I’m a 20 year old male enrolled in school, with no real prior medical history besides a couple visits for cardiovascular concerns of high blood pressure that were generally attributed to anxiety. Since the age of sixteen, I have experimented quite heavily with numerous substances, primarily including: all variants of psychedelics (several times a year), MDMA (several times a year), cocaine (sporadically), amphetamines/modafinil (monthly), marijuana (sporadic periods of daily or weekly but generally ubiquitous), and nootropics (such as racetams). I would never consider the use severe, as I placed high emphasis on self-monitoring, but I nevertheless have experienced many adverse effects I would attribute to this use. Before going into detail on these, it is important to note I am consulting because I believe I have been progressively developing symptoms not directly caused by such use. Hypochondria has no doubt stemmed out of desire to monitor any appearing deficits and be as ‘responsible’ as one can while being making risky substance decisions.
Ever since experimentation with these substances, I have had the expected effects of fatigue, general depersonalization and cognitive effects such as impaired memory and focus. Exercise, diet, supplementation and meditation have all been implemented variously to alleviate these symptoms, with success. The last few months however I have noticed an acute shift in these symptoms, and the addition of more. Perhaps any of these symptoms taken individually I could attribute as nothing to worry about, but taken altogether I have become concerned.

1) Focus and memory impaired. Seems to be a general rather than specific memory deficit. Heavily exacerbated with alcohol use, most nights of drinking involve brown/blacking out despite associated deficits like total coordination loss. Can seem to be rather lucid but will have no recollection, far worse memory than compared to others who will drink similar quantities.
2) Difficulty thinking/brain fog. Perhaps the most prominent symptom, while most of the day can go by with no problems, it is the acute periods that cause concern. Periods of total blank mind and ‘empty head’ feeling accompanied by extreme difficulty with verbal articulation or even determining what to do. Sometimes manifests as concerning ‘thought glitches’ in which random thoughts and images surface that feel like a regurgitated patchwork of thoughts, sometimes involving looping thoughts or words.
3) Anxiety. As I have been considered a social person, this too has been easily prominent as it seems spontaneous and severe in past few months. Seemingly spontaneous anxiety involving any group social situation, making it difficult to do or say much of anything. A couple weeks were so bad merely having attention put on me would result in full flushing (not blushing) of neck, chest, face bright red. sweating, pounding heart. This elicited a feedback loop of being more anxious out of worry it would happen, and then even flushing at the thought of it happening. Has since subsided but was particularly concerning.
4) ‘Brain’ observations. Occasional periods of odd brain sensations involving pressure, hyperawareness of pulsations in various parts, or a slight burning irritation. Not reminiscent of any type of headache, and usually accompanies the more acute brain fogs.
5) Cardiovascular. As related to anxiety, periods of 100+bpm resting heart rate, occasional palpitations, feeling of ‘working hard’ and feeling pulse throughout much of body.
6) Motor. Recently developed tremors noticeable in fingers, hands, jaw and thighs. Exacerbated by caffeine. Motor coordination sometimes past what would be called clumsy, additional level of thought is needed for involved movements, hand eye coordination etc. Previously very high level of dexterity now diminished with deficits in writing and typing. Sporadic, very acute RLS.
7) Gastrointestinal. Seemingly always active GI system, bloating tied to periods of cognitive difficulty and fatigue.
8) Visual. Recently developed blurriness that (odd as it sounds) is worth noting because it seems only occasional, only when present with other symptoms. I admit this seems laughably trivial as someone concerned about losing 20/20 vision.

Again, I’m aware much of this sounds like a hypochondriac delusion, and according to your website some anxiety can cause such hypersensitivity to the body. Nonetheless as with any delusion, this doesn’t make it any less real, and these symptoms have begun to worry me mainly when taken all at once - as a couple times throughout the week I will be: at a complete loss for words or thoughts, with hands slightly shaking, dexterity impaired, a pressure in my head, and general depersonalization that has me asking myself how much better I used to be able to think and different I feel from ‘myself’.
Further, a ketogenic diet, various supplements (amino acids, fatty acids, b-complexes, herbals, racetams, etc), exercise, and meditation all help. It is only in these times of lows that I wonder how all of these things should be necessary to only feel closer to a baseline person. Please let me know any advice or recommendations you have, or if you think any additional information would be helpful. There are times I feel I won’t be able to rest easy until I see an MRI to rule out anything sever underlying such as a tumor, multiple sclerosis, etc.