Q I have run for 25 years but recently I have begun to feel jittery and anxious about 30 minutes after a run. The feeling lasts for a few hours. My GP and cardiologist can't explain my symptoms. Are there other tests I might try?
A One possible cause is a pheochromocytoma - a rare tumour that develops in the core of one of the two adrenal glands. Pheochromocytomas can cause excessive secretion of the hormones adrenaline and noradrenaline, either continuously or in shorter bursts, and physical activities like running may trigger such attacks. The release of these hormones typically leads to feelings and physical symptoms of anxiety.
Tests used to determine whether a pheochromocytoma is present include blood and specialised urine tests to look for raised levels of these hormones or their breakdown products. A computerised tomography (CT) scan of the abdomen can detect the tumour in most cases.
If you do not have this problem, have a 24-hour heart rhythm monitor fitted to see if you are experiencing any cardiac arrhythmias after your run. Meanwhile, continue to stay active.
—Dr Roger Henderson, GP and marathon runner
