Significant Pulse Drop At Night Combined With Major Anxiety And Breathlessness. Any Ideas?

[nikkmm]

Hello Peaties :) I am new here although I have been lurking for some time trying to absorb as much information as I can. I am a 29 year old female looking for help with, well, lots of things! I have been Peating for a month after coming from yo yos between Paleo, vegan 80/10/10 and most recently ketoish paleo. (I know - a mess). At night I frequently experience panic attacks, feelings like I am going to die and breathlessness. Normally I just take an ambien and knock myself out but I really want to stop this habit. Now that I am monitoring my heart rate because of Peat, I know that these attacks coincide every time with a significant drop in heart rate. Usually comes on around 10 pm. My HR will drop to low 60s and sometimes down to the 50s as the night progresses. It's strange because I feel panicky and I used to think it was too much caffeine or adrenaline or something but now with the HR monitor I believe it's something else. It doesn't happen every night, and the nights that it doesn't happen I fall asleep soundly on my own with a HR around 70-75. I have tried sugar/milk, doesn't help. Doctors think Im crazy and say my HR is fine and natural. Any ideas?

 

[member 2106]

It's normal for the HR to slow as you get closer to sleep. Is it a sudden drop you're observing?

 

[nikkmm]

It's normal for the HR to slow as you get closer to sleep. Is it a sudden drop you're observing?

The HR drop isn't sudden I don't think (I don't watch it all the time) but the anxiety feeling that comes with it is very sudden.

 

[Orion]

Hello Peaties :) I am new here although I have been lurking for some time trying to absorb as much information as I can. I am a 29 year old female looking for help with, well, lots of things! I have been Peating for a month after coming from yo yos between Paleo, vegan 80/10/10 and most recently ketoish paleo. (I know - a mess). At night I frequently experience panic attacks, feelings like I am going to die and breathlessness. Normally I just take an ambien and knock myself out but I really want to stop this habit. Now that I am monitoring my heart rate because of Peat, I know that these attacks coincide every time with a significant drop in heart rate. Usually comes on around 10 pm. My HR will drop to low 60s and sometimes down to the 50s as the night progresses. It's strange because I feel panicky and I used to think it was too much caffeine or adrenaline or something but now with the HR monitor I believe it's something else. It doesn't happen every night, and the nights that it doesn't happen I fall asleep soundly on my own with a HR around 70-75. I have tried sugar/milk, doesn't help. Doctors think Im crazy and say my HR is fine and natural. Any ideas?

What do you eat/drink and how many calories, are you lean or some weight to lose?

This is a good hypothyroidism primer (not about cancer): Preventing and treating cancer with progesterone.

"Some hypothyroid people have a very slow pulse, apparently because they aren't compensating with a large production of adrenalin. When they eat, the liver's increased production of T3 is likely to increase both their temperature and their pulse rate."

 

[member 2106]

The HR drop isn't sudden I don't think (I don't watch it all the time) but the anxiety feeling that comes with it is very sudden.

I used to have a very similar anxiety about my heart slowing to a stop, but I realise now that my mind was just playing tricks on me, and it's okay for the HR to slow down a bit late at night.

I take it you've had a 24-hour-or-longer ECG done to rule out any actual cardiac issues?

 

[ecstatichamster]

sounds like more of a panic attack than a problem with your heart rate.

Perhaps a bit of cyproheptadine at night would help?

 

[nikkmm]

What do you eat/drink and how many calories, are you lean or some weight to lose?

This is a good hypothyroidism primer (not about cancer): Preventing and treating cancer with progesterone.

"Some hypothyroid people have a very slow pulse, apparently because they aren't compensating with a large production of adrenalin. When they eat, the liver's increased production of T3 is likely to increase both their temperature and their pulse rate."

Thanks for the link!
I am fairly lean, about 125 lbs at 5'5". I used to naturally be much smaller, around 115 lbs without exercise or watching my diet. I put on around 10 lbs with veganism. I would like to lose it but am focusing on getting healthy now. (I know this might sound low - I have a very small frame). Diet now (the past month) is 1% milk, sugar, quark, oranges, carrots, gelatin, mushrooms and I rotate beef/shrimp/cod. But I have had this issue for years. Can't directly recall it coinciding more or less with a specific diet. I end up with around 1,600-1,800 calories a day.

 

[nikkmm]

I used to have a very similar anxiety about my heart slowing to a stop, but I realise now that my mind was just playing tricks on me, and it's okay for the HR to slow down a bit late at night.

I take it you've had a 24-hour-or-longer ECG done to rule out any actual cardiac issues?

I know it's OK and expected, but I find it strange that I have panic attacks when my heart rate is low. Usually you would think they come when your heart is racing. I was hospitalized for a panic attack once. Had an ECG but not 24 hours. No problems that they saw.

 

[nikkmm]

cyproheptadine

I have never heard of that, I will check it out thank you!

 

[Orion]

Thanks for the link!
I am fairly lean, about 125 lbs at 5'5". I used to naturally be much smaller, around 115 lbs without exercise or watching my diet. I put on around 10 lbs with veganism. I would like to lose it but am focusing on getting healthy now. (I know this might sound low - I have a very small frame). Diet now (the past month) is 1% milk, sugar, quark, oranges, carrots, gelatin, mushrooms and I rotate beef/shrimp/cod. But I have had this issue for years. Can't directly recall it coinciding more or less with a specific diet. I end up with around 1,600-1,800 calories a day.

Sounds like you are eating the right stuff. Monitoring your temps and pulse before and after meals, should let you know whether you have high or low stress hormones, and you could tweak your diet from there. It could be related to blood volume, or endotoxin/serotonin. So eating adequate salt for blood volume, or cypro like @ecstatichamster for opposing serotonin.

Since its only been a month, might take time for your metabolic rate to climb up, and displace/deplete some stored PUFA. What is your waking oral temp?


These ideas might be related.

Calcium to reduce PTH:

"The antimetabolic actions of PTH mimic those seen in aging and diabetes, and surgical removal of the parathyroid glands has been known to eliminate diabetes. PTH can cause diuresis, leading to loss of blood volume and dehydration, hypertension, paralysis, increased rate of cell division, and growth of cartilage, bone, and other tissues.
Simply eating an adequate amount of calcium and magnesium can alleviate many problems related to stress and aging that are considered serious, such as heart arrhythmia, pancreatitis, and tissue calcification. The antiinflammatory, anti-allergy actions of calcium and magnesium are well established, and there is clear evidence that obesity and various emotional disturbances can result from their deficiency. Chronically high PTH can produce anemia, by a variety of mechanisms. "

Growth hormone:

"The increase of GH during sleep might seem to be utterly incompatible with the idea that it is a stress hormone, but in fact the other stress hormones, adrenalin, cortisol, and prolactin also tend to increase during night-time sleep. Thyroid function and progesterone function decrease at night. As I have argued previously darkness is one of our major stressors. Considering GH's tendency to cause edema, tissue swelling, it could play a role in the nocturnal increase of the viscosity of blood, as the volume of blood is decreased by the leakage of fluid into the tissues. Another process with potentially deadly results that increase with aging and stress, is the passage of bacteria from the intestine into the blood stream; this process is increased under the influence of GH."

"Acute, short term studies definitely show growth hormone to be a stress hormone with some destabilizing effects. Over a lifetime, it is possible that such things as chronically increased levels of unsaturated fatty acids in the blood, and increased leakiness of the blood vessels, could cumulatively produce the effects that Denckla ascribed to the Death Hormone."

You could try to lower the amount of PUFA intake:

"
The loss of blood volume through leaky capillaries tends to be self-aggravating. The concentrated and viscous blood doesn’t flow as well through the capillaries, and this energy deprivation leads to increased leakiness of the cells, and to swelling of the endothelial cells, decreasing the internal diameter of the small blood vessels. The energy-deprived state increases lactic acid, adrenaline, and free fatty acids, all of which contribute to increased leakiness and impaired circulation.

In the bowel, the capillary malfunction increases the absorption of endotoxin, which intensifies the systemic energy problem. (Polyunsaturated oils, especially fish oil, damage the bowel capillaries, allowing more endotoxin to be absorbed.)"

Increasing progesterone, with vitamin A, sugar(for cholesterol) and coffee might help:

"
Szent-Gyorgyi spent most of his career studying muscles--from the anal sphincter to pigeon breast to tense goats. One of his most interesting experiments investigated the effects of estrogen and progesterone on the heart muscle. He showed that estrogen excess prevents the increase of stroke volume as the speed increases, but that progesterone increases the stroke volume as the heart accelerates, making pumping more effective without unnecessary acceleration of the heart rate. These effects are parallel to Selye's observation that estrogen imitates the shock reaction.

In shock, the blood pressure decreases, mainly because the blood volume decreases. Water is taken up by the tissues, out of the blood. Much of the remaining blood volume is accumulated in the relaxed veins, and little is returned to the heart, yet the increased need for circulation accelerates the heart, causing each stroke to pump only a small amount. The reduced blood pressure caused many people to think that adrenaline would help to improve the circulation, but actually the “resistance arteries,” small arteries that provide blood to the arterioles and capillaries, are constricted in shock, (Lin, et al., 1998,) and adrenaline usually makes the situation worse. When tissue is poorly oxygenated (or is exposed to estrogen) it takes up water, swelling and becoming more rigid, turgid. (It also takes up calcium, especially under the influence of estrogen, causing muscles to contract.) This swelling effect will be much more noticeable in small arteries than in major arteries with very large channels, but when the effect is prolonged, it will affect even the heart, causing it to “stiffen,” weakening its ability to pump. There is some evidence that estrogen can make large arteries stiffen, over a span of a few months. (Giltay, et al., 1999)"

 

[nikkmm]

Sounds like you are eating the right stuff. Monitoring your temps and pulse before and after meals, should let you know whether you have high or low stress hormones, and you could tweak your diet from there. It could be related to blood volume, or endotoxin/serotonin. So eating adequate salt for blood volume, or cypro like @ecstatichamster for opposing serotonin.

Since its only been a month, might take time for your metabolic rate to climb up, and displace/deplete some stored PUFA. What is your waking oral temp?


These ideas might be related.

Calcium to reduce PTH:

"The antimetabolic actions of PTH mimic those seen in aging and diabetes, and surgical removal of the parathyroid glands has been known to eliminate diabetes. PTH can cause diuresis, leading to loss of blood volume and dehydration, hypertension, paralysis, increased rate of cell division, and growth of cartilage, bone, and other tissues.
Simply eating an adequate amount of calcium and magnesium can alleviate many problems related to stress and aging that are considered serious, such as heart arrhythmia, pancreatitis, and tissue calcification. The antiinflammatory, anti-allergy actions of calcium and magnesium are well established, and there is clear evidence that obesity and various emotional disturbances can result from their deficiency. Chronically high PTH can produce anemia, by a variety of mechanisms. "

Growth hormone:

"The increase of GH during sleep might seem to be utterly incompatible with the idea that it is a stress hormone, but in fact the other stress hormones, adrenalin, cortisol, and prolactin also tend to increase during night-time sleep. Thyroid function and progesterone function decrease at night. As I have argued previously darkness is one of our major stressors. Considering GH's tendency to cause edema, tissue swelling, it could play a role in the nocturnal increase of the viscosity of blood, as the volume of blood is decreased by the leakage of fluid into the tissues. Another process with potentially deadly results that increase with aging and stress, is the passage of bacteria from the intestine into the blood stream; this process is increased under the influence of GH."

"Acute, short term studies definitely show growth hormone to be a stress hormone with some destabilizing effects. Over a lifetime, it is possible that such things as chronically increased levels of unsaturated fatty acids in the blood, and increased leakiness of the blood vessels, could cumulatively produce the effects that Denckla ascribed to the Death Hormone."

You could try to lower the amount of PUFA intake:

"
The loss of blood volume through leaky capillaries tends to be self-aggravating. The concentrated and viscous blood doesn’t flow as well through the capillaries, and this energy deprivation leads to increased leakiness of the cells, and to swelling of the endothelial cells, decreasing the internal diameter of the small blood vessels. The energy-deprived state increases lactic acid, adrenaline, and free fatty acids, all of which contribute to increased leakiness and impaired circulation.

In the bowel, the capillary malfunction increases the absorption of endotoxin, which intensifies the systemic energy problem. (Polyunsaturated oils, especially fish oil, damage the bowel capillaries, allowing more endotoxin to be absorbed.)"

Increasing progesterone, with vitamin A, sugar(for cholesterol) and coffee might help:

"
Szent-Gyorgyi spent most of his career studying muscles--from the anal sphincter to pigeon breast to tense goats. One of his most interesting experiments investigated the effects of estrogen and progesterone on the heart muscle. He showed that estrogen excess prevents the increase of stroke volume as the speed increases, but that progesterone increases the stroke volume as the heart accelerates, making pumping more effective without unnecessary acceleration of the heart rate. These effects are parallel to Selye's observation that estrogen imitates the shock reaction.

In shock, the blood pressure decreases, mainly because the blood volume decreases. Water is taken up by the tissues, out of the blood. Much of the remaining blood volume is accumulated in the relaxed veins, and little is returned to the heart, yet the increased need for circulation accelerates the heart, causing each stroke to pump only a small amount. The reduced blood pressure caused many people to think that adrenaline would help to improve the circulation, but actually the “resistance arteries,” small arteries that provide blood to the arterioles and capillaries, are constricted in shock, (Lin, et al., 1998,) and adrenaline usually makes the situation worse. When tissue is poorly oxygenated (or is exposed to estrogen) it takes up water, swelling and becoming more rigid, turgid. (It also takes up calcium, especially under the influence of estrogen, causing muscles to contract.) This swelling effect will be much more noticeable in small arteries than in major arteries with very large channels, but when the effect is prolonged, it will affect even the heart, causing it to “stiffen,” weakening its ability to pump. There is some evidence that estrogen can make large arteries stiffen, over a span of a few months. (Giltay, et al., 1999)"

Wow thank you for the information! I hadn't ever thought of considering blood volume. Although I know mine is low because the nurses comment on how low my blood volume is when having my blood drawn. They always tell me to drink more water. I also notice that I am more bloated/hold more water in the morning and will drop some water weight as the day goes on, which I always found odd. Most people are leaner first thing in the morning and become bloated or gain water weight as they day progresses. I will look into this more. Will also start supplementing with Peat's Progest E. Last time I had labs done my calcium was OK, 9.7 mg/dL with 8.7-10.2 being normal.

 

[ecstatichamster]

You might try a bit of activated charcoal at night. Sometimes people say it helps them a lot to take it a few hours after dinner, before bedtime. I've been doing it every other night. Still not sure, but it could help.

 

[Orion]

Wow thank you for the information! I hadn't ever thought of considering blood volume. Although I know mine is low because the nurses comment on how low my blood volume is when having my blood drawn. They always tell me to drink more water. I also notice that I am more bloated/hold more water in the morning and will drop some water weight as the day goes on, which I always found odd. Most people are leaner first thing in the morning and become bloated or gain water weight as they day progresses. I will look into this more. Will also start supplementing with Peat's Progest E. Last time I had labs done my calcium was OK, 9.7 mg/dL with 8.7-10.2 being normal.

Salt, magnesium(OJ, coffee, leafy green broths), potassium(fruit, juice), calcium(milk, cheese, yogurt, leafy green broths), vitamin A/E/K2 should all help.

Lowering estrogen; raw carrot away from meal, very low PUFA intake, easily digestible foods, very well cooked starch/vegetables, vitamin E, cascara

Dosing for progesterone: http://raypeat.com/articles/articles/progesterone-summaries.shtml

 

[Orion]

You might try a bit of activated charcoal at night. Sometimes people say it helps them a lot to take it a few hours after dinner, before bedtime. I've been doing it every other night. Still not sure, but it could help.

Good idea, AC can drive blood sugar down as its works through the intestines, make sure to have lots of carbs/sugar before dosing.

 

[Regina]

Sounds like you are eating the right stuff. Monitoring your temps and pulse before and after meals, should let you know whether you have high or low stress hormones, and you could tweak your diet from there. It could be related to blood volume, or endotoxin/serotonin. So eating adequate salt for blood volume, or cypro like @ecstatichamster for opposing serotonin.

Since its only been a month, might take time for your metabolic rate to climb up, and displace/deplete some stored PUFA. What is your waking oral temp?


These ideas might be related.

Calcium to reduce PTH:

"The antimetabolic actions of PTH mimic those seen in aging and diabetes, and surgical removal of the parathyroid glands has been known to eliminate diabetes. PTH can cause diuresis, leading to loss of blood volume and dehydration, hypertension, paralysis, increased rate of cell division, and growth of cartilage, bone, and other tissues.
Simply eating an adequate amount of calcium and magnesium can alleviate many problems related to stress and aging that are considered serious, such as heart arrhythmia, pancreatitis, and tissue calcification. The antiinflammatory, anti-allergy actions of calcium and magnesium are well established, and there is clear evidence that obesity and various emotional disturbances can result from their deficiency. Chronically high PTH can produce anemia, by a variety of mechanisms. "

Growth hormone:

"The increase of GH during sleep might seem to be utterly incompatible with the idea that it is a stress hormone, but in fact the other stress hormones, adrenalin, cortisol, and prolactin also tend to increase during night-time sleep. Thyroid function and progesterone function decrease at night. As I have argued previously darkness is one of our major stressors. Considering GH's tendency to cause edema, tissue swelling, it could play a role in the nocturnal increase of the viscosity of blood, as the volume of blood is decreased by the leakage of fluid into the tissues. Another process with potentially deadly results that increase with aging and stress, is the passage of bacteria from the intestine into the blood stream; this process is increased under the influence of GH."

"Acute, short term studies definitely show growth hormone to be a stress hormone with some destabilizing effects. Over a lifetime, it is possible that such things as chronically increased levels of unsaturated fatty acids in the blood, and increased leakiness of the blood vessels, could cumulatively produce the effects that Denckla ascribed to the Death Hormone."

You could try to lower the amount of PUFA intake:

"
The loss of blood volume through leaky capillaries tends to be self-aggravating. The concentrated and viscous blood doesn’t flow as well through the capillaries, and this energy deprivation leads to increased leakiness of the cells, and to swelling of the endothelial cells, decreasing the internal diameter of the small blood vessels. The energy-deprived state increases lactic acid, adrenaline, and free fatty acids, all of which contribute to increased leakiness and impaired circulation.

In the bowel, the capillary malfunction increases the absorption of endotoxin, which intensifies the systemic energy problem. (Polyunsaturated oils, especially fish oil, damage the bowel capillaries, allowing more endotoxin to be absorbed.)"

Increasing progesterone, with vitamin A, sugar(for cholesterol) and coffee might help:

"
Szent-Gyorgyi spent most of his career studying muscles--from the anal sphincter to pigeon breast to tense goats. One of his most interesting experiments investigated the effects of estrogen and progesterone on the heart muscle. He showed that estrogen excess prevents the increase of stroke volume as the speed increases, but that progesterone increases the stroke volume as the heart accelerates, making pumping more effective without unnecessary acceleration of the heart rate. These effects are parallel to Selye's observation that estrogen imitates the shock reaction.

In shock, the blood pressure decreases, mainly because the blood volume decreases. Water is taken up by the tissues, out of the blood. Much of the remaining blood volume is accumulated in the relaxed veins, and little is returned to the heart, yet the increased need for circulation accelerates the heart, causing each stroke to pump only a small amount. The reduced blood pressure caused many people to think that adrenaline would help to improve the circulation, but actually the “resistance arteries,” small arteries that provide blood to the arterioles and capillaries, are constricted in shock, (Lin, et al., 1998,) and adrenaline usually makes the situation worse. When tissue is poorly oxygenated (or is exposed to estrogen) it takes up water, swelling and becoming more rigid, turgid. (It also takes up calcium, especially under the influence of estrogen, causing muscles to contract.) This swelling effect will be much more noticeable in small arteries than in major arteries with very large channels, but when the effect is prolonged, it will affect even the heart, causing it to “stiffen,” weakening its ability to pump. There is some evidence that estrogen can make large arteries stiffen, over a span of a few months. (Giltay, et al., 1999)"

Yea, great ideas Orion. I think I have low blood volume. I always have very low blood pressure. I am petrified of blood draws because it nearly always goes badly with blood not going into the tube. Although, since Peating, I had my first easy-going blood draw.
I have horrible sleep. My mind isn't racy during the day but races after I lay down to sleep at night. I'm throwing everything Peaty I can think at the problem. Still can't crack this code. I'll try upping my salt.

 

[tara]

I end up with around 1,600-1,800 calories a day.

This looks to me as though your metabolism is low. Whether that's a cause or effect of your low-calorie diet I don't know - but I doubt you can raise or sustain a healthy metabolism on so little food. You could try eating a bit more and see if it helps with the night time issues. Undereating can mess with my sleep, and when that appens, a little (carby) snack often helps. But better to avoid the situation.
Also wondering if the breathlessness could indicate hyperventilation. Do you typically breath nasally and abdominally, including at night? When I get breathless, it usually means I have to both eat something and move a bit (with my mouth shut) - I assume it works partly by helping raise CO2.

 

[Orion]

"Tom Brewer, an obstetrician who devoted his career to educating the public about the importance of prenatal nutrition, emphasizing adequate protein (especially milk), calories, and salt, was largely responsible for the gradual abandonment of the low-salt plus diuretics treatment for pregnant women. He explained that sodium, in association with serum albumin, is essential for maintaining blood volume. Without adequate sodium, the serum albumin is unable to keep water from leaving the blood and entering the tissues. The tissues swell as the volume of blood is reduced."