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Suggest Treatment For Episodic Symptoms Of Anxiety
Question: Hello,
I have had some recent symptoms for about two months or more that have me a bit concerned.
I wake up at night about an hour after falling asleep with my heart racing, feeling weak and I start to shake and I feel lightheaded. These episodes last anywhere from a few minutes to a half hour. I will have these episodes frequently and then they will not happen for like a month. During the day I also feel fluttering inside my chest and sometimes my heart will beat faster then normal. today I experienced one in the day while napping. I woke up about an hour after falling asleep with theses symptoms and I drank some apple juice. Before I took a nap I was feeling very fatigued and tired. I wonder if this is related to my blood sugar. When these episodes happen they are very scary. Sometimes when the episodes happen I have breathlessness. I also have been experiencing a sensation in my chest on my left side like vibrating or a spasm. It does not hurt but feels awkward. it happens a lot when I am lying down. I also have a lot of tingling and numbing sometimes burning sensation in my arms, hands and feet when I lay down. This has been going on for over a year. I wake up cause it can be so bad at times. I have had some thyroid tests taken etc and all comes back normal although one of the thyroid tests taken was on the low to normal side but still within normal range. At night when I am asleep I sometimes wake up in a cold sweat for no apparent reason and this seems to only happen around my period but is a newer symptom. lately I have been feeling more tired and weak in my muscles. I do not drink coffee, tea ,smoke or drink. I am fairly active but not like I could be. I am 31, 5'2 and 120 pounds. So I am not over weight. I also tried to start working out again and had problems with fluttering in my chest and my heart rate was like 147. I was feeling a bit lightheaded at the time so I decided to take it down a few notches and just walk instead of run. About a year ago I got really sick and my liver enzymes were high but the Doctors could not figure out why. They did a lot of blood work and all was normal. I was loosing weight, looked sickly and could eat certain things like red meat etc. I overtime finally started feeling better but it took about a year. I don't know if this could be related to what I am going through now. Any suggestions? Also I seem to get itchy skin at times and have rashes. Not sure what that's all about...
I have had some recent symptoms for about two months or more that have me a bit concerned.
I wake up at night about an hour after falling asleep with my heart racing, feeling weak and I start to shake and I feel lightheaded. These episodes last anywhere from a few minutes to a half hour. I will have these episodes frequently and then they will not happen for like a month. During the day I also feel fluttering inside my chest and sometimes my heart will beat faster then normal. today I experienced one in the day while napping. I woke up about an hour after falling asleep with theses symptoms and I drank some apple juice. Before I took a nap I was feeling very fatigued and tired. I wonder if this is related to my blood sugar. When these episodes happen they are very scary. Sometimes when the episodes happen I have breathlessness. I also have been experiencing a sensation in my chest on my left side like vibrating or a spasm. It does not hurt but feels awkward. it happens a lot when I am lying down. I also have a lot of tingling and numbing sometimes burning sensation in my arms, hands and feet when I lay down. This has been going on for over a year. I wake up cause it can be so bad at times. I have had some thyroid tests taken etc and all comes back normal although one of the thyroid tests taken was on the low to normal side but still within normal range. At night when I am asleep I sometimes wake up in a cold sweat for no apparent reason and this seems to only happen around my period but is a newer symptom. lately I have been feeling more tired and weak in my muscles. I do not drink coffee, tea ,smoke or drink. I am fairly active but not like I could be. I am 31, 5'2 and 120 pounds. So I am not over weight. I also tried to start working out again and had problems with fluttering in my chest and my heart rate was like 147. I was feeling a bit lightheaded at the time so I decided to take it down a few notches and just walk instead of run. About a year ago I got really sick and my liver enzymes were high but the Doctors could not figure out why. They did a lot of blood work and all was normal. I was loosing weight, looked sickly and could eat certain things like red meat etc. I overtime finally started feeling better but it took about a year. I don't know if this could be related to what I am going through now. Any suggestions? Also I seem to get itchy skin at times and have rashes. Not sure what that's all about...
Brief Answer:
Such episodic symptoms can occur due to anxiety
Detailed Answer:
Hello thanks for asking from HCM
I have read your query and can understand your concern. You are a 31 years old healthy female with average weight and height. You have symptoms of racing heart, light headedness and shakiness and such symptoms can occur due to some anxiety and possibly Panic disorder. As these symptoms occur in episodes and are acute onset and last for short duration so this also supports diagnosis of panic.
But before diagnosing panic we have to rule out other medical reasons. Hyperthyroidism, Vitamin B12 deficiency, Anaemia, hypoglycaemia, some cardiac problems should be kept in differential diagnosis.
- You have already checked your thyroid status so we can rule out this cause easily.
- Other possibility is some cardiac lesion. Though episodic presentation is not common still I would advise you to get echo done to rule out cardiac cause.
- Other reason for such symptoms is reduced sugar levels but dizziness is more common presentation. To rule out you can get your Random sugar levels checked during episode. Most likely ECG and sugar levels will come in normal range.
- Iron deficiency anaemia is other possible cause that should be ruled out. Reduced levels of hemoglobin can present with symptoms of panic and anxiety.
- One more cause that should be ruled out is Vitamin B12 deficiency. You also have symptoms of tiredness, numbness, tingling in arms along with anxiety and such symptoms are common in B12 deficiency. B12 deficiencies predispose to anxiety and panic. Get your B12 checked to rule out the cause.
Did you repeat liver enzyme tests? Do you have any history of fatty liver?
Do you have any history of bile duct stones? Increased levels of bile pigments can also cause skin itching.
Since when are you having itching and rashes? Any history of contact dermatitis or allergy?
If everything comes normal then we are left with panic and anxiety as cause for your symptoms. Consult a psychiatrist for treatment and evaluation of such symptoms.
Thanks, hope this helps you. Please ask again for more doubts.
Take care
Such episodic symptoms can occur due to anxiety
Detailed Answer:
Hello thanks for asking from HCM
I have read your query and can understand your concern. You are a 31 years old healthy female with average weight and height. You have symptoms of racing heart, light headedness and shakiness and such symptoms can occur due to some anxiety and possibly Panic disorder. As these symptoms occur in episodes and are acute onset and last for short duration so this also supports diagnosis of panic.
But before diagnosing panic we have to rule out other medical reasons. Hyperthyroidism, Vitamin B12 deficiency, Anaemia, hypoglycaemia, some cardiac problems should be kept in differential diagnosis.
- You have already checked your thyroid status so we can rule out this cause easily.
- Other possibility is some cardiac lesion. Though episodic presentation is not common still I would advise you to get echo done to rule out cardiac cause.
- Other reason for such symptoms is reduced sugar levels but dizziness is more common presentation. To rule out you can get your Random sugar levels checked during episode. Most likely ECG and sugar levels will come in normal range.
- Iron deficiency anaemia is other possible cause that should be ruled out. Reduced levels of hemoglobin can present with symptoms of panic and anxiety.
- One more cause that should be ruled out is Vitamin B12 deficiency. You also have symptoms of tiredness, numbness, tingling in arms along with anxiety and such symptoms are common in B12 deficiency. B12 deficiencies predispose to anxiety and panic. Get your B12 checked to rule out the cause.
Did you repeat liver enzyme tests? Do you have any history of fatty liver?
Do you have any history of bile duct stones? Increased levels of bile pigments can also cause skin itching.
Since when are you having itching and rashes? Any history of contact dermatitis or allergy?
If everything comes normal then we are left with panic and anxiety as cause for your symptoms. Consult a psychiatrist for treatment and evaluation of such symptoms.
Thanks, hope this helps you. Please ask again for more doubts.
Take care
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
I did have blood work taken again months later and my liver enzymes returned to normal. I do not have any history of fatty liver disease. I do have higher then normal cholesterol though. My blood test results for my cholesterol were 193 and from what I have read it shouldn't be over 200. That seems on the higher end to me.
The itching and occasional rashes have been going on for almost 2 years. It started when I got sick. My hands would itch a lot and I would see these bumps under my skin that were kind of whitish. I'm more worried about my episodes with my heart at this point. Sometimes I cannot slow down my heart beat and my body feels very achy an tight all over. I'm not hyperventilating or anything, I do have lower then normal bp. When I lay down it gets pretty low like 87/50. When I had that episode yesterday I checked my bp and it was normal but my heart rate was 120. I basically felt like crap the rest of the evening. I have had low blood sugar in the past also. They did a two hour fasting test and my blood sugar results came back 54. Do you have any suggestions on what I should do when theses episodes happen? Should I be eating something inpaticular before bed?
The itching and occasional rashes have been going on for almost 2 years. It started when I got sick. My hands would itch a lot and I would see these bumps under my skin that were kind of whitish. I'm more worried about my episodes with my heart at this point. Sometimes I cannot slow down my heart beat and my body feels very achy an tight all over. I'm not hyperventilating or anything, I do have lower then normal bp. When I lay down it gets pretty low like 87/50. When I had that episode yesterday I checked my bp and it was normal but my heart rate was 120. I basically felt like crap the rest of the evening. I have had low blood sugar in the past also. They did a two hour fasting test and my blood sugar results came back 54. Do you have any suggestions on what I should do when theses episodes happen? Should I be eating something inpaticular before bed?
Brief Answer:
Most likely these symptoms are due to panic disorder
Detailed Answer:
Hello again and thanks for asking a follow up question
Low sugar levels of 54 need further evaluation and if you have access to tests get Random Glucose Levels done at least at two different occasions. If this comes normal then there is no need to worry.
Heart rate may increase due to panic attacks as your lipid profile is in normal range and your are just 31 so possibility of cardiac lesion is rare.
I would advise you to try Breathing Exercises and Progressive Muscle Relaxation Exercise to keep your self relaxed. Practice these exercises in evening before going to bed and you will see improvement. You can take help of a therapist or youtube to learn about these exercises.
I would advise you to take diet rich in complex carbohydrates and proteins and low in refined carbs and fats. This will improve the anxiety and panic symptoms.
Avoid tea, coffee and alcohol in evening.
Start taking Omega 3 Fatty Acid and B12 supplements. Both these supplements help to improve the symptoms of anxiety.
St Johns Wart is a natural extract and it has been found to be useful in some patients of anxiety. Diets rich in omega fatty acids like Flex seeds, salmon fish, sardine, walnuts, hazelnuts etc help in improvement.
Try to follow these lifestyle changes and you will see improvement.
Thanks, please ask again for more doubts.
Most likely these symptoms are due to panic disorder
Detailed Answer:
Hello again and thanks for asking a follow up question
Low sugar levels of 54 need further evaluation and if you have access to tests get Random Glucose Levels done at least at two different occasions. If this comes normal then there is no need to worry.
Heart rate may increase due to panic attacks as your lipid profile is in normal range and your are just 31 so possibility of cardiac lesion is rare.
I would advise you to try Breathing Exercises and Progressive Muscle Relaxation Exercise to keep your self relaxed. Practice these exercises in evening before going to bed and you will see improvement. You can take help of a therapist or youtube to learn about these exercises.
I would advise you to take diet rich in complex carbohydrates and proteins and low in refined carbs and fats. This will improve the anxiety and panic symptoms.
Avoid tea, coffee and alcohol in evening.
Start taking Omega 3 Fatty Acid and B12 supplements. Both these supplements help to improve the symptoms of anxiety.
St Johns Wart is a natural extract and it has been found to be useful in some patients of anxiety. Diets rich in omega fatty acids like Flex seeds, salmon fish, sardine, walnuts, hazelnuts etc help in improvement.
Try to follow these lifestyle changes and you will see improvement.
Thanks, please ask again for more doubts.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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