I seem to have quite a few autoimmune like things. Diagnoses at the moment are inflammatory arthritis, fibromyalgia, hypermobility, vitamin d deficiency, menieres (sqad, is this the same thing as autoimmune ear disease or different?) and bile acid malabsorption. They did a load of blood tests and a urine test recently looking for lupus/connective tissue disease or immune problems (been plagued with infections and rashes and such) but bloods ok save low vit D. Always have a raised ESR too.
I was on sulfasalazine but couldn't tolerate it so on plaquenil now as apparently much easier to tolerate (had a few vision problems but hopefully a one off), methotraxate was brought up but I'd rather avoid that if I can. Also have been on vit D supplements and have codydramol, acid meds and others.
They initially thought maybe crohns but have checked all over and not found it but found the BAM. My rhumatologist referred me to gastro to see due to the connection between Crohns/UC and arthritis and my gastro symptoms. Do you see a rhumatologist to manage the arthritis symptoms and look at fibromyalgia?
Could you try taking the amitriptilyne a bit earlier in the evening? See if that helps or go down to something like 5mg to ask your GP if a different drug would suit you better. They mentioned getting me back on it for chronic pain issues and to help me get more effective sleep but decided against as I have dry eyes/mouth symptoms and they said it could make that worse so suggested fluoxetine. I've tried that before and it made me feel really sick so I went for citalopram.
I found the pill helped a bit with mood too and flares around that time.