Hello Shockspray,
Wow, you MUST feel miserable, but your situation is NOT hopeless.
First things first. You MUST take your full dose of levothyroxine,
(and all your medications). An out of kilter thyroid can cause
numerous problems, an irregular heartbeat being one of them. Zoloft
can also cause dizziness, especially during the first days you take
it.
These are the symptoms of hypothyroidism (Low thyroid):
--------------------------------------------------------
Weight gain
Puffy face
Loss or thinning of eyebrows
Cold intolerance
Low sex drive
Depression
Abdominal bloating
Cold hands or feet
Dry or thinning hair
Joint or muscle pain
Thickening of the skin
Thin, brittle fingernails?
As your thyroid hormone levels fall over the following months, the
skin becomes rough and dry, hair coarsens, and mental
activity?including concentration and memory?may become slightly
impaired.
Depression can develop, and some experts believe that even mild
thyroid failure can lead to major depression.
Other later symptoms include a husky voice and numbness of the arms
and legs. Muscle pain, weakness, and carpal tunnel syndrome may occur.
Some people experience hearing loss, depression, mental confusion,
uneasiness, daytime sleepiness, or memory problems, especially in the
elderly. Obstructive sleep apnea, in which tissues in the upper airway
collapse at intervals during sleep, thereby blocking the passage of
air, is common.
http://www.armourthyroid.com/hypothyroidism/symptoms.html#summary
?They found that the older patients had fewer symptoms, and some of
the classic signs (eg, cold intolerance, weight gain) were often
absent. Moreover, the common clinical features of hypothyroidism (eg,
fatigue, constipation, cognitive loss) are often attributed to normal
aging (table 1). These factors, along with the fact that
hypothyroidism has an insidious onset and affects multiple organ
systems, may cause considerable delay and difficulty in diagnosis.
Therefore, it is important to have a high index of suspicion and a low
threshold for screening for thyroid dysfunction in elderly patients
who present with vague, nonspecific symptoms.?
http://www.postgradmed.com/issues/2003/05_03/mohandas1.htm
Continue on with the Zoloft, unless you experience side effects, and
if you do, notify your doctor. Antidepressants can take 2-3 weeks to
work well. In 2-3 weeks you should see an improvement. If not, let
your doctor know; there are many other good SSRIs (A form of
antidepressant) available, and not all work for all people. Lexapro is
one that works quickly and has few side effects for most people, if
any.
?Other aspects of seniors' lives can also put them at risk for
depression. While living longer, many will also be living with some
condition such as arthritis, heart disease, or diabetes, which limits
their activities or causes chronic symptoms or pain. These limitations
can deprive older people of the satisfactions of exercise, social
contact, and meaningful activities such as volunteer jobs or
participation in cultural events. Understandably, chronic pain often
causes depression -- what could be more discouraging than being
uncomfortable most of the time? In addition, some medical conditions
which are common in the elderly cause depression directly through
physiological mechanisms -- Parkinson's disease and stroke are the
most obvious examples. Finally, excess use of prescription drugs or
alcohol, surprisingly common among the elderly, may contribute to
depression (or be a symptom of it).
So far we have been discussing depression in the abstract, as if we
know what it is. But what, in fact, constitutes true depression, and
how does it differ from a normal response to life's difficulties??
?If depressive symptoms are more serious, professional attention may
be necessary. Counseling may help a person cope with loss, family
conflict, or health problems. Antidepressant medications are also a
mainstay of treatment for significant depression. Modern
antidepressants are much safer and have fewer troublesome side effects
than older ones. These medications, once shunned except in extreme
cases, often produce dramatic improvement and welcome relief from
suffering. Perhaps most importantly, today's primary care doctors are
much more alert to depression than in past years, and many of them
know how to use antidepressants wisely. In more serious cases, they
may refer elderly patients to a psychiatrist for evaluation and
treatment.
Either way, the important thing is for depressed older patients to get
the attention that they need. Fortunately, today's elderly are more
willing to acknowledge depression as a problem than in previous
generations -- and are less hesitant to get help for it. Detecting
depression in the first place is the most critical step. As long as
someone recognizes the problem, modern treatment is more effective and
more available than ever.?
http://www.pamf.org/health/toyourhealth/depressedelders.html
?Older depressed individuals often have severe feelings of sadness,
but these feelings frequently are not acknowledged or openly shown.
Sometimes, when asked if they are "depressed", the answer from persons
suffering from depression is "no". "Depression without sadness" is one
of those seeming paradoxes that impedes its recognition. Some general
clues that someone may be suffering from depression in such cases are
persistent and vague complaints and help seeking, along with frequent
calling and demanding behavior.?
?Although there is no single, definitive answer to the question of
cause, many factors -- psychological, biological, environmental and
genetic -- likely contribute to the development of depression.
Scientists think that some people inherit a biological make-up that
makes them more prone to depression. Certain brain chemicals -- like
norepinephrine, serotonin, and dopamine -- are probably involved in
major depression.
While some people become depressed for no easily identified reason,
depression tends to run in families, and the vulnerability is often
passed from parents to children. When such a genetic vulnerability
exists, other factors like prolonged stress, loss, or a major life
change can trigger the depression. For some older people, particularly
those with lifelong histories of depression, the development of a
disabling illness, loss of a spouse or a friend, retirement, moving
out of the family home or some other stressful event may bring about
the onset of a depressive episode. It should also be noted that
depression can be a side effect of some medications commonly
prescribed to older persons, such as medications to treat
hypertension.?
http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=7515
?Symptoms
? depressed or irritable mood
? feelings of worthlessness or sadness
? loss of interest or pleasure in daily activities
? temper, agitation
? change in appetite, usually a loss of appetite
? change in weight
o unintentional weight loss (most frequent)
o weight gain
? difficulty sleeping
o daytime sleepiness
o difficulty falling asleep (initial insomnia)
o multiple awakenings through the night (middle insomnia)
o early morning awakening (terminal insomnia)
? fatigue (tiredness or weariness)
? difficulty concentrating
? memory loss
? abnormal thoughts, excessive or inappropriate guilt
? excessively irresponsible behavior pattern
? abnormal thoughts about death
? thoughts about suicide
? plans to commit suicide or actual suicide attempts
?Antidepressant drug therapy has been shown to increase quality of
life in depressed elderly patients. These medications are carefully
monitored for side effects, and doses are usually lower and increased
more slowly than in younger adults.?
http://www.nlm.nih.gov/medlineplus/ency/article/001521.htm
Your Parkinsons? medication may be responsible in part for your
depression! However, do NOT discontinue taking the Sinemet! Discuss
this with your doctor.
Physical factors, including genetics
? inherited tendencies toward depression
? co-occurring illness (such as Parkinson's, Alzheimer's, cancer,
diabetes or stroke)
? vascular changes in the brain
? a vitamin B-12 deficiency (as yet unclear if this is caused by poor
eating habits or a result of depression)
? chronic or severe pain
Personality characteristics (may also be symptomatic of unresolved trauma)
? low self-esteem
? extreme dependency
? pessimism
Medications (all medications have side effects, but some can cause or
worsen the symptoms of depression)
? some pain medicines (codeine, darvon)
? some drugs for high blood pressure (clonidine, reserpine)
? hormones (estrogen, progesterone, cortisol, prednisone, anabolic steroids)
? some heart medications (digitalis, propanalol)
? anticancer agents (cycloserine, tamoxifen, nolvadex, velban, oncovin)
? some drugs for Parkinson?s disease (levadopa, bromocriptine)
? some drugs for arthritis (indomethacin)
? some tranquilizers/antianxiety drugs (valium, halcion)
? alcohol.
http://www.helpguide.org/mental/depression_elderly.htm
Side Effects of Zoloft:
----------------------
?Adverse Effects
In clinical development programs, sertraline has been evaluated in
1902 subjects with depression. The most commonly observed adverse
events associated with the use of sertraline were: gastrointestinal
complaints, including nausea, diarrhea/loose stools and dyspepsia;
male sexual dysfunction (primarily ejaculatory delay); insomnia and
somnolence; tremor; increased sweating and dry mouth; and dizziness.
In the fixed dose placebo controlled study, the overall incidence of
side effects was dose related with a majority occurring in the
patients treated with 200 mg dose.
http://endoflifecare.tripod.com/huntdiseasefaqs/id52.html
http://www.rxlist.com/cgi/generic/sertral_ad.htm
Sinemet
-------
Have you tried Sinemet CR? If not, you may want to speak to your
doctor. Fewer ?off times? are reported with Sinemet CR than Sinemet.
Sinemet can also cause dizziness and light-headedness, especially when
standing up from a sitting position. A rapid heartbeat (tachycardia)
and loss of appetite can be caused by Sinemet. Your blood should be
checked regularly for kidney and liver function while taking Sinemet.
You are probably aware that over time, Sinemet may be less effective
than it was when you started taking it.
?In clinical trials, patients with motor fluctuations experienced
reduced off time with Sinemet CR when compared with Sinemet. Global
ratings of improvement and activities of daily living in the on and
off states, as assessed by both patient and physician, were slightly
better in some patients during therapy with Sinemet CR than with
Sinemet. In patients without motor fluctuations, Sinemet CR provided
therapeutic benefit similar to Sinemet but with less frequent dosing.
Pyridoxine hydrochloride (vitamin B 6), in oral doses of 10 mg to 25
mg, may reverse the effects of levodopa by increasing the rate of
aromatic amino acid decarboxylation. Carbidopa inhibits this action of
pyridoxine.?
http://www.rxcarecanada.com/Sinemet%20CR.asp
Charts of side effects:
http://www.rxlist.com/cgi/generic3/sinemet_cr_ad.htm
See page 5 of this document for side effects. (I am unable to copy this material)
http://www.msd-newzealand.com/content/downloads/SINEMETCR%200720004%20(%20Code%20No%20only)%20CMI.pdf
(Sinemet) ?Dosage should be titrated to the individual patient needs
and this may require adjusting both the individual dose and the
frequency of administration.
Studies show that the peripheral dopa decarboxylase is saturated by
carbidopa at approximately 70 to 100mg a day. Patients receiving less
than this amount of carbidopa are more likely to experience nausea and
vomiting.?
http://www.medsafe.govt.nz/Profs/Datasheet/s/Sinemettab.htm
Take your medications as prescribed. If you suffer from side
effects, you must visit your primary care physician for an assessment
and blood tests to determine your medication levels, thyroid, etc. I
would recommend not wasting money on digestive aids. Instead, as I
previously mentioned, eat a balanced diet,take your meds properly and
see your doctor.
Keep all your medication in a dry, dark place, away from moisture and
sunlight. Do you have one of those weekly pill boxes? This is an easy
way to remember which pills you took. Make yourself a schedule or
chart where you can record your medications, perhaps checking them as
you take them. It?s important to take your pills on time, in full
dosage, as needed!
Pill Box
http://www.forgettingthepill.com/cgi-bin/ForgettingThePill/order.cgi?orderone++Organizers+1+312+1
Here?s a printable reminder chart
http://www.derwentside-pct.nhs.uk/medicine_management/documents/medication/med_reminder_chart.pdf
Here?s a reusable chart:
http://www.epill.com/chart.html
I?m concerned with your loss of appetite, which your medications
can worsen. Try to eat small portions, but eat often ? grazing, it?s
called. Do you have dentures, and if you do, do they fit well? It
sounds as if you need to be seen by your doctor, and take care of
these problems. Are you able to take short walks? Exercise will do
wonders for your outlook and spirit, not to mention your muscles,
heart and lungs! On days when you don?t feel like eating, try
nutrition-enriched drinks, such as Ensure or Boost. Ovaltine in a
glass of milk provides needed vitamins and protein.
Do you have friends or family to eat with? Is there a senior center
you could join to have meals with company? Continue taking a (one)
multi-vitamin each day, but don?t take extra B vitamins that can
interfere with your Sinemet. Add more fiber (formerly called
roughage!) and calcium to your diet by way of fruits, vegetables,
whole grains, and dairy products. Be sure and stay hydrated by
drinking plenty of water and juices. A glass of orange juice a day can
supply needed folic acid needed to produce stomach acid for digesting
food.
?Do you have trouble chewing? If so, you may have trouble eating foods
like meat and fresh fruits and vegetables.
What to do: Try other foods.
Instead of: fresh fruit Try: fruit juices and soft canned fruits,
like applesauce, peaches and pears
Instead of raw vegetables Try: vegetable juices and creamed and mashed
cooked vegetables
Instead of meat Try:ground meat, eggs, milk, cheese, yogurt, and
foods made with milk, like pudding and cream soups
Instead of sliced bread Try:cooked cereals, rice, bread pudding, and
soft cookies
Problem: Can't shop
You may have problems shopping for food. Maybe you can't drive
anymore. You may have trouble walking or standing for a long time.
What to do:
? Ask the local food store to bring groceries to your home. Some
stores deliver free. Sometimes there is a charge.
? Ask your church or synagogue for volunteer help. Or sign up for help
with a local volunteer center.
? Ask a family member or neighbor to shop for you. Or pay someone to
do it. Some companies let you hire home health workers for a few hours
a week. These workers may shop for you, among other things. Look for
these companies in the Yellow Pages of the phone book under "Home
Health Services."
Problem: No appetite
Older people who live alone sometimes feel lonely at mealtimes.
Loneliness can make you lose your appetite. Or you may not feel like
making meals for just yourself.
Maybe your food has no flavor or tastes bad. This could be caused by
medicines you are taking.
What to do:
? Eat with family and friends.
? Take part in group meal programs, offered through senior citizen programs.
? Ask your doctor if your medicines could be causing appetite or taste
problems. If so, ask about changing medicines.
? Increase the flavor of food by adding spices and herbs.
http://www.proteinhealth.com/weight_loss_eating_well_older_adults.php
?Since you are eating less food to maintain a healthy weight, you have
to be more careful about choosing low-fat and nutrient-rich foods. As
the years pass and you lose lean body mass (muscle), your metabolic
rate slows down and you burn calories more slowly. Exercise is the
best way to maintain lean body mass and speed up your metabolic rate.
As for vitamin and mineral requirement, even healthy elderly people
may exhibit deficiencies for vitamin B6--resulting from lower intake
and higher requirements; vitamin B12 and folate -- due to low intakes
and malabsorption; vitamin D -- as a result of reduced exposure to
sunlight, low intakes, age related decreased synthesis; and zinc --
resulting from low intake associated with low energy intakes.?
Dental problems may incline some seniors to avoid eating foods that
must be chewed well?skin on fruits and certain meats, for example.
Changes in the senses of smell and taste?which can result from aging
itself or from drug therapy?can cause decreases in food consumption or
disinterest in, even aversion to, formerly preferred foods. By age 75,
people have only half as many taste buds as they did at 30. In
addition, loneliness, depression and the financial restrictions of
living on a fixed income can interfere with an older person's ability
to buy and prepare good food. Since food is often associated with
family and social events, preparing food and eating alone can be
difficult for older people who have reached a stage in life where many
of their loved ones have either died or moved away. For many, a loss
of appetite follows the loss of companionship. Older men who have lost
their wives (who did the cooking) may be at special risk.
? Add a little more spice or sugar to foods to enhance their flavor.
? Due to the importance of getting enough calcium, ensure that you
focus on high calcium foods. If milk is unacceptable, try fish with
bones like ikan bilis or sardines, tofu, cooked beans or even low-fat
ice cream. Take a supplement if you know you are not consuming enough
calcium.
?Elderly patients with unintentional weight loss are at higher risk
for infection, depression and death. The leading causes of involuntary
weight loss are depression (especially in residents of long-term care
facilities), cancer (lung and gastrointestinal malignancies), cardiac
disorders and benign gastrointestinal diseases. Medications that may
cause nausea and vomiting, dysphagia, dysgeusia and anorexia have been
implicated. Polypharmacy can cause unintended weight loss, as can
psychotropic medication reduction (i.e., by unmasking problems such as
anxiety).
A specific cause is not identified in approximately one quarter of
elderly patients with unintentional weight loss. A reasonable work-up
includes tests dictated by the history and physical examination, a
fecal occult blood test, a complete blood count, a chemistry panel, an
ultrasensitive thyroid-stimulating hormone test and a urinalysis.?
Polypharmacy means taking many medications.
http://www.aafp.org/afp/20020215/640.html
?An estimated 30% of seniors lose their ability to make stomach
acid, and this interferes with the absorption of some nutrients such
as vitamin B12 and folic acid. Deficiencies in these nutrients, as
well as vitamin B6, can cause neurological changes such as decline in
alertness, loss of memory, and numbness of the extremities.
The reduction of the natural movement of food and enzyme activity in
the gastrointestinal tract, known to be associated with aging, often
results in digestive difficulties in dealing with certain foods. Also,
this reduction in the natural movement of food through the intestines
causes food to remain in the intestines for a longer period of time,
producing harder stools and resulting in constipation.
Aging affects certain senses, such as taste, smell, vision, and in
turn affects the types of foods that will be chosen. Salty and sweet
taste sensations can decline markedly with age, causing some to prefer
foods that are richly seasoned. However, certain spicy foods produce
gas. Many older persons complain of "heartburn," that often is not
caused by increased acidity but by gas production. Others resort to
extra salt in order to overcome their gradual loss of taste. Sodium
and its role in water retention and high blood pressure may then
become a problem.?
Ideas for adding variety to your meals
? Get out of the rut of thinking that certain foods are meant only for
certain meals. Try vegetable soup and a tuna fish sandwich on
pumpernickel bread at breakfast, or a cheese omelet, bran muffin,
vegetable salad, and fresh fruit for dinner.
? Experiment with recipes created especially for one or two people.
? Combine leftover meats and vegetables into one-dish casseroles that
can be easily heated for lunch or dinner, or frozen for later use.
? Share pot-luck lunches and dinners with friends or acquaintances on
a rotating basis. Not only will it add variety to your diet, but it's
also a great way to make new friends.
http://seniors-site.com/nutritio/guides.html
?Some older people have a poor appetite as a result of their health
conditions, lack of exercise, or as a side effect of certain
medications. Older people with low food intake who rely on a
nutritional supplement to help provide needed amounts of protein,
vitamins and minerals should seek the advice of a health professional
when selecting a supplement. Well-meaning family or friends do not
have the educational background to help you avoid dangerous drug
interactions. Store clerks may be more interested in selling products
than providing reliable information. Liquid nutritional supplements
are very expensive and don't always contain other important dietary
components such as phytochemicals or fiber. Your doctor, dietitian, or
pharmacist is the best source of information.?
http://www.ext.vt.edu/pubs/nutrition/348-020/348-020.html
?Malnutrition is often due to one or more of the following factors:
inadequate food intake; food choices that lead to dietary
deficiencies; and illness that causes increased nutrient requirements,
increased nutrient loss, poor nutrient absorption, or a combination of
these factors.4 Nutritional inadequacy in the elderly can be the
result of one or more factors--physiologic, pathologic, sociologic,
and psychologic (Table 1). The difficulty for the clinician is in
identifying the underlying factors contributing to the problem and how
to intervene effectively.?
?Interventions appropriate for addressing nutritional deficiencies may
include one or more of the following actions:
? Remove or substantially modify dietary restrictions (ie, liberalize
the patient's diet);
? Encourage use of flavor enhancers and frequent small meals;
? Offer liquid nutritional supplements for use between (not with) meals;
? Improve protein intake by adding meat, peanut butter, or protein powder;
? Treat depression with antidepressants that do not aggravate
nutritional problems;
? Remove or replace medications that have anorexia-producing side effects;
? Evaluate swallowing as well as functional ability to manage eating;
? Obtain a social services assessment of living situation of
community-dwelling adults.6
http://xnet.kp.org/permanentejournal/sum05/elderly.html
A tooth abscess can indeed have caused you to feel poorly. Tooth
abscesses can cause spread of infection, infection to the jaw, soft
tissues, even cause brain abscesses, heart infections and pneumonia!
http://www.nlm.nih.gov/medlineplus/ency/article/001060.htm
Oral infections such as an abscess or yeast/fungal infection, lost
teeth, poor dentition can cause dry mouth and loss of taste. A dry
mouth can also increase risk of cavities and dental disease.
?Saliva substitutes and oral lubricants are available without a
prescription. Although they can provide some relief, they do not have
any of the protective properties of saliva. The risk of oral or dental
disease in people with dry mouth can be greatly reduced by maintaining
good oral hygiene, along with dietary restrictions such as eating less
sugar. Everyone with a dry mouth should have comprehensive and
frequent preventive dental care, including regular fluoride
treatments.?
?Problems in the mouth can have a major effect on overall health and
social well-being. Proper oral health is important for everyone, but
particularly for older adults who are frail or at risk of nutritional
problems (see also Nutrition). Older adults tend to have more oral
problems than younger people, because underlying health problems and
side effects from medication are more common as we age. However, there
is no evidence that oral health and function specifically decrease
with age. Therefore, mouth problems such as tooth decay, missing
teeth, gum disease, and low saliva levels are not a part of normal
aging. In most cases, these problems can be avoided or adequately
treated. With proper oral care, most people can expect to have a
healthy mouth well into advanced age.?
http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=46
You didn?t say why you were taking Clindamycin, but I can guess you
had a respiratory tract infection or a skin rash/infection. While
Clindamycin is not a drug known for its side effects, it can bother
some people.
?Although side effects from clindamycin are not common, they can
occur. Tell your doctor if any of these symptoms are severe or do not
go away:
? upset stomach
? vomiting
? gas
? diarrhea
Tell your doctor if any these symptoms are severe or do not go away
while using clindamycin vaginally or on your skin:
? dry skin
? redness or irritation
? peeling
? oiliness
? itching or burning
If you experience the following symptom, or any of those listed in the
IMPORTANT WARNING section, stop taking clindamycin and call your
doctor immediately:
? skin rash
Please visit your doctor and explain all you?ve told me. Do you have
family and friends nearby? Do you live alone? You may benefit fm
talking with a geriatric therapist and a social worker who can help
you with your meals and getting out a bit. I believe you can conquer
your depression and anxiety, through proper use of your medications, a
balanced diet, a bit of exercise, and contact with friends and family.
I wish you the best!
I see that your question has gone unanswered for a while... I am
sorry, but I hope this answer is still useful to you.
I hope this has helped you out! Please ask for an Answer Clarification
if anything is unclear, and allow me to respond, before rating this
answer. I will be happy to assist you further, before you rate.
Sincerely, Crabcakes
Search Terms
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Zoloft + adverse effects
stimulating appetite + elderly
Sinemet CR
Sinemet + Adverse effects
Anorexia + elderly
loss appetite + senior citizens
Nutrition + senior citizens
Depression + senior citizens
Hypothyroid symptoms |
