Holly26: tapering venlafaxine with a compound

[Holly26]

Hi Everyone,

 

I am in Venlafaxin for 13 years.  I tapered from 225mg now down to 30mg. I have a German compound who weighs the extended release beads and puts them back into a capsule. I now heard its impossible to do that because one can not weight down to 30mg active ingredient.  How do they know what are fillers and whats the ingredient?? Ich have 30mg one day with 20% filler and 80% active ingredient the other day 40%/60%??? That would be really bad. This would greatly mess with my brain chemistry. The other questions is what happens to the extended release? Do bigger beads mean they take longer to release the active ingredient???how do they find the best mixture of beads??? I called Pfizer they said they have research studies showing its NOT save to do it. But what other Option do i have? There are also pellets here in Germany.  They are standardised 3x12.5 which is 37.5mg. Would that be better????

Thank you for any help.

 

Kind Regards 

 

Edited October 31, 2020 by ChessieCat
removed name

[Shep]

Hi, Holly.

 

Welcome to SA.

 

Please have a read of this thread, as I think it will answer some of your questions. 

 

Tips for tapering off Effexor and Effexor XR (venlafaxine)

 

Are you currently taking any other drugs or supplements? 

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

 

If you have questions after reading the "tips for tapering" thread, please post them here in your introduction thread. 

[Holly26]

Wellbutrin while tapering Effexor

 

Hi,

 

I would appreciate your opinion. Im currently on 15mg of Effexor i taper 10% every 6 weeks.  Im so depressed that my psychiatrist suggested to add Wellbutrin.  I took it four days i had one good day on it than i got anxiety, insomnia so i had to quit. I consider to try again tbh.  He said an Alternative would be valdoxan.  Does anyone here know if Wellbutrin makes Venlafaxin wd worse? Thank you!!

 

Edited October 28, 2020 by ChessieCat
added topic title

[ChessieCat]

We need to know more about your drug history.  We need to know what reductions you have made to see if you have been tapering too quickly.  How you are feeling now might be related to how fast you have been tapering.  It might be that you need to hold for longer instead of continuing to taper, or perhaps a tiny updose might help.  These would be better options instead of adding a new drug.

 

As previously requested please create your drug signature by following these instructions.  Include ALL current and previous drugs AND supplements.

 

Instructions:  Withdrawal History Signature
Account Settings – Create or Edit a signature

 

Please note that SA assists members with reducing/getting off their psychiatric drugs, not adding in new ones.

 

Whenever a doctor makes a suggestion about a drug it is a good idea to do some research about it.  Check this site for information about side effects.  I did this recently when a doctor wanted me to take a very strong antibiotic and because of the FDA warnings about it I decided not to take it.  The infection cleared by itself with no treatment.  However, if I did need to take an antibiotic I would have asked the doctor to try other gentler ones first to see if they worked.  Some of the SA members have taken the strong antibiotic that the doctor wanted me to take and they had very bad reactions to it.

 

https://www.drugs.com/

 

You could also do a search for members who are taking the drug combinations that the doctor has suggested.  Use the following search strings in a search engine:

 

site:survivingantidepressants.org Effexor venlafaxine Wellbutrin bupropion

 

site:survivingantidepressants.org Effexor venlafaxine Valdoxan agomelatine

 

It is also helpful to do a drug interaction check.  Include ALL drugs you are currently taking (and also supplements, but they don't always have them in the database).

 

Drug.com Interactions Checker

Medscape Drug Interaction Checker

[ChessieCat]

30 minutes ago, Holly26 said:

Im so depressed

 

Please describe what this feels like.  Is it all the time or is it better/worse at different times?  How long have you felt like this for?

 

What (include when) withdrawal symptoms have you been getting this year?  Do you wait until they improve before you reduce again?  We call this withdrawal normal:  WDnormal

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

8 minutes ago, ChessieCat said:

It is also helpful to do a drug interaction check. 

 

Effexor and Valdoxan - I was unable to find Valdoxan in the interaction checkers because Valdoxan is not available in the USA.  The following is about this.

 

An internet search found the following from https://walrus.com/articles/what-is-agomelatine-and-why-isn-t-it-available-in-the-united-states

 

* See:  https://www.bmj.com/content/348/bmj.g2157/rr/692220

 

Quote

 

While the study from The Lancet showed results that pointed to agomelatine being safe and effective, it doesn't discuss two well-known problems with the drug:

• CYP1A2 drug interactions
• Potential liver damage

CYP1A2 Drug Interactions

CYP1A2 is one of the major metabolizing enzymes in the body and is responsible for the metabolism of many different medications. Agomeltine can potentially alter levels of CYP1A2 which could theoretically affect concentrations of a variety of different drugs. A high level of caution* would be needed in those taking agomelatine and other drugs that affect the CYP1A2 enzyme.

Liver Damage

While agomelatine may be relatively well tolerated during shorter clinical trials, often times more serious adverse effects are seen with long term use and this appears to be the case with agomelatine. Long term use of agomelatine was found to be associated with liver damage and its use in the markets it is approved in is contraindicated in patients with impaired liver function.

 

Impaired liver function in individuals is fairly common. Even the presence of elevated liver enzymes may preclude the use of agomelatine. If agomelatine were to be approved and used in the United States, routine lab monitoring of liver enzymes and function would be recommended throughout treatment.

 

 

 

[Holly26]

Thank you very much for your reply!! I have tapered Venlafaxin very slowly (10% every 4-8 weeks) over the last 3 years from 225mg too now 15mg. I feel like i cant cope anymore. I am depressed for 5 years now. Sleeping all the Time, tired, brain fog. I cant work i have no Life. I need to get off Effexor asap and go on Wellbutrin but i dont know how.  I cant wait another year and just vegetate through the days.  My alternatives would be valdoxan or Tianeptin.  Thanks for your reply!!

[Holly26]

Oh wow. Thank you for the article on Valdoxan.  I guess thats off the table.  Than it will be Wellbutrin i guess.  Problem is i need to get off the Effexor first. Could cbd be beneficial?  It blocks the cyp2d6 from Effexor and i thought with it it might prolongue its half life.  Idk anymore 😔

[ChessieCat]

On 4/27/2020 at 9:00 PM, Shep said:

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months.

 

Please add your drug signature.  This has been requested twice before.

 

On 4/27/2020 at 9:00 PM, Shep said:

Are you currently taking any other drugs or supplements? 

 

Please answer this question.

 

22 minutes ago, Holly26 said:

It blocks the cyp2d6 from Effexor and i thought with it it might prolongue its half life. 

 

What form of Effexor are you taking?

 

You may be experiencing interdose withdrawal.  You might need to be splitting your dose and take it twice a day.  If you would like us to assess this for you please keep daily symptoms notes for 3 consecutive days following these instructions.  Post a 24 hour period at one time:

 

Keep Daily Symptoms Notes

 

18 minutes ago, Holly26 said:

Could cbd be beneficial? 

 

See:  cannabis-marijuana-hashish-thc-cbd-or-hemp-oil

 

28 minutes ago, Holly26 said:

I need to get off Effexor asap and go on Wellbutrin but i dont know how.  I cant wait another year and just vegetate through the days.  My alternatives would be valdoxan or Tianeptin. 

 

I suggest that you try and find a doctor who knows how to do this the best/safest way.  Many doctors do tele-consults these days.  It would be good if you can find a doctor to plan your switch and get them to contact your family doctor.

 

recommended-doctors-therapists-and-clinics

 

 

 

[ChessieCat]

3 minutes ago, ChessieCat said:

What form of Effexor are you taking?

 

You may be experiencing interdose withdrawal.  You might need to be splitting your dose and take it twice a day.  If you would like us to assess this for you please keep daily symptoms notes for 3 consecutive days following these instructions.  Post a 24 hour period at one time:

 

Keep Daily Symptoms Notes

 

If you are experiencing interdose withdrawal, then splitting your dose might improve your situation.  It would be worth making the effort over the next few days to provide the notes to prove/disprove this BEFORE adding/switching drugs.

[Altostrata]

Hello, Holly.

 

What do you mean by "depressed"?

 

Are your symptoms better or worse at any particular times of day? Please post those daily notes.

 

We don't recommend drugs for treating fatigue here, that's your doctor's job. Effexor and Wellbutrin both can be stimulating. You say your fatigue increased after you reduced the drug. Have you had a check up for hypothyroidism, Lyme disease, or other medical condition that might be causing fatigue?

[Holly26]

Hello ChessiCat,

 

I take only 14mg of Venlafaxin currently.  Xr from Pfizer. I have two psychiatrists one added Wellbutrin to the 15mg of Venlafaxin and i had pretty strong side effects like anxiety insomnia rapid heart beat so i stopped the Wellbutrin after 4 days.  The other psychiatrists says to simply stop Venlafaxin and take Wellbutrin the next day. I dont trust that advice i think i will get pretty severe WD from Venlafaxin.  By depression i mean hypersomnia lack of motivation tired all day.  Its pretty bad.  This is why i took Venlafaxin 14 years ago. I dont necesssarily think its a WD Symtom i had it before i took Venlafaxin. 

 

Kind Regards 

Holly

[Holly26]

Hi Altrostata,

 

its more than fatigue.  I have all symptoms of clinical depression. I checked everything. Multiple blood work.For years i supplement D3, B12, Magnesium and get it checked regular. Mri, chiro, scan of my neck. I even had my genes tested.  Turned out I have mthfr 667 heterozygous which means i have reduced capacity to methylate b Vitamins which are crucial for neurotransmitters. Since than i take l methofolate.  No change in my mood. I got diagnosed with bipolar 2 ,14  years ago but now they reasses me and they dont know if i am bipolar or not their tendency is no since i only have very low mood over the last years.

 

Kind Regards 

Holly

[ChessieCat]

10 hours ago, Holly26 said:

I dont necesssarily think its a WD Symtom i had it before i took Venlafaxin. 

 

Q:  Had you taken any other drugs prior to venlafaxine?

 

Q:  Did you have any major life stressors before ever taking drugs?  OR lots of less-than-major life stressors?

 

Is it withdrawal or relapse?  Or something else?

How do I know it's withdrawal and not relapse?

 

Also see this post.

[Holly26]

Thank you for your answer! No i never even smoked or drank alcohol. Only Venlafaxin and lithium. Yes i had a major stressor before my first episode.  Loneliness seems to trigger it aswell.  I had a shock trauma when i was 8 years old. But the fact that i was diagnosed with bipolar 2 currently they dont know anymore, makes me think i need meds 🤷‍♀️

[ChessieCat]

Once a person has taken a psychiatric drug, diagnoses go out of the window.  The reason is that the drug adds chemicals to the brain and the brain adapts to getting those chemicals.  We need to take the drug away slowly so that the brain can gradually adapt back, ie reverse the process.

 

I suggest you check out this topic.  Chemical imbalance was a theory and was disproven at least 20 years ago.

 

again-chemical-imbalance-is-a-myth-stop-the-lies-please

 

If something/some things caused you to feel depressed before you started the drug/s and you haven't resolved/dealt with/received appropriate counselling for those things, then they are still there in your memory.  They haven't magically disappeared just because you took a drug that numbed your emotions.

 

You might be interested in what led up to me taking an AD.    See this post.  They were life stressors.  Some major, some minor, but over a long period of time, and not resolving as they arose, they built up so that I was unable to cope and willingly took an AD thinking that it would solve my problems.  All it did was delay that process for a very long time.  From what I know now if I had received counselling, been taught life, self soothing and coping techniques and received support I probably would not have end up on an AD.

 

Just prior to starting tapering I did an online CBT course which I have found very helpful.  Since joining SA 5 years ago I have learned many other very helpful non drug coping techniques.  And I'm now down to 0.56mg Pristiq after being an an AD for 25+ years.  And I'm now 63 years old.

[Holly26]

Thank you very much for your interesting post! I will look into your suggested links.  

Wow you came a pretty long way with tapering.  Awesome that you are almost finished 🙌🙌🙌. I feel totally lost in between diagnoses back and forth bipolar yes or no and not knowing what steps to take. I recognised i get ocd like symptoms every time i reduce Venlafaxin.  Can this be? Thank you so much for your help and awesome that you are almost down to 0!!!!! 

[KayJayBee]

Hi Holly. I took Valdoxan in order to help as I tapered off Venlafaxine. After feeling increasingly agitated and suffering akathesia my GP suggested I double the Valdoxan. Bad move - my akathesia and agitation became unbearable. I stopped it immediately and continued to taper without it. Much better. I have been off venlafaxine now since the end of September 2020 and feel pretty awful. I’ve also tried CBD oil (prescribed here in Australia), but after 6 weeks I don’t think it’s helping me. So I’m not sure what my next step is. Thinking of you! 💐

[Holly26]

I have another question. Is bridging to prozac for example adviced here to avoid WD? Thank you!

[ChessieCat]

Q:  What age are you?

 

If you are still menstruating, different times of the month can

 

the-prozac-switch-or-bridging-with-fluoxetine

 

In your case you are taking an SNRI.  Prozac is an SSRI.

 

On 11/1/2020 at 9:29 AM, ChessieCat said:

If you would like us to assess this for you please keep daily symptoms notes for 3 consecutive days following these instructions.  Post a 24 hour period at one time:

 

Keep Daily Symptoms Notes

 

I think this would be a good idea for you to provide these.  There may be something that the mods can notice that you haven't.

[Holly26]

Hi Chessie,

 

I am 37. I dont think its worse during my period, its too persistent. I feel depressed most days.  I could get my hormones  checked though.  That might be an idea. Sometimes i think im just lonely.  I dont want to get out of bed or do anything.  I will have a look at the Link you suggested.  Thank you!

[ChessieCat]

18 minutes ago, Holly26 said:

Sometimes i think im just lonely.

 

Has it got worse this year?

[Holly26]

Sorry i just saw your answer now!

Ya i am pretty lonely tbh. After a relationship breakup and moving back from Canada too Germany , i feel pretty lost. My depression kicks in again and the tapers are getting worse !!! The last drop from 15 to 14 mg was scary. Flu like symptoms dizzy  , tired that i couldnt drive anymore i layed down and had the most horrific nightmares. Derealisation. My psychiatrist want to bridge me with celexa. Im at 14mg of Venlafaxin and he gave me 5mg Celexa. How likely is it that i get a Serotonin Syndrom with this strategie? Im terrified. He wasnt specific on when to stop Venlafaxin with celexa conpletely 🤔. I guess I cant take them together for long. Next question would be how long until celexa is instaled in my brain chemistry ? I guess I will get withdrawls from celexa than . THANKS!!!

[ChessieCat]

You've had a relationship breakdown (major life stressor) and moved countries (another major life stressor).  Both of these can also cause loneliness.  And a relationship breakdown also causes grief.

 

Were you working in Canada?  Changing jobs or becoming unemployed are also major life stressors.

 

And then there is the upheaval and uncertainties caused by covid this year.

 

Venlafaxine is an SNRI and citalopram (Celexa) is an SSRI.  Changing from an SSRI to and SNRI (which is what happened to me - I was on citalopram) generally is okay but going the opposite way might not work and you could possibly get withdrawal symptoms caused because the SSRI doesn't have the "N" which your brain has adapted to getting.

 

I'm going to ask the other mods for their thoughts about your drug situation.

 

At this time I suggest that you do not change anything.  And I definitely would not be starting the citalopram until after the mods have assessed your situation.

[Holly26]

I really appreciate your help!!! Yes i wanted to immigrate to Canada and i was looking for a job there but didnt had one. You are right, all together plus the covid made my depression worse. But i also noticed that the slow taper from Venlafaxin doesnt work well anymore. Everytime i decrease i get hit by withdrawls. My psychiatrist said that the Noradrenalin part from Venlafaxin starts at 225mg. Since im down to 14 mg i was hoping that im only dealing with blocked serotonin receptors and that there might be a Chance that it works. Thanks again for your help!!!!!

[ChessieCat]

31. Oktober 14mg Venlafaxin 

Since i am at 19mg i experience WD

 

Q:  Did you continue tapering whilst experiencing withdrawal symptoms from 19mg? 

 

Many members find that the lower there dose gets the slower they need to go.  There also seems to be some doses (different for different people/drugs/doses so no guidelines) that members have difficulty getting post.  This topic helps to explain why this might be the case:

 

Why taper paper: dose-occupancy curves

 

I've asked one the mods who experienced poop out to check in on you.  You've been on the drug a long time.  I had been taking citalopram for a long time and when I experienced several major life stressors over a short period of time I had a break down.

 

Q:  Can you remember when you started noticing a difference in your mood?

 

Q:  Did it come on slowly over a long period of time?

[Holly26]

Hi Chessie,

 

no i always waited for the withdrawls to subside. Since i hit 19 i always wait a month or 2 before the next drop. I always get wd around the first week.Flu like symptoms, anxiety attacks, nightmares, sweating, dizzy.Not always everything but the last drop from 15 to 14 was scary.  I had derealisation i didnt feel like i was in my flat i felt confused and i was in bed and the dream 😳. The Depression is there for am pretty long time. 5 years with some relief while i was in Canada. Since being back in Germany my mood got worse. Thats why im currently watched by the mental health crises Team and they suggested bridging with Escitalopram. Im really scared of the Serotonin Syndrom tbh. But Im only at 14mg and they want to start with 5mg Celexa. Thank you very much for your help!! Much appreciated!!!!! 

[ChessieCat]

Thank for answering my questions.

 

Another question.  Do you find that your symptoms are worse before you take your dose and improve later on?

 

Just a reminder:

 

9 hours ago, ChessieCat said:

At this time I suggest that you do not change anything.  And I definitely would not be starting the citalopram until after the mods have assessed your situation.

 

To better assess your situation, please provide 3 consecutive days of daily symptom notes, 24 hour period at a time.  This post explains what is required. 

 

Keep Notes on Paper

 

[ChessieCat]

Are you taking any other drugs or supplements?

[Holly26]

My Withdrawls YES!! I was going back to 15 mg the last time after about 3 days on 14 and within one day the symptoms where gone. But my mood is low most of the time. I take the Effexor in the evening, in generell i dont feel a change in anything after i took it. No i didnt Start the Escitalopram.  Im not going to simply trust a psychiatrist ever again. 

[Holly26]

No im only on Venlafaxin.  I take fish lol, b vitamis, d3, b13 and Magnesium. 

[ChessieCat]

35 minutes ago, Holly26 said:

b vitamis

 

Some members find B vitamins activating, especially B6.

 

Please check your magnesium to see if it contains B vitamins.  I have only found one brand with only contains magnesium.  Others contains B vitamin/s and/or calcium.  Calcium should be taken 2 hours before or after magnesium if you are wanting the calming effect.

[Holly26]

Hi Chessie,

 

Ya i heard that before with the b Vitamins 🤔interesting. My Magnesium sais DiMagnesium Malate, Plant Cellulose, Rice Bran Extract. The only time my anxiety Sky rocketet was around my taper. Im not prone to to panick attacks, luckily, just generally overthinking, more GAD and OCD maybe . If I dont bridge with Escitalopram, can i expect the tapers to get worse the lower i get or is it more like you never know how bad the next taper will be? Because i think i couldnt handle worse to be honest

[ChessieCat]

58 minutes ago, ChessieCat said:

To better assess your situation, please provide 3 consecutive days of daily symptom notes, 24 hour period at a time. 

 

Please try this first.  Sometimes there might be something simple that can make a difference.  It would be silly changing to something else if it wasn't necessary.

[Holly26]

Hi Chessie,

 

the mental health crisis Team brought me the Escitalopram and i have to make a decision until tomorrow 😟. My main fear is that i will get the Serotonin Syndrom from 5mg Escitalopram and 14mg Venlafaxin.  They are not taking me off within a weak or so they want me to keep tapering slow along taking 5mg Escitalopram.  Im so scared 

[ChessieCat]

  This is from the Tips for Tapering Lexapro (escitalopram) topic:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

 

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

 

 

Alto, SA's founder, quite often suggests if a member bridges to a different drug that they switch to Prozac OR citalopram.  Citalopram is a gentler cousin drug to escitalopram.

 

Many members here have difficulties getting off Lexapro/escitalopram.  Do a search for them.

 

If it was me I would be telling them that you will think about it and decide in 1 month's time.  And during that time get further advice from here before making a decision.  Do your own research and get informed.  It's better to do this BEFORE you start something instead of taking something, possibly having difficulties and then trying to reverse things.  If you end up getting worse and then change back or change to a different drug/add one (which quite often happens) your brain can become very confused and your nervous system can become sensitised.

 

Remember they are not the ones who are going to be affected by the drugs.  It is you.

 

When bridging from one drug to another you do not stay on the first drug for very long (some doctors have members on both drugs for months and this is not the right way to do it).  You gradually reduce the old and increase the new.  Your doctor probably wants to keep you on venlafaxine for longer because of the difference between SNRI and SSRI.  Please carefully read Post #1 of this topic.  It is about switching to Prozac but a some of the information is relevant to switching to a different drug:

 

the-prozac-switch-or-bridging-with-fluoxetine

[ChessieCat]

Hi Holly,

 

One of the more experienced mods has read your topic and I have explained their suggestions below.

 

It seems that up until recently you have had a fairly easy, symptom free (or very minimal symptoms) taper.  The symptom pattern that you are describing is consistent with the symptoms that hit after a normal reduction but because they are new they are something that you are unfamiliar with.  This is a new symptom pattern for you and as such can be a bit scary and cause stress which in turn can increase the withdrawal symptoms.  You also have other things going on your life which is adding stress and would cause problems for anyone, even people not tapering.

 

Your taper has been a steady march, so the new symptom pattern is an indication that a  long hold is required before continuing. This will allow the brain to do some catching up making its adaptations.  After a long hold and the taper is resumed there will probably be symptoms with each reduction.  This is something that you will need to get used to.  Instead of tapering by 10% each month, a gentler way of tapering is the Brass Monkey Slide.  It's slower than the 10% every 4 weeks protocol, but the aim is to get off the drug with minimal discomfort.

 

Bridging to another medication or adding something else is not necessary and will only cause complications.

 

The suggestion is to stick with the venlafaxine and let things settle down.  That might take 3-6 months.  You've been on 14mg for 1 month now so the brain will already have made some adjustments.  You will probably find that over the next month the symptoms will improve even more.  However even if you start to feel okay after 2 months, the suggestion is to continue holding, not only for the brain to continue doing what it needs to do, but also because of the current situational stressors in your life.  Laying a solid foundation now will be helpful for when you recommence tapering.

 

Please understand that changing to a new drug may not cover the withdrawal symptoms from venlafaxine and you have no idea whether you will get start up/side effects/adverse reaction to a new drug.  You will not know what has caused any issues if they arise because of the variables.

 

And my (CC's) personal opinion is stick with the drug you know.  At the very least give it another couple of months.

 

Keep notes on paper so you can be more objective.  Sometimes there can be improvements that we don't notice unless we can look back to compare.  You might find it helpful to rates your symptoms.

 

Computer and printable versions of symptoms lists and also blank versions to add your own:

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

This is Karma's post about what she does: 

 

On 2/17/2012 at 2:02 PM, Karma said:

 

I rate my symptoms daily on a scale of 1 to 10, 1 being "awful, I feel like I'm dying, I can't take it any more", 10 being "great, flipping fantastic!", a 7 is when I feel the symptom, but I can tolerate it and get through the day - so for me a 7 is acceptable. Before I decrement my dosage I want at least two weeks of 7 or better in my symptom ratings ... especially anxiety and depression.

I rate my sleep the next morning and I rate anxiety, depression, ringing in my ears, pain, etc. at night. In the morning I go through the list and rate my sleep from the night before - I make a note next to some of the other symptoms, e.g. Aches & Body Pains - slight pain in right wrist AM, Anxiety - none AM, Ringing in the ears - mild AM, moderate by noon - that way I have reminders of how I've felt throughout the day to accurately rate my symptoms in the evening.

It doesn't matter if my 7 and your 7 are different - this rating system is for you. Once you start thinking about how the specific symptom felt during the day compared to the day before, you will begin to see when a specific symptom is improving or deteriorating. I find it really helpful when I am trying to tweak thyroid treatment or determine when I'm through initial withdrawal symptoms associated with decrementing my dosage.

Below are all of the things I rate daily - note that some of these symptoms are no longer a problem for me and generally get a rating of a 10. But I started this in 2008 when I was healing from celiac disease and getting my thyroid treatment optimal from hashimoto's thyroiditis. I had bone and muscle pain, fatigue and energy challenges, so should any of those problems come back I want to be able to detect it. E.g. the wrist pain I have is tendonitis and for me it is an indicator of whether my thyroid treatment is optimal.

Aches & Body Pains, Anxiety, Appetite, Energy, Ringing in the Ears, Fatigue, Mood (flat, upside or downside of flat, joyful, irritable), Drowsiness or Sleepiness in AM or during the day, Night sweats/day sweats, and Bowels/Digestion.

You should rate your symptoms, these are just examples of my symptoms.

 

 

 

 

Edited November 15, 2020 by ChessieCat