DEAR DR. GOTT: My husband enjoys reading your articles. He thought he had cut one out for future information but cannot find it. He has muscle pain more than joint pain, hot flashes, insomnia, and sometimes what he calls “no legs” as he cannot feel them in the sense of walking.
He is 60 years old and has a very physical job. He works out with weights for his upper body and has for years. He is using prescribed testosterone cream trying to maintain strength. He takes blood pressure medication and it is under control. He takes cholesterol meds, Tramadol and Ambien. He is so bad he can hardly talk or walk from the shaking but yet his face feels hot to the touch only on his head. He worries a lot.
I’ve told him I think these spells are brought on by pushing himself in his job physically and mentally and by a lack of sleep. His job is outside year ’round. He tans quickly but his face can be seen red to the point that he has been asked by people if he is okay. He says he feels alright, just tired.
I know this is lengthy but any suggestions as to what is going on with his body (taking into consideration his age) would be appreciated. He does not look 60, maybe like someone 10 years younger.
DEAR READER: Phew, he has a lot going on! He has hypertension, high cholesterol readings, has difficulties sleeping, is taking medications for relief of his general pain and testosterone cream purported to regulate fat, maintain muscle mass, increase energy, regulate blood sugars, and more.
Side effects of Tramadol can include dizziness, weakness, nervousness, agitation, problems with sleep, uncontrolled shaking of a part of the body, drowsiness, sweating, muscle tightness, and still more.
Side effects of Ambien can include, among others, drowsiness both day and night, a drugged feeling, sluggishness, stomach upset, and weakness.
While I don’t know which medication your husband is on to lower his cholesterol, those that contain statins can cause muscle and joint pain, nausea, diarrhea, constipation and if not monitored properly, liver damage. Niacin is notorious for causing flushing.
You don’t mention which blood pressure medication he is on so I cannot be specific but can generalize. Hot flashes and night sweats have been linked with his diagnosis. Beyond that, the main side effect of many of the agents prescribed is an increased urge to urinate. That act itself can cause an excessive excretion of potassium, essential for the proper functioning of muscles, nerves, heart, and kidneys.
I think by now you can see where I’m going with this thought process. Almost everything your husband is taking can contribute to his symptoms. I feel he should have a complete physical examination, laboratory testing, a baseline EKG and anything else his physician might deem appropriate. They should have an in-depth discussion regarding his medications. If his physician feels one may be at the top of the list of possibilities, perhaps a reduction in the dosage or a change to another drug without the side effects I mentioned might be appropriate. Your husband might consider asking about adding co-enzyme Q10 if he is on a statin which may combat the side effects of muscle and joint pain. Unfortunately, your husband can only eliminate one drug at a time; otherwise no one will know which one is to blame. There may be a crossover effect from one drug to another. Help and relief are possible for your husband but it may take some time until the answer is found through the process of elimination.
Readers who would like related information on pain relief can order my Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order made payable to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
