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Adrenaline rush when emotional. Now have nerve pain in abdomen, heart rate and dopamine levels increased

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General & Family Physician
Practicing since : 2005
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For as long as I can remember when I am nervous, excited or panicked I feel an adrenaline rush in the abdomen, or 'butterfly's' as some people call it and an elevation in heart rate - the fight or flight response. On April the 12th I noticed in a situation in which I would normally panic that I was unusually calm, amazingly calm, and I noticed the normal adrenaline sensation wasn't happening, at all, and I liked it! In fact my abdomen felt 'hollow', as the days went on what I discovered was that in place of the normal adrenaline 'fight or flight' response I felt terrible (what I imagine to be) nerve pain in the abdomen. This pain has been present off and on since April and can be debilitating and is worsening. And normally during the 'fight or flight' response my heart rate would elevate this just isn't happening at all. I have a heart monitor I purchased and have tested this. This is very strange, so my question is have you ever heard of this happening? And what could be the possible cause(s)? Thanks. (also, my dopamine levels were slightly elevated earlier this year - the Dr used the word 'marginally')
Posted Wed, 25 Apr 2012 in General Health
Follow-up: Adrenaline rush when emotional. Now have nerve pain in abdomen, heart rate and dopamine levels increased 27 minutes later
-REVISION OF QUESTION -

For as long as I can remember when I am nervous, excited or panicked I feel an adrenaline rush in the abdomen, or 'butterfly's' as some people call it and an elevation in heart rate - the fight or flight response. On April the 12th 2011 I noticed in a situation where I would normally panic I was unusually calm, amazingly calm, and I noticed the normal adrenaline sensation wasn't happening, at all, and I liked it! In fact my abdomen felt 'hollow', as the days went on what I discovered was that in place of the normal adrenaline 'fight or flight' response I felt terrible (what I imagine to be) nerve pain in the abdomen and I felt weak and nauseous. This pain has been present off and on since April and can be debilitating
and is worsening. And normally during the 'fight or flight' response my heart rate would elevate this just isn't happening at all. I have a heart monitor I purchased and have tested this. Also, if I have a coffee the nerve pain is debilitating and even tea can be bad. I have tried to have a cigarette (as I do from time to time) and even this causes imense pain, I've experimented with Nicotine Chewing Gum and the pain is terrible. It seems as if any stimulant is causing this problem to worsen - I have never had a major problem with Nicotine or Caffiene other than the later sometimes causing anxiety. This is very strange, so my question is have you ever heard of this happening? And what could be the possible cause(s)? Thanks. (also, my dopamine levels were slightly elevated earlier this year - the Dr used the word 'marginally').
 
 
Answered by Dr. Radhika 14 hours later
Hi,
Thanks for the query.

What you are experiencing is a panic attack, which is a sudden surge of overwhelming anxiety and fear. You feel dizzy, nausea and pain in your stomach. It is not nerve pain. Often it strikes without any warning. They may even occur when you’re relaxed or asleep.

A panic attack may be a one-time occurrence, but many people experience repeated episodes. The symptoms can be Shortness of breath or hyperventilation, Heart palpitations, Chest pain or discomfort, trembling, choking feeling, feeling unreal or detached from your surroundings, sweating, nausea or upset stomach, feeling dizzy, light-headed, or faint.

Panic attacks can also be caused by medical conditions and other physical causes. If you’re suffering from symptoms of panic, it’s important to see a doctor to rule out the following possibilties:

Hyperthyroidism.
Hypoglycemia.
Stimulant use (amphetamines, cocaine, caffeine).
Medication withdrawal.
medication for Diabetes, you will have to rule out the possibility for hypoglycemia.

You could try various method of treatment like :

1. Cognitive behavioral therapy which is generally viewed as the most effective form of treatment for panic attacks, panic disorder, and Agoraphobia.
2. Exposure therapy for panic disorder, you are exposed to the physical sensations of panic in a safe and controlled environment, giving you the opportunity to learn healthier ways of coping.
3. Medications used for panic attacks and panic disorder include Antidepressants and Benzodiazepine.

Avoid smoking and caffeine. Smoking and caffeine can provoke panic attacks in people who are susceptible. Nicotine chewing gum also does contain nicotine in small amounts.
Learn how to control your breathing. Practice relaxation techniques such as yoga and meditation.

Your dopamine levels were marginally elevated there is no need to fear regarding this. As normally a fall in dopamine levels generally makes you more at risk for experiencing anxiety and panic attacks. Serotonin and dopamine are neurotransmitters that stabilize your mood and sense of well-being.

Hope I have answered your query. I will be available for follow up queries if any.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Adrenaline rush when emotional. Now have nerve pain in abdomen, heart rate and dopamine levels increased 3 hours later
No it is not a panic attack.

I have suffered panic attacks for many years so much so I have been held in a hospital twice because they were so bad, since this experience panic attacks have completely and utterly STOPPED without the influence of any medication. My family have said it is highly unusual, its simply not who I am. I do not feel adrenaline, I do not feel an elevated heart rate, I do not feel panic, at all.

I have never felt weak or nausea when I have had a panic attack I feel high levels of energy as the Epinephrine is released into my system.

I have done cognitive behavioral therapy and am intimate with Acceptance Commitment Therapy.

I don't have hypoglycemia I have a home Blood Glucose monitor, I have never monitored any level considered to be low blood sugar levels.

I can prove my heart rate is not elevating in stressful situations as it has done in the past, I have an ECG accurate heart monitor and it is not elevating at all, which proves that either Epinephrine is being released by the adrenal glands and the sinus nodes aren't responding or that the adrenal glands are being disrupted and not releasing Adrenaline (Epinephrine).

Also, I have lost my ability to achieve an Erection via visual or cognitive stimulus (and even the feelings of sexual arousal have been significantly dampened - its not a hormonal issue, I have had multiple blood tests done and my blood tests showed normal testosterone and other hormone levels) and now I'm wondering, given these strange symptoms, that certain nerves in the brain responsible for carrying signals to certain organs are failing or being disrupted somehow. I have Pre diabetes. It was only diagnosed a few months ago and I am on Metformin. All Blood sugar readings prior to this test have been perfect. I cant see how it could be diabetic nerve damage.

Maybe you misread, I said in situation I would normally panic I am completely and utterly calm, it makes no sense. Yet I am getting sever nerve pains throughout my abdomen.

So my next question is.....

Is it possible for the brain to fail in its attempt at signalling the adrenal glands to release Epinephrine during the fight or flight response?

Follow-up: Adrenaline rush when emotional. Now have nerve pain in abdomen, heart rate and dopamine levels increased 52 minutes later
Could this be the problem???

Hypoadrenalism.........

refers to the state wherein the adrenal glands do not function properly, they function below the required levels. These glands are small in size and are present above each kidney.
 
 
Answered by Dr. Radhika 1 hour later
Hi,
Thanks for the follow up.

I am sorry, I could not convince you with my explanation during our last conversation. Let me try now.

I have gone through your query. Your main concerns are pain in abdomen, failure to achieve erection, loss of libido and absence of flight and fight response.

There can be various causes for this like Nutritional deficiencies (B-12 and folate), chemical exposures, pressure on nerves, or medications.

Neuropathy can also be a cause for the symptoms in the gastrointestinal tract and failure to erection.

Autonomic neuropathy affects the nerves that control involuntary activities of the body, such as the action of the stomach, intestine, bladder and even the heart.

You may need to certain tests under your physician's guidance like electromyography (a test that measures the response of muscles to electrical impulses) and nerve conduction studies (a study of the flow of electrical current through the nerves) combined with clinical observations may help a physician rule out other possible causes of pain, and diagnose Neuropathy. You will also have to check out your Vit B12, folate levels.

You have also mentioned the possibility of the brain to fail in its attempt at signalling the adrenal glands to release Epinephrine during the fight or flight response and Hypoadrenalism.

The symptoms of hypoadrenalism are due to a deficiency of the steroid hormone cortisol.
Autoimmune Addison's disease is chronic (ie long-standing), and antibodies to the adrenal cortex may be detected in a person's blood many years before damage to the adrenal cortex is apparent. Most of the patients do complain of vague stomachaches or other gut symptoms.

There might be a rare possibility, for this you could get the following blood tests done to confirm like:
ACTH (adrenocorticotropin or corticotropin) hormone, aldosterone, plasma renin activity, noradrenaline and adrenaline.

Hope, this answers your query.

Wishing you good health.

Regards.
Above answer was peer-reviewed by
 
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