapered down using Norco. I am still on 7.5mg of Norco and 900mg of gabapentin. Its been about 10 months and I still get very tired, achy (mainly in my stomach), mild headache in the afternoon. I wake up fine, lots of energy and I do not have the symptoms. Then 10-15 minutes after I eat lunch, I get this tired achy feeling, lethargic, mild headache and I have to lay down. It's worse on nights that I don't sleep well. Are these normal DAWS symptoms or could there be something else going on?

I am scheduled for a complete physical and blood test in early August.

Thanks for your thoughts!

[badnights]

Looking for some thoughts on symptoms I am experiencing in the early afternoon right after I eat lunch. I had been taking Mirapex for 8 years. The daily dosage was 1.0mg until September of 2020 when I went off due to augmentation. I tapered down using Norco. I am still on 7.5mg of Norco and 900mg of gabapentin. Its been about 10 months and I still get very tired, achy (mainly in my stomach), mild headache in the afternoon. I wake up fine, lots of energy and I do not have the symptoms. Then 10-15 minutes after I eat lunch, I get this tired achy feeling, lethargic, mild headache and I have to lay down. It's worse on nights that I don't sleep well. Are these normal DAWS symptoms or could there be something else going on?

Hi Tim
I was scrolling thru old posts and saw that no one had replied to this one. First I wanted to say congratulations on getting off the pramipexole! Your symptoms don't sound much like DAWS. Are you still having them? If so, I'll ask, do they happen 10-15 minutes after eating even if you eat an hour later than usual? (are they related to eating, or to something else?)

Are you taking any other medications? It could be interaction between Norco and another med.

Or a side effect of another med.

Norco is a bad one to be taking , I Think I've mentioned it to you before, for two reasons, one you don't need acetominophen, it doesn't help and just causes your body to have to use up resrouces to break it dwon and excreete it, and two, hydrocodone is not very powerful so it probably doesn't last long enough.

What happened in August? Did you see your doctor? Was anything resolved?

[timphillips]

Hello -
Thank you for your response! Yes, I am still having the same issue. The problem is very dependent on how well I slept the night before. Its been 15 months since I last took pramipexole (Mirapex). The duration and consistency of my sleep is continuing to improve. My RLS severity and frequency has significantly improved from where I was 15 months ago. My RLS symptoms are now manageable with stretching, activity, etc. However, on a night that I don't sleep well the problem raises its evil head and I am miserable for about 3 hours in the middle of the day (typically right after lunch). This is what I am taking on a daily basis:
7.5mg Norco. I know I should switch. My Neurologist just quit her practice. I am now seeing my General Family Physician and am thrilled he will prescribe an opioid. Perhaps in a few months I will suggest a change.
1200mg Gabapentin (600mg @ 7 pm, 600mg @ 9:30 pm)
Cannabis 8-10mg (edible) @ 8:30 pm
B12 Vitamin 5000mcg mid-day
Magnesium 400mg mid-day
Potassium 100mg mid-day

Any thoughts? I have read a few articles that mixing cannabis and opioids can cause problems. I'm thinking my dosages are low enough that isn't a problem.

[Frunobulax]

Hard to make a remote diagnosis, but there is something you should check out.

Do the symptoms depend on the type of food? Are they the same after high-carb meals (western diet) and low-carb meals (predominantly fat and little carbs)? Might make sense to do an insulin/prediabetes array, ideally take a Kraft test. Your postprandial symptoms sound very much in line with symptoms observed in prediabetes. Dopamine agonists are known to lower blood glucose (even though I know no studies about Mirapex, what I remember is https://dom-pubs.onlinelibrary.wiley.co ... /dom.14183 with cabergoline and bromocriptine), so maybe your glucose control is worse after coming off DAs.

Other markers of prediabetes are HbA1c over 5.6, triglycerides over 150, fasting insulin over 10 (~=HOMA-IR over 2.5) and HDL-cholesterol below 50.

You could also try a ketogenic diet for 2-3 weeks. If you feel better after this timespan then you have issues with glucose control. Note that symptoms may be much worse for a few days, and eating any carbs in this time willl invalidate the results.

[timphillips]

Wow, Frunobulax, thank you for your thoughts!