Palpitations, dizzy and exhausted - please help

[anna114young]

Since March I have been exhausted. The type of tired that sleep doesn't resolve. I have slept 12 hours + some days with no improvement.

I went to the GP, had all the usual blood tests and everything came back normal but by chance they noticed my pulse is really fast at rest. Recommended I wore my smart watch and kept an eye on it.

I have now realised that at rest my heart rate at rest can be anything from 55bpm to 141bpm. Walking slowly round a supermarket it can be 165bpm!

Due to this I have had an ECG (normal but heart rate was 115bpm) and echocardiogram (normal too.)

Day to day I am dizzy, tired and feel palpitations and chest pains on and off.

I have been told it could be POTS (although my heart rate doesn't seem to change from sitting to standing), Chronic Fatigue or Long Covid (I had Covid in November).

Nothing seems to fit and NHS waitlists are long. I just want to get better - FAST. Does anyone have any ideas of what to do next? I am on a waitlist for a 48hr heart monitor but apart from that it feels like I have hit a brickwall....

How old are you? Perimenopause have me these symptoms esp the palpitations. I started HRT because of it, I thought I was having a heart attack at one point.

Can you write your blood teat results out? as "fine" for NHS doesn't really mean much.
I get symptoms like that when my b12 is below 400 (although nhs say its technically fine for them it just means they cant afford to treat you if you arent literally about to drop dead)

As mentioned by previous poster, definitely get your results and the ranges. I had similar and was told that my results were ‘fine’ by the surgery. Turns out that my ferritin was below range and my B12 was right at the very bottom of range. NHS ranges are massive and you really need to be your own advocate for your health.

I have had similar. Heart rate 123 brushing my hair, 110 walking slowly between rooms, going crazy when I turned over in bed. Negative tilt table test (test for POTS). I also had two episodes of fast AF last year.
Tried bisoprolol and flicanide but still tachycardic on minimal exertion.
Cardiologist put me on propafenone which improved me 80% although still got lots of ectopic beats.
Had an ablation on Saturday.
Otherwise completely fit and well. Covid related? Who knows!

Also I was put on HRT but it didn't help the cardiac symptoms. Ended up going private as I just couldn't function. A low point was DH having to wash my hair over the bath.

Thanks so much for all the responses.

@SmartHome I am 33 so hopefully not perimenopause!

@Leo227 @Iheartmysmart I have had my results and from what I can see all well within normal ranges. I already take B12 as that used to be low, also on high dose folic acid.

I have had all the blood tests, full blood count, b12, thyroid etc etc. All seem normal or really good!

@cptartapp This sounds so similar! It seems my "normal" is always around 100-115.

They have queried depression/anxiety/stress and its frustrating as I don't think it is any of these but I am starting to feel quite down due to it. In January and February I was going to the gym a few times a week, walking the dog, working full time. I now have reduced hours at work as I am not coping, rarely walk the dog and have stopped going to the gym....

When you say you "take b12" and that it used to be low - do you mean as in you take it orally as a vitamin tablet? Are you vegan/vegetarian? If not, then if it "used to be low" the chances are you can't absorb it orally. I think taking tablets means it could impact the levels that show up on a test, but not actually be functional b12 that your body can use.

Yes I was asked what I was anxious about several times!!!
Have never really got an answer to the cause but last summer was awful. We had to cancel two holidays and I was off sick for the best part of four months. I was relegated to practically crawling upstairs to try and keep my heart rate down. I had a Covid booster and within 48 hours was back in A&E with heart rate spiking. I couldn't get dressed without keep sitting on the bed.
I have to stop my meds in six weeks and see what happens.

@ChristmasKraken Good question! I am not vegan/vegetarian but it came up as low in a routine blood test in 2020 and they weren't doing the injections because of covid. They said to try tablets first and see if I was absorbing it. My levels shot up immediately so they were happy for me to take tablets. If the levels didn't go up we were going to move to injections (they thought I might have pernicious anaemia where you can't absorb.)

My b12 levels are on the higher end of the range so they seem happy with it now!

@cptartapp That sounds so familiar. I am slowly, slowly doing less and less because I feel so incapable. It's like walking through water constantly and even sat at my desk today I have had palpitations. Have been considering going private - would you recommend it?

It does sound like pots or orthostasis. Look on the pots UK website and maybe try the recommendations on there of lots of water, additional salt, electrolytes and maybe compression stockings. It's dx via a tilt table test. There are a few different types of pots. Cfs & long Covid also can cause these things. No condition is cookie cutter identical. You could have bits of all of these.

@anna114young

Around Xmas I had the same thing, so fatigued, every task I would do felt like such a huge effort, heart racing, and I could feel palpitations at night. I struggled to walk up the stairs and would have to have a break after.

I went and got an ECG and was immediately rushed to hospital by my GP. The right side of my heart was enlarged. Two days later was given a right heart catheterisation and was diagnosed with pulmonary artery hypertension. It's progressive and terminal but can be treated with medication that can really improve your quality of life. But it is so important that you get diagnosed early.

I'm only 38 with 2 small kids and completely fit and healthy, so never expected this.

Since being diagnosed I have read that this is rare but more common in women. Linked to hormones etc. But women often get fobbed off by doctors and told they have asthma or anxiety.

Your ECG should flag up if there is any high pressure in your arteries/lungs, if so please push for a catheterisation as it's the only way to fully diagnose.

I hope it isn't this as it sucks...but good luck with whatever happens..

@whatcanidotobelieve I am so sorry to hear of your experience, I really hope the medication helps you and the doctors continue to support you. I have had two ECGs now and this hasn't been picked up but thank you for sharing your experience.

It seems to be a common theme that women get fobbed off with anxiety etc. This is my biggest fear here, if there is something wrong I want to know what it is and what to do about it! I have been fobbed off in the past before (I have two other health conditions) and now I know how hard you have to push to be taken seriously.

I was lucky to see a private cardiologist through BUPA, DH added me to his works cover.
The NHS waits were so long and I needed to get my life back.

@anna114young what other health conditions do you have ,could there be any links to those?

@holaholiday Good question! I have epilepsy (has been under control for 5 years now with no changes to medication) and endometriosis.

Get the GP to refer you to the Long Covid clinic. They should do bloods and a chest x-ray as routine before referral.

This is how I was post-Covid with POTS. I had an ECG done in A&E (HR was over 200 standing), then a holter ECG. Compression socks or tights, extra salt and fluid helped me the most, I didn't need medication. It helped the fatigue, dizziness and palpitations. 2.5 years on my POTS has improved, I still have fatigue, but I am working again in a busy, active job. Some people benefit from medication. GP's will sometimes prescribe propranolol as a trial, but other medications need a cardiology referral.

For the compression socks/tights you need 20-30mmhg. I buy mine on Amazon, but POTS UK has recommendations for stockists on their website.

https://www.potsuk.org/managingpots/

@cptartapp Can I ask what they did with your ablation? I have PSVT and the meds aren't working well anymore so it looks like I'm heading towards ablation and I'm a bit nervous.

@anna114young Cardiology is such a mess post-Covid. Even though I have a diagnosed condition I have had to wait nearly a year to have a new heart monitor and get in to see the cardiologist. Have you tried the Valsalva Manoeuvre?

I had laser ablation under a general anaesthetic. They couldn't initiate an arrhythmia during the procedure but went ahead and treated the area that causes the problem the vast majority of the time anyway. I'm still getting ectopic beats (not as many) but it will take a few weeks to settle. Have to continue my propafenone and am on anti coagulants both for a further month. Then stop and see.
I was incredibly nervous but it has been relatively pain free, was home the same day and am recovering well.

If your heart rate doesn't rise significantly from lying to standing, then it's not PoTS. It could be another type of Dysautonomia though, possibly caused by Covid

But from your posts about B12, it is most likely to be this. Or at least your B12 deficiency needs corrected first and then see what symptoms are left. B12 levels will be falsely high when taking B12 supplements of any kind, which is why the NICE guidelines now state that retesting isn't helpful after treatment begins. The first step would be talking to your GP about getting switched to injections, and hopefully they will listen.... a B12 deficiency caused by malabsorption should always be treated with injections.

Thank you for sharing that. I'm very glad you're recovering well. Fingers crossed there's improvement once it settles.
I'm sure ablation will be next step for me because meds aren't doing what they should.
All the best.

Just the headline of the post made me think "B12". I don't absorb B12 orally, I need injections. And when diagnosed, I was just in the bottom of the normal range for B12, luckily my GP thinks outside the box!

Following this thread with interest. I also get palpitations and missed beats. I had an ECG and it showed I have some kind of arrhythmia and they've referred me to the arrhythmia clinic. I've had Covid twice so wondering if it's related to that. I've always suffered with palpitations but not this bad. I'm 27

I had all this shit post vaccine for 8 months (4th vaccine) it is gradually improving after 6 months of Bisoprolol which I am now weaning off as it sent my heart below 50 an awful lot. I also got a ton of neurological stuff came on, dizziness, lightheaded weird feeling, pins and needles in feet multiple times a day if I sat still and just felt totally out of sorts- like you bloods fine apart from being pre diabetic which I didn't know. It's been a slow slog of multi vits, magnesium and vit d supplements etc but what was weird for me was why active vit B 12 was good- but I decided to do the spray under the tongue stuff and within 2 days many symptoms started to subside. I definitely wouldn't discount covid/vaccine issues as the symptoms you have are so common with it and seem to go on for a very long time for many normally fit and well people

Forgot to say I had intermittent chest pains with it too