RSD Puzzle #036

H. Hooshmand, M. D.

DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY

BOARD CERTIFIED IN ELECTROMYOGRAPHY

BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE

INTRACTABLE NEUROLOGY

EPILEPSY, PAIN, MS

An International Referral Center dedicated to Treatment, Education and Research

RSD PUZZLE #36
"A FEW YEARS AGO WHEN I STARTED SUFFERING FROM RSD, I
KEPT LOSING WEIGHT. NOW AFTER 5 YEARS I HAVE A PROBLEM
WITH GAINING WEIGHT REGARDLESS OF HOW MUCH I DIET OR EXERCISE."

As mentioned in the RSD Puzzle regarding the immune system disturbance, in acute stages of RSD there is plasticity and power of adjustment of up and down regulation and attempt at correction of the sympathetic dysfunction by the sympathetic nervous system. However, after a few years (usually 2-3 years), the ability of the sympathetic system to be capable of fluctuation and adjustment (plasticity) is lost. As a result, an exhaustion of the immune system as well as exhaustion of other functions of the sympathetic system develops. In the acute stage, the patient usually loses weight due to the increased body metabolism and caloric consumption. In the chronic stage, as the immune system becomes defective, the patient also develops a tendency to gain weight.

Other therapy factors also play a role. Long term treatment with tricyclic antidepressants (especially Elavil or Tofranil-Amitriptyline or Imipramine) results in obesity, aggravation of chronic fatigue, and slowing down of the body metabolism. The aggravation of chronic fatigue and insomnia result in generalized weakness and secondary increase in oral intake of food.

Switching the treatment from the tricyclic antidepressants to SSRI antidepressants, especially Prozac or Paxil counteracts the problem of weight gain. Paxil has the best potential of counteracting the fatigue.

Following the 4-F diet (fresh fruit, fresh vegetable, fish, and fowl) never skipping any of the four meals a day (breakfast, lunch, supper, and snack at bedtime), exercising and making certain to avoid any butter, margarine, mayonnaise, vegetable oil, and red meat of any kind, are very effective in counteracting the fatigue and obesity.

H. Hooshmand, M.D.

Copyright © 1997-2006 than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.

Send e-mail to Eric Phillips: EricmP9512@aol.com with questions or comments about this media and content.

The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.