Experiencing Ongoing Palpitations and Dizziness After Rybelsus Discontinuation – Seeking Guidance
As a male in my forties, I have long dealt with infrequent palpitations for the past twenty years. However, my circumstances took a turn for the worse following my use of Rybelsus (oral semaglutide) and the subsequent decision to stop taking it. Here’s an overview of my situation: **History (2015–2023):** - I experienced sporadic palpitations accompanied by a sensation of fluttering in my upper abdomen. - I underwent numerous cardiac evaluations, including an MRI, stress echocardiogram, treadmill testing, and numerous echocardiograms, all of which returned normal results aside from a mild, stable thickening of the septum (13 mm) for nearly a decade. - I never encountered chest pain, experienced fainting episodes, nor did I have limitations in physical activity. **Current Challenges (2024 onwards, after stopping Rybelsus around four months ago):** - New and persistent symptoms have emerged, such as: - Dizziness and a sensation of imbalance, particularly when at rest or after periods of fasting. - Brief episodes of palpitations (lasting between 2–10 seconds), accompanied by a feeling of my heart “leaping” into my throat or ears. - Sudden blurred vision coinciding with the onset of palpitations. - A continuous sense of internal tension, clenching of the jaw, headaches, and reduced libido. - Heightened irritability coupled with the feeling that my body is persistently in a state of fight-or-flight. - I have noticed some improvement in symptoms while taking mirtazapine at night, although they persistently return. - Metoprolol and candesartan at low doses provide minimal relief while increasing my fatigue. - Almost any medication impacting the nervous system seems to modify my symptoms either positively or negatively. **Medical Evaluation to Date:** - Recent tests, including a cardiac MRI, stress echocardiograms, and echocardiograms, have shown structural normality. - Normal systolic functioning, no signs of ischemia, and no significant valvular issues were detected. - My blood pressure is currently between approximately 122/70 and 135/80 while on minimal medication. - I am currently undergoing monitoring with a Holter monitor; routine EKGs indicate only nonspecific ST-T changes. - Healthcare professionals have indicated that there’s nothing alarming, halting further investigation and advising me to simply "relax." My quality of life is deteriorating; work performance, my relationships, and mental well-being are all getting impacted as I consistently feel as if my body is in an alarming state. I would greatly appreciate any advice or insight, as words cannot convey how much it means to me.
Answers (1)
7/31/2025, 5:02:04 PM
OpenHealth AI
It sounds like you're experiencing significant distress due to ongoing palpitations, dizziness, and other symptoms following the discontinuation of Rybelsus. It’s understandable that this is impacting your quality of life, especially given your history and the normal results from multiple cardiac evaluations. Let's focus on actionable steps that may help alleviate your symptoms and improve your overall well-being.
Key Points:
- Palpitations and Dizziness: These symptoms can be distressing, and although cardiac evaluations are normal, they can have non-cardiac origins.
- Potential Anxiety and Stress Reactions: The combination of your symptoms and your experiences suggests a possible connection to anxiety or stress responses, particularly since you've noted that medications affecting the nervous system change your symptoms.
- Emphasis on Self-Care and Management: Implementing coping strategies and lifestyle changes may help you regain control and improve your quality of life.
Explanation:
Your experiences may be influenced by heightened stress responses, which can affect how your body perceives and reacts to sensations like heart palpitations or dizziness. Stress can amplify feelings of anxiety and uncertainty, making these sensations feel more pronounced and distressing. Given that your medical evaluations have been clear, focusing on self-management techniques might be most beneficial.
Actionable Next Steps:
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Practice Deep Breathing and Relaxation Techniques:
- Try structured exercises such as diaphragmatic breathing, progressive muscle relaxation, or mindfulness meditation. Start with 5-10 minutes daily and gradually increase as you feel comfortable. These practices can help reduce the body's stress response and improve your sense of calm.
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Monitor Dietary Habits:
- Since you experience symptoms after periods of fasting, consider sustained, balanced meals throughout the day to maintain blood sugar levels. Small, frequent snacks that include protein and healthy fats can be beneficial.
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Physical Activity:
- Engaging in regular, gentle exercise (like walking or yoga) can help reduce symptoms of anxiety and improve overall physical and mental health. Aim for at least 30 minutes most days, if feasible.
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Maintain a Symptom Diary:
- Keep track of your symptoms, triggers, and any fluctuations in intensity. This information can help identify patterns and find connections to specific activities or stressors.
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Consider Professional Support:
- Since you are experiencing significant emotional and mental stress, talking to a therapist or counselor who specializes in anxiety or stress management could provide strategies tailored to your experiences. Cognitive Behavioral Therapy (CBT) has been shown to be effective for anxiety-related symptoms.
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Stay Engaged with Your Healthcare Team:
- Continue monitoring your symptoms and follow up with your healthcare professionals, especially if new symptoms arise or existing ones worsen. Keeping an open line of communication about your experiences can help ensure you receive appropriate support.
Conclusion:
You're not alone in feeling overwhelmed by these symptoms, and it's commendable that you're seeking advice to help manage your situation. Implementing self-care strategies can significantly improve how you feel day-to-day. Remember to take things one step at a time and prioritize your mental well-being along this journey. If you need further information about specific techniques or feel your symptoms are significantly affecting your daily life, let me know, and I can provide more tailored suggestions.
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