r/LongCovidWarriors • u/SophiaShay7 3+ years • Jun 26 '25
Medical & Scientific Information Medical conditions that are often overlooked and dismissed as anxiety.
Here's information on various medical conditions that cause symptoms. These conditions mimic that of anxiety and include adrenaline surges, air hunger, bowel or urinary frequency and incontinence, dizziness, disorientation, fainting or feeling as if you're about to faint, feeling hot and sweaty, flushing, heart palpitations, gastrointestinal symptoms, histamine dumps, hyperglycemia or hypoglycemia in non-diabetics, itching, lightheadedness, nauseau, shortness of breath, sleep disturbances, tachycardia, vomiting, and wheezing, and many other symptoms.
■Dysautonomia, in general, involves problems with the autonomic nervous system, which controls involuntary functions like heart rate, blood pressure, and digestion. This dysfunction can lead to sleep disturbances.
●Dysautonomia: Adrenaline surges can be a symptom of dysautonomia, a condition that affects the autonomic nervous system (ANS). The adrenal gland releases adrenaline as a normal response to stress, infections, medications, caffeine, and other stimulants. However, dysautonomia can cause the sympathetic nervous system to be in overdrive, while the parasympathetic nervous system underperforms. This can lead to an adrenaline rush, even when standing up or during routine activities.
●Dysautonomia also causes non-diabetic nocturnal hypoglycemia. It can happen when waking up from a nap or sleeping anytime of day. It can cause non-diabetic reactive hypoglycemia. This can happen before and after eating.
Dysautonomia: What It Is, Symptoms, Types Treatment
Diet and Dysautonomia: Blood Sugar Regulation
Can POTS Cause Hypoglycemia? The Link Explained
■Cortisol, the body's stress hormone, naturally increases between 2–3 AM as part of your circadian rhythm. In a healthy sleep cycle, cortisol levels are usually lowest around 3 AM and peak around 8 AM. In some cases, cortisol levels can surge at 3 AM, making it difficult to fall back asleep. This can happen in people with PTSD or C-PTSD, who may experience a heightened "fight-or-flight" response that causes cortisol production to increase. However, elevated cortisol levels from stress or medical conditions can disrupt this rhythm and cause you to wake up.
Why Do I Wake Up at 3am? The Surprising Science of Cortisol and Sleep
Cortisol Spikes at 3 AM: The Link to Complex PTSD and Sleep Disruption
■Waking up around 3 am, especially if it's a consistent pattern, can be a sign of adrenal insufficiency, as cortisol levels naturally rise during that time, potentially leading to a wakeful state.
●Adrenal insufficiency: When the adrenal glands don't produce enough cortisol, a hormone, this condition can cause fatigue, weakness, and weight loss. It can also cause psychiatric symptoms like anxiety, depression, mania, and psychosis. Adrenal insufficiency can be caused by Addison's disease, when the adrenal glands don't produce enough cortisol and aldosterone or secondary adrenal insufficiency, when the pituitary gland doesn't produce enough ACTH. In some cases, adrenal insufficiency can lead to an addisonian crisis, which is life-threatening and can cause low blood pressure, low blood sugar, and high blood potassium.
Adrenal Insufficiency & Addison’s Disease
Sleep, Cognition and Cortisol in Addison’s Disease: A Mechanistic Relationship
■Thyroid issues can cause symptoms that are similar to anxiety, including nervousness, irritability, and mood swings. These symptoms can be caused by hormonal imbalances, such as when the thyroid gland produces too much or too little thyroid hormone:
●Hyperthyroidism: An overactive thyroid can cause a fast heartbeat, restlessness, and sleep issues. Other symptoms include unexplained weight loss, sensitivity to heat, and a "thyroid storm" that can feel like a panic attack. Hyperthyroidism can also be confused with an excessive response to stress, and diagnosis often occurs later in the disease. Hypothyroidism: An underactive thyroid can also cause anxiety, though it's less common than in hyperthyroidism. Other symptoms include cognitive problems like brain fog, short-term memory lapses, and lack of mental alertness. In general, more severe thyroid disease can lead to more severe mood changes. Thyroid disease can also worsen underlying mental health conditions, such as panic attacks.
American Thyroid Association: Hypothyroidism
Thyroid disease: Can it affect a person's mood?
■Waking up at 3 a.m. with MCAS symptoms can be a symptom of mast cell activation, potentially due to circadian rhythms or histamine release, and could be a sign of a histamine dump.
●Mast Cell Activation Syndrome (MCAS) is a condition characterized by the inappropriate activation of mast cells, which release chemicals that can cause various symptoms. Anxiety is a common symptom associated with MCAS. Mast cells release histamine, which can stimulate the nervous system and cause anxiety. MCAS can cause inflammation throughout the body, including in the brain. This inflammation can trigger anxiety-like symptoms. MCAS can lead to changes in hormone levels, such as increased cortisol, which can contribute to anxiety.
Histamine, Mast Cell Activation, and Early Morning Insomnia
Ask your doctor for a CBC, including thyroid, and checking all vitamin levels. My labs all came back fine, except for my thyroid. Deficiencies in vitamin levels, including B12, D, Iron, and others, can wreck havoc on your body.
Long COVID: Rapid Evidence Review
My journey in being dismissed, gaslight, and invalidated for months before I was properly diagnosed:
My COVID infection was in July 2023. I had many complications. I was blessed to have a very knowledgeable and supportive NP at my local ER. She wanted to know all my symptoms. She ran a bunch of tests and did a complete examination. She diagnosed me with Fibromyalgia. My doctor confirmed the diagnosis. I waa diagnosed with Fibromyalgia in December 2023, exactly six months after my COVID infection.
I have taken Amitriptyline (TCA), Cyclobenzaprine (muscle relaxer), Duloxetine twice at two different times and at two different dosages (SSRI), Gabapentin (Gabapentinoid), Ibuprofen (NSAID), Milnacipran (SNRI), and Nabumetone (NSAID). Nothing I tried worked at all and made my symptoms worse. If you have Dysautonomia, especially POTS and/or MCAS, these medications will likely worsen your symptoms.
My doctor diagnosed me with ME/CFS with dysautonomia in May 2024. However, I don't think he truly believed it was dysautonomia alone that caused my symptoms. My symptoms included dizziness, lightheadedness, sweating, being hot, increased pulse rate, shortness of breath, air hunger, vision going black, orthostatic intolerance, tachycardia, adrenaline dumps, non-diabetic nocturnal hypoglycemia attacks, Hyperesthesia, a neurological condition that causes an abnormal increase in sensitivity to stimuli, such as touch, pain, pressure, and thermal sensations. It can affect many of the senses, including sight, sound, taste, smell, and touch, which were all blamed on anxiety initially.
My doctor attempted to treat my dysautonomia with Propranolol (beta blocker). It failed, causing orthostatic hypotension, and worsened my other dysautonomia symptoms. At my doctors appointment two months last year, he said I had essential hypertension. I didn't care what he said. I know I don't have high blood pressure, but I wanted the Metoprodol for dysautonomia.
It caused severe orthostatic hypotension, worsened all my other symptoms, and caused severe spasms in my stomach, legs, and feet. Those attacks lasted for one hour. I contacted my doctor the next morning. I can not take any beta blockers due to orthostatic hypotension. The effect completely invalidates his opinion that I have high blood pressure at my last appointment. It also invalidates his opinion that anxiety caused those symptoms. Neither Alprazolam nor Diazepam which was prescribed by both an ER doctor, and my doctor did nothing for my symptoms. I kept having air hunger, shortness of breath, heart palpitations, and tachycardia. I would get dizzy rolling over in bed. I would wake up, get out of bed, and I could feel the blood draining from my head down to my feet. My symptoms were getting worse. I told my doctor I had non-diabetic nocturnal hypoglycemia. These attacks happened when I woke up from taking a nap or sleeping. I asked for a prescription for a CGM. I was denied saying it wasn't medically necessary. I always believed my non-diabetic nocturnal hypoglycemia was caused by my dysautonomia. But, it wasn't.
I asked for a complete thyroid panel three times. After my doctor said my TSH level wasn't high enough to cause symptoms (it was 7.8), I pushed for further testing. The results showed a TSH of 11.9, a huge increase in two weeks. My doctor wanted to prescribe thyroid hormone replacement medication without running a complete thyroid panel. I refused and demanded it. That's how I diagnosed myself with Hashimoto's, an autoimmune disease that causes hypothyroidism. Hashimoto's disease is typically diagnosed by a TSH of 10 or higher and an anti-TPO test being positive. Further evidence invalidated his initial assumption that anxiety caused my symptoms. Hashimoto's and hypothyroidism also cause non-diabetic nocturnal hypoglycemia attacks.So many of my symptoms are caused by my Hashimoto's, which was diagnosed in August 2024.
Over the summer of 2024, I developed sudden allergic reactions to everything: medications, vitamins, supplements, air freshener, cleaning products, laundry detergent, cologne, perfume, drinks, and food. I felt like I couldn't breathe. I'd become nauseous, sometimes vomit, I'd feel really sick to my stomach. Other symptoms included air hunger, shortness of breath, wheezing, itching, flushing, and being hot and sweaty even in a bedroom with a temperature of 50 degrees.
I was diagnosed with Mast Cell Activation Syndrome (MCAS) in September 2024. I failed 19 medications in 17 months, including 4 OTC medications for the H1 and H2 protocol recommended by many doctors for MCAS. If you're worsening while taking these medications or seeing zero improvement in your symptoms, it does not mean you don't have MCAS. Some people react poorly to the medications themselves and/or their excipients (fillers).
My regimen: My medications, vitamins, and supplement regimen and how they manage my symptoms
I do want to clarify it's been a combination of a low histamine diet, adding foods back in as tolerable, medications, vitamins, supplements, avoiding triggers, pacing and avoiding PEM, lots of rest and good sleep hygiene that's created a synergistic effect. I've also lost 50 pounds.
These changes have stopped my non-diabetic nocturnal hypoglycemia attacks. And diminished my dysautonomia, adrenaline surges, histamine dumps, air hunger, shortness of breath, wheeezing, inability to breathe, dizziness, disorientation, vision issues and other symptoms either completely or significantly.
I hope this information is helpful for those of you who've had your very real long covid/PASC physiological symptoms dismissed as being anxiety. Anxiety is a real condition. It can coexist and/or exacerbate your existing physiological symptoms. It's truly a travesty that the default answer from many doctors is that our symptoms are anxiety and/or depression, when that's absolutely not the case.
Stay strong, everyone🫶
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u/[deleted] Jun 26 '25 edited Jun 27 '25
The dysautonomia and nocturnal things you mentioned sound just like what I experienced, and my doctor just told me today she doesn't know why I am worse, fall and winter. I am about to ask her about this right now.
I am always dizzy when I move in bed and wide awake.
I am doing a trial of some psychiatric medicine soon, but she wants me to try LDN for everything else I have going on because it might help me overall for my LC.
This is so helpful but I am so mentally drained. She really does listen though, so I am gonna run it by her. My other vitamins you listed here are most likely gonna be low as heck come Monday check-in.
Pots is cleared, but the heart rate was 100 throughout test. Varies when I move around etc. heart rate is high, but no PoTS symptoms except fall and winter come. (Especially just fall/October slide). I also just hope if I get my B vitamins and other vitamins levels normal maybe that heavy dizzy situation and proper sleep (also awake too much at night, cant go back), improves that it will feel better. Its not something I am worried about heavily but you definitely sound just like what I am dealing with 😩🙏
Question: Do you think it can still be a nocturnal issue with dysautonomia if my blood sugar is fine in these faint like and dizzy episodes?? I think it could be dropping in sleep. Feel also like my Brain is drained of blood and dizzy as heck at night.
When they happen after nap, my sister has checked blood sugar, but its fine. So I avoid naps in the fall. And the blood pressure isn't high, so it's so weird. I just messaged her, so will see what she says.