If it happens at the beginning of a meal, i'd be thinking about food allergy/sensitivity or histamine intolerance, and i'd be trying to track trigger foods.

Also sounds like an adrenaline surge.

I would not let a GP or Pdoc anywhere near such thorny, complex issues. I'd go straight to a functional medicine doc, get to the bottom of things. GPs and Pdocs seemingly will just add a new drug for every symptom, creating increasingly convoluted polypharmacy and side effects that cannot easily be traced.