Which blood tests are required for a condition that causes hyperventilation and palpitations?

[Peterw112]

Hi Everybody,

I would appreciate your advice on which blood tests are appropriate for my condition. For many years, I have been experiencing heart palpitations and hyperventilation. My heart can start racing, even when I am feeling relatively relaxed. I went to my GP about this and he checked my heart beat but did not find any major issue. However, blood tests were not taken.

My condition has confused me because mentally I do not feel anxious, despite physical symptoms such as my racing heart. At times, I have taken anti-anxiety medication for my condition. A few months ago, I started taking Vitamin B12 supplements (1000 MG) and they made a significant difference for both my breathing and preventing palpitations. It felt as though my body's oxygen levels had been significantly increased. During this time, I did not take anti-anxiety medication. It was a great sense of relief.

Unfortunately, after approximately two months, the palpitations and hyperventilation returned. Perhaps my body's ability to absorb B12 on a longer-term basis changed, as it no longer feels that my lungs have the same levels of oxygen (compared to the first few weeks of taking the B12 supplements).

I have Beta Thalassemia minor which I am fairly certain is contributing to my condition and insufficient oxygen levels. Since the Vitamin B12 made such a positive difference when I started it, I would like my doctor to investigate how my body can maintain sufficient absorption.

Which other blood tests should I ask my doctor to carry out? Any advice would be greatly appreciated!

Thanks for reading my post.

[Nackapan]

If you concerned about your b12 level your Gp could do a blood test. The NHS do a serum level. The test usually involves checking your folate level too.

I hope you are under w consultant.

I find that specialists do not communicate to put the jig saw puzzle together.

When your heart races it dies cause anxiety like feelings. Pysicsj rather than psychological.

Have toy teas about POTs one of the many conditions that causes tiur heart to race.

Your doctor coujd oi a standing test.

It often goes misdiagnosed for some time.

[Peterw112 in reply to Nackapan]

Thanks for the information and useful suggestions! I agree about the jigsaw.

[FlipperTD]

This is the scientific answer, not the medical one.

Focussing on your Beta Thalassaemia Trait; this is highly unlikely to be causing any symptoms. It's only relevant to ensure that no-one starts treating for you iron deficiency simply because your MCV is reduced. Your Haemoglobin level is the one to consider, and if that's in the 'normal range' quoted, or in fact even if it's a bit below, then your oxygen levels will be more than sufficient.

In terms of what tests might be relevant, well...

If you're taking B12 supplements then measuring serum B12 is probably not that helpful.

Serum Folate however is a good idea, and Red Cell Folate [if available] is even better.

Likewise, ferritin, to give you a clue about your iron status, or Iron & TIBC.

A Full Blood Count is likely to be very helpful, and should put your mind at rest. All of these tests need careful interpretation.

I hope this helps.

[Peterw112 in reply to FlipperTD]

Thank you for your response, it is very helpful.

From a blood test sample from my mid-thirties, my Haemoglobin level was 13.0 g/dl. Do you think that this level could cause palpitations?

I may stop taking the B12 supplements prior to the blood test. I hope to find out why B12 supplements were so effective, at stopping the palpitations, when I started to take them but then suddenly seemed to stop having this impact.

[FlipperTD in reply to Peterw112]

Hi. As always, scientist, not medic, but from my understanding of haemoglobin levels, then I'd say no, it's highly unlikely. That level is considered normal for females, and they don't get palpitations associated with it, and whilst my assumption is you're not female, the same logic applies. Haemoglobin is a 'wonder molecule' and has so much spare capacity that symptoms would be unlikely until it was considerably lower, or unless you had greatly increased oxygen requirement [training, endurance running etc], or living at high altitude [like very high, not anywhere in the UK!] and in fact a slightly lower Haemoglobin level can result in a slightly lower whole blood viscosity so it's likely that it flows more easily, but this is a rather complex area.

Of course, it may be worth getting the FBC checked again, as things can change over time.

Good luck!

[Nackapan in reply to FlipperTD]

Here b12 is always tested with folate aw whenever I want folate levels b12 is done as well.

[FlipperTD in reply to Nackapan]

Yes, it was in my lab too. At one point in the past, the tests were done using one assay kit, 'Simultrac' so it wasn't possible to do one without the other. It's certainly easier interpreting results, with the FBC, when you've got both. However, when you know the B12 doesn't need measuring, and getting a meaningless high number back, and then someone actually takes notice of it, the trouble starts! Life's complicated but that's what makes it fun.

[Cherylclaire Forum Support]

I had a thumping heart which would sometimes wake me up at night, as if some loud noise had suddenly woken me - but without the noise. It also started thumping during the day, mostly after eating dinner. I had seen this included on B12 symptoms lists, so was not unduly worried. GP suggested anxiety, but I knew it only felt like that. You get used to absorbing "new normals" fairly quickly.

For some reason, it got worse or at least far more frequent, until it was several times a day and most nights. I had a 24hr heart monitor fitted and it revealed ventricular ectopics : a condition that is thought to be harmless, no reason known for why it occurs and can disappear without help with no known reason for this either. The only treatment I was offered for this was Bisoprolol, which I decided not to take because I'd once been told in 2017, while having preparations for a surgical procedure, that I had sinus bradycardia- a slow heart. It didn't seem appropriate to have betablockers.

The thumping heart has now improved on it's own and is back to a manageable level.

A heart monitor might be the logical next step - if you return with the same problem to your GP, s/he might suggest this as a next step anyway (although difficult at present time to know). Without this, I don't think you can know for sure what is going on and best not to waste time guessing. It would be good to rule out any possibility of a heart condition anyway.

[Nackapan in reply to Cherylclaire]

Yes my daughter had to collect a heart monitor so perha8s possible in this climate. Sge had activities she had to do at certain times. I've als8 had a thudding heart at rand8m times and nothing tk di with actual anxiety

Sometimes just walking down stairs . Strange not upstairs. Kforgot about that.

So many odd aympt8ns worth b12 deficiency. Also so many that overlap with other conditions.

So yes get every investigation done .

[Peterw112 in reply to Cherylclaire]

Many thanks Cheryl. My palpitations also seem to get worse after eating.

A heart monitor is a good suggestion - I will discuss this with my doctor.

[Nackapan]

I teloed to cherryclaire by mistake. Just adding