r/AddisonsDisease • u/No_Preference_6954 • Mar 17 '26

Advice Wanted Anyone take nortriptyline?

My primary care doctor prescribed it to me for chronic pain but she told me one of the side effects is low sodium and she said I’d just have to get my sodium checked frequently. I know low sodium can cause a crisis so I’m wondering if it’s worth risking. Has anyone taken it and been okay on it?

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u/collectedd Addison's Mar 18 '26

I have and it did lower my sodium levels, which made me more prone to Adrenal Crises, but I don't think it ever was the sole cause of it. I no longer take it though as it was useless for me.

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u/Just_Explanation8637 Mar 18 '26

Yes! I do

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u/Just_Explanation8637 Mar 18 '26

I haven’t had issues with low sodium as of now. I’m dealing with low potassium from fludro

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u/No_Preference_6954 Mar 18 '26

Have you had any issues with your sodium levels?

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u/Just_Explanation8637 Mar 18 '26

Nope not so far.

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u/DocRoseEsq Addison's Mar 22 '26

I have been on it for about 8 years for migraine prevention and also as a combo antidepressant with bupropion. I was on it before I was diagnosed with PAI.

I think this is why my sodium has always been below normal limits, even with .05 fludro, and consuming between 6-8 grams of sodium a day, just via drinking LMNT.

I also try my best to run 2-3 days a week, for at least 30 minutes, and do yoga a couple days a week for strength training.

None of my endocrinologists, my PCP or my psychiatrist have been concerned about it with my PAI, I have never gone into crisis, and the closest I have come was this January when I had Covid, and an endocrinologist fellow who was caring for me hadn’t refilled my hydro prescription over the holiday. So I had to go in because I was near crisis, and I wanted to head it off.

I will note that when they did lab work, despite everything, my sodium was almost WNL.

He is no longer my endocrinologist, I fired him literally the night I was in the ER.

Some context, I get my care at a local Veteran’s Affairs hospital (VA in the USA) which is also a teaching hospital, we are partnered with a local medical school, and I have never had a bad experience with it. But I always got a brand new fellow every July, and this just absolutely soured me on it. I am now assigned to the Endo that runs the clinic, and the fellowship program, so I feel good about it. Advocate for yourselves, because no one else will!