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I'm having symptoms that doctors can't seem to figure out?

37 year old Caucasian male. Never overweight, never had any health problems. Fit and in shape.

It started out with 3 ER visits for out of nowhere panic attack-like symptoms between December 2019-January 2020. No history of anxiety problems. Rapid heartbeat out of nowhere, pressure feeling in the face, facial flushing, shortness of breath, trembling all over with adrenaline, dizziness, etc. ER did all kinds of blood work, EKG, contrast CT scan of the abdomen, etc. All organs looked normal. Nothing found. Blood pressure was as high as 173/100 and the ER had no idea why and discharged me shortly after it went down. I had little waves of smaller attacks for a month or two afterwards. I went to a number of doctors, they did all kinds of blood work and found nothing.

Cardiologist visit. Blood pressure was 160/90. He did a full Stress Echocardiogram. They looked at my heart with ultrasound while resting, then checked my EKG while doing the stress test on the treadmill, then looked at my heart again with ultrasound immediately after the stress test to see how it was doing. The Cardiologist said it was fine, that my heart was healthy and strong. Another primary care doctor worked me over for all kinds of tests. All blood work was fine. My cholesterol suddenly became quite high around the beginning of the year because I no longer felt like doing much exercise, but it has progressed back down to a more reasonable level.

February 1, my whole household got hit with a nasty stomach virus. A week or two after that, I started having bad stomach pains and ended up with Gastritis. An Upper Endoscopy showed only a swollen stomach lining and biopsy was negative for cancer or bacteria. I've been taking Proton Pump Inhibitor meds for about 3.5 to 4 months now. I no longer have any stomach pain and that is gone, but my initial dizziness is back with a vengeance. From the time that I get up in the morning until the time that I go to bed, I feel dizzy. Every step that I take, I feel a pressure in my body like my blood pressure is instantly changing with each step. Each foot step feels more like I'm "bouncing" or something. It is a struggle to walk properly, as if I can partially control my legs (due to the weakness, not lack of feeling) and I basically don't have the energy to move them. My usual cognitive abilities are not there. I can't even type properly on the computer sometimes. My legs and arms feel week each day. I have no energy and sometimes have a headache.

I went to a thyroid doctor and he ran a bunch of tests.

All normal. I went to an ENT doctor/sleep doctor because I have some sleep issues, but they haven't been identified yet. Home sleep study said 13 apneas/hour. He said he's not convinced and that's just mild sleep apnea. There's a condition called Upper Airway Resistance Syndrome that he does recognize (some sleep docs don't, which is why I went to him), but he said my anatomy doesn't fit that of a person with UARS. Dizziness/dysautonomia is a classic symptom of UARS and he said he's never had any apnea patients in all of his years complain of dizziness. Online on a sleep forum, people are telling me that they had similar symptoms with their UARS and the only thing that helped was a Bi-Level (BiPap) machine, but of course a sleep doc isn't going to listen to random stuff like that.

Also, I suspect that I've had sleep issues for half of my life and I'm 37, so it seems odd that just for the last several months that I'd magically get dizziness from lack of sleep after being used to it for all of this time.

What the heck could be wrong with me? Did I randomly get POTS? Dysautonomia? Is my Autonomic Nervous System malfunctioning due to some underlying condition that I have magically developed? Sometimes my blood pressure seems to bounce up and down when I take it with the monitor. The "irregular heartbeat" icon shows up to note that during the 30 seconds or so of the test, my heart rate changed 25% or more up or down. There are times when my blood pressure is 145/90 and other times it is a bit low. Other times it is around 120/80 and there is no irregular heartbeat, but I still feel dizzy.

For a lot of my life, I've been "jumpy" neurologically since I was a kid. Things startled me more than most people. While standing upright, if I go to do something with my hands/arms, sometimes I'll get this "jolt" that runs through my body. I think it may come from my back. Sometimes if I nearly drop something I'll get a similar jolt. It is like my whole body wants to react to what should just be my hand/arm reacting. At previous doctors offices, when I sat back in the chair and the back of my head unexpectedly touched the back of the chair, my body "jumps" and they noticed that and at first asked if I had MS.

If it isn't showing up in my blood work, isn't anything wrong with my heart, isn't my thyroid...what in the heck could it be?  I don't even know what to expect from the doctors now. About 7 days ago, I called up my cardiologist and asked for a Holter monitor. They approved it for 30 days and I'm still on that now. I have recorded probably 150 "events" of various symptoms (it is the Body Guardian One system with the direct cellular connection to Preventice Solutions) ranging from shortness of breath to chest pain/pressure, dizziness, fatigue/weakness, etc.  She said that if anything is wrong, Preventice will notify my doctor's office even after hours. So far, they've found nothing. I wake up in the middle of the night feeling just AWFUL sometimes and also my legs will be tingling for no apparent reason, then I'll go back to sleep. I know that I do sleep very poorly. A previous in-lab study showed 4.7 AHI, but an 18 Respiratory Disturbance Index. I had about 50 RERAs in about 2.75 hours and only got around 6 minutes of total REM time. All night long, my hypnogram bounces up and down and I mostly bounce in and out of stage 1 and stage 2 of sleep, then back awake again. On camera at home, I consistently toss and shift all night long every 30-35 minutes like clockwork. Lately I feel pressure vertically on each side of my neck, basically in the area where the veins run up. No reason to suspect blood clots or anything like that.

Suggestions? Sleep lab is currently closed. A previous CPAP that I was using didn't help me with anything. I feel anxious and just fidgety a lot of the times, unlike myself. It doesn't feel like anxiety from life stress, it feels like anxiety from body stress due to something malfunctioning. The question of WHAT is malfunctioning is one that we can't seem to find the answer to.
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207091 tn?1337709493
One thing that may be causing it is your PPI -

https://www.ncbi.nlm.nih.gov/pubmed/8180297 - talks about dizziness

https://www.uspharmacist.com/article/proton-pump-inhibitors-considerations-with-longterm-use - talks about muscle weakness

https://www.mayoclinic.org/drugs-supplements/omeprazole-oral-route/side-effects/drg-20066836?p=1 - this mentions to call your doctor right away if you have muscle weakness. There is something called  hypomagnesemia (low magnesium in the blood), which can happen with PPIs, but it usually happens if you've been taking it for more than a year, or if you're taking them with digoxin (Lanoxin®) or certain diuretics or "water pills".

Don't stop the PPI without talking to your doctor, though. Just ask him about the possibility.

I've had a 30 day Holter. They will notify your doctor for anything serious, like A-fib, or heart stoppages, etc. They won't notify them for rapid heartbeats, slow heartbeats, etc., unless it's life-threateningly slow or fast. It feels terrifying to you, I know, but that doesn't mean it's life-threatening. Just keep recording your events.

I went through it all, and they found very little, but did put me on a beta blocker for tachycardia and palpitations, which has helped a LOT.

Has anyone checked your testosterone? Having low T levels can affect a LOT. That should be done to at least rule it out.

What thyroid tests did they do? If it was a TSH only, that's not enough. You need a Free T3, Free T4, and thyroid antibody tests.
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