Can all these symptoms be due to Perimenopause?

[Novemberstorm1]

As the title says, I'm not sure what is causing these symtoms which all started 10 months ago. I'm 42, slim, no health issues.

Main symptoms are:
-Fatigue, mainly during the afternoon which makes me really need a nap

• Low blood pressure. My norm used to be 118/73, now it's around 100/63
• Air hunger/short breath which coincides with low bp

The last two symptoms bother me the most.
I've been to the GP, all bloods normal including iron, ferritin (60), b12 (350) , thyroid etc.

I'm waiting on referral to cardio - I'm so scared this is heart related (i.e. failure). GP trying to calm me down as I have history of HA.

Has anyone had any of these symptoms? GP mentioned PoTs but I don't think PoTs causes air hunger which I feel most of the day (and coincides with low blood pressure.).

Thank you

What you describe as "air hunger" is a major symptom of anxiety, linked with hyperventilation and excessive yawning. Do you have anxiety?
Otherwise it's something associated with end of life, in the last days and hours in my experience with elderly relatives.

Air hunger can be a symptom of low b12 or folate. Your b12 whilst not NHS low, may not be optimal (eg in some countries such as Japan they treat it when it's under 500).

What was your folate level (normally tested at same time as b12)?

@givemeanother thanks, my folate was 5.2 which I think is within the normal range?

But I dont think air hunger is relates to low bp and I think it's the low bp which is causing the breathlessness....

Sorry meant to say I don't think low b12 is related to low bp and I'm sure my air hunger is only when my bp falls..

I don't have a medical background so worth noting I'm just sharing personal experience. It's good it sounds like your GP is listening and referring you to cardiology.

Folate of 5.2 is also in NHS normal range, but towards the lower end and for me, I don't feel well when my levels are that low. I supplement folic acid tablets and sublingual b12 every day and that has eased symptoms of air hunger that I used to get.

There are of course other potential reasons. Have you noticed any pattern to when your blood pressure is lower? Sometimes you can increase it by drinking fluids/electrolytes or wearing compression socks can help if your blood pressure drops on standing.

I hope you find a cause and feel better soon.

@givemeanother thanks, can I ask how long after supplementing folic acid and b12 did your air hunger go?

No pattern to low bp. I might have a run of 2 days where my bp is around 118/70 (good normal for me) and I will feel fine. When I don't feel so great, I take my bp again and it's 100/60. So wondering if it's hormone related..

It's not immediate. GP told me to expect a couple of months when we agreed I would try supplementation, but I think it was more like 3-4 weeks. Perhaps it was quicker because my levels were NHS borderline rather than low.

I take 2000mcg folic acid every day which is above the 400mcg recommended daily amount (but lower than the 5000mcg the NHS would prescribe if you met their definition of low). And I take 1000mcg of a sublingual (dissolves under your tongue) b12.

I had similar for a few months earlier this year. Like you I was referred to cardiology however my symptoms had actually resolved in the meantime.

For me it was actually a post covid response. I had covid mildly in August, breezed through it, however 6 weeks later I was floored. Awful anxiety, so emotional, getting out of breathe faster when out walking, would also notice shortness of breathe or just an awareness of breathing when driving or sitting on the sofa in the evening. Eventually went to my GP who talked me down but referred me as reassurance. Cardiologist was so lovely and told me this is especially common after covid and very prevalent in women under 40 with low blood pressure and high vagal tone.

For me it actually explained another episode I had in March and one last year.

Hope you get some answers and peace of mind soon x

@Nellie67 thanks for sharing your story. I often wonder if this could be post covid related as I've heard lots of stories from people with long covid who struggle with Air hunger. The issue is I can't remember being poorly before this started in December 2024 and I only had a mild cold last winter. Even if it is a post covid problem, it's been almost 12 months and it hasn't improved.
Interesting to hear the link with women of 40 and with low bp though