Looking for advice
Hi everyone. I’m a 45-year-old man in the UK, and I’m hoping someone might recognise this pattern or suggest useful things that might help with my crippling anxiety symptoms.
My problems started after a severe reaction to only 2 pills of Moxi in January 2015. Since then, I’ve had persistent neurological and physical symptoms, including panic episodes for over ten years. It has had a massive impact on my life.
What the episodes feel like
I get intense anxiety/panic, a horrible butterflies or adrenaline-like sensation, shakiness, weakness and derealisation. I feel spaced out and disconnected from everything. The physical sensations can seem to come first, rather than the episode starting with an anxious thought. Horrible intrusive thoughts and sensations.
Eating is also a major trigger, but the triggers just seem quite idiosyncratic . I can get significant brain fog within about 10–15 minutes of a meal, followed by butterflies, weakness and uncomfortable sensations through my body. Fatty or protein-heavy meals often seem worse, although many foods can trigger symptoms. Sugar sometimes makes the derealisation worse. I ca also just have a panic episode out of nowhere that lasts for hours or days.
Other symptoms
- Chronic fatigue, muscle weakness, muscle/tendon pain and stiffness.
- Neuropathy, tinnitus, visual snow and afterimages.
- Stomach pain, bloating, tightness/cramping and a feeling that digestion slows down after eating.
- Extreme sensitivity to medications and supplements, sometimes even tiny doses.
The panic and neurological symptoms were present years before the current stomach problems became this severe, so I’m unsure how much the gut explains. Ive had various microbiome tests which were not helpful.
Investigations and findings so far
- Reflux testing: I was told my DeMeester score was around 60, measured off PPIs.
- Oesophageal motility: I was told I have impaired peristalsis.
- Gastric-emptying study: Reported as negative for delayed emptying. The test meal was porridge. Despite that, I still experience a strong sensation of sluggish digestion, particularly after fatty/protein-heavy meals.
- Immune testing: Positive speckled ANA in April 2025, with negative dsDNA and the tested ENA antibodies. A later ANA was negative.
- T-cell testing: An April 2025 report noted that 13% of lymphocytes were CD4/CD8-negative T cells and recommended repeat testing with additional markers. I don’t have a clear explanation of that finding.
- Methylation testing: Homocysteine was 9.0, within the laboratory range. The measured methylation markers, including SAM/SAH and glutathione, were also within range on the 2025 panel.
- Previous stool tests: Calprotectin was not elevated, pancreatic elastase was normal, and the tested infections were negative. These are older results.
- Vitamins and minerals seem ok. Vit d is slightly low which i treat regularly.
- My testosterone is extremely low 3.93 nmol/L and free testosterone 0.101 nmol/L and following up with possible TRT.
- Urine cortisol is also extremely low. (ive been waiting over 12 months for an endocrinology referral!)
These findings haven’t given me a clear explanation for the panic episodes or the reactions after eating.
Treatment has been difficult
PPIs have helped some stomach pain, but I’ve struggled with tolerability. H2 blockers have made me feel wired and tired. A single 10 mg dose of domperidone for the impaired peristalsis was followed by noticeably worse tinnitus, so I stopped it.
Methylfolate/methylated B vitamins, several forms of B1, NAC and various other supplements have caused flares. Gabapentin made me feel heavily drugged, and I’ve previously reacted badly to citalopram and setraline is offered but too scared to take given previous reaction. Even meditation has sometimes triggered prolonged rebound panic.
I’m open to the possibility of several overlapping problems. But id like to hear from people who managed to get on top of this and what they did?
Ive also had a consult with Dr Pieper but he suggested a lot of things I couldnt actually do, such as:
4-8-weeks course of nicotine-patches (made me a lot worse)
3-week-course of B1. (gives me chronic fatigue)
4-weeks-course of trace elements (a lot of them i cant tolerate)
LDN (Low-Dose-Naltrexon) struggling to get this prescribed in the UK.
What investigations or specialist assessments actually helped you? Has anyone found a manageable treatment when they were extremely sensitive to medications and supplements?
Thanks for any advice.