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Panic attacks, brain MRI clear, diagnosed as seronegative spondyloarthropathy, back pain, weight loss. Is immune disorder the main reason?

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I am 27 year old guy. I have had symptoms since last 2 years like palpitations, strong heart beat, breath lessness , dizziness, nausea, abdomen pain, sudden blackout, feeling like gonna faint, sweating, extreme weakness in legs and srms. This was just like the symptom of Panic Disorder. Consulted neurophysician ant clear brain MRI. Whenever I have these symptoms, my heartbeat goes upto 105-130 and BP 110-160 (maximum). Consulted a cardiologist, he suggested some blood test, USG abdomen and 2D echocardiogram. Echo was clear except results like Aortic Root=32.4mm (should be less than 22mm) and Left atrium Diameter= 33.1mm (should be less than 22mm). Doctor said Ultrasound is OK and result read- "Mild Hepatomegaly with grade I fatty Liver" and "Liver is mildly enlarged (152.1 mm), "Parenchymal echogenicity is diffusely increased with masking of vascular wall echoes". In blood tests, he found that Vitamin level was very low. It was 126 pg/mL (range 211-911). He said all above symptoms are mainly because of deficiency of vitamin b12 and when I searched on net, found it true that b12 causes this type of symptoms. He prescribed 5 Nurokind Gold (methylcobalami) injections for alternate days and then once every month. And Nexito 5, A to Z capsules, XXXXXXX 60 K (deficiency of D3 was also there in report). My question is are the medicines OK? Secondly Nexito 5 is prescribed as Antidepressant but I don't have any depression or tension. And it is addictive also. Should I take nexito 5 or not. He asked me to take nexito 5 for at least 3 months, once a day. I've read horrible side effects after leaving nexito 5 and it is difficult to come out of the addiction of this medicin. Plz suggest. Doctor also asked me to go for 24 Hr Urine test Catacholamine, Metaniphrine and 5-4I-AA or 5-HI-AA or 5-NI-AA (writing not clear). Please suggest for this also. He said he is asking this to rule out adrenal disorder or tumor.
Symptoms like Panic attack but reason is still unkown. Brain MRI clear. Other tests are being conducted. Got Diagnosed as seronegative spondyloarthropathy and Immune disorder. Back Pain is also severe if I stand for more than half n hour. Unexpected Weight loss, extreme tiredness, sweating, palpitation and strong heartbeat, back pain after prolonged standing position, sudden blackout together with dizziness/vertigo, breathlessness, fatigue are the symptoms which made me very tense and I am still not sure what specialization should I choose when deciding a doctor. Please suggest. I need help. Is the Immune system disorder the main reason or anything else.
Posted Mon, 18 Jun 2012 in Mental Health
 
 
Answered by Dr. Ashish Mittal 13 hours later
Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

From your description it appear that you are having anxiety disorder. Severity of anxiety may vary time to time. If anxiety or panic not treated on time, it may lead to Depression.

Other symptoms of anxiety which may or may not be present in your case: nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, muscle spasm (may lead to pain in multiple parts of body), heaviness in body, decrease appetite (Unexpected Weight loss), choking sensation in breathing, easy fatigability (extreme tiredness), headache, sleep disturbance, palpitation and dry mouth.

Anxiety occur due to neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter. This may be due to inherent anxiety disorder in body or secondary to causes like: B12 deficiency (+in your case), Thyroid hormone imbalance or Adrenal hormone imbalance. You may need treatment with psychiatrist to treat your anxiety as they are specialized to treat these condition. It is not clear if you received any treatment in past from psychiatrist, but believe me people life changes after treatment.

In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines are used and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors) like Nexito are used. SSRI takes around 3-4 weeks to show its effect.

All these process is complex. I have just simplified it to make you understand it. So, overall your treatment is appear to right but in some cases improvement may take time. But better to take treatment from psychiatrist for anxiety symptoms and continue treatment from other specialist for other problem, depending on investigation findings.

Apart from above advice following simple measures will help you:
-Decrease worrying about symptoms as they will cure after treatment.
-Healthy diet: Milk and fruits in diet.
-Jogging in morning time

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

Above answer was peer-reviewed by
 
Follow-up: Panic attacks, brain MRI clear, diagnosed as seronegative spondyloarthropathy, back pain, weight loss. Is immune disorder the main reason? 9 hours later
My life is going smooth, professionally and personally. I don't have any depression or anxiety then how come I admit that I have anxiety issue. I appreciate your timed response but please suggest about the reports details I had mentioned in my question. Secondly, symptoms being faced by me may arise due to adrenal tumor/disorder and B12 deficiency (you obviously know this) so why shoould I consult a psychiatrist. Please help and clarify test results also. Shuld I go for this 24 hour urine test for catacolamin, metanephrine and 5-HI-AA ?
 
 
Answered by Dr. Ashish Mittal 4 hours later
Hello again,

Thanks for follow up,

Your case is not straightforward. Even your current multiple physicians having difficulty to explain this. Your current physician also suspect anxiety disorder that is why he is giving you Nexito.

Anxiety symptoms can occur due to:
-Inherent anxiety disorder in body
-secondary to causes like: B12 deficiency (+in your case), Thyroid hormone imbalance or Adrenal hormone imbalance.

For anxiety disorder we do not see only anxiety or low mood. We see multiple symptoms as mentioned in primary question. You already mention several symptoms: (palpitations, strong heart beat, breath lessness , dizziness, nausea, abdomen pain, sudden blackout, feeling like gonna faint, sweating, extreme weakness in legs and srms. This was just like the symptom of Panic Disorder).

You need B12 supplement and investigation for Thyroid hormone imbalance or Adrenal hormone. I just gave you my interpretation of your case. I have seen several cases having presentation like your case and they improved after treatment. I just intend to help you in decision making.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.




Above answer was peer-reviewed by
 
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