Adrenaline spikes: Med detective needed, award given

Hi @sierrawoods I just came across your post from 2018 about your experience of an adrenaline rush each night. I have been scouring the web for a few years trying to find a solution to exactly the same problem I just turned 54 but have been going through this problem for nearly 8 years An endocrinologist has had me wearing a freestyle libre glucose monitor for the past month and it has shown that my blood glucose drops low ( under 50) around 3 or 4 AM just as I have been experiencing the adrenaline rush sensation accompanied by high heart rate and at times sweating Although I am clearly entering perimenopause I do not have hot flashes during the day and I have eliminated nearly any prescriptions ( what’s on 12.5 MG atenolol daily for high heart rate and was trying bioidentical hormones for about a year) I am experiencing the same affects of the poor quality of sleep at night after night I like you drscribed. What years ago was only a few times a month has become a nightly thing for probably the past six months I wake up feeling as if I’ve been in an accident. The effect on my day is just as you described. I’m not exercising or even functioning efficiently. I am very slim and weight is not a problem, but I feel a great degree of fatigue and I’m pretty sure I have been sliding into a depression after seeing so many different doctors for years now and not being able to find any type of answer. It has a detrimental affect on my day (and now life) just as you described. I did have a brain MRI that showed a small nodule on my pituitary but the neurologist said not to worry about it. I remember you mentioning wanting to look into that for yourself on your post I hope you are doing better and I am just wondering if you have found any answers to this confounding, frustrating, and now debilitating situation. I just remarried about two years ago, my children are doing wonderfully, and I have very little stress in my daily life. This nightly occurrence is wrecking havoc on my life at what should be such a happy time. Just wondering if you have found any answers or additional information. Would sincerely appreciate any advice you may have. Thank you so much, and I hope you’re doing better.

Hi aclmalibu! I am not sierrawoods, and I would also like an update from them, however, I have found that by taking a very small dose of Cytomel (only 1/4 of a 5mcg tab...I cut them into quarters myself) combined with 112 mcg of Synthroid that my adrenaline rushes have stopped altogether. I used to wake up between 2:30-4:30 every night as well, and was desperately searching on the web that also brought me to this discussion. I am on HRT (both estrogen and progesterone) after being into surgical menopause after having my ovaries and uterus removed.

I had a very difficult time convincing my doc that the night time issue was a thyroid imbalance, but I actually found a walk-in clinic doc who helped me greatly by prescribing Cytomel. Many family docs and endocrinologists don’t agree with it at all, but I swear it is the reason that my nighttime episodes have disappeared and I feel like myself again!

The tricky part is that most North American doctors are stuck on TSH levels only, and don’t check T3 or T4 levels or anything else! It is very frustrating because I suffered for years when 1/4 of a tab of inexpensive medicine changed my life...literally overnight!

There is an interesting new Thyroid research app out of Germany that I’ve been following called “Boost Thyroid” run by a scientist who also has hypothyroidism. I’ve learned a lot about thyroid issues from it.

Not sure if any of that helps, but if I’ve found relief, it might be worth pursuing...you might have to fight to find the right balance for you though!

Good luck!

Hi @libjen. Thank you so much for the advice. I will look into Cytomel. I have not been diagnosed with any thyroid issue after taking many tests for it over the years, but based on your experience, will look into it further. I wrote my first post on my phone this morning in a hurry....so to recap the key symptoms in case anyone else can relate or offer advice, they are as follows:
Female Age 54. Episodes of what I can only describe as an "adrenaline rush" began periodically in 2006, but have escalated to being a nightly event now for about six months. I experience a racing heart (about 110-120 lying down according to my iwatch) feeling fearful and shaky as if I have stage fright, and having an odd sort of "butterflies" in abdomen or kicked in stomach feeling. Sometimes I also can become quite hot and sweaty when this happens (but I do not experience "hot flashes" at any other times.) I went through a terrible divorce around the time these episodes started, so naturally everyone (myself included) attributed it to anxiety. Fortunately, my life has turned out quite happy and stress-free now with a wonderful new husband, and very happy and successful college-age children. It's now a very unsettling mystery and sleep-depriving existence to have this experience nightly. I know it is taking a toll on my health and often wakes my husband as well (who has a lot on his plate as the CEO of a large company and needs his sleep.) My other medical history is: History of heart palpitations and diagnosed with SVT about 3 years ago and had a loop recorder implanted which documents the SVT. Have used 12.5 mg of Atenolol to keep SVT episodes pretty quiet at this point. In fact I am even stopping the atenolol currently out of concern that it may be lowering my BP too much. I have recently had BP readings of 80/50 at the doctor's office. I failed a cardiac tilt table test earlier this year and have been told that I have POTS, (Postrual Orthostatic Tachycardia Syndrome) but am still learning what exactly this is. I am thin and up until recently have been in very good shape...I just haven't felt well enough or strong enough to work out much lately. I am currently being evaluated for "Non-Diabetic Reactive Hypoglycemia". About a month ago I started wearing a Freestyle Libre glucose monitor. Much to my surprise, my glucose was dropping under 50 right around 3-4 AM nightly...and even earlier if I went to bed earlier. This has been easily corrected by simply eating a protein-rich snack before sleeping. I thought we had solved the mystery, but no...not at all it turns out. Now I can prevent the nighttime glucose dips, but I am still experiencing the "adrenaline rush" attacks at 3-4AM even though my glucose meter is reading 80 or 90. To complicate things, I am currently embarking on menopause, technically peri-menopause...but my estrogen has plummeted this year. I tried bioidentials (divigel, progesterone, and testosterone cream) last year for about 9 months but so many of my doctors and my husband were concerned. Having a (benign) breast biopsy last November was when I stopped taking the bioidenticals. I have been experiencing a great degree of "brain fog" over the past two years, and I am not sure if this is menopausal or an effect of such poor sleep for so long. It's concerning as I am usually very highly functioning and productive. I have had a history of hormonal migraines, but that has resolved with the onset of menopause. An MRI of my Brian about a year ago noted a small nodule which has remained unchanged for several years on the pituitary, and the neurologist said not to worry about it since it was small and unchanged. In addition, I have been having lots of osteoarthritis issues with neck, spine, and hips and X-rays are showing degeneration which is unusual for my age. In addition my eyesight seems to be getting worse and my contact prescription is changing about every 6 months. I also have a generalized sense of fatigue that is not like me at all. My husband (again we just got married about two years ago and are very happy) and I have been looking forward to traveling the world and having fun now that my kids are off, but sadly, I have never felt more exhausted and unwell in my life...even traveling (which I love) sounds difficult. I really need to solve this. Seeing one doctor after another who just shrugs and says it is either anxiety or beyond their scope of practice is chipping away at my usually optimistic self and I am increasingly feeling hopeless. I am open to any advice, information, or experience anyone thinks could be of value, and I hope my experience may be of use to someone else as well.

Please look into taking a small dose of T3 just to see what happens...the change was immediate for me! And maybe you can just get on with your awesome life! I’m in Canada so I know it is called Cytomel here, but I think it the generic term is Liothyronine. I can’t believe the solution was that easy, although if you have a heart condition, I’m sure you have to be careful what you take!

I also have Psoriatic Arthritis (first diagnosed in 1981 when I was 6), and have had quite a lot of autoimmune issues over the years. I also started with the high protein snack before bed, but it just wasn’t enough.

I wish you all the luck in the world!! Try to stay optimistic...you are not in this alone, although it often feels like we are...hang in there!

Thank you so much @libjen. I really appreciate the advice and the encouraging words. I hope I didn't make my life sound too "amazing"...just trying to explain that I really don't see stress or anxiety as the root cause of these nightly episodes. I will definitely talk to my endocrinologist (who seems to completely puzzled by my symptoms) about the possibility of a thyroid issue. In the meantime, thank you again for all your advice. Wishing you all the best!

No, I didn’t mean it that way. I’m also in a second marriage and things are going really well, so I understand the desire to enjoy every minute of it!

I wish you all the best, and hope that you find a solution soon 🙂

As someone who has dealt with this issue for years, and has read up on it, I've seen a lot of potential causes for it come up. I don't know if any of them are the cause for me, but maybe the info can be useful to someone else.

So potential causes I've seen in the various threads I've read over the years include, but are not limited to, things like

Hormonal changes around menopause (many times this happens to women around menopause or perimenopause age. I have no idea what the solution is though)

GERD or acid reflux (supposedly the stomach acid irritates a nerve that sends signals to the brain)

Heart arrhythmias

Serotonin drugs (either starting or stopping a drug that can affect serotonin levels)

Hypoglycemia

Thyroid issues

Stress and anxiety

Some kind of environmental toxicity (people in this thread mention mold or copper toxicity, or drugs building up in their bodies. I've seen other threads say similar things could be a factor)

Adrenal and cortisol dysfunction

I'm sure there are dozens of other causes. I wish there was more research into this condition. It is miserable.

For me, when mine acts up I take a benadryl and propranolol. Taking those drugs seems to help keep the intensity of the surges down, but I still have symptoms.

Hello @asthena94 Can you go into more detail about your cortisol? I also have this issue of nighttime adrenaline surges, and I also have high cortisol.

My cortisol readings were out of the normal range for 8am, noon and evening readings. Night time readings were in the 'normal' range, but at the very peak (readings are supposed to be 0.4-1.0 ng/ml. Mine were 0.9ng/ml before bed).

But I know my noon readings were very high. Normal readings are 1.2-3.0 ng/ml, mine were almost 6 at noon.

I'm wondering if my adrenaline surges are due to my cortisol being out of whack.

I have the same issue and was clinically diagnosed with EDS as well... Beta blocker an hour before bed helps, but the only thing that guarantees me a good night sleep is a full body workout for 30 to 60 minutes during the day. Treadmill and stairmaster don't cut it. Must be something like a bar or yoga class, or tennis -- and I can't do yoga anymore because of the EDS and my mast cell activation, which turns me beet red and passing out in most yoga classes, but especially hot yoga. It's the EDS. Check out some EDS Facebook groups and you'll see the adrenaline night surges issue all over the place -- it's prolly cortisol too -- and for me, it's meant weight gain so I'm now getting serious about trying to figure out how to stop it. The beta blocker is less and less affective as I get older, but it may mean I have to change my dosage.

I had complete relief of adrenaline rushes with a small dose of the beta blocker, Atenolol, before bed.