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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18451
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am a male aged 35 who trains a lot and is fit. I suffer

Resolved Question:

Hi I am a male aged 35 who trains a lot and is fit. I suffer from health anxiety and was diagnosed by a neurologist with benign fasculation syndrome 2 years ago because of muscle twitching. Because of my health anxiety I did a lot of reading regarding
ALS/MND which has remained in my memory. For the last three weeks I have had a need to clear my throat. My throat feels irritated and sometimes dry. My speech isn't slurred and I can eat ok and swallow liquids fine and gargle water ok. I have my gag reflex
and can blow out my cheeks move my tongue about and press my tongue against my cheeks. I am worried this constant throat clearing could be the start of bulbar als due to information I read 2 years ago and I am scared to google. Basically Im asking with my
age and the symptoms I am showing is there anyway this could be bulbar als. Also I think the throat clearing has partly become a habit as I am always thinking about it. the throat clearing doesn't happen in bed or affect my sleeping and it isn't all the time.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
As a general rule, doctors never like to say “never”, and asking if there is anyway this could be bulbar ALS would require that a negative response would be another way of saying “never”.
However, a fairer question would be whether there is any reasonable concern that this is from bulbar ALS, and the answer to that question is no. The most common early symptoms from bulbar ALS are loss of speech or difficulty swallowing. And while difficulty swallowing is frequently associated with food, liquids, or saliva going down the wrong tube and causing the need to clear the throat, it is unusual for bulbar ALS to present with a frequent need to clear the throat as the sole symptom.
On the other hand, a need to clear the throat associated with irritation and dryness of the throat is common from other medical problems. It is most often related to allergies or other conditions that cause inflammation of the upper airways. It also can be related to acid reflux causing irritation because of the acidity of the stomach contents.
It is also true that once it starts from a medical condition, it can be perpetuated as a nervous habit, and this may persist long after the original cause of the symptom has resolved.
At this point, it would be appropriate to focus on these conditions, rather than being concerned about bulbar ALS.
If I can provide any additional information, please let me know.
Customer: replied 1 year ago.
I had a chest infection which cleared up two weeks ago and I noticed at the gym last night that some acid came up after doing situps and a I have been sneezing a few times a day with my nose blocked sometimes. However if this was something like bulbar surely it would affect me sleeping and would be all the time, as you say my food goes down normally. Also watching a film the other day with my son I didn't notice it all. I suppose putting these all together I am being ridiculous and letting my anxiety get the better of me ?
Customer: replied 1 year ago.
Also is bulbar als for a male aged 35 rare ?
Expert:  Dr. D. Love replied 1 year ago.
If you are having other symptoms suggesting acid reflux, then that would increase the likelihood that these symptoms are also due to acid reflux.
If it were bulbar ALS, the weakness would typically be more consistent, but since people are not swallowing all the time, the difficulty swallowing and the irritation from solids or liquids going in the wrong tube may be noticed intermittently.
Yes, bulbar ALS is rare in a 35 year old, and the average age at diagnosis for any non-familial type of ALS is at age 65, but it has been reported in individuals as young as the teenage years.
Customer: replied 1 year ago.
Many Thanks, ***** ***** to worry about then ?
Expert:  Dr. D. Love replied 1 year ago.
Correct. There is no reason for you to be worried.
Customer: replied 1 year ago.
Also can stress create these symptoms, such as lump feeling in throat and tense throat muscles resulting in feeling like you need to clear your throat. I have had 16 different physical symptoms that where all anxiety/stress and went away when I started worrying about something else. Just wondering is the stress/anxiety a big factor to play in this aswell. Do you think I am being crazy over the bulbar fear, if you think so please say so I can see some common sense.
Expert:  Dr. D. Love replied 1 year ago.
A lump sensation in the throat is one of the more common anxiety symptoms, sometimes called globus. Overall, allergies and reflux are more common causes of a need to clear the throat, but it also can be due to anxiety.
Of course, “crazy” is not a medical term. However, using the laypersons’ use of the term, it is not crazy to ask a question that is bothering you, but if you continue to fixate on a health concern after reassurance that there is no reason for worry, then it may get to a level of being crazy, depending upon how much you fixate on the concern.
Customer: replied 1 year ago.
Well answered, I will try to forget about this because there is no doubt if you constantly think about throat clearing then you will more than likely want to clear your throat. I suppose it is like when I am at the dentist and you have to keep your mouth open. Normally you don't think about swallowing but sitting in the dentist chair I start thinking about it because your trying not to do it because you have your mouth open and then for me its all I can think about.
Expert:  Dr. D. Love replied 1 year ago.
Yes, once the mind has started to focus on a nervous habit, trying to think about stopping the habit can be counterproductive. It is usually more effective to try to ignore the issue, which may be helped by distraction with other activities, although you obviously cannot be at the movies 24/7.
Customer: replied 1 year ago.
Yes I was thinking the more I clear my throat which by the way doesn't really produce any saliva or mucus the more irritated I will make my throat and so the cycle continues. Have a nice day and thanks for putting my mind at ease.
Expert:  Dr. D. Love replied 1 year ago.
You are most welcome.
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