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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 55791
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I need to speak to a specialist in myalgic enphalytis, I

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I need to speak to a specialist in myalgic enphalytis
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: I have had it for many years recently it has got worse again
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: Will he or she be an M E specialist

How may I help you with Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)?

Customer: replied 3 days ago.
I was put on Amitriptyline 10 mg dose a number of years ago by a specialist Is it possible to see a specialist without going through my doctor

This is not a telemedicine website, unfortunately.

The website is only meant to provide medical education and answers specific to your questions only.

I apologize for the inconvenience.

I know that’s not what you want to hear right now.

I would be happy to answer any other medical concerns you have.

A prescription of any kind here would be both illegal and malpractice

The website is not authorized to issue any prescriptions or notes or referrals.

An urgent care center can do that for you.

I am just a messenger, I am afraid.

Sorry again.

The primary treatment modalities of ME are cognitive behavior therapy (CBT) and graded exercise therapy (GET).

During the CBT sessions, the therapist emphasizes the role of thought process and its impact on the patient’s actions and feelings as well as recognize behaviors that cause them to feel more tired and hence minimize them. Multiple trials have shown the positive benefits of CBT on improving fatigue, mood, and post-exertional malaise.

Graded Exercise Therapy (GET) involves a supervised, gradual increase of physical activity intensity and duration. This therapy has shown effectiveness for fatigue and functional impairment with the GET.

Customer: replied 3 days ago.
Can I discuss a medication

Sure.

Customer: replied 3 days ago.
I was put on Amitriptyline and touch it for many years 10 mg . I came off it last year I was doing ok without but recently had a bad patch

The bad patches are common and need to be managed on the basis of;

1) CBT and GET.

2) Management of the symptoms you are experiencing; sleep disorders, pain, depression and anxiety, memory and concentration difficulties, and dizziness and lightheadedness.

3) Or considering going back on Amitriptyline. Though as you know, the role of medications is not much or significant.

Customer: replied 3 days ago.
I feel the Amitriptyline is not working as well as it was doctor Do you know of anything else I could try that would have a similar effect I feel like I might need it in an even lower dose now

The following medications can be tried;

Doxepin,

Nortriptyline,

Desipramine.

Customer: replied 3 days ago.
Would they be in a low dose ? Would St Johns Wort be of any use?

Yes, these would be in low dose.

St. John's wort is likely to help significantly.

Customer: replied 3 days ago.
I think I might try that can you recommend a dosage

The dose would be 300 mg twice a day.

Customer: replied 3 days ago.
Thanks for that would that be in the morning or at night

It is twice a day so one dose is in the morning and the other is at night.

Customer: replied 3 days ago.
Thankyou

You are very welcome.

Wishing you a speedy resolution and all the very best in life.

It was a pleasure to assist you.

I sincerely hope that I have helped you and that I have earned my 5-star rating today!

Thank you.

Stay blessed.

Dr. Arun Phophalia and other Medical Specialists are ready to help you