Why Am I Always Sweating?

Here is My Question:
I have 2 questions.

1) I am always hot and sweat constantly. I can be sitting still in an air conditioned room and still have sweat drip down my face, soak my shirt and the hair hanging down the back of my neck is wet.I am especially likely to swat after a shower despite taking vey brief cool showers. I find this quite miserable since it also makes me feel more fatigued. I used to have allot of autonomic problems attributed to my MS, syncope, dizziness, orthostatic hypotension, tachycardia and urnary retention. All of these things actually resolved after a C5-6, C6-7 ACDF. But now I am chronically tachycardic again, restng HR in 90's and hot and sweaty. This has worsened over the past year. Is this MS or medication related or both? I have been on the same meds for many yeas except that venlafaxine increased from 112 mg/day to 225 mg/day. I recently completed a course of rTMS with excellent results. Meds are diltiazem, atenolol, Adderall, Allegra, singular, Advair, omeprazole, venlafaxine, trazadone and Tecfidera. Is there any treatment for this overheating and sweating?

2. How often do I really need to see my neurologist/MS specialist? I get nothing but a Tecfidera prescription and annoyance from these visits. My primary doctor who I have been with for a long time and like allot is more than happy to check a CBC/diff every 6 months. I have been on Tecfidera for 4 yeas after 6 years on Tysabri and 18 months on Avonex. My MRI has not changed since 2005 except for involution of old lesions into black holes. Other than intermittent nerve pattern n in my feet and fatigue that is overwhelming without Adderall, and dffculty with close focusing when I am tired I have few manifestations of MS. I find no benefit to me from 25 ft timed walk, 9 hole peg, various vision tests and stupid questions about why I get depressed and need TMS. I have a good therapist and see an excellent ophthalmologist once a year. How often do they really need to see my neurologist and why? I know how to find no him if I have a new problem.
Thanks.

Answer:
Good questions:

1. Hyperhidrosis or excessive sweating is relatively uncommon. This can run in families, be related to autonomic dysfunction or related to involvement of certain parts of the spinal cord. It sounds to me like you may have paroxysmal orthostatic tachycardia syndrome (POTS). This is commonly associated with excessive sweating. This is one area where you will need to see a neurologist for help. Some academic centers like the Mayo clinic are very knowledgable about hyperhidrosis.
   
2. I would say in your circumstance that you could probably visit your MS Specialist once a year or when problems develop. He or see may be able to help you with the sweating or you may need to see an autonomic specialist.

Good luck.
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego