Adrenal Surges And Endocrine Tests At Endocrinology

[jenglynn]

I am sure this is a silly question... but there are so many times that I have these feelings that you all describe as "adrenal surges". My heart will start to race and pound, I will feel dizzy, clammy and feel like I am having something like what I would assume a panic or anxiety attack would feel like, but to my knowledge I don't ever recall having either.

I have tried to self soothe, lie on my tummy, deep breathing... nothing really helps. The feeling is so much like that you feeling you get when you just avert something dangerous happening- near miss car accident or something- for me anyway. I have also had the metallicy taste in my mouth. I can also feel the adrenaline just rising in my chest and my heart rate will just increase until I feel like I am going to explode. If anyone is close enough to me they can hear it beating. So that is my experience..

So on to my question... Have we all be tested by Endrocrinology to make sure that our adrenals are working right? I explained these "surges" to the Endocrinolgist and he said it was possible that my adrenals were out of whack. They took vials and vials of blood from me (more than I think I had, actually lol) and they did this cortisol test where I was given some kind of stimulant or adrenaline and then I had to come back twice 30 minutes apart and have the blood drawn again. All of my endrocrine tests (except my thyroid) came back perfectly normal. Is it possible to have these adrenal surges even though my endocrine system apparently works just fine? Or what else is happening? He told me that I can't be having adrenal surges because according to the tests he ran my endocrine responds appropriately. Then what on earth is happening to me because it happens on a regular basis and to me one of the worst symptoms of P.O.T.S. Any info someone can share with me would be wonderful!!

Thanks,

Jen

[julieph85]

The same thing happens to me. Actually what you are describing is a panic attack. However, when they happen with POTS they are not from an anxiety disorder, it is from just what you described, an adrenaline surge. I have both POTS and an anxiety disorder that i've had for 10 years. The adrenaline surges I get feel exactly like a panic attack and actually metabolically almost the exact same thing is happening in my body when I have either. The difference I have noted is that when I have a panic attack and not an adrenaline surge 1) my heart does not beat as fast 2) I have way more "mental" symptoms like obssesive worry and fear. Also when I have a panic attack there is presipitating anxiety, like i'm worried about something or it is a known trigger to me. The adrenaline surges don't happen like that. They either happen after eating, sleeping, or standing up too long. Since I've had such experience with both I can definitely tell the difference. Adrenaline surges are a part of hyperandrenergic POTS from what I understand. From what I have read it is do to an overactive sympathetic nervous system. The norepinephrine and adrenaline are so high that any small physiological or environmental trigger can cause a surge. In my case it is sleeping and eating that often trigger it and it lasts for up to an hour sometimes. I have also had the full adrenal work up and mine is also normal. It is because the problem is not coming from the adrenals but from the nervous system- the sympathetic in particular. That is why anti-anxiety medication often helps people with hyperandrenergic pots. You mentioned your thyroid- what exactly is wrong with it? hyperthryoidism and hashimotos disease can also cause adrenaline like surges that will go away with thyroid replacement therapy.

[jenglynn]

Thank you Julie for the quick response! That makes sense... it is just our adrenals (which are "healthy") responding to our nervous system which is "not so much." so. Excellent analogy and now I finally get it. Why couldn't the endocrinologist just tell me that?

My thyroid I don't quite understand. Even the endo doesn't quite get it. In the last year my TSH has went from .68 last Dec to .43 in July and in the hospital last week .12. Well this is quite a change toward hyperthyroid. But then they checked my T3 and T4 numbers and those were normal but were more toward the lower number toward HYPO-thyroid... so the endocrinologist said she had no idea what to say about my thyroid levels. She said the downward trend is concerning but nothing matches up. They want me to have a scan of my thyroid but her guess is that POTS is affecting my thyroid and pitituary gland and that is why the numbers don't make sense. So I guess I will have the scan and go from there but she said unless there is something abnormal on either gland, which she wouldn't expect, there is nothing to treat because the number contradict each other and make no sense. So I left that appt. more confused than I went in.

[lissy]

I agree with Juliph85, the only way I can tell the difference is how long they last and if I can relax myself out of it, with the adrenal rush I have no choice or control over it...I have also had an endocrine workup and everything is normal.

[E246]

Hi,

I experience exactly what you do. It took me a while to figure it out. It is definitely the POTS. i find it happens if i have done too much.

I have had a 24 hour urine test which showed nothing but another doctor said it was the wrong test. Like a lot of our tests nothing is found and it leads doctors to dismiss the experience. But be reassured it is the nervous system kicking off. I would be very careful about letting anyone say it is anxiety.

It is difficult to self soothe but i deep breathe into my stomach if that helps. And mine was caught on an ambulance monitor so finally i was believed.

You sound like you are managing them really well - well done.

[julieph85]

Jenn, my thyroid is a lot like yours. Right now my tsh is testing just above normal (.6) but in the past two years it has tested lower. However, just like you my T3 and T4 test on the low end so this confuses the doctors! They say there is no way it is hyper thyroid because of the low normal t3 and t4. I definitely think you should get the scan. You could have hashimotos which causes a swing in your levels in the beginning. I have a personal theory that hashimotos is in some way related to pots because there are a bit of people on here who have both and hashimotos is in my family and now i have pots. I would definitely look a little further into the thyroid problem. Good luck and I hope you feel better