Adrenaline Surges Same Time Every Day?

[p8d]

Hi Everyone,

I'm getting adrenaline surges every day at roughly 4pm. I had a blood test that confirmed this is happening. Dr prescribed propranolol but it isn't helping after 2 weeks. Tried increasing the dose to no avail. I suspect this is also the reason for the insomnia. Anybody else have this at a specific time everyday? Xanax is all that helps but neurologist doesn't like me taking it. Any other meds/advice (I have searched the forum) just getting desperate and Dr doesn't seem to interested in helping with this.

Thanks so much for any help.

[Dr. Rob]

Hi p8d!

In my opinion, catecholamine surges happen at the same time everyday around 4pm because cortisol levels are reaching their lowest point of the afternoon. In your body's attempt to create energy because there is low cortisol, (cortisol instructs the liver to start gluconeogensis for energy) your adrenal glands release epinephrine to instruct the fat cells to release glycerol and 3 fatty acids for energy, hence your "Clockwork Adrenaline Surges". In order to prevent these surges eating low glycemic fruits like apples, blueberries, raspberries, strawberries may help, before the low cortisol dips, which generally occur at 10AM, 2PM, and 4PM.

Edited September 2, 2015 by MomtoGiuliana

[p8d]

Dr Rob,

Thank you for the explanation and suggestions. I'm surprised in a way because I eat something, nuts/fruit, veges, quinoa about every 2 hours during the day. I will definitely give this a try. I wish my Dr had known or told me. I am extremely grateful.

P

[Dr. Rob]

Hey P!

You could try switching to brown rice if not allergic, quinoa, while healthy does not provide enough slow carb., in my opinion.

[Bigskyfam]

I've been having surge like flares in afternoons for two months... No matter if I've had my fluids salt etc

[Dr. Rob]

Hi Bigskyfam!

There are physiologic dips that occur in the release of cortisol during the day. They occur at 10AM, 2PM and 4PM with concomitant adrenaline surges, especially with altered adrenal function which is quite commonly seen in dysautonomia patients, to include myself when my POTS was uncontrolled, having had POTS now for 6 years and controlled for 4 years. In my opinion....the answers lies in your nutrition, intracellular nutrient testing, methylation genetics (correcting BH4 cycle mutations, Dysautonomics commonly have MOA, COMT, & GAD1 mutations leading to the slower degradation of catecholamines which contribute to the increased sympathetic drive "surges") and in gluten and cross reactivity proteome testing.

[ramakentesh]

When essential hypertension patients are given too much antihypertensive medication they often experience 'adrenalin surges' as when the body interprets reductions in cerebral or reduced stroke volume it tries to compensate by activating beta receptors (increased heart rate but beta 2 receptors actually increase thoratic vasodilation which is probably not helpful).

These adrenalin surges seem a part of POTS whether its a compensatory mechanism or just part of the problem. Researchers are looking at autoantibodies to beta receptors as well as antagonist ones to alpha 1 receptors. Perhaps variations in these aabs causes these strange symptoms but who knows. beta hypersensitivity is common in POTS.

[Sylvie33]

Hi All,

I feel so validated in reading this. I also experience a disturbingly intense, debilitating surge at 4pm which basically lasts all night. This was one of my most obvious presenting symptoms for a full dyautonomic assault which just began this past April. Of course, I (and my GP) thought it was anxiety because I was working on a book project (overdue) and 4pm marked the end of yet another unproductive day. Yet, I was becomeing increasingly dizzy, fatigued, and unable to work (I've been symptomatic since April, 2014, but I had no idea what was occuring: yet I did not have insomnia, crashing fatique, surges, or neuropathy of hands and feet etc. etc. etc. until a year later). It was my own research that pinpointed dsyautonomia as a cause, and I am now being worked up.

I had been taking Klonopin for insomnia (1 mg per night divided into four doses as I wake often) and my GP suggested I begin taking it at 4pm. So I do take half of a .5 mg pill. It really helps, but I ultimately feel benzodiazipines are not a good option overall: I am afraid of rebound and/or ineffectivenss over time as well as exacerbation of brain fog.

I will try the berries, why not?

I do meditate, and just found sitting is too much, so I now lay on a yoga mat. This really helps. I try to meditate for at least 30 minutes.

I have copied the information here and will take it to my neurologist appointment today. Thank you Dr. Rob and others!

--Syvie

[MomtoGiuliana]

When my POTS symptoms were severe I would have these surges as well. I was not diagnosed for awhile, but my endocrinologist recommended increasing protein and fats and salt in my diet (I was pregnant at the time--and also pretty much vegetarian). I did find that smaller meals at regular intervals with more protein, fats and salt did actually reduce these events and their intensity. One doctor I saw theorized that I was not exactly experiencing reactive hypoglycemia, but the symptoms were caused by an overreaction to/overcorrection of blood glucose changes. Later I was told by another doctor that these symptoms mimic hypoglycemia but that it is not related even tho it feels like it is. I had several glucose tolerance tests and all had "normal" results--I didn't meet the criteria for any blood glucose problem.

Over time these events diminished for me, as did many of my POTS symptoms.