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I Sweat A Lot. What Causes That?

February 16, 2012 / Charles W. Lapp, MD / Ask The Doctor

I sweat a lot. What causes that?

Excess perspiration is a common symptom of both CFS/ME and FM. The etiology is not clear. Dysautonomia is common in CFS/ME/FM, and may cause perspiration (diaphoresis). Also, PWCs have a narrow comfort range for environmental temperatures. In other words, it is easy for a PWC to get overheated and sweat. Lastly, certain medications increase perspiration. These include some antidepressants (Elavil / amitriptyline, Sinequan / doxepin, and Effexor / venlafaxine come to mind), narcotic pain medications, and cholinergic drugs. The latter stimulate the parasympathetic nervous system but are usually only used for glaucoma (eyedrops), Sjogren’s syndrome (Salagen / pilocarpine, Evoxac /cevimeline), myasthenia gravis, and during surgery. Some pesticides may be cholinergic, and overexposures are characterized by salivation, excess tearing, diarrhea, and sweating.

Anticholinergics may reduce these symptoms by blocking the parasympathetic response or stimulating the sympathetic nervous system. Examples include some anti-nausea drugs, Benedryl / diphenhydramine, drugs for irritable bowel or irritable bladder, hyosciamine, scopolamine, Atrovent / ipratropium, Artane, and Cogentin. However, these drugs are not recommended for the treatment of sweating due to associated side effects.

Overall excess sweating is difficult to treat. Most patients do well by controlling the ambient temperature and keeping a fan close at hand, especially while sleeping.

Please read this before posting to Ask The Doctor

Chronic Fatigue Syndrome, Coping with CFS/ME/FM, Fibromyalgia

3 comments on “I Sweat A Lot. What Causes That?”

  1. Brenda Elliott says:
    February 21, 2012 at 4:12 pm

    I have been on Amitryptiline and Cymbalta for several years. I found this combination worked best for me so I’ve stuck with it. Not until recently did I learn that the Amitryp. has been the source of frequent blurred vision and extreme sweating. I am currently cutting down the dosage and am experiencing massive sweating. I cannot even do a single bit of movement without the miserable sweats. I hope to be off of this medication soon with the hope that I can get by with using only the Cymbalta.

  2. Madaline Franz says:
    February 24, 2012 at 12:29 pm

    Thank you for explaining this one so well.

  3. Marian Smartt says:
    February 26, 2012 at 2:44 am

    So happy you brought this topic to our attention! This addresses one of my questions for you in an upcoming appointment! Lo and behold I was blessed with a “sweat free” life…before CFS that is. I was very athletic and my friends were quite envious that I never ended up with a sweaty wet body after exercise. My husband swore I was born without sweat glands! Then enter ME/CFS. Now every day I have a period of debilitating diaphoresis (sweating) that drives me crazy. However, I have found a cure, for me anyway. When this starts, I take a tepid bath, including washing my hair. Then out of the tub, and into loose cotton clothing. For some reason, the cycle gets broken for another 24 hours! Maybe this will help others…I sure hope so.

Dr. Hillman

Dr. Hillman

Dr. Hillman was born and reared in Utica, New York. He attended college at Clarkson University where he earned a bachelor’s degree in engineering, and then spent two years toward a master’s degree in biochemistry/oncology at the University of Buffalo’s Roswell Park Division, where he did research in leukemia. Dr. Hillman attended St. George’s University School of Medicine, and completed his clinical years at the Maimonides Medical Center in Brooklyn, New York, graduating in 1996. During the Summer of 1994 he also did research at the University of Buffalo Dental School using PCR technology on RNA subtyping of gram negative oral bacteria. Following medical school, Hillman went on to a Family Practice Residency at North Shore / Long Island Jewish Hospital in Bay Shore, NY.

After his residency, Dr. Hillman worked for the US Army at the West Point Military Academy (Keller Army Hospital family practice unit), worked in the Emergency Room and hospital admitting areas, and ran a private practice as well. From 2005-2006 he also worked at the Winn Army Hospital at Fort Stewart, GA, before setting up a private Family Practice in Huntersville, NC in 2007. In addition to his private practice Dr. Hillman also has an interest in helping clients with disabilities. He has worked for ProMed Urgent Care in Occupational Medicine and performed over 13,000 examinations for Social Security Disability.

Dr. Hillman has a family member with Chronic Fatigue Syndrome, so he has a long standing interest and empathy with the disorder! He is married and has two sons and a daughter. The family lives in Huntersville.

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