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Help understanding diagnosis: Overactive Autonomic Nervous System due to Adrenaline


I have been diagnosed with an overactive autonomic nervous system - a problem somehow linked with my adrenal system.  I went to a very experienced and respected neurologist who diagnosed me but was not very good at describing my condition.  I haven't been able to find much information online so I am hoping someone can describe it to me.  I am especially interested in learning what physiological processes are causing the symptoms, and what sort of general prognosis I might expect.  Is this curable or only manageable?  Does it get worse?  The doctor was vague.  I have taken a good deal of college biology and human phys classes so it's okay to give a technical description.  I'll let you know if there's something I don't understand.

Medical history:

I am a white 23 y/o male with no prior history of drugs, health problems, head injuries, surgeries, allergies, etc.  I am 6'5" 205lbs and run 30 min. daily.  I would drink the occasional cup of coffee, and drank socially.  I have ADD and have had depression in the past.  My mother and sister have anxiety disorders, and my father has had panic attacks.  There is a history of alcoholism on both sides of my family.  My grandfather died of skin cancer.  Last year I had waking sedation for a colonoscopy.  I was diagnosed two years ago with tarsal-tunnel syndrome in both feet, presumably because I had been doing a lot of distance running.  A neurologist did a nerve conduction test and found I had a problem with both plantar nerves.  Everything else was normal.  I have been under a great deal of work-related stress for the last year.

The symptoms:

Ten months ago I started taking Concerta to treat ADD (I had tried many ADD meds at age 14 but had never stuck to one for longer than a month because I was uncomfortable about the idea of medicating).  Concerta was my first real med in about 9 years, and the psychiatrist worked me up to 72mg.  I was on it for about 3 months or so.  After the 3rd month, I noticed my hair starting to fall out at a faster rate.  Worried, I stopped the meds in January..  Shortly thereafter, I noticed a slight tremor in my hands when I tried to hold them very still.  My hands had always been rock steady.  I saw my GP and she did bloodwork and some reflex tests and diagnosed a familiar tremor.

About a month later the tremor had started to subside and I noticed my hair had stopped falling out.  I began to notice tics.  It started with my thumb.  Just sitting there, resting, it would twitch in hard as if to grab something.  No cramping or pain, just annoying and worrisome.  Soon, I noticed it in my quad and then in individual toes and then in my lower calves, eyelids, and weird little foot muscles.  The thumb twitches mostly went away, but I was left with the leg twitching and the occasional little-finger twitch.  The twitches are at a random rate and occur in random muscles for up to three days although they sometimes just twitch once and stop.  I have rare twitching in upper body and torso muscles like lats, bis, stomach muscles etc, but this is much less common.  Sometimes I will go a day with almost no twitching at all.  Sometimes its non-stop.

The twitches seemed to get slightly more frequent over time and I began to get worried.  My anxiety became increasingly worse and I became fixated on the twitching, increasingly convinced that I was developing ALS or something.  This is unusual for me because I am not an anxious person, although my sister and my mother both suffer from anxiety disorders and my father has had panic attacks.  By about a month ago, I began waking up in the middle of the night with what felt like panic attacks.  High anxiety, profuse sweating, pounding heart, knot in chest.  I assumed that's what they were.  They would last for two or three hours.  This convinced me to finally see a neurologist, which I did about three weeks ago.

The neurologist looked at the bloodwork from my tremor test with the GP, the results of a recent (4 months) physical, and the nerve-conduction test. He then did all sorts of nerve response tests with a hammer and a rolling spike wheel, looked into my eyes with a scope, and had me flex my quad hard for a while so he could look for signs of ALS.  I passed all the tests (of course nothing was twitching at the time... like when you finally bring your car into the shop and that noise it was making suddenly stops).

The doctor then timed me putting pegs into a board with either hand and flipping my hand over and back repeatedly on the desk as fast as I could.  Apparently I didn't do as well on these tests and my left hand was a fair degree slower.

The doctor said he could rule out any of the real bad problems such as ALS and Parkinsons, and almost completely rule out MS, though to do so 100% for MS would require a contrast MRI.  I have not had cramping or any of the pain that seems to be associated with MS.

He diagnosed me with an "overactive autonomic nervous system associated with adrenaline".  He said that my sympathetic nervous system was too revved-up.  He then talked about secondary messengers sending signals into the synapse and a positive-feedback system that would lead the problem to spiral over time. I didn't catch it all - but that was part of the sort of explanation I am looking for here (with more detail).

He said I needed to "relax", avoid stimulants, and try to stimulate the parasympathetic nervous system.  "Five years ago, we might have put you on beta-blockers" he said, "but we've found that yoga or meditation can be very effective at stimulating the parasympathetic system".  He recommended that I try these activities.

I didn't really come away with a good idea of what exactly is going on in my body, or how they explain my symptoms.  I also am unclear as to whether this is something I can expect to live with , or whether it can be cured.  

I began to meditate 20 minutes per day, and this (or just the knowledge that I was not dying) seemed to help me get the panic attacks under control within a week and a half.  However, the ticks have continued and if anything gotten worse.  I had another panic attack last night, although I drank, and drinking more than a few glasses of beer seems to trigger the attacks after four or five hours of sleep (another effect I would love to understand).  Because the twitches are continuing unabated and I don't really have an understanding of the condition or what to expect from it, I have wondered if I should get a second opinion. However, the neurologist I went to was very competent, so I'm hoping if I can understand better, then I will become more comfortable with the diagnosis and better able to do what I need to do to treat the condition.

Thank you in advance for any help you can provide me!

17 Responses
Avatar universal
Hey there,

I have recently read a fantastic book called "Adrenaline and Stress" by Dr. Archibald D. Hart which I would like to recommend to you.

It looks at the overactive adrenal system, and puts symptoms such as what you've described (twitches, panic attacks, anxiety, sleeping difficulties) down to too much stress, which seems to concur with your neurologist's opinion.

Hart gives much hope to the reader, and is realistic, encouraging and practical about bringing change into one's lifestyle.

I am twenty three as well (although I think you posted nearly a year ago so you're probably older now), and found the book easy to understand. I identified lots of my own bad habits that add stress to my life (poor sleeping patterns, too much coffee, bad time management, no relaxation time) but I am hopeful that I can slow down before my adrenal system gets too worked up for its own good.

I wish you best of luck and hope that you don't give up in your search for healing!
I would also recommend counselling, as I have found it invaluable, but it's not for the faint hearted.
Cheers mate!
- H
Avatar universal
Sounds like you have a similar condition to mine.  Try wearing dark sunglasses, staying out of the sun.  Supplement your diet with Vitamin D and Magnesium (Vitamin D to compensate for lack of sun. I use room darkening shades and all dark tones which also helps.  See if your doctor will prescribe you a mild tranquilizer also.  Loud noises, using computer too much can activate your already overactive nervous system.  Almost sounds like you need a muscle relaxer.  Doctors don't seem to have the patience to work with people when a solution is not staring them in the face.  Don't feel awkward about your situation.  There most likely is a physical reason for your symptoms.  Hope you have had your thyroid checked.  Take care
Avatar universal
i also have a problem that i cant figure out along with other problems that im dealing with.   i get movements under the skin also like a electric shocks under the skin  like if u were to touch your tonge on a battery the movements come and go during the day like creepy crawly feeling. like something is actually moving. i was wondering if this could be over active nerves   or something sending responces. i know this may sound crazy but this is what it feels like. please help with some kind of info or if someone has anything similar going on
143746 tn?1301274822
I am experiencing similar issues and after doing a lot of research am also thinking it is a overactive autonomic nervous system. Angelina, it is probably some form of neuropathy. I have had similar electric shock feelings. Does anyone have problems with "reactive hypoglycemia" feelings? That has been a central part of my experience.
Avatar universal
I'm former athlete. Otherwise healthy. 6 years ago my body went haywire. Racing heart, migraines, jittery, light heated when standing, "panic attack" feelings, excessive sweating at times."....in essence I felt really wired and no longer in control. Took its toll emotionally. Check out Mytral Valve Prolapse and Autonomic Nervous Center in Birmingham Alabama. Website very helpful.  I was tested and treated there and it changed my life for better!!!!!!! What they did for me/recommended......
1. I was on beta blocker (atenolol) for several years gradually reducing.
2. Limit any stimulants....limited caffeine, limited cold meds w/ stimulants etc. They compared it to using speed. We are already overstimulated and additional adrenaline or stimulants is more than body can manage.
3. Keep blood volume high by drinking lots of water.
4. Learn to recognize triggers.....particularly stressful situations WILL make it worse!!!!
5. Continue regular exercise

I realized after treatment, I'm not crazy my nervous system is. It can effect physical and mental well being. CHECK THEM OUT ONLINE!!!
Avatar universal
I went to that website thanks. It helps. I have classic symptoms of ANS/mitral valve prolapse. Just this week I went ot my cardiologist because I thought I was having a heart attack. When I go back to see him I'm going to discuss what I read. He too wanted me to try beta-blockers but I've been afraid because sometimes my blood pressure is low.
Could you tell me more about your experiences with beta-blockers
Avatar universal
I know you posted a long time ago, but I have alot of trouble with reactive hypoglycemia as well as getting panic attacks and heart palpitations at the drop of a hat. I never know if i'm dizzy because of blood sugar or anxiety. I know when my blood sugar drops quick that the adrenaline kicks in. So for me it happens everyday from that. and when stress happens my whole day is spent anxious and then trying to eat when I feel sick to my stomach from the panic but have to eat before my sugar drops. so basically my adrenaline is up and down all day on my "bad" days. How are you coping?
I am interested to knowing what to do for my adrenals, I know how to eat for stable blood sugar, but when I'm under stress it seems nothing is the right thing to eat. I do meditate and try to do exercise every other day, but I can't do vigorous exercise because my blood sugar only lasts so long if you know what I mean.
143746 tn?1301274822
I try very hard to avoid higher glycemic foods and I eat about 5 meals a day. I have had a problem with exercise as well. I used to jog every other day and now if I try, my heart will start racing more than it used to and I feel like I can't breathe. Sometimes this happens if I am on a walk, too. I can go for 30-45 minutes, then all of a sudden I can't breathe and can't move. Other times I can walk for 5 miles without any problems. One thing I think is contributing to my problems is migraine. I didn't realize I had them because the headaches I get aren't always that bad, but I get strong muscle weakness and exhaustion from them, as well as blurry vision and numbness on my face. I get these every day. I am not sure how all these things are connected with the adrenals, though.
Avatar universal
Please have your (active) B12 levels checked! Low (and low-normal, under 300) levels can cause all symptoms you describe. Non-treated B12 deficiency can lead to permanent disability eventually. It's treated with low-cost b12 intramuscular injections.  
Avatar universal
I have the same problem. I am almost 30 and I wasn't expecting to have problems like this until later on in life. My doctor is now trying to figure out why I have over active nerves. He tells me this is the reason for that "shocking feeling" he just doesn't know why it is doing it yet.
6772167 tn?1384647359
I could never figure out all these aches and pains and burning, tingling feelings mostly in my calves and feet plus not having any sense of relaxation.  I had MRI X-rays EMG's and nothing really could confirm where this was coming from.  I also have muscle twitches in my buttocks and legs,  Until I finally realized my central nervous system was out of wack.
This was from a  prolonged overload of constant stress, which I was experiencing.  It was like a "flight or flight", this has been going on for over five years, and on top of that my husband passed away a little over 3 months ago so  the symptoms got worse. I noticed that I have myofascial pain, trigger points and calcium deposits on my sacrum and hips.
I went to a massage therapist and she broke up about 50% of the clusters of muscle knots and small scattered trigger points that was in the muscles which are like sore spots that cause numbness in the muscle fibers. It is very had to slow down something that automatically happens in my nervous system.  Its like toxic chemicals released  throughout my body. I self massage this bumps and knots and do light stretches which help to a certain degree. I take vitamin B complex, magnesium, and vitamin C. I was told I have peripheral neuropathy ? The Doctors don't know what causes this and just told me its outside the spine with no explanation . When your adrenalin  and natural cortisol  releases to much in your central nervous it goes weary. Be kind to yourself and take a few deep breaths and try not to tense up and unlearn the evilness of STRESS. I knew a person who lost his job and was 3 months short of his full pension and died of a heart attack 6 months later, It was too much for him to bear but that was him God bless him. Stress can be a killer.
Avatar universal
Hi--you have some form of dysautonomia, maybe POTS. If you google around, you will find lots of good explanations. Dysautonomia often runs with connective tissue disorders like Ehlers Danlos Syndrome (which is frequently misdiagnosed as fibromyalgia). It is not as rare as people think.
Avatar universal

I am really not sure about taking the meds. for ADD. The scientific community are not really sure about the long term effects. I suffer from hyperhydrosis (genetic) which began shortly after hitting puberty. I am 54 years old, and have been afflicted with this for years. I also suffer from chronic (lifelong) depression, and have been treated for this with medication for 30 years. Lately, I have been feeling hyped up on a daily basis. I do drink coffee in the morning. I have no problem sleeping.

I was prescribed a beta-blocker for the hyperhydrosis, but quit taking it because it wasn't doing anything. I have recently started taking it again to see if it helps with what I think is an overactive sympathetic nervous system. Once in a while (one every few months), in a highly stressful situation like a job interview, I take a Lorazepam 0.5 mg. My doctor wants me to take them more frequently because I also pick my skin - which she wants to stop. If you have a problem with drug abuse, this one is not good because it is very addictive.

I feel like I'm on meth sometimes. I know that people who use this drug also pick at their skin - and, basically act crazy! My mind is racing from the time I get up. I multitask all day long due to the fact that I am a single mother (my kids whole lives) finishing up my masters degree.

I would try to ignore the ticks. Perhaps, wrap an ace bandage around the area to lessen the feeling of them. I would ask to try a low dose beta blocker as long as your BP is ok. The Lorazepam works wonders - but shouldn't be taken daily (my opinion). I think in the long run, this should help with your panic attacks and twitching.

Avatar universal
hi there i am reading this page and it is dated 2011, we now have 2015 quite some time has past. But i any case I landed here because I am doing some research for 2 of my children, that have an overreactive nervous system one of them has the reactive hypoglycemia with seizures.
I found the website Holistichelp.net/Dysautonomia very good explanations.
And also I came across Mitochondrial dysfunction being related to dysautonomia. It took us 9 years to figure this out by ourselves doctors were of no help at all. You can contact me via email if you want to
Wishing you well and the best. Here is a concoction I came across online to keep Bloodsugar level more stable especially during the night and after exercising   I use juice about 32 oz cup with some ice and add 3 heaped tbsp of cornstarch mix it up and my daughter drinks it especially after we go to the pool we live in the desert so the heat as a major negative effect on her. Good luck.
Avatar universal
Have them do a genetic check on your COMT gene.  That might provide an answer.  COMT regulates the removal of adrenalin.
Avatar universal
Avatar universal
What the doctors do not tell you is most of those drugs that are called psychotropics and they have long term causative effects and some can become permanent. Tardive Dyskinesia can result from taking drugs in that realm. Please be careful and choose meds wisely... Try to use other coping mechanisms to control your ADD, ADD and ADHD have a lot of similar effects, my son had ADHD growing up and is now 20 years old and doesn't have it anymore, I see no signs of it. I'm not one to quickly take meds, do more research before you start new meds and look @ all aspects, do a comparsion and see if the benefits outweigh the cons to taking meds... I hope the info was helpful and good luck.
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