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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 32561
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Hi, Im being treated with iron supplements for low iron stores

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Hi, I'm being treated with iron supplements for low iron stores (current ferritin level 18, up from 6), and was recently diagnosed with low progesterone. I am working to manage the crazy anxiety that comes with perimenopause, however, my anxiety from 4 am to 8 am is nearly unbearable. I've also noticed that my hypoglycemia is running rampant! Could this be the crazy trembling and anxious feelings I'm getting at 4 am? Any suggestions would be appreciated; however, I am not interested in medications. Thank you!

Greetings Kim.

Perimenopause can be associated with the anxiety. It is a complex interplay of the hormones, which body and mind are trying to adjust. If your thyroid hormone were not done; these may be considered to ascertain the cause of your manifestations. Hypoglycemia can be responsible for anxiety experienced at 4 AM to 8 AM. You may get a blood sugar by the home glucometer. Meanwhile following would be able to help you in the anxiety management;

1) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT); done by a psychologist.

2) Relaxation training and biofeedback.

3) Hypnosis

4) Acupuncture and acupressure

5) Yoga

6) Meditation

7) Group sporting activities

8) St. John's wort

9) Melatonin
10) Valerian root


Following herbs may help in perimenopause symptoms;


1) Evening primrose oil

2) St. John's wort

3) South Pacific herb kava; this has sedative action as well anxiety reduction property.


Following dietary measures help in low iron;


1) Cream of Wheat

2) Prune juice

3) Spinach

4) All-Bran cereal

5) Almonds

6) Dried beans and peas

7) Liver, chicken

8) Kidney, beef

9) Liver, calf

10) Liver, beef


Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.


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Customer: replied 4 years ago.

My thyroid studies were all normal. It just seems odd to wake up every morning at 4 am, no matter what time I go to sleep. I've even tried eating greek yogurt before I go to bed to see if that will help. thank you

You are welcome, Kim.

Apart from the hypoglycemia (or progesterone playing some role in anxiety between these early morning hours), you may be looked for acid reflux (gastroesophageal reflux disease / GERD), which may be occasionally concomitant and may aggravate the anxiety. Following may help;

1) antacids; Maalox

2) acid blocker; Prilosec

3) loosing weight, if overweight.

4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products

5) avoiding large meals. Eat 5 small meals in a day.

6) wait three hours after the meal before you sleep.

7) elevate head end of the bed by 8 inches.

For acid reflux (GERD), following also would be helpful;

A. Herbs;

1) Cranberry
2) Peppermint

B. Homeopathy

1) Nux Vomica
2) Pulsatilla

C. Nutrition and supplements;

1) Multivitamin; vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
2) Probiotic supplement
3) Omega 3 fatty acid
4) Avoid; cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.5) Also avoid; white breads, pastas, and especially sugar, red meats,
6) Eat lean meats, cold water fish, tofu, beans, olive oil.

It is privilege assisting you.
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