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[MerrynK]

Hi everyone,

This is my first post after lurking for a while. Apologies for the war and peace below, but I'd be so grateful if anyone had any thoughts on my symptoms as they are really disrupting my life.

I've just turned 50 and am still having periods fairly regularly (last year I went four months without one, but other than that I have one approx every 28-35 days, although recently I had one after only 20 days). I'm not on HRT yet.

My main symptoms, which are totally debilitating, are:

- crippling anxiety - mostly in the form of health anxiety (I started on Sertraline 4 weeks ago)
- crushing fatigue, accompanied by lightheadedness and the constant feeling that I'm about to faint, although I don't actually faint
- low blood pressure (it's normally around 100/70, but when I'm experiencing the lightheadedness it goes down to around 85/55) I should say that it's always been on the low side of normal, but seems to have got lower in the last few years.
- palpitations/panic attacks/whooshing feeling in head
- intermittent nausea/digestive issues
- lack of motivation, low concentration/focus, low confidence
- weird electric shock sensations as I'm trying to get to sleep
- waking up about 20-30 times a night according to my Fitbit (though apparently this is 'normal')

I also have PCOS.

Other symptoms that are present but not totally disruptive yet: night sweats/tinnitus/thinning hair/gum issues/itchy skin/neck pain

Almost always, I have the fatigue/lightheadedness during the week after my period. Sometimes for another few days in between. But it literally comes on the last day of my period and lasts about a week. So that makes me think it's hormonal. But because of my health anxiety I've managed to convince myself that I also have a major issue with my heart. Along with my low blood pressure, I have a slow resting heart rate of about 50 bpm, and I'm not an athlete. The opposite - need to lose about 40 pounds (lost about 20 so far, and trying really hard to get fit, but it's 2 steps forward 1 step back). A slow heart rate is known as bradycardia, and not necessarily anything to worry about unless you're having symptoms - which I am. However, I've had an ECG a year ago and it was normal. I'm worried because I just feel so zapped, like there's not enough oxygen pumping around my body. I keep having to go and lie down during the day, which sends me into a spiral of anxiety due to work commitments (I work for myself but am starting a new full-time normal job soon - panicking that I'm going to have to withdraw.)

Does anyone have any thoughts about what could be causing this? I spoke to the doctor last week as a follow up to my Sertraline prescription, and I asked her - she's told me to come in this week for blood tests and another ECG. So that's good. She wants to test iron and thyroid. However, I had both of these done last September and they were 'optimal'.

If it's hormonal, I don't really fully understand how. Isn't your estrogen supposed to go up again during your period and immediately after? Isn't this the time when you're supposed to have the *most* energy in your cycle?

I have an appointment with a private menopause specialist on 19th Aug so I wanted to tap the wisdom of this forum beforehand, so I know I'm asking the right questions. So grateful for any thoughts! Thank you so much. Merryn.

[CLKD]

Some GPs won't look any further regarding thyroid function tests if they are 'within normal limits' so you could ask for an appropriate referral or wait until you go to the Menopause Appt..

Some find that keeping a mood/symptom/food diary of use. 

I have the electric zaps, I take anti-depressant medication so am used to them.  Can make me jump even still!  Get rid of the Fitbit! the human turns over many times a night, as well as sleep depth rising and falling. 

As oestrogen levels fall so the body may become dry: inside and out. Do read the 'bladder issues' and 'vaginal atrophy' threads.  Skin, deep in the ears, nostrils, scalp, vagina ....... and the muscles may become lax = aches and pains.  Get your gums seen by a dentist - mine advises regular use of 'Tippe' stick thingies for getting deep into the gums.  I have implants so this is important.

Browse round. Make notes.  Sounds 'normal' from where I'm sitting ;-)

[Wrensong]

Hello Merryn & 

I'm sorry to hear you are having such a rough time of it, but you have come to the right place for help & support as so many members will sympathise with the way you're feeling.

I'm glad to know your GP is testing thyroid & iron for you.  What you say here made me wonder whether you could be hypothyroid . . .

I have a slow resting heart rate of about 50 bpm, and I'm not an athlete. The opposite - need to lose about 40 pounds (lost about 20 so far, and trying really hard to get fit, but it's 2 steps forward 1 step back). A slow heart rate is known as bradycardia, and not necessarily anything to worry about unless you're having symptoms - which I am. However, I've had an ECG a year ago and it was normal. I'm worried because I just feel so zapped, like there's not enough oxygen pumping around my body. I keep having to go and lie down during the day

You mention palpitations & these too could be the result of either low thyroid or low iron, but confusingly many of us suffer from them at menopause without either of the other 2 conditions being implicated.

I see your thyroid was tested last Sept but that's a long time ago, so your GP is wise to retest for you now.  Please don't worry about this, if you are hypothyroid the right treatment should help you feel a great deal better.

I wonder too whether you have had B12 & Vit D levels tested?  Being low in either can lead to fatigue & a whole array of other symptoms.

Sorry no time for a more detailed post now, but others will hopefully be along soon.
Wx

[Gynaikeíos]

Hi MerrynK, sympathies that you have so much to cope with at once.

I wonder, have you tried breathing exercises? They can help to reduce feelings of anxiety when they start.
Dr Michael Moseley made a radio series called Just One Thing that is on BBC Sounds. The short programme called Take A Breath explains a very simple exercise that you might like to try.

With best wishes.

[MerrynK]

Thanks for replying CLKD, Wrensong and Gynaikeíos :-))

CLKD - that's interesting about the electric shocks. I didn't put 2+2 together re: the ADs. It's probably that. I know what you mean about Thyroid tests; I had my TSH and FT4 done last time but not FT3. Getting more bloods done tomorrow so will ask. The gums thing is weird - have had perfect teeth all my life until last two years - now apparently have gum disease, and had to have root planing treatment last month. It's manageable, but still gutting.

Wrensong - I wondered about hypothyroidism too, as this is one of the first things that's mentioned in conjunction with a slow heart rate. But I'd kind of written it off because of my previous results. Be interesting to see if they've changed much. I did actually have my Vit D and B12 tested at the same time. Both were low end of normal, as was folate. I started taking higher Vit D (was already taking B12 & folate) and I did actually feel better for quite a few months, with a lot more energy, but when I look back this was exactly the same time I also went four months without a period - so I don't really know. My iron was 'normal' too but I've read that what's considered normal and what's actually needed for a perimenopausal woman are quite different. Need to look into it more.

Gynaikeíos - thanks, I will look into that on BBC Sounds. I do actually do quite a lot of breathing exercises. They do help most of the time. Sometimes it just all gets a bit on top of me, but I'm hoping that a couple more weeks on the Sertraline will see things settle down a bit. So bored of feeling rubbish!

[Wrensong]

Merryn, I'm long term hypothyroid on thyroid replacement & had chronic, very scary issues with heart rhythm disturbance throughout the peri years & several years into postmenopause so I get how unnerving this situation can be.  I hope your upcoming tests will throw some light on what's going on for you.  Not saying I think you are hypothyroid but the onset of this condition does often coincide with menopause & if you are struggling to lose weight & have a slow heart rate & extreme fatigue, as you know these can indeed be due to low thyroid.

You mention though, that your fatigue is really pronounced immediately following your period, so I do wonder whether your iron stores are being depleted, especially if your bleeds are prolonged & or heavy.

Are you still taking Vit D?  I ask because although I'd been taking a low dose daily long term under endocrinologist advice, having tested suboptimal some years ago, on booking a retest recently, ironically to check levels hadn't become too high over time, the result was lower than before I started Vit D & now classed as deficient, so that I've had to increase the dose.  Endo said being low in Vit D would cause inordinate fatigue.  As the widespread benefits of optimal Vit D levels are increasingly coming to light, I would ask your GP whether it might be sensible to get this retested  .  B12 too, especially if your last result was low end of ref range.  Mine was always lowish too & my Endo suggested I supplement.  I now take 50mcg every 3-4 days & this gives me a mid-range B12 result, which he says is perfect.  A low dose B-group supplement together with the additional B12 is often advised & might be sensible if your folate was low & your GP doesn't advise taking a standalone folate supplement -  incidentally low folate can result from hypothyroidism.  I would run it past them though.  I find it's easier to build trust when we're upfront about anything we want to supplement with, as there's a risk we may do more harm than good & this can skew results of some tests we may not be aware of.

Please let us know how you get on with the tests & how you are if you feel like sharing.

[ChampagneSally]

Hello Merrynk
I’ve just come across your post and could have written this about myself!
I hope you managed to find out what was causing your symptoms and managed to get the right treatment.

I have been suffering pretty much the same symptoms as you on and off for nearly 8 years, particularly the slow heart rate and feeling lack of oxygen, sluggish etc but all my thyroid tests come back as normal and I don’t know what else to test for.  I’ve added vitamin D and B12 to the other rake of vitamins I take. Not on HRT, so also wondering if this is hormone related.

I would be keen to hear how you got on and if your test results flagged anything.
I hope you are doing better!
Many thanks