Has anyone tried hydroxyzine or flexeril to sleep?

Hi gang,
I made another message about trting to sleep... Have been on xanax just at bed and trying to keep my bp down while i get off it and have been told of flexeril and hydroxyzine aka Atarax or Vistaril...has anyone used these? I tried remeron a few weeks ago and it made me tachycardic....i just want OFF this xanax after four months, it is now causing me rebound anxiety and i dont want my afib to come back!!!
Thanks
Ben

Flexeril like all of the muscle relaxers, make me more tired lazy and sleepy. Is something bothering you, that you need to tend to that keeps you awake?

I have had insomnia my whole life, even being tired from apnea doesnt put me out... The xanax relaxed me but now its aking me up after sux hours and causing my always normal bp to spike a bit.... Ive been on it four months and want off it without having another afib attack... Have tried melatonin and valerian and all other otc stuff....
Thanks
Ben

Are you taking magnesium at bedtime? If so how much and what form?
Consider soaking first in a warm Epsom Salts bath for relaxing.

Also, consider the relaxing, anti-anxiety amino acid, L-theanine at bedtime. 200 mg - you may want to start earlier in the evening with a dose and then take one at bedtime as well. I've used the Jarrow brand for years.

or

Pharma Gaba (Stress Relax) by Natural Factors at bedtime. Try one capsule first; add a second if needed.

I have reports for both I can send if you want to read more. Send me a PM.

Jackie

5 mg of Sublingual MELATONIN 1 hour before bedtime. Works well for me.

Starwarsfan

I can relate----i too have had sleep problems for a number of years. I have taken Benadryl at night which helps me, also i have taken Ativan it too helps me. I take the smallest amount possible, but I have been reading that these pills can cause brain decline so I am trying to find some natural methods and get off these pills. I take magnesium before bed, might help a little.

I usually go to sleep when I go to bed but only sleep for about 4 hrs. then wake up and that is when i have a hard time going back to sleep. I usually feel my heart beating strongly, a heart doc. once said to me that i had a very strong heartbeat.

I have tried a few herbs like valerian which made me dizzy, the phone rang, getting up and answering it, I got dizzy so I don't take take one. Maybe we just are not able to sleep for 8 hours, I understand that Trump only sleeps for about 4 to 5 hours.

Liz

Thanks guys!
I do mag before bed, inhave taken for over ten yrs probably, i take it and taurine 4grams an hr before bed....takenboth for years, just for heart health, then THIS YEAR i get afib!

Jackie, i take the CALM powder, 2 tsp, which i believe is 325 mg, and then i take two more source naturals mag malate 125 mg throughout the day..i have added those since i had my first attack dec 1st....ive taken taurine and magnesium for at least 8-10 years and coq10 100mgfor fifteen yrs, since my twenties....
I have a REALLY large heart though, im a pretty tall and big guy though, i have no pwave abnormalities but large atria and ventr... My pulse is usually 52-56bpm lately, it has actually gone DOWN since ive stopped weight training, which sort of scares me...the weights i have done for thirty years with only a six month break once, started at twelve..
I also think my HR is lower from a med i take for pituitary tumor called cabergoline... It lowers norepinephrine...and sometimes thyroid, but my tsh was 1.9 a wk ago, best reading in yrs...
Melatonin made me sleep deeper, but popped up after one sleep cycle..
Liz- i dont know the half life of ativan, but i feel like xanax which is similiar definitely wakes me up sooner due to rebound anxiety...i think the taurine maybe helps stay asleep, i also take about 25 mg of vitamin b6 coenzyme called p5p before sleep, seems to make me stay asleep/dream more..
I have the hydroxyzine and flexeril, i guess no one has taken those?

Starwarsfan.... Thanks for the details. To answer your question on flexeril, yes, I was prescribed that many years ago for fibromyalgia which was actually a misdiagnosis, so it did nothing for the FM but did make me feel terrible. One of the listed side effects is an irregular heart beat.

Since you offer that you are tall and "big guy"... you might consider increasing your dosing of magnesium. I'd change to the amino acid chelated form.... magnesium glycinate.... since it has the best chance of being transported directly to the cell's interior which is where it functions. Increase dosing and change the form. Let bowel tolerance be your guide as to how much you take daily. That can vary depending on depleting influences such as stress and the fact that you do take Rx drugs which help deplete magnesium...so it's a battle to stay optimized.

Glad you have stopped the weight lifting, esp. if your heart is enlarged. That's a whole other and very important topic.

I also take the coenzymated form of B6 (P5P) and have for many years along with a B Complex for balance, but I've always been instructed to take B vitamins in the morning because later in the day can be too stimulating. You may want to change your dosing from bedtime to morning or at least by noon.

Also, although TSH is not the best marker for thyroid function, it is the most commonly referenced and when the number gets lower than 2.0, it's smart to make sure it doesn't go much below that as that trends toward hyper-thyroidism and the symptoms of that can be arrhythmia, insomnia and much more.

Are you in the care of a practitioner who incorporates nutritional therapy and testing in the patient's treatment plan?

Jackie

PS - on the magnesium... consider soaking in an Epsom Salts bath before bed. Relaxing and a good way to add more magnesium. You can also use the topical magnesium (transdermal).... for quick delivery.



Edited 1 time(s). Last edit at 04/13/2017 09:12AM by Jackie.

As Jackie noted TSH is not at all a robust stand-alone thyroid marker and is actually more a pituitary gland hormone that impacts thyroid levels. Using Free T3 and Free T4 are much more valuable guides to thyroid function.

That said, since TSH is so often overused as the sole marker used to treat thyroid function ... inappropriately in my view and that of many more enlightened endocrinologist ... it does have a role used along with Free T3 and Free T4 and the ideal TSH levels range from 0.4 to 1.0. even TSH levels as relatively low as 2.1 and higher are increasingly associated with increased arterial plaque and arteriosclerosis. The cut off number for diagnosing hypothyroidism used to be a TSH of 10!... Dooming untold millions to living a sluggish, highly fatigued life with pronounced CVD risk and mild cognitive dysfunction with slower brain speed from the classic hypothyroid brain fog.

The Endocrinology societies then lowered the threshold for Hypo diagnosis to a still too high 5.0/4.5 and still far to many blood labs still use 5 or 4.5 as the marker for Hypo and thus still leave out millions of clearly clinically diagnosable hypo sufferers. Now, most Endo societies recognize a TSH of 3.0 as the threshold for treating hypothyroidism which is significantly better. However the vast majority of more thyroid-enlightened physicians now recognize and offer thyroid treatment to all those from TSH 2.0 and above, provided the patients Free T3 and Free T4 tests confirm the diagnosis, and no really well informed thyroid doctor will use TSH alone to make such a determination, and especially will not use TSH alone for thyroid dose adjustment which is a travesty!

Shannon



Edited 1 time(s). Last edit at 04/17/2017 09:10AM by Shannon.

Shannon:

Your statement of " the ideal TSH levels range from 0.4 to 1.0. even TSH levels as relatively low as 2.1 and higher are increasingly associated with increased arterial plaque and arteriosclerosis" is perplexing. You are saying that TSh levels above 1.00 are associated with aterial plaque and arteriosclerosis, where is that coming from.

i have had to increase my thyroid meds a few months ago and the last blood draw my tsh was 1.1. However, during my thyroid history i have had my levels a little lower than 1.1 and much higher than 1.1, my thyroid was zapped in the early 90s, that is 27 years.

liz

Hi Liz,

I am saying that an ideal TSH rangers from 0.4 to 1.0 statistically but that the beginning of detectable plaque/ arteriosclerosis begins from 'as low at 2.1 TSH.

The range between 1 and 2 is the rough 'fudge factor' done where there is generally no need to add thyroid hormone replacement therapy and most people will still be within a broader sweet spot from 0.4 to 2.0 with a more precise optimal range for near ideal TSH is 0.4 to 1.0 ... like in all things hormonal there will be a fairly broad healthy range in the U shaped curve with increasing dysfunction the further one moves out of the sweet spot or optimal target either towards hyperthyroidism general well lower than 0.4 TSH or for hypothyroidism the farther you go above 2.1 TSH'. Keep in mind that the lowest threshold where mild plaque formation was noted in people getting TSH testing was as low as 2.1, but that does not mean a person will be manifesting overt hypo symptoms at the low a level and thus the readings of FT3 and FT4 will better define which of your those people with a TSH of ranging from the lowest of 2.1 up to say around 2.5 or a bit higher would get a diagnosis of mild to moderate hypothyroidism. The point about detectable plaque increase being statistically significant in folks averaging TSH starting in the range from 2.1 to 2.5 or so is offered just to show that even often subclinical changes such as early plaque accumulation often begins in the broad range beginning from the low 2s of TSH, but as always it takes FT3 and FT4 levels analysis plus the findings of a thorough clinical physical signs and symptoms assessment before considering a formal diagnosis of hypoT and begin threatme with thyroid hormone replacement.

And these findings of early stage plaque formation staring as low as 2.1 is just one of several more subtle markers in this same range of the low to mid 2s TSH levels where the slippery slope into what increasingly will typically progress into formal hypo to further one goes above the low to mid 2s. This is why so many Thyroid knowledgeable physicians use around 2.1 and above as the lowest point where they typically consider starting treatment in those who are clearly suffering early hypoT symptoms.

I know of no physicians who would consider treatment with the thyroid replacement hormone therapy below 2.0 TSH unless the patient had undeniably significant hypo symptoms and signs such as markedly delayed achilles' tendon reflexes, pronounced morning fatigue and mental sluggishness etc etc along with direct thyroid hormone levels such as FT3/FT4 showing a hypoT range too.

Keep in mind too that TSH is NOT a precise indicator of overall thyroid function by any means. I would never consider a dose adjustment based solely only on TSH and without a Free T3 and Free T4 reading taken at the same blood draw ... at a minimum. The smart and experienced doctor will also include careful assessment of physical signs and symptoms along with the the three primary thyroid panel test numbers ... and not just make treatment decisions on lab results alone as too often do the rather lazy docs (or just poorly informed) with an inadequate approach to thyroid treatment in my view .

The 0.4 to 1.0 optimal range for TSH alone is a widely accepted range among many advanced thyroid trained physicians and many blood labs in North American and Europe, although still far too many labs use a too high threadhold of 4.5 TSH before even considering a hypoT diagnosis.

At 2.1 TSH levels with equal test evidence of early mild onset hypothyroidism it is just the beginning of where, on average, such clinical evidence of hypo can start being detected. Numerous studies have confirmed this association, as noted at every BHRT fellowship training conference I have been to over the last ten plus years as well.

The reason I point this out, is not to suggest some great calamity will happen with untreated mild hypo starting at TSH 2.1 , but rather the evidence points to TSH above 2.1 com bined with confirming FT3 and FT4 plus at least mild early physical signs and symptoms of hypo strongly suggest this is the range when thyroid treatment, whether with desiccated thyroid hormone replacement, low dose T4+ perhaps some added very low dose T3, or just glandular thyroid extract plus herbal and nutritional thyroid support can be considered in the earlier stages, especially if the patients is already having clear symptomatic early hypo symptoms.

Most people can limp along pretty good up to TSH 3.0 if their FT3 is still decent, but it is not ideal by any means typically by the time one is consistently 3.0 TSH and above.

Shannon



Edited 1 time(s). Last edit at 04/17/2017 09:49AM by Shannon.

Shannon:

I have not ever read anything that the beginning of detectable plaque/ arteriosclerosis begins from 'as low at 2.1 TSH. Are you saying that If my TSH is usually 2.5 ( which it has been) then plaque/arteriosclerosis has been cooking in my body?

I agree that TSH is not the only indicator, free t3 and free t4 are very important. So, if my free t3 and free t4 are very good and my tsH is 2.5 or 3.5 then I am accumulating plaque/arteriosclerosis? For years the medical testing range for tsh was up to 5.0, it has been only in the last few years that the levels have dropped.

The thyroid hormone is powerful, I would rather be around 1.5 to 2.00. Once upon a time after my thyroid was zapped I was feeling a little tried, I knew my Pharmacist and I mentioned it to him. He suggested taking a little more of the synthroid which I did, I did not realize how powerful that little pill was. One day my heart ran away flipping and flopping I was in AF which was the beginning of my journey.

Liz

No Liz,

The reference for TSH being 'associated' with TSH as low as 2.1 and above are from the combined analysis of several large meta-analysis in the published medical literature. It has been presented at many BHRT conference with full references and when I have the actual time to go fishing through all of my records I will try to dig it up for you, but this reference is valid and very often cited at such large bio-identical hormone therapy/Integrative medical conferences I have attended.

What it does NOT mean though is that you, Liz, definitely have plaque build up the moment your TSH goes above 2.1. Many factors can alter the course of plaque build up in any given individual with TSH being only one associated variable. And like I said a couple times above, TSH only has real meaning as a diagnostic tool, in my view, within the context of FT3 and FT4 readings, with at times a given person also needing Reverse T3 results, and/or Anti-TPO levels (the latter to test for possible Hashimoto's thyroiditis), in addition to the FT3/ FT4 and TSH tests, in order to gain a more well-rounded thyroid health picture.

These are statistical findings too Liz , and show the overall trend is for a rise in plaque with the beginning of mild arteriosclerosis noted once TSH starts to rise above as low as 2.1, versus the collection of many subjects across multiple large studies combined in these meta-anaylsis reports who had TSH under 2.0 in which early plaque formation was largely absent.

With a strong FT3 and FT4 that should, indeed, provide whatever measure of benefit that a robust theraputic levels of thyroid hormone production can give toward reducing plaque and arteriosclerosis risk, in spite of whatever your TSH number is (up to a degree). This is because as, we both noted Liz, FT3 and FT4 when in an optimal range, are far better markers of robust thyroid function than any TSH number alone.

But remember too, heavy arterial plaque build up has a very long associated history with Myxedema and severe hypothyroidism as far back as the late 1800s to early decades of the 1900s there are numerous autopsy records showing people in Europe and the US who died of multiple causes and who also suffered from several hypothyroidism with pathology findings of the classic puffy bloated features of myxedema, and in many of the autopsy an almost universal finding was a very significant arteriosclerosis with many of these severely hypo patients having died of CVD, heart attacks, and strokes. Now myxedema is a severe stage of hypothyroidism to be sure, but the point of this discussion is that very early physical signs of hypo can start as low as a TSH of 2.1, even when in some cases at that level the person may have little to no physical symptoms of hypoT yet.

I recall reading a pathologist account written from those old days, when the only diagnostics for hypothyroidism were learning physical signs and symptoms (still the best way, in my view, to accurately diagnose thyroid dysfunction, but alas it is very much a lost art too for so many modern physicians and even endocrinologists. In any event, this pathologist noted that they could diagnosis hypothyroidism simply by the degree of plaque build up in the arterial system. The pathologist noted that: " those with pronounced myxedemia on post mortem review invariably had severe "hardening or the arteries" as it was called back then.

So it's not very surprising at all that the early stages of such plaque build up could be detected at some point relatively early along the curve of gradual onset hypothyroidism, as only one of any number of dysfunctional health outcomes associated with poorly treated hypothyroidism.

Anyway Liz, at some point when I have the time to breathe I will try to look up the exact reference for the meta-analysis that showed the first increase risk of added arterosclerotic changes at a TSH as low as 2.1 and above,, but you can trust me Liz, it is there in the literature. And keep in mind, this does not mean that from a TSH level >2.1 everyone will officially have CVD at that point ... not by a long shot!

That is not at all what is being suggested by those studies, it only highlights the well-known association of hypothyroidism and increased risk of CVD over time, with a host of other variables determining if, and to what degree, any given person will actually manifest full blown CVD or have a heart attack with a TSH increasingly higher than 2.1.

In the meantime, I just googled Myxedmena and arteriosclerosis and from the very first reference that popped up, I have copied these few paragraphs below to show the well known connection from a random reference.

Hypothyroidism and traditional cardiovascular risk factors

There is substantial evidence that overt hypothyroidism alters several of the traditional risk factors for cardiovascular disease. These studies support a biologically plausible role for hypothyroidism increasing the risk of atherosclerotic cardiovascular diseases, via increases in circulating levels of highly atherogenic low-density lipoprotein (LDL) cholesterol particles, induction of diastolic hypertension, altered coagulability, and direct effects on vascular smooth muscle. Furthermore, some evidence suggests that hypothyroidism may exacerbate the cardiovascular risks associated with cigarette smoking and insulin resistance.

Elevated levels of total cholesterol, LDL cholesterol, and apolipoprotein B are well documented features of overt hypothyroidism (14). Significant progress has been made in clarifying the mechanisms leading to these adverse changes in circulating lipid concentrations. Early studies in humans with hypothyroidism, using isotopically labeled LDL, demonstrated a prolonged half-life of LDL cholesterol because of decreased catabolism, an effect that was reversible with T4 therapy (15). Additional data in human fibroblasts verified that the T3-induced increase in LDL degradation was mediated through an increase in LDL receptor number, without any change in the affinity of LDL for its receptor. A specific effect of thyroid hormone on the LDL receptor was suggested by a lack of T3 effect on LDL concentration in cultured cells without LDL receptors (16). These findings were supported by an in vivo study in a hypothyroid woman whose receptor-mediated LDL catabolism was reduced, compared with euthyroid controls, with significant improvement after T4 replacement therapy (17). Further studies in rats with propylthiouracil-induced hypothyroidism showed a reduction in LDL receptor mRNA levels by 50% (18, 19). Molecular mapping has revealed functional thyroid response elements in the promoter region of the LDL receptor. When the LDL receptor promoter was linked to a reporter gene and cotransfected with the β1 isoform of the thyroid hormone receptor into a hepatic cell line, specific stimulation by T3 of this chimeric gene’s activity was observed (20). Furthermore, deletion of the upstream thyroid response elements in the LDL receptor promoter inhibited T3-mediated reporter gene activity.

Additional potentially atherogenic effects of hypothyroidism on lipid metabolism include a reversible reduction in clearance of chylomicron remnants (35); reduced activity of cholesteryl ester transfer protein, which is involved in reverse cholesterol transport pathway (36, 37); and decreased activity of hepatic lipase (38, 39) and lipoprotein lipase (38).

Hypothyroidism can also increase cardiovascular risk by causing diastolic hypertension. In one study of 169 women with overt hypothyroidism, the prevalence of hypertension was nearly 3 times higher than in a euthyroid control group (14.8% vs. 5.5%) (40). Euthyroid normotensive patients in another report had an increase in diastolic blood pressure after thyroidectomy-induced hypothyroidism (41), and hypertension was reversed by T4 treatment./i][/b]

The take home message, is adequate thyroid function is important at all stages of life. For us Afibbers, especially with active AFIB, we often have to compromise somewhat on achieving an optimal thyroid hormone profile in favor of making sure we dont have too much T3 circulating around to trigger an active tendency for the flippies .. thyroid balance for Afibbers it thus often a fine balance, but ignoring hypothyroid is not good for overall health as well as heart health and is not good for AFIB either.

Shannon



Edited 2 time(s). Last edit at 04/17/2017 09:58AM by Shannon.

Shannon:

I see nothing in your article that says 2.1 TSH is considered to be hypothyroid, my TSh has tested many times in the past around 2.1 + or -, Dr. Brownstein found nothing wrong with those numbers.

My t4 is usually around the middle of the lab values, now my T3 is toward the lower end. I am not saying that hypothyroidism isn't a bad thing, but I don't think that 2.1 is hypo. I am sure that in the early 1800 and 1900s there were a lot of people with hypothyroidism, real hypo, not maybe a little hypo.

My thyroid meds have been increased, I feel good but now I have started getting more AF. I used to get it once every 2 or 3 months sometimes a little more often now I just started getting it every few days, I don't know if the increase in thyroid meds is doing this but I am going back to my previous dose, If this keeps up I may have to go to Texas, perhaps they do not do ablations at my age?

Liz



Edited 1 time(s). Last edit at 04/16/2017 11:53PM by Elizabeth.