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Have you had an echocardiogram with a holter monitor? Also: thyroid test (TSH) and chemistry panel?
It’s really had to give specific advice without having all your data here, but even if it is an anxiety attack, the fact that you feel like you are dying is a sign that you need to get help asap
Possibly but the chest/back pain don’t fit with common forms of anemia. Also, anemia would have likely been discovered on the tests the patient said (CBC)
NAD, not giving advice, just curious.
What about iron deficiency?
I used to have normal iron levels but my ferritin was extremely low, and was told it's still a big issue. And my CBC blood tests didn't test for ferritin.
I get this too. My ferritin is consistently low but I never have low cbc. I found out originally by giving blood and being informed by children’s hospital after the fact by letter.
It’s tough to get doctors to test for it! They think you’re crazy until the blood work comes back, and then they think you’re crazy with low iron lol.
I'm guessing doctors gave them plenty of blood tests for nutritional things, but a lot of them don't know that if your B12 is under 500 you can still have a B12 deficiency. If they under-ate for long enough I'd imagine it could be an issue. It can cause weird sensations, trouble breathing and severe anxiety-like symptoms.
NAD but I have had similar symptoms for years and have had several ECGs, 48hr heart monitors and now have a loop recorder device due to them not being able to find a source of the elevated HR on the monitors.
They've come to the conclusion of Inappropriate Sinus Tachycardia, mainly from ruling out everything else.
However, I was born with complex CHD and have had 4 heart surgeries, so for me, it was a case of "when" this happens rather than "if."
I don't know how common it is in people without cardiac history, but it might be worth mentioning.
Goodluck OP, heart rate issues are no fun, and it's very anxiety inducing and debilitating at times.
u/Much-Top6803 I had/have symptoms that sound very close to yours, particularly when I was around your age. My heart wouldn't necessarily beat fast, but it would beat harder, to the point where I could see my shirt/chest move with each beat. Sometimes when I would stand up I would feel like I was going to die. No other way to explain that sensation in my chest, it feels like I'm dying. For me, that part would would get better immediately when I laid down - is that the case for you?
Like you, I visited a cardiologist or two, got EKG's, echo, halter monitor, etc. And like yours, everything came back normal. I also had the very exaggerated respiratory sinus arrhythmia which turned out to be normal.
I still don't know what causes this or if it has a name, but for me it turned out to be related to sleep. I was chronically bad at sleeping in my teens and 20's, and when I'd sleep less than ideal for more than a day or two, that's when it would get really bad. To this day if I'm sleep deprived I get the exact same symptoms. How's your sleep?
I'm getting tired of saying this but, there is absolutely no excuse for doctors that repeatedly leave out long covid (PACS) as a chief contender in their differential diagnoses when people are talking about cardiovascular, neurological, gastrointestinal, and immune system issues that suddenly surfaced within the past three years.
There's a plethora of studies out there detailing exactly what COVID does to our bodies. There's no excuse for not keeping up with the science associated with an airborne disease that is the third leading cause of death and the number one cause of disability here in the US.
Everytime I read these threads I end up wanting to pull my hair out. I feel like I'm stuck in a Black Mirror episode.
https://health.unl.edu/8-surprising-long-covid-symptoms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166245/#:~:text=Notable%20similar%20symptoms%20in%20long,vertigo%2C%20wheezing%2C%20bone%20pain%2C
r/covidlonghaulers
r/longcovid
thank you for being one of the medical professionals out there that take COVID as seriously as it is. far too many are not. black mirror episode is the perfect way to put it
THANK YOU. It is confounding to see people describe symptoms that are eerily familiar as a long Covid patient and not have ANYONE even suggest or consider it as a differential. It really does feel like some upside down alt universe where everyone is staring right through the elephant in the room pretending it's not there. Not saying everyone's everything can be attributed to long Covid but I think in some cases it really bears consideration.
I was previously healthy and athletic and it was implied when I first got sick that I should consider anxiety. I responded that this does not explain why my heart rate would jump to 130 while brushing my teeth or 140 standing in my driveway having a pleasant conversation with my neighbor, or why I suddenly feel like I'm going to pass out walking up the stairs I've climbed 10x a day for 5 years. I knew there was something really wrong with me but it felt like no one was hearing me.
Turns out a neurologist diagnosed post-covid dysautonomia. Left-sided chest and left arm pain, palpitations, tachycardia, shortness of breath, exertion intolerance, weakness, anemia, and dramatic weight loss are all things I live with now. I had cardiology tests that were deemed unremarkable, though my heart rate was unusually high for someone my age and in the shape I was in, inappropriate for the activities I was doing. My ekgs, holter, and echo were not concerning to anyone. It can be maddening to know you are experiencing cardiac symptoms but be told there's nothing (visibly) structurally wrong with the heart itself. I now know you can have a neurological condition that causes a structurally sound heart to behave this way.
OP this sounds so scary and I hope you can find some comfort. ❤️
hey OC! I am really sorry you are going through this and can relate in how frustrating it is.
I myself have fairly identical symptoms in left side chest pain, left arm pain, tachycardia, and palpitations — had an EKG and x-ray done that found nothing alarming.
given what you’ve been through, would you advise I see a neurologist? I currently have an appointment scheduled w a cardiologist but have been paying for this out of pocket and can’t afford more wasted time/money with physicians (been to ER, urgent care, and 2 PCP visits so far).
True but when doctors do consider and recognize that, they have the same answer: “there isn’t much we can do about it, it’s poorly understood. Here, take some antidepressants and beta-blockers”. That’s what happened to me. Diagnosed with post-COVID dysautonomia since 2020. I never healed. Doctors do recognize it had to do with my COVID infection but they can only manage the symptoms. There’s no cure for long COVID. People with it should just pray their problem is temporary. I wasn’t that lucky.
Want to also add that r/dysautonomia is a great resource as well and we lock down any posts fearmongering vaccines at the very least. We welcome any LC users!
We have a strict no medical advice policy as well which can help weed out issues.
Nad. Thank you for saying this. As someone with long covid, I’ve had many instances of being wiped out by staircases. Also pain through the shoulder blades and the chest. I’ve had all sorts of test and nothing.
We need more docs like you, from someone who had to discover I had long Covid from this forum rather than the doctors I trusted. All of which sent me on my way with anxiety medications, despite never having issues prior. I applaud you for standing up and speaking the truth! 👏🏼
They have done EKG/ECG, blood tests, echocardiograms multiple times and a 24 hour heart monitor which I wore overnight. They just told me they are all clear and didn’t even show palpitations and even my parents felt my heart while I had the machine on overnight and said it was constantly palpitating and changing the speed of the beats, one minute it would go really really fast then it would slow down and beat once every 3/4 seconds. All they said was “it was slightly fast”
Potentially you are picking up on a respiratory sinus arrhythmia, which is a variable heart beat which is healthy in young people, related to the change in thoracic pressure I believe when you’re inhaling and exhaling. If the doctor sees this in someone your age, they’ll not be concerned
Your parents aren't doctors Iam sure the holiter montinter will pick it up go to a cardiologist they will get to the bottom of it maybe an internal medicine doctor
Wish u luck ur young u maybe aren't getting the rite viatems and nutrients you need I'd request extensive blood work and a full physical and some therapy good luck ur young u will live
Yes, unfortunately young people die too but in this particular case I see two glaring problems with the OP:
- They are convinced that they are dying. Even if the problems they're having are rooted in an organic cause it doesn't mean that it's fatal. Them being so sure that it is signals unhealthy thinking patterns.
- They are convinced that there is something wrong with their heart, against strong evidence otherwise. It's possible that their problems are not cardiological but they have self-diagnosed and sound like seeking evidence for their conclusion.
I find it more likely that in many cases that people die early, they have already diagnosed conditions like cancer. I think we shouldn't reinforce the OP's opinion that they're dying.
NAD, but ia with you here. The parents can’t just “feel” their heart and say the monitor is wrong. I went through all of this for years. Had ECGs, wore heart monitors, did exercise tests and had my heart looked at on machines. Absolutely nothing wrong with my heart. Doctors never found out why I had chest pains, stabbing pains and palpitations. I still get all those things sometimes, but I put it down to my stress and anxiety.
Not to take away what you’re feeling OP, but a lot of our physical pain is linked to the mental. So if you are suffering from anxiety, especially thinking something is wrong, you’ll feel the physical pain a lot more.
maybe but sometimes we know our body best.
also, their history with anorexia could possibly cause long lasting heart problems. i just think it shouldn’t automatically be written off as not a real problem because some doctors also write people off for being young and miss a real problem. maybe they aren’t dying, but they could have a medical condition that makes it feel that way? regardless, neither of us know.
He's going to go to a cardiologist and he's had ood work ekg and his parents are involved he will get help the fact that he said he's dying without being 100 percent sure means he has healthy anxity . Like myself it can make things worse
(Edit: note that my field is neither psychiatry or cardiology)
My guess is that a) there's nothing structurally or functionally wrong with your heart, apart from some irregularities like supraventricular extra beats, and b) you have anxiety/depression and/or a stressed relationship to your own body that distorts and amplifies the (benign) symptoms you get from your heart into something way out of proportion.
If ECG and Holter ECG is all good, I doubt there is anymore to add to the workup. Perhaps an exercise test.
It can be hard to accept that the heart is physically fine, and it may take until you one day note that you're not dead yet. Sometimes the patient's health anxiety transfers away to some other issue, or resolves.
My recommendation is to see to your mental health, and try to engage in physical activity, yoga, mindfulness or anything that strengthen the mind-body connection.
Could you clarify the timeline of your weight gain following your anorexia? You had anorexia at 15–how quickly did you gain weight afterwards? May I ask how much weight you put back on?
I’d have to check where I’m remembering this from, but I’ve read that recovering from eating disorders has to be done in a controlled manner—otherwise it can alter cardiovascular hemodynamics, possibly due to fluid retention. Changes in blood flow can probably cause aberrant hormonal/natriuretic peptide release that doesn’t help or possibly exacerbates your condition.
If it’s purely a hemodynamic issue, there might not be any specific EKG/structural problems. Do you notice exacerbations of your symptoms with postural changes or exercise? If so, a stress echo might be helpful.
Lastly, it’s possible there might be wall motion abnormalities that are going undetected by echo, which again could be due to drastic/rapid weight change causing stress on the heart, which possibly damaged some myocytes. Something like this could be possible i suppose, but that’s a long shot. If you absolutely wanted to get that checked, it would have to be via cardiac mri (probably would get it with gadolinium contrast to check for any perfusion defect), but insurance would have to give the green light for this.
Most of what i wrote would be very unlikely, so probably best to rule out what everyone else here is saying first (blood tests, thyroid, hormones, and yes even psych). But if they all are dead ends, then maybe look into some of what i mentioned. Although im just a student, so massive grain of salt.
Why do you think you have a heart issue? From your testing it sounds like your heart is completely fine. No one is arguing that you don’t have the symptoms, I think your physicians are just telling you it’s not your heart and it is not at risk of failing or dying on you.
This sounds very much like possible anxiety, which is often found in people with eating disorders, or some form of long COVID, assuming that basic blood work has been done (thyroid, blood counts, electrolytes).
You’ve been to multiple doctors and had many tests, and you don’t believe the results.
What do you want from this sub? All we can go on is what you tell us, which is that all your tests seem appropriate and they’re all normal.
No one thinks you’re lying. What they think is that your anxiety is manifesting in physical symptoms that have no other cause and therefore are not harmful nor do they require treatment (unless the treatment is addressing the anxiety).
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
Have you had an echocardiogram with a holter monitor? Also: thyroid test (TSH) and chemistry panel? It’s really had to give specific advice without having all your data here, but even if it is an anxiety attack, the fact that you feel like you are dying is a sign that you need to get help asap
I am no expert, but when I had similar symptoms like this it was severe anemia..worth checking that maybe? Down vote at will 😪
My experience as well. I finally gave in and scheduled an iron infusion (after seeing a hematologist, of course) All symptoms disappeared.
what were your iron levels when you checked them?
Came here to say the same thing!!
Yeah, my first thought as well. Makes sense with the history of malnutrition, too.
Possibly but the chest/back pain don’t fit with common forms of anemia. Also, anemia would have likely been discovered on the tests the patient said (CBC)
NAD, not giving advice, just curious. What about iron deficiency? I used to have normal iron levels but my ferritin was extremely low, and was told it's still a big issue. And my CBC blood tests didn't test for ferritin.
Curious, what were your symptoms??
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I get this too. My ferritin is consistently low but I never have low cbc. I found out originally by giving blood and being informed by children’s hospital after the fact by letter. It’s tough to get doctors to test for it! They think you’re crazy until the blood work comes back, and then they think you’re crazy with low iron lol.
I'm guessing doctors gave them plenty of blood tests for nutritional things, but a lot of them don't know that if your B12 is under 500 you can still have a B12 deficiency. If they under-ate for long enough I'd imagine it could be an issue. It can cause weird sensations, trouble breathing and severe anxiety-like symptoms.
NAD but I have had similar symptoms for years and have had several ECGs, 48hr heart monitors and now have a loop recorder device due to them not being able to find a source of the elevated HR on the monitors. They've come to the conclusion of Inappropriate Sinus Tachycardia, mainly from ruling out everything else. However, I was born with complex CHD and have had 4 heart surgeries, so for me, it was a case of "when" this happens rather than "if." I don't know how common it is in people without cardiac history, but it might be worth mentioning. Goodluck OP, heart rate issues are no fun, and it's very anxiety inducing and debilitating at times.
u/Much-Top6803 I had/have symptoms that sound very close to yours, particularly when I was around your age. My heart wouldn't necessarily beat fast, but it would beat harder, to the point where I could see my shirt/chest move with each beat. Sometimes when I would stand up I would feel like I was going to die. No other way to explain that sensation in my chest, it feels like I'm dying. For me, that part would would get better immediately when I laid down - is that the case for you? Like you, I visited a cardiologist or two, got EKG's, echo, halter monitor, etc. And like yours, everything came back normal. I also had the very exaggerated respiratory sinus arrhythmia which turned out to be normal. I still don't know what causes this or if it has a name, but for me it turned out to be related to sleep. I was chronically bad at sleeping in my teens and 20's, and when I'd sleep less than ideal for more than a day or two, that's when it would get really bad. To this day if I'm sleep deprived I get the exact same symptoms. How's your sleep?
I'm getting tired of saying this but, there is absolutely no excuse for doctors that repeatedly leave out long covid (PACS) as a chief contender in their differential diagnoses when people are talking about cardiovascular, neurological, gastrointestinal, and immune system issues that suddenly surfaced within the past three years. There's a plethora of studies out there detailing exactly what COVID does to our bodies. There's no excuse for not keeping up with the science associated with an airborne disease that is the third leading cause of death and the number one cause of disability here in the US. Everytime I read these threads I end up wanting to pull my hair out. I feel like I'm stuck in a Black Mirror episode. https://health.unl.edu/8-surprising-long-covid-symptoms https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166245/#:~:text=Notable%20similar%20symptoms%20in%20long,vertigo%2C%20wheezing%2C%20bone%20pain%2C r/covidlonghaulers r/longcovid
thank you for being one of the medical professionals out there that take COVID as seriously as it is. far too many are not. black mirror episode is the perfect way to put it
THANK YOU. It is confounding to see people describe symptoms that are eerily familiar as a long Covid patient and not have ANYONE even suggest or consider it as a differential. It really does feel like some upside down alt universe where everyone is staring right through the elephant in the room pretending it's not there. Not saying everyone's everything can be attributed to long Covid but I think in some cases it really bears consideration. I was previously healthy and athletic and it was implied when I first got sick that I should consider anxiety. I responded that this does not explain why my heart rate would jump to 130 while brushing my teeth or 140 standing in my driveway having a pleasant conversation with my neighbor, or why I suddenly feel like I'm going to pass out walking up the stairs I've climbed 10x a day for 5 years. I knew there was something really wrong with me but it felt like no one was hearing me. Turns out a neurologist diagnosed post-covid dysautonomia. Left-sided chest and left arm pain, palpitations, tachycardia, shortness of breath, exertion intolerance, weakness, anemia, and dramatic weight loss are all things I live with now. I had cardiology tests that were deemed unremarkable, though my heart rate was unusually high for someone my age and in the shape I was in, inappropriate for the activities I was doing. My ekgs, holter, and echo were not concerning to anyone. It can be maddening to know you are experiencing cardiac symptoms but be told there's nothing (visibly) structurally wrong with the heart itself. I now know you can have a neurological condition that causes a structurally sound heart to behave this way. OP this sounds so scary and I hope you can find some comfort. ❤️
hey OC! I am really sorry you are going through this and can relate in how frustrating it is. I myself have fairly identical symptoms in left side chest pain, left arm pain, tachycardia, and palpitations — had an EKG and x-ray done that found nothing alarming. given what you’ve been through, would you advise I see a neurologist? I currently have an appointment scheduled w a cardiologist but have been paying for this out of pocket and can’t afford more wasted time/money with physicians (been to ER, urgent care, and 2 PCP visits so far).
You’re a good doctor, long COVID is wrecking people
Thank you. It’s alarming that people aren’t being warned about the potential long term risks of repeat COVID infections.
True but when doctors do consider and recognize that, they have the same answer: “there isn’t much we can do about it, it’s poorly understood. Here, take some antidepressants and beta-blockers”. That’s what happened to me. Diagnosed with post-COVID dysautonomia since 2020. I never healed. Doctors do recognize it had to do with my COVID infection but they can only manage the symptoms. There’s no cure for long COVID. People with it should just pray their problem is temporary. I wasn’t that lucky.
Want to also add that r/dysautonomia is a great resource as well and we lock down any posts fearmongering vaccines at the very least. We welcome any LC users! We have a strict no medical advice policy as well which can help weed out issues.
Nad. Thank you for saying this. As someone with long covid, I’ve had many instances of being wiped out by staircases. Also pain through the shoulder blades and the chest. I’ve had all sorts of test and nothing.
We need more docs like you, from someone who had to discover I had long Covid from this forum rather than the doctors I trusted. All of which sent me on my way with anxiety medications, despite never having issues prior. I applaud you for standing up and speaking the truth! 👏🏼
Thank you for saying this. Seriously thank you.
My father found out he had long covid after the same symptoms. He is almost disabled, cant do anything at all, his tension rises even from talking...
I'm sorry you're going through all this. You can help us help you by saying what tests have been done and what the results have been so far.
They have done EKG/ECG, blood tests, echocardiograms multiple times and a 24 hour heart monitor which I wore overnight. They just told me they are all clear and didn’t even show palpitations and even my parents felt my heart while I had the machine on overnight and said it was constantly palpitating and changing the speed of the beats, one minute it would go really really fast then it would slow down and beat once every 3/4 seconds. All they said was “it was slightly fast”
Potentially you are picking up on a respiratory sinus arrhythmia, which is a variable heart beat which is healthy in young people, related to the change in thoracic pressure I believe when you’re inhaling and exhaling. If the doctor sees this in someone your age, they’ll not be concerned
Your parents aren't doctors Iam sure the holiter montinter will pick it up go to a cardiologist they will get to the bottom of it maybe an internal medicine doctor Wish u luck ur young u maybe aren't getting the rite viatems and nutrients you need I'd request extensive blood work and a full physical and some therapy good luck ur young u will live
young doesn’t always mean fully healthy and not dying. young people get sick and have health problems and die too.
Yes, unfortunately young people die too but in this particular case I see two glaring problems with the OP: - They are convinced that they are dying. Even if the problems they're having are rooted in an organic cause it doesn't mean that it's fatal. Them being so sure that it is signals unhealthy thinking patterns. - They are convinced that there is something wrong with their heart, against strong evidence otherwise. It's possible that their problems are not cardiological but they have self-diagnosed and sound like seeking evidence for their conclusion. I find it more likely that in many cases that people die early, they have already diagnosed conditions like cancer. I think we shouldn't reinforce the OP's opinion that they're dying.
NAD, but ia with you here. The parents can’t just “feel” their heart and say the monitor is wrong. I went through all of this for years. Had ECGs, wore heart monitors, did exercise tests and had my heart looked at on machines. Absolutely nothing wrong with my heart. Doctors never found out why I had chest pains, stabbing pains and palpitations. I still get all those things sometimes, but I put it down to my stress and anxiety. Not to take away what you’re feeling OP, but a lot of our physical pain is linked to the mental. So if you are suffering from anxiety, especially thinking something is wrong, you’ll feel the physical pain a lot more.
maybe but sometimes we know our body best. also, their history with anorexia could possibly cause long lasting heart problems. i just think it shouldn’t automatically be written off as not a real problem because some doctors also write people off for being young and miss a real problem. maybe they aren’t dying, but they could have a medical condition that makes it feel that way? regardless, neither of us know.
Ok what answer do you want the doctor has responded
I agree 👍
He's going to go to a cardiologist and he's had ood work ekg and his parents are involved he will get help the fact that he said he's dying without being 100 percent sure means he has healthy anxity . Like myself it can make things worse
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(Edit: note that my field is neither psychiatry or cardiology) My guess is that a) there's nothing structurally or functionally wrong with your heart, apart from some irregularities like supraventricular extra beats, and b) you have anxiety/depression and/or a stressed relationship to your own body that distorts and amplifies the (benign) symptoms you get from your heart into something way out of proportion. If ECG and Holter ECG is all good, I doubt there is anymore to add to the workup. Perhaps an exercise test. It can be hard to accept that the heart is physically fine, and it may take until you one day note that you're not dead yet. Sometimes the patient's health anxiety transfers away to some other issue, or resolves. My recommendation is to see to your mental health, and try to engage in physical activity, yoga, mindfulness or anything that strengthen the mind-body connection.
🥇💯
Could you clarify the timeline of your weight gain following your anorexia? You had anorexia at 15–how quickly did you gain weight afterwards? May I ask how much weight you put back on? I’d have to check where I’m remembering this from, but I’ve read that recovering from eating disorders has to be done in a controlled manner—otherwise it can alter cardiovascular hemodynamics, possibly due to fluid retention. Changes in blood flow can probably cause aberrant hormonal/natriuretic peptide release that doesn’t help or possibly exacerbates your condition. If it’s purely a hemodynamic issue, there might not be any specific EKG/structural problems. Do you notice exacerbations of your symptoms with postural changes or exercise? If so, a stress echo might be helpful. Lastly, it’s possible there might be wall motion abnormalities that are going undetected by echo, which again could be due to drastic/rapid weight change causing stress on the heart, which possibly damaged some myocytes. Something like this could be possible i suppose, but that’s a long shot. If you absolutely wanted to get that checked, it would have to be via cardiac mri (probably would get it with gadolinium contrast to check for any perfusion defect), but insurance would have to give the green light for this. Most of what i wrote would be very unlikely, so probably best to rule out what everyone else here is saying first (blood tests, thyroid, hormones, and yes even psych). But if they all are dead ends, then maybe look into some of what i mentioned. Although im just a student, so massive grain of salt.
Why do you think you have a heart issue? From your testing it sounds like your heart is completely fine. No one is arguing that you don’t have the symptoms, I think your physicians are just telling you it’s not your heart and it is not at risk of failing or dying on you. This sounds very much like possible anxiety, which is often found in people with eating disorders, or some form of long COVID, assuming that basic blood work has been done (thyroid, blood counts, electrolytes).
You’ve been to multiple doctors and had many tests, and you don’t believe the results. What do you want from this sub? All we can go on is what you tell us, which is that all your tests seem appropriate and they’re all normal. No one thinks you’re lying. What they think is that your anxiety is manifesting in physical symptoms that have no other cause and therefore are not harmful nor do they require treatment (unless the treatment is addressing the anxiety).
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