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does your dose of neurontin make you sleepy? If it doesn't you are probably not getting an adequate blood level. You can ony metabolize about 2000mg at a time, anymore wont do anything. If a hefty dose like that doesn't make you sleepy you may lack the enzyme needed to metabolize it across your guy. have you ever tried Lyrica?

With C spine lesions like that you will almost certainly have not only a number of long tract symptoms (RLS, muscle spasm, pain) due to spinal cord d/d, but it also wouldn;t surprise me if you are fatigued during the day because these symptoms can seriously fragment your sleep.

Here is a relatively new and informative sleep site by Harvard. It might provide some helpful information.

http://healthysleep.med.harvard.edu/

hope it helps,

TOL

Hi Yeb4432: yes the neurontin does make me drowsy most of the time, but for some reason my body is fighting it. Or possibly it isn't being absorbed properly like you mention for some reason or another.

I haven't tried Lyrica and fatigued is an understatement. I feel like I'm pulling a dead weight around half of the time. When I do sleep, it is regular fatigue, but when I don't it is 100x worse.

I agree with jimmylegs that my levels must be off. Either the gabapentin is preventing absorption or something else has caused hormonal confusion. If this is the case my body must be producing too much of something or not enough of what I need to sleep? I wish I could pin point it.

What is your take on Lyrica? I will have to look it up because I'm not familiar with it at the moment. I'm the type of person who references children's books on neurology...

Thanks thinkingoutloud....I'm going to read that link right now.
Maybe it will put me to sleep...hahah<-----tired and giddy

Hi Miss Feisty

I'm currently reading, "The MS Solution: How I Solved the Puzzle of My MS" by Kathryn Simpson so in the 'for what it's worth' category, here are some quotes from the book:

Hypothyroidism often causes insomnia, as do estrogen or progesterone deficiency. Hypothyroidism usually results in having a hard time falling asleep, whereas with low estrogen for women or low testosterone for men, you can fall asleep but you sleep lightly and wake up often. (p. 90)

Muscle health depends on thyroid, and without adequate hormone levels, muscles can become sluggish and infiltrated with fat, which can cause pain, stiffness and cramping. Pain and cramping in hands, feet, and neck is specifically thryroid related. (p. 91).

I saw you mentioned "hormones", so I thought I'd toss that out for your consideration too...puzzles galore.

Sharon

does the book link hypothyroidism and low testosterone in women shayk?

Sorry JL

Don't know yet or can't remember. I'll let you know if I come across it. She has written another book I haven't yet read, "The Women's Resource Guide to Complete Thryoid Health".

Sharon

Lyrica is similar to neurontin, but has a longer half life, so it might help. unlless you have a brain completely full of ms, it is likely not the direct cause of your fatigue, more than anything else it is sleep related. if you have serious restless legs mirpex or requip might be the ticket.

Looking at the sleep website provided by thinkingoutloud, I have evaluated my environment and habits for "sleep hygiene".
-temperature
-noise, remove pets
-bed comfort
-no stress, large meals or exercise before sleep time
-no caffeine, alcohol
-no workstation in the bedroom

I am considering moving the furniture around, I don't know if this will help or hinder but I'll try it.

I will also try the cal, mag and D3 increase.

I can definitely say I have a circadian rhythm interuption, it is like jet lag.
One suggestion is chronotherapy....changing the sleep and rising hours for a week until the "desired" hours are met.
I have a few things to try anyway. There is hope.

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Melatonin is a hormone produced by the pineal gland during the dark hours of the day-night cycle (circadian rhythm). Melatonin levels in the body are low during daylight hours. The pineal gland (located in the brain) responds to darkness by increasing melatonin levels in the body.

Your comment is interesting Sharon.

Hypothyroidism often causes insomnia, as do estrogen or progesterone deficiency.

I have looked for a few other articles on the effects of estrogen and sleep.

One reason estrogen might help sleep is because of the way it interacts with certain neurotransmittal systems. It enhances the action of GABA (gamma-aminobutyric acid), the major inhibitory system of the brain, the system that sleeping pills augment to damp us down. It enhances the action of serotonin by decreasing the neurotransmitter’s uptake and making it more available, the way selective serotonin reuptake inhibitor antidepressants such as Prozac or Zoloft do. Or, it may be that hormone supplements simply keep hormone levels more constant, thereby eliminating the fluctuations that cause trouble. Then again, estrogen itself lowers body temperature, and that may be why it helps. Not enough is known. From article, Why We Can't Sleep by Gayle Greene.

There is a good article on the Reader's Digest site entitled "Menstral Insomnia".
http://www.rd.com/living-healthy/menstr ... 54629.html

no probs shayk thx
sounds like you've got some good strategies to help miss good luck!

here's an interesting couple of clips - i did not know estrogen was made *from* testosterone. funky
anyway, the clips:

Testosterone Therapy for Women
...Testosterone and other related hormones (DHEA and DHEAS) in the body (also known as androgens) have known physiological roles in women. Firstly, oestrogen is actually made from testosterone and DHEA, and without the ability of our bodies to make testosterone we cannot make oestrogen. Testosterone and DHEA appear to have direct independent effects in different parts of the body, and some women may experience a variety of physical symptoms when their blood levels fall. Such symptoms may include:
* Impaired sexual interest (loss of libido or sexual desire), and lessened sexual responsiveness
* Lessened wellbeing, loss of energy
Testosterone therapy may be beneficial for some women who have had their ovaries surgically removed or in some who have significant symptoms in the form of loss of libido, fatigue and diminished wellbeing.

i know testosterone secretion in men increases during the night and if there isn't enough they can get sleep disorders like cheer's hubby used to have. it's hard to find info on women's overnight secretion of testosterone, but there are a lot of results out there linking testosterone and insomnia. and we know what you need to maintain serum testosterone - zinc. it's just my thing lately i guess

Thank you everyone for the helpful tips and suggestions. I am now more the wiser. I will post a follow up down the road. You are all so wonderful sharing your knowledge and experiences.

Shayk & Jimmylegs
I would like to find more info on the hormones, estrogen, progesterone, testosterone etc. Like hyper & hypothyroidism mentioned they seem to have a significant play with ms or any body system. I think I'll pop over to the hormone thread I noticed earlier.

Yeb4432 comments that ms is not a direct cause of fatigue. I would have disputed that but I think it's true. The ms is causing a system deficit that in turn causes the fatigue; whether it is a hormonal imbalance, sleep disorder, nutritional deficit etc. There is a middle man with fatigue.

I think a general band aid solution is not necessarily helpful like Provigil. Wouldn't it be more significant to evaluate the patient more thoroughly with these matters to find a solution?

Off I go on a hormone goose chase........

Take care and be well.

Miss Feisty

You've probably discovered it by now, but I'd recommend reading "The MS Solution: How I Solved the Puzzle of My MS", by Kathryn R. Simpson.

You asked:

Wouldn't it be more significant to evaluate the patient more thoroughly with these matters to find a solution?

That is the essence of the book--she recommends having your hormone, Vitamin and mineral levels tested and to take it from there. The book does have a lot of info about hormones, including thyroid issues. She recognizes the importance of diet and exercise too.

The web site Women In Balance has a research and resources tool that might be helpful. I just entered "progesterone" and "brain" and there was a list of studies.

A more "traditional" source (endocrine society) of some info is The Hormone Foundation

I thinkHormonal Perspectives in MS and Hormonal Therapy of MS both by Patricia Coyle , Director of the MS Comprehensive Care Center of SUNY at Stony Brook are worth a go too.

If I remember any more I'll let you know. Hopefully it won't be a wasted goose chase.

Sharon

Thanks Sharon, I'll definitely look into your suggested reading.

I wanted to post a quick follow-up.

My sleep patterns have not been as erratic over the last two months.
Although, I have had moments during the day where I've simply "passed out".

I've slowly added Cal, Mag & Zinc to the supplement list and upped the D3 periodically. This may have stabilized the sleep pattern to an extent.

I've adjusted environmental factors and they are fine.

I now believe there is definitely a hormonal influence (spike or drop). I'm going to ask for hormone tests next week. At this point, I do not know if I should request any special tests outside of the routine check. Any suggestions?

hey there miss, that's great news!
what's your daily intake of those various minerals and the d3 now?
if you are interested, see how close your zinc level is to 18.2 umol/L. zinc (among other things) is pretty important when it comes to hormones.