<s>[INST] I am a pretty healthy 52yr old wondering if I am having a strange medication reaction. I take metoprolol 25mg for pac/pvc which are controlled. I take protonix for duodenitis/reflux (and probably caused by nsaid use for headaches which I am off of to heal that). I take progeterone orally. Bioidentical hormone therapy pellet implants of estrogen and testosterone. I recently started spironalactone for mild side effects from the testosterone. Finally, I am on my second 40 day diet plan using 18.5mg phentramine and hcg with b12/multivit injection weekly. I feel great during day but at night I am awakened by strange restlessness of shoulders and upper back and sinking feeling in chest th at is increasing in freq and intensity. help. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Check for nocturnal asthma or allergy or gastroesophageal reflux disease with laryngopharyngeal reflux etc. Until examination is done it is difficult to say what it is. It may side effects to hormone replacement or fluid retention etc. Please consult your doctor, he will examine and treat you accordingly. Take care. </s>