Conversation: The conversation between human and AI assistant.
[|Human|] Good Evening, I had a few concerns about some recent symptoms I have been experiencing for the last 4 to 6 weeks. I am 30 years of age, 5 2 and 119 pounds. I have a higher then normal cholesterol level of 193. When researching I have read that anything under 200 is considered normal although the docs do consider it to be a bit high. I have also experienced low blood sugar in the past off and on for about 5 years. I seemed to have low blood sugar issues since I caught the virus mononucleosis in 2007. Honestly, my body has never been the same. I have been waking up at night about an hour after falling asleep with rapid heart rate, higher then normal BP of usually 130 to 145 over 93 and heart rate can get up to 110 to 113 at times. I start shaking all over and become weak all over and lightheaded. I feel cold in my hands and feet. I also have a lot of numbness in my hands and feet while lying down and while sleeping at night. this symptom has been going on over a year. I have been to the ER and was told I had a heart arrhythmia but nothing serious whatsoever. I also had a low Rdw of 12.2 blood test and low phosphorus of 2.1. I also have a drop in blood pressure when lying down. sometimes is goes as low as 87/44 but heart rate is within normal range. These recent blood tests were the only tests that were low. I did have an ekg which was normal and chest x-ray which was normal as well. I was recently thinking maybe I had a thyroid issue or endocrine issue. I have had basic thyroid tests done and they were in normal range but my direct T4 seemed to me to be on the lower end of normal. When I told a Nurse from the ER my recent thyroid test results, He said it was on the low normal side. Do I seem to have some kind of heart issue and why do I have these episodes at night? Sometimes the episodes are so severe I have to get into the shower just to shock my body. It can be very scary. Any suggestions or input you can provided me with would be greatly appreciated.
[|AI|]  Hi, This is Chat Doctor. Increased heart rate & palpitations can have a lot of causes. It can be normal sinus tachycardia due to anxiety or stress, or it could be abnormal supra ventricular tachycardia. For the diagnosis, you need to do ECG at the time of palpitation & tachycardia. If the duration of palpitations are short enough to reach a nearby hospital, we put a 24hr ECG monitoring (Holder Monitor). You also need to do a 2D Echo & thyroid function test to see for any associated abnormality if any. As you have already done a thyroid profile which seem to be normal, I'll recommend you for an echo & holder study to see if there is really some heart abnormality. Your cholesterol is normal & you don't have to worry about that. Normally when we sleep, our body tend to get relaxed & thus our BP falls. This is also a normal phenomenon. But if the BP is falling significantly on changing posture than it sometimes mean fluid deficiency in body & you need to take more of fluids. Rest be stress-free, live a healthy life & you Will be absolutely fine. Thanks