Heart Palpitations

Palpitations are often benign but deserve evaluation. We look at autonomic balance, minerals, thyroid, blood sugar, hormones, histamine, sleep apnea, and stimulants that irritate the heart.

What you may be noticing

A flutter, a thud, a skipped beat, or a run of racing beats that seems to come out of nowhere. Sometimes it happens lying down at night, after a meal, with stress, or around your period. It can be frightening, especially when it disrupts sleep.

Palpitations with chest pain, fainting, severe shortness of breath, or a sustained very fast heart rate need emergency care. All new palpitations deserve evaluation by your physician, including an ECG and often a heart monitor.

Why it is rarely one thing

Most palpitations come from extra beats that are common and usually harmless in a healthy heart. The useful question is why your heart has become more excitable now.

The heart listens constantly to the nervous system. I picture the autonomic system as a teeter-totter: the sympathetic side speeds the heart, and the vagus nerve slows and steadies it. Resilience is the capacity to shift smoothly between them. When the system is held in sympathetic overdrive by stress, poor sleep, blood sugar swings, or sleep apnea, the heart receives a steady stream of activating signals.

Chemistry matters as much as wiring. Low magnesium or potassium makes heart cells more excitable. Excess thyroid hormone speeds the heart. Blood sugar drops release adrenaline. Perimenopause shifts estrogen and progesterone, which influence rhythm and autonomic tone. Histamine released by mast cells can raise heart rate, which is why palpitations sometimes travel with flushing, hives, or reactions to foods and environments, including mold exposure. Caffeine, alcohol, nicotine, decongestants, and some supplements irritate the heart, and reflux can provoke beats after meals.

Patterns we look for

• Autonomic balance, heart rate variability, and heart rate response to standing.
• Magnesium and potassium status, including intracellular magnesium.
• Thyroid function.
• Blood sugar stability.
• Sex hormone changes, especially perimenopause.
• Iron deficiency and anemia.
• Histamine and mast cell patterns, and environmental exposures such as mold.
• Sleep apnea and breathing pattern.
• Stimulants: caffeine, alcohol, nicotine, energy drinks, and decongestants.
• Reflux, stress physiology, and cortisol rhythm.

How I evaluate it

I coordinate cardiac evaluation with your physician first. The comprehensive functional neurological exam measures autonomic responses, including heart rate and blood pressure from lying to standing, vagal reflexes, and breathing mechanics. Heart rate variability gives us a window into autonomic flexibility.

Functional labs may include a comprehensive metabolic panel with potassium, red blood cell magnesium, a full thyroid panel, ferritin and a complete blood count, fasting glucose and insulin, sex hormones where relevant, a cortisol rhythm, and histamine-related markers when the pattern suggests mast cell involvement.

How we address it

• Rule out structural heart disease and significant arrhythmias with your physician.
• Remove triggers: excess caffeine, alcohol, nicotine, and stimulating supplements.
• Rebalance minerals, especially magnesium and potassium, through food and guided support.
• Stabilize blood sugar, and address thyroid, hormone, and histamine patterns.
• Calm before you activate: slow nasal breathing with a long exhale, humming, and brain and heart coherence practice to build vagal tone.
• Address reflux, sleep apnea, and stress patterns that provoke symptoms.
• If you have a known rhythm condition or a device, breath-holding drills and heat therapy are used only with your cardiologist in agreement.

A simple log of when palpitations occur, along with meals, sleep, caffeine, and cycle day, often reveals the pattern quickly. Most people feel deep relief once serious causes are ruled out, and that relief itself calms the nervous system.

A calmer heart often follows a calmer, better-nourished nervous system.

Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.