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Having panic attack, anxiety, mood swings and fatigue. Help?

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Practicing since : 2000
Answered : 634 Questions
hi doctor,

I am writing with an act of desperation..

I have always been a sport addict boxing, gym, swimming...

About a year ago while training I felt nauseous dizzy an went pale. They took me to emergencies they did tests, ECG, tension, blood pressure.. nothing. It was clearly a normal issue.

The day after I started having panic attacks anxiety, fatigue, pale face.... Started to really worry so went to visit doctors. Had fatigue a anxiety red eyes mood swings issues sleeping morning fatigue, sometimes tinglings and muscles shaking for about 5months then things went better(took magnesium supplements) I remember. After that started going gym again training well sleeping well (was never perfect but better) then lately it came back... always worsen by physical activity any (running climbing stairs gym or even sex). Saw so many specialists : neuro, XXXXXXX medicine, sport doctor, endocryno, psychiatrist, heart doctors etc... each one of them doesn't find anything and says it may be stress. Well I know it is not, I live in dubai, lot of sun, nice job, nice environment, and if it was I would be in a bad shape all the time!! Well why is it most of the time triggered by physical activity?

I went to visit another endocrinologist who told me you have diabetes in your family (grand ma grandpa, dad) you must have bad genes!! Well I always eat healthy for 6 years now as I used to compete, proteins complexes carbs, fruits veggies... he said you have reactional hypoglycemia do a test : 4 blood test in the morning while fasting : 1 blood test result was 90 - 2nd after hyper sweet drink result 120 -then 3 test and hours after that result 70. He concluded I was reactional hypoglycemic. I am not a doctor but I am sorry this is not bad results they seem normal to me.

Nowadays i have learned a lot about all the deseases, my knowledge is quite good over a year (when it all started) - can sum the symptoms this way.

If no exercise : morning fatigue - irritability (times to times) - fatigue that starts with red eyes (after 15 20 min walk for example).

If exercise : anxiety, muscle movements, exercise intolerence, nausea, fatigue (need 3 or 4 days to recover).

I beg you if you can doctor help me cause I am desperate no sports no physical activities and above all living with something no one seems to understand.

TESTS DONE : XXXXXXX desease - Brain MRI, Blood test, Tyroids, Holter, ECG, Brain activity, magnesium and other vitamines, sugar levels and diabetes... all normal...

Many thanks.
Posted Wed, 19 Jun 2013 in Mental Health
Answered by Dr. Payman Hajiazim 1 hour later
Hi there, thanks for asking. Another condition that should be assessed is familial hypokalemia. It is a condition which could be seen just in his person despite the name (it has two types, the recessive and dominant gene. The recessive one is seen in people who do not have the family history necessarily. It can cause drop in the potassium level after sport. Sometimes it is hidden from the eyes because potassium level drops just after exercise or physical activity or eating lots of sugar or bread. You should first ask your doctor if he has had this issue in his mind. It is not common in people so it may not be diagnosed easily. Let me know about it to see better what it is. Best wishes.
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Follow-up: Having panic attack, anxiety, mood swings and fatigue. Help? 34 minutes later
Hi doctor thanks a lot for the answer. You think so? My potassium level was normal when blood checked and I don't have cramps and I am not on any medication?
Can this be? Plus I experience high symptoms especially after sport. :(. Drives me crazy. Some say it is anxiety but you are a psychiatrist you know better that exercise help and doesn't make things worse. Plus anxiety kicks in hard only after training 2 3 4 sessions depends.

Many thanks for your help
Answered by Dr. Payman Hajiazim 20 minutes later
Hi again, It may be the reason for you. It is exacerbated in the warm weather as well. and it is not improved with time. You can ask about its treatment from the doctor and hopefully you will enjoy the exercise soon. Let me know about its process.
Above answer was peer-reviewed by
Follow-up: Having panic attack, anxiety, mood swings and fatigue. Help? 1 hour later
Thanks a lot for your help. When you say it might be the case for you, you are referring to the hipokalemia not the anxiety right?

Answered by Dr. Payman Hajiazim 4 hours later
Hi again, exactly, i am referring to hypokalemia. Let me know about how it goes with your exercise. If you want to try nutrition before medications, you can take banana, avocados, salmon fish and dried apricot or some other foods that have more potassium before exercise to see how it goes. Let me know about it.
Above answer was peer-reviewed by
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