Brief Answer: Pheochromocytoma Detailed Answer: Pheochromocytoma is a rare, typically benign tumor of the adrenal glands that produces symptoms similar to the ones you are reporting. There is a simple blood test to screen for the possibility of this condition. It is called Plasma Fractionated Metanephrines. There is no need to fast for this test. It can be done at anytime of day or night. If you have a spell / episode on that day, it might be of even more value. However, it is unlikely this condition has gone on for 3 decades, although anything is possible in medicine. What I mean is that if one has a pheochromocytoma, it is very well known to be undiagnosed or misdiagnosed for many years before it is presented to an endocrinologist, but 30 years is too long a time frame because generally well before that, the tumor causes severe complications that are acute and life threatening. It would also be well worth it to check for CBC CMP TSH Free T4 in the same blood sample. None of these require fasting either. If your physician suspects adrenal insufficiency (given the history of low blood pressure), you may wish to consider doing a blood test call 8 am serum cortisol

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