Is It Autonomic Nervous System Dysfunction? Your Symptoms

Is it autonomic nervous system dysfunction?

Hello Doctor,
Over two months ago, I smoked some marijuana while abroad.
I'm not sure if it was too potent or mixed with something else, but that night I experienced severe palpitations and overall weakness.
Although I felt a bit better after a few days, about a week later, I suddenly woke up in the middle of the night with persistent palpitations and a strange wave of sensations throughout my body, including anxiety and chest tightness.
After a few days, my condition stabilized somewhat, but I continued to feel weak, had a poor appetite, and my heart would race with even slight movement.
This lasted for over a week before improving.
Then, on another day, I drank a cup of coffee on an empty stomach (which I used to do regularly in Taiwan without issues), and I experienced palpitations again.
This episode lasted for a month.
During this month, my heart rate would often exceed 100 beats per minute, I frequently experienced sudden tinnitus, felt fatigued, had a poor appetite, and my mouth would become very dry.
I often woke up in the early morning, and then I started to feel a dull pain in my chest.

I consulted local doctors while abroad, and they said there was nothing wrong.
I returned to Taiwan and had an electrocardiogram and an ultrasound, both of which also indicated no issues.
However, my symptoms persist.
It has been over two months now, and I am taking traditional Chinese medicine, but I still feel easily fatigued, have strong heartbeats (my body and hands move along with it), and sometimes experience sudden tinnitus.
I often feel the need to take deep breaths, and when my heart rate increases, my mouth becomes very dry, and drinking water doesn't help.

I feel a sensitivity in the area below my sternum, around the diaphragm, which is hard to describe.
I experience chest tightness and occasional dull pain in my chest, but it’s not severe and is mostly on the left side.
My mental state is deteriorating due to these symptoms; I feel anxious and restless.
I’m unsure what is wrong with me.
Although I have decided to return to my home country, I am worried about potential heart issues during the flight.

I suspect I might have autonomic nervous system dysfunction, so I sometimes practice diaphragmatic breathing, but it sometimes triggers tinnitus, so I hesitate to do it.
The doctors here are not very reliable.
Could this be autonomic nervous system dysfunction? What can I do to feel better? Thank you.

Xiao Lin, 20~29 year old female. Ask Date: 2016/01/03

Dr. Jiang Junyi reply Neurology

Hello, based on your description, cannabinoid receptors are present in neurons in various regions of the brain.
These areas are associated with memory (hippocampus), attention (cortex), perception (sensory areas of the cortex), and movement (cerebellum, substantia nigra, globus pallidus).
The effects on the body are multifaceted and can lead to addiction.
I am unsure if you smoke, but the symptoms mentioned are similar to those of nicotine withdrawal (symptoms of sympathetic nervous system overactivity).
Generally, the autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems; one acts as the accelerator, while the other acts as the brake.
The sympathetic nervous system is responsible for stimulating the body, while the parasympathetic nervous system helps to calm it down.
For example, during exercise, the sympathetic nervous system is activated, leading to increased heart rate, faster breathing, and increased sweating.
Once the exercise stops, the parasympathetic nervous system takes over, slowing the heart rate, reducing breathing rate, and decreasing sweating.
It is advisable to train the parasympathetic nervous system; in addition to proper diaphragmatic breathing, engaging in light aerobic exercise can be beneficial.
I recommend discussing further evaluation and treatment with a neurologist to rule out conditions affecting the sympathetic nervous system, such as hyperthyroidism.
Wishing you good health, peace, and happiness.

Reply Date: 2016/01/03

More Info

Based on your detailed description of symptoms and experiences, it seems you are dealing with a complex interplay of factors that could indeed be related to autonomic nervous system (ANS) dysfunction. Your symptoms, including heart palpitations, fatigue, anxiety, and gastrointestinal discomfort, suggest that your body is in a heightened state of stress or anxiety, which can significantly affect the ANS.

The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, respiration, and digestion. It consists of two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' activities. When the ANS is out of balance, it can lead to a variety of symptoms, including those you are experiencing.

Your initial experience with marijuana could have triggered an acute stress response, leading to the heart palpitations and feelings of weakness. The subsequent episodes of anxiety and physical symptoms may have created a feedback loop, where anxiety exacerbates physical symptoms, which in turn increases anxiety. This is a common scenario in individuals experiencing ANS dysfunction.

The fact that you have had medical evaluations, including an electrocardiogram (ECG) and echocardiogram, which returned normal results, is reassuring. However, it is essential to understand that ANS dysfunction can manifest with symptoms that may not show up on standard tests. Conditions like panic attacks, anxiety disorders, and even post-traumatic stress disorder (PTSD) can lead to similar physical symptoms without any underlying heart disease.

Here are some strategies that may help you manage your symptoms:
1. Breathing Exercises: While you mentioned that abdominal breathing sometimes triggers ear ringing, it can be beneficial to practice controlled breathing techniques. Try to find a comfortable position and practice slow, deep breaths. Inhale through your nose for a count of four, hold for four, and exhale through your mouth for a count of six. This can help activate your parasympathetic nervous system and promote relaxation.

2. Mindfulness and Relaxation Techniques: Engaging in mindfulness meditation, progressive muscle relaxation, or yoga can help reduce anxiety and improve your overall sense of well-being. These practices can also help you become more aware of your body’s responses and manage stress more effectively.

3. Physical Activity: Gentle exercise, such as walking or stretching, can help improve circulation and reduce feelings of fatigue. However, listen to your body and avoid overexertion, especially if you feel your heart rate increasing.

4. Diet and Hydration: Ensure you are eating a balanced diet and staying hydrated. Sometimes, dehydration can exacerbate symptoms like fatigue and palpitations. Avoid excessive caffeine and sugar, as these can increase anxiety and heart rate.

5. Seek Professional Help: Since you are experiencing significant anxiety and distress, consider consulting with a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective for anxiety and panic symptoms. A therapist can help you develop coping strategies and address the underlying issues contributing to your anxiety.

6. Medication: If your symptoms persist and significantly impact your quality of life, discussing medication options with a healthcare provider may be beneficial. Anti-anxiety medications or antidepressants can help stabilize mood and reduce anxiety symptoms.

7. Return to Your Home Country: If you feel safer and more comfortable returning home, it may be beneficial for your mental health. Ensure you have a plan for follow-up care once you arrive.

In conclusion, while your symptoms may be indicative of autonomic nervous system dysfunction, they can also be influenced by anxiety and stress. Implementing relaxation techniques, maintaining a healthy lifestyle, and seeking professional support can help you manage your symptoms more effectively. Remember, you are not alone in this, and there are resources available to help you navigate through these challenges.

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