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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35479
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I am a 68 year old female diagnosed with Sjoegren Syndrome

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I am a 68 year old female diagnosed with Sjoegren Syndrome about 2 years ago. I also have neuropathy in my feet and legs which is connected with the Sjoegren. I take Paquinol (generic) Metoxicam for inflammation, blood pressure med and amitriptyline. I have been having problems with severe sweating (not at night) and my skin is hot to the touch all the time. I feel that most of my problem is hormonal but have not gotten any real response from my doctor. I feel fine just the body heat. It gets worse during the day that my nighttime I am rally hot.
I saw an answer you gave to an inquiry and I feel that I fit into that category. I also have GERD which is under control. I have a hard time losing weight. I have done a lot of research and my conclusion is hormonal.
I would appreciate an answer. Thank you.

Hello Uta ,
I am Dr. Arun and will be helping you today.

Were your hormonal blood work done?
Since when is the severe sweating and hot skin?

Do you think that these symptoms appear after any of the medication was started?

Customer: replied 4 years ago.

I have had hormonal blood work done. Just the usual, nothing in depth.

I have had the severe sweating for over a year. I don't go to the gym because of it. The hot skin started gradually. First it started at night and then all day. It is most severe at night. I have been taking the meds pretty much from the beginning of the Sjoegren. The only new med I take is Meloxicam for inflammation but I had the hot skin before this.

Hello Uta,

Amitriptyline may be one of the possibility of excessive sweating as it is a known side effect of it. Several common medications occasionally produce hyperhidrosis / excessive sweating. These are;

1) tricyclic (amitriptyline) and serotonin reuptake inhibitors,

2) opioid analgesics,

3) acyclovir,

4) naproxen.

Many time the side effects of the medications may appear later and initially may not occur so correlation may not be easy. Please read the side effect of amitriptyline in this resource;

Hyperhidrosis (excessive sweating) need investigations for following (some of which may have been investigated for you):

1) pheochromocytoma,

2) thyrotoxicosis,

3) diabetes mellitus,

4) diabetes insipidus,

5) hypopituitarism,

6) anxiety,

7) menopause,

8) carcinoid syndrome.

If all the investigations are normal, it would be considered as idiopathic or primary hyperhidrosis. The excessive sweating in various areas of the body of no ascertainable cause is considered as primary hyperhidrosis (hyper is increased and hidrosis is sweating or water), as there is no cause except the sweat gland in the skin are increased in size and they respond excessively to body's hormones (increased cholinergic sympathetic stimulation of the sweat glands). Idiopathic means; cause not known or not ascertainable. A dysfunction of the central sympathetic nervous system, possibly of hypothalamic nuclei, or prefrontal areas or their connections is suspected. But before going for any definite treatment it is ideal to check the adrenal gland also in the absence of diabetes and thyroid disease (as we discussed above), to rule out any abnormality, as this can secondarily cause excessive sweating. Your internal medicine specialist or primary care physician would be able to get it done.

Following is the treatment protocol, if hormonal causes are ruled out;

1) dietary restriction of coffee, tea, cola soft drinks, and chocolate.

2) application of aluminum chloride hexahydrate or zirconyl chloride in absolute alcohol

3) iontophoresis, done by dermatologists in their office. Iontophoresis, the topical introduction of ionized medications into the skin using direct current, can be quite effective with hyperhidrosis. Iontophoresis is generally used for palms/soles hyperhidrosis.

4) medications like atropine, propranolol

5) Botox injection

6) Alternative therapies; St. John's wort, hyssop, sage, and black walnut bark can be brewed into a tea.

7) Surgery; results are good for the perspiration but cosmetically not acceptable due to scarring of the skin.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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