Dr. Hive - diagnose me - need more brains on this one

[bethben]

So, I started going to a functional medicine doctor to help me clear up my eczema and help me get off of a drug that reduces restless leg syndrome and helps me sleep.  She did blood work and found a few food intolerances (Cashews, Almonds, pineapple, avocados, and eggs) along with some inflammation that was just into the moderate category.  My intestine permeability was just into the moderate category and on another day may have been normal (it's basically just over the line between normal and moderate).  My adrenals were pumping out half of what they should have been.  

So, she put me on vitamins/herbs to help the gut heal, a bovine adrenal supplement for the adrenals, some methyl b and an herbal mixture to help with the autoimmune.  The autoimmune supplement made my knee pain go away but the adrenal supplement, while helping me feel like an awake person during the day, seems to also keep me awake at night.  

The doctor basically told me we're in the "gray area".  Basically, every doctor I've gone to to help clear up my sleep and eczema issues gets to this point.  The "I don't know what's wrong with you" level.  My labs look really good for the most part.  My thyroid looks perfect.  Everything except my adrenals looks pretty healthy.  But, my eczema is getting worse and I'm having a lot of trouble sleeping.  I do have a lot of stress in my life and am getting a lot better at managing it.  

So, anyone want to help me get out of the gray area?  

[Jean in Newcastle]

I  have lived in the grey area for 30 years (though I do have a black and white diagnosis of fibromyalgia to go with it).  The kind of issues you are describing are (at least for me) like an onion..  You peel off one layer and treat it and find another layer below it. . .

I personally found that adrenal supplements didn't work for me.  Adrenal supplements can vary but I found that some actually drained things further by stimulating my body when that was the last thing it needed. 

For eczema I would ask about Quercetin and/or vitamin D.  Vitamin D levels can and should be tested. 

 

[bethben]

Vitamin D is in the "great" range.  All my vitamin levels are great.  

[Ottakee]

Have you been eating any more of a certain food recently?  Milk was a trigger here for eczema.

 

 

[catz]

Have you tried keeping a food journal?  Do you take a good quality supplement? I get restless legs if I forget to take my supplement a few days in a row.  

Do you exercise?  That is really the best maintenance for me of stress levels and I do think for people with tendancies for auto immune responses, clean diet and regular exercise/yoga/meditation can help quite a bit.  Treatment for anxiety and/or depression can be helpful too if that might ring a bell.  Even thinking too hard about your health can start a spiral of depression and then auto-immune responses.  

[ktgrok]

Have you done traditional allergy testing? Eczema is often from environmental allergies - pollen, dust, etc. 

[bethben]

I got rid of milk and cheese and the eczema is still getting worse.  I've quit a lot of foods lately and have been eating more vegetables (butternut squash, sweet potatoes, brussel sprouts...)  My stress levels are less than they were a month or more ago for example.  I'm taking it easy.  I haven't exercised much lately mostly because I feel so wiped.  I am going to start again in a week or so.  

No, I haven't done traditional allergy testing.  Would environmental allergies also cause restless leg syndrome and insomnia?  The eczema is just one of the things I'm looking at.  My insomnia issue is much much bigger.  I have eczema year round.  

[catz]

I do think allergies can make nutrition absorption possibly not be as efficient and could definitely affect sleep cycles.  I think there is so much we don't know about auto immune responses, mental health, and gut health and how systems are tied together.  

Even if you are wiped consider doing like 5 minutes of like yoga and 10 minutes of a gentle walk.  That's a great start.  I really think all bets are off if you are short on sleep.  

I don't want you to get too personal online but consider what is causing your stress levels.  Do you need to make some over arching changes?  Would working through some things with a therapist possibly be helpful?

[ktgrok]

18 minutes ago, bethben said:

I got rid of milk and cheese and the eczema is still getting worse.  I've quit a lot of foods lately and have been eating more vegetables (butternut squash, sweet potatoes, brussel sprouts...)  My stress levels are less than they were a month or more ago for example.  I'm taking it easy.  I haven't exercised much lately mostly because I feel so wiped.  I am going to start again in a week or so.  

No, I haven't done traditional allergy testing.  Would environmental allergies also cause restless leg syndrome and insomnia?  The eczema is just one of the things I'm looking at.  My insomnia issue is much much bigger.  I have eczema year round.  

Not that I know of, but it would be one thing to check off the list as far as the eczema. 

Low ferritin/iron seem to be my cause of restless legs. Did they do a full iron panel, with ferritin, etc?

[bethben]

34 minutes ago, FuzzyCatz said:

I do think allergies can make nutrition absorption possibly not be as efficient and could definitely affect sleep cycles.  I think there is so much we don't know about auto immune responses, mental health, and gut health and how systems are tied together.  

Even if you are wiped consider doing like 5 minutes of like yoga and 10 minutes of a gentle walk.  That's a great start.  I really think all bets are off if you are short on sleep.  

I don't want you to get too personal online but consider what is causing your stress levels.  Do you need to make some over arching changes?  Would working through some things with a therapist possibly be helpful?

 

I have gone to a therapist for about 9 months.  That is why I'm less stressed than I was.  I have come realized that there is a lot I cannot change and some things that I have to do differently.  I am a small town girl living in one of the fastest growing cities in the country.  Just being in my backyard being able to see everybody's back yard for 5-6 houses and what they are doing is very fishbowly to me (I am making plans to fix that).  I am working with my therapist on how to be able to do the things I need to do while reducing the stress of "people people people/ traffic traffic traffic" that exists in where I live.  We are thinking of moving at some point, but that's in the 10 year plan right now due to a lot of factors.  I have also learned how to listen to myself.  

23 minutes ago, Ktgrok said:

Not that I know of, but it would be one thing to check off the list as far as the eczema. 

Low ferritin/iron seem to be my cause of restless legs. Did they do a full iron panel, with ferritin, etc?

 My ferritin is normal - my iron was too much.  I was taking a lot of supplementation of iron for restless leg.  I had to back off.  

[Ellie]

When you say your thyroid is "perfect," how do you define that? Free T3 and Free T4 tested, or only TSH? But AFAIK, thyroid issues wouldn't affect your eczema, only your sleeping issues.

My dd's eczema cleared up quite a bit when she started using Amway laundry products. Have you tried changing laundry products?

[Kanin]

If it were me, I'd be concerned about the intestinal permeability, and would eliminate the "biggies," like gluten, dairy, nightshades, excess sugar, even if they weren't detected on an allergy test. 

You could go as far as doing the AIP diet, or your own variation of it.

There's some ingredient in many laundry detergent that aggravates eczema, a long name that start with an "m." I'd also wash clothes a bunch in plain water, and then use something super gentle like soap nuts, or even baking soda/vinegar, to see if it calms down your skin.    https://itchylittleworld.com/our-eczema-trials-safe-laundry-detergent-alternatives/

Sorry you're dealing with eczema, it's miserable 😞 

[bethben]

My eczema is on my lower arms/hands and face mostly.  The places least likely to be touching fabric.  And no personal care products are used on both so that doesn't lead me to believe that they are cleaning/self care products.  My bigger problem is sleep.  

[J-rap]

Depending on your age...  a lot of women in their late 40's/50's have trouble sleeping as their hormones change.  Possibly your sleep problems are as simple as that.  

Have you ever tried a GF diet for your eczema?  I have a friend who did that and it cleared up completely.  In fact come to think of it, one of my dd's used to have minor eczema but she's now GF and hasn't had a big problem with eczema for a long time.  Maybe it's related.

[Arctic Bunny]

Have you had a sleep study?

https://www.medscape.com/answers/1124613-166581/what-is-the-role-of-cpap-in-the-treatment-of-vesicular-palmoplantar-eczema

[EKS]

19 hours ago, bethben said:

No, I haven't done traditional allergy testing.  Would environmental allergies also cause restless leg syndrome and insomnia?  The eczema is just one of the things I'm looking at.  My insomnia issue is much much bigger.  I have eczema year round.  

It's possible that they are being caused by entirely different things.  If sleep is the bigger problem, have you gone to a doctor that specializes in sleep disorders?

[bethben]

9 hours ago, Seasider too said:

 

Our family allergist treats eczema as part of the allergy triad - rhinitis, asthma and eczema. Environmental allergens are the trigger - mostly different varieties of pollen. However, some foods are cross reactive - for example, during ragweed season, my eczema people cannot eat melon without an eczema flare. They also show signs of oral allergy syndrome to bananas and sometimes apples, when ragweed is pollinating. They can eat these things problem free at other times of the year. In our experience, eczema is tricky because different people can have different triggers, it takes time to figure it out. 

I also agree with some things already mentioned, like the affects of stress, and the benefits of exercise and proper vitamin D levels. I’ll add EFA supplements (the right kind for your genetic profile, either or both EPA and DHA). 

If your doc put you on methyl B, I wonder if you also have the MTHFR mutation - do you know if you do?

 

I'll ask the doctor about doing allergy testing.  Could I also have a histamine intolerance?  There is a list of foods to avoid with a histamine intolerance and all of my intolerances that show up on the list happen to be on the don't eat with a histamine intolerance list.  She doesn't know if I have a MTHRF mutation.  She is just trying her next best guess.  

6 minutes ago, EKS said:

It's possible that they are being caused by entirely different things.  If sleep is the bigger problem, have you gone to a doctor that specializes in sleep disorders?

 

Yes, I did go to a doctor who specialized in sleep disorders.  He prescribed a drug for restless leg.  That was the extent of that appointment.  My gut feeling is that sleep (and restless leg) is a brain issue with a possible genetic component unfortunately.  The eczema is probably unrelated to the sleep and the adrenal glands are plain old stress.  

[EKS]

9 minutes ago, bethben said:

Yes, I did go to a doctor who specialized in sleep disorders.  He prescribed a drug for restless leg.  That was the extent of that appointment.  My gut feeling is that sleep (and restless leg) is a brain issue with a possible genetic component unfortunately.  The eczema is probably unrelated to the sleep and the adrenal glands are plain old stress.  

Did you ever follow up with him?  Perhaps the drug was meant to be the first in a potential series of interventions to see what might help.

[bethben]

1 minute ago, EKS said:

Did you ever follow up with him?  Perhaps the drug was meant to be the first in a potential series of interventions to see what might help.

No- That was the extent of it.  He also gave me a prescription for an anti-depressant if the gabapentin didn't work on it's own.  I never filled that prescription.  There was no suggestion of follow up.  That particular sleep center felt like a place where you get your oil changed.  Very conveyor belt.  I do want to get off of the prescription.  Staying on it for 30+ more years just doesn't appeal to me because your body does develop an intolerance.  I guess I'm just trying to see if I can attack the restless leg thing another way.  If it's genetic, I may not be able to though.  

For some reason, the supplements messed up my sleep.  I was sleeping OK before I started the supplements.  There is no good reason why they are interfering with sleep.  I'm also a redhead.  I have found that just that factor seems to make me more of a mystery - there are times when I don't respond the same as the general population.  

[bethben]

17 hours ago, J-rap said:

Depending on your age...  a lot of women in their late 40's/50's have trouble sleeping as their hormones change.  Possibly your sleep problems are as simple as that.  

Have you ever tried a GF diet for your eczema?  I have a friend who did that and it cleared up completely.  In fact come to think of it, one of my dd's used to have minor eczema but she's now GF and hasn't had a big problem with eczema for a long time.  Maybe it's related.

I'm GF already and have been for a while.  I've had sleep issues starting when I was 36. It's been 14 years and during that time, there have been more times than not that I've had medication of some sort to help me sleep.

[J-rap]

2 minutes ago, bethben said:

I'm GF already and have been for a while.  I've had sleep issues starting when I was 36. It's been 14 years and during that time, there have been more times than not that I've had medication of some sort to help me sleep.

I'd tend to think that the two issues are unrelated.  Lots of people have sleep issues, unfortunately.  I think many people just have brains that are wired to work overtime and not relax easily.  Have you tried natural sleep supplements?

I have RLS, btw.  It can be terrible for getting to sleep some nights.  What I've found most helps the RLS is iron supplements.  I seem to need more iron than what is usual.  

[kbutton]

 

13 hours ago, Seasider too said:

Our family allergist treats eczema as part of the allergy triad - rhinitis, asthma and eczema. Environmental allergens are the trigger - mostly different varieties of pollen. However, some foods are cross reactive - for example, during ragweed season, my eczema people cannot eat melon without an eczema flare. They also show signs of oral allergy syndrome to bananas and sometimes apples, when ragweed is pollinating. They can eat these things problem free at other times of the year. In our experience, eczema is tricky because different people can have different triggers, it takes time to figure it out. 

Do you have good resources regarding cross-reactions? I would be interested in having good information. I know about the principle in general.

3 hours ago, bethben said:

I'll ask the doctor about doing allergy testing.  Could I also have a histamine intolerance?  There is a list of foods to avoid with a histamine intolerance and all of my intolerances that show up on the list happen to be on the don't eat with a histamine intolerance list.

Just so you know, that's not as much of an answer as a gray area as well. I am in that same boat, however, knowing this doesn't seem to help lower those levels or get me anyplace productive.

3 hours ago, Seasider too said:

You could try magnesium for the restless legs. 

Agreed. Also, potassium supplementation is a game-changer for me. I don't seem to get enough from diet, even if I plan my entire day around potassium-rich foods. If I take a supplement that provides me with the same amount of potassium as a couple of bananas or potatoes, I am good. 

[KungFuPanda]

Have they not recommended any herbal sleep aids; herbal or otherwise?

Do you get regular exercise? If so, have you experimented with what time of day you do it?  I can sleep like a rock after exercises, but some people can't do it at night or it keys them up.  I think a lot of modern lives are missing a physical component that really helps with sleep.  It might also help to switch from screens to paper reading at night.  I know if I get on these boards I can stay up crazy late, but if I read a book with pages I get sleeeeepy.  

I've heard of people resetting their sleep clocks with just a few days of camping.  Can you unplug and head out to a state park?  If you get a site with a camper cabin you can go with minimal gear.

[geodob]

B12 deficiency is a major cause of Restless Leg Syndrome.
It causes a loss of the Myelin coating that surrounds the nerves.  Which needs to be addressed early, as this can result in permanent nerve damage.
So that it would be worth making sure that you don't have a B12 deficiency?
Which can be quickly corrected, with weekly injections for a few weeks.