All About Low Blood Sugar Issues

[sue1234]

I know a few people have been talking about blood sugar issues lately, so I thought I would start a thread about it to see how many people have issues with it.

I have a HUGE issue with blood sugar. I have had "reactive" hypoglycemia for probably 20 years. I lived with it just fine by being sure I didn't skip a meal. About 5 years ago I had to make sure I ate about every 3 hours. Last year everything got soooo much worse. I was having blood sugar drops every 2 1/2 hours during the day. I bought a glucose meter and was shocked to find that when I had symptoms, my glucose was already in the upper 50s. I have been as low as 40. My typical symptoms that I've had for the last few years are shaking hands first, then anxiety, palpitations, and a heat surge. Then comes the confusion and irritability.

I had an OGTT done two years ago and these were my results:

time glucose insulin

fast 92 8.8

30 min. 167 40

60 min. 194 97

2 hr. 149 185

3 hr. 57 34

I have been investigaed this year for an insulinoma, but so far no positive result. I feel like I put out too much insulin, and have to eat every 1 1/2 now.

During the above thest, I had horrible symptoms at 3 1/2 hours and they didn't test, but gave me orange juice. I wish they would have done the labs, as I am sure I was in the 40s.

I'd like to hear with anyone's issues with hypoglycemia and any labs you have. I am sure having alot of hypos is not helping my autonomic issues at all!

I would like to add that I have lost 20 lbs. this year, and my fasting blood sugar is now between 75-80, so good there. But, I still put out the high insulin, as evidenced by my continuous hypo episodes.

[Dizzysillyak]

Hi Sue,

I'm pooped right now but before I forget, here are my results and a few comments from people I trust at GFAB ... My insulin wasn't tested until this year but I had GTTs in 2006 and 2008.

http://www.glutenfreeandbeyond.org/forum/v...&highlight=

HTH ... Marcia

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My GTT + insulin May 2010 --- I felt a little nauseas and sleepy starting at the 1/2 mark and a little whiney at the 2 hours mark but I never felt shakey or weak.

fasting 86 insulin = < 2

1 hr glucose = 113 insulin = 81

2 hr glucose = 61 insulin = 29 (My doc said that my high insulin was causing this low BGL)

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In 5/2008 - My fasting BGL was 83, 1hr = 182, 2hr = 89 and 3hr = 78

I wasn't surprised it was normal because other than feeling a little nauseas after drinking the glucose and extremely sleepy either after the 1 hr or 2 hr draw, I felt great. I could think and I never got shakey or weak.

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In 2006, my fasting was 83, 1hr = 162, 2hr = 105 and 3hr = 65

Despite a fasting glucose of 83 here, I almost passed out while waiting for the fasting draw and after I drank the glucose my head was so fuzzy, I couldn't think at all. I was also jittery / super chatty .... not good for the other patrons ...

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My doctor's instructions are to stick with the Paleo / low carb diet and if I'm going to eat anything sweet, eat just a little and eat some protein with it. Overall it looks better this year than it did in 2008.

[dianne.fraser]

Sue

I do poorly on carbohydrates - I'm much, much more fatigued on bread, pasta or rice. If I really need to stay awake in the afternoon, I avoid eating any of these things at lunchtime. I've been checked for diabetes at least annually for years, and I've also been tested for pre-diabetes - all results have been normal. I no longer agree to glucose tolerance tests - 3-4 hours after my last one, my feet seemed to freeze and, when they thawed and I got feeling back, some of my toes ached for days. I was also much more fatigued for days afterwards.

I had never heard of reactive hypoglycaemia before I found this Forum - next time I see my doctor I'll talk to her about whether that might be my problem.

With best wishes

Dianne

[juliegee]

Me too. My labs are similar to yours, but I start at a lower number after drinking the sugar shake, 140. I got down to 50 after 3 hours. My home meter reads "low" frequently.

I do well with lots of protein and complex carbs, like whole wheat bread or pasta, and veg- NO fruit or anything sweet. It causes too big a swing for me. I can go 3 hours on this diet between food. I have to limit caffeine & alcohol.

Your weight loss and limited time between meals is troublesome. I hope your thyroid has been thoroughly investigated. You seem hyper to me.

Hope you figure it out-

Julie

[sue1234]

I had practically given up "white" foods, except still eat some potatoes.

I have lost 20 lbs. by choice--after my 3 day fast in the hospital I cut down on the amount of food I ate, and got rid of the white foods. I still don't eat any bread, except for occasional gluten-free bread. I also don't eat fruit because of the sugar.

I'm not hyperthryoid, as I have no thyroid, and since losing the weight, have lowered my thyroid meds. I have been hyper before my thryoid was removed and I am not feeling any of that(fast resting pulse). I guess I need to be clear that the shaking hands and other symptoms come on when my sugar drops, and that cluster of symptoms go away when I get my levels back up within 15-30 minutes. It is directly related to my hypo when it is happening.

I know doctors can say 'oh, it's just insulin resistance, the precursor to diabetes". I have NO diabetes in my family history at all, and initially when my hypos started, I weighed 120. I am now 150 20 years later, and still fighting hypoglycemia. I am still working on losing more weight.

I would be curious how many more of us are so sensitive to carbs.

Julie, you didn't have your insulin levels drawn during your test?

[issie]

Has anyone tried iodine? I've been reading up on it. I guess it is supposed to help thyroid issues and the balance between the thyroid-hypothlymus-adrenals. I think the adrenals have allot to do with the bood sugar drops, in my case. I've had times when I would nearly faint from the BS swings. I've had high BS at times too. My doctor had me start taking GTF (glucose tolerance factor) Chromium. It has totally leveled out by BS and I don't have much of an issue with the swings any more. I used to wake myself up at night with the BS drops. I sleep through the night now. And my BS is normal in the mornings.

[toddm1960]

I have this same hypoglyemic feeling after very little activity, I think I to need to look into a GTT also. When you think about what's going on with us low blood volume and our endocrine system all over the map, it's no wonder we have low blood sugar issues.

[juliegee]

I had practically given up "white" foods, except still eat some potatoes.

I have lost 20 lbs. by choice--after my 3 day fast in the hospital I cut down on the amount of food I ate, and got rid of the white foods. I still don't eat any bread, except for occasional gluten-free bread. I also don't eat fruit because of the sugar.

I'm not hyperthryoid, as I have no thyroid, and since losing the weight, have lowered my thyroid meds. I have been hyper before my thryoid was removed and I am not feeling any of that(fast resting pulse). I guess I need to be clear that the shaking hands and other symptoms come on when my sugar drops, and that cluster of symptoms go away when I get my levels back up within 15-30 minutes. It is directly related to my hypo when it is happening.

I know doctors can say 'oh, it's just insulin resistance, the precursor to diabetes". I have NO diabetes in my family history at all, and initially when my hypos started, I weighed 120. I am now 150 20 years later, and still fighting hypoglycemia. I am still working on losing more weight.

I would be curious how many more of us are so sensitive to carbs.

Julie, you didn't have your insulin levels drawn during your test?

No, I didn't, but I will if I ever do it again. My blood sugar issues flare & subside. As long as I stick to my current diet, I'm OK for now. I wondered about an insulinoma (so did my endo) BUT I dread the testing for that as I know I will get very sick. Things are somewhat stable now, but I do have a bad day now and then. I suspect that those of us with dysautonomia have GI tracts that work in fits and starts. When my blood sugar gets really low, I surmise that my GI tract is working really fast that day and I eat accordingly. \\\

Yours sounds consistently very fast....I think it warrants further investigation. Have you explored the insulinoma?

Julie

[vemee]

I have only recently confirmed reactive hypoglycemia when I finally got to see an endo. She gave me a glucose monitor and I went to town taking my levels whenever I had symptoms. I would go through about 8 strips in about 30 minutes and I found that my levels would jump and fall 20-60 points in just a short amount of time like 2 minutes. The most comforting thing I found was that when I was really acting like a jerk was when my sugar was below 40; the last incident when I was screaming about nothing found my sugar at 34. I say it is comforting because it was suggested that my behavior was due to psych problems.

Fruit and carbs are the main culprits for me and I have had to eliminate fruit altogether. I also was given precose which slows digestion. Sugar binges can really send me off into a dark mood as can chocolate. I can eat something and it will give me hypoglycemia and then I can eat the exact same meal at another time and it will not effect me.

I would say based on the feeling I have when my sugar drops below 40 that this has been occurring over 30 years. I am not diabetic. 20 some years ago a doctor told me that my body over reacts to increases or decreases in my sugar levels but I only went to him twice and had to leave because of health insurance problems. He did not think that my levels actually dropped below 60 so I was surprised when I found they did.

[sue1234]

Julie--the 3-day fast(in hospital) itself wasn't really that bad. Just on the third day I was having some high heart rates even though I was thoroughly hydrated through IVs and drinking water. I feel it is time to look a little deeper into the insulinoma case though. I have sent a fax to my dr. that did the fast, and explained how I cleaned up my diet and still have issues.

Vemee--those blood sugar levels are too low. I get that if I wait and don't eat when symptoms start. You really need to have a glucose tolerance test with insulin levels and see what's going on. I would like to add that I've read numerous articles while researching insulinoma about cases of people being misdiagnosed with bipolar, etc., while all the time they had too much insulin causing chronic hypoglycemia. It might help even if you can get your doctor to get a fasting glucose, insulin and pro-insulin levesl and start from there.

I have read some medical literature that says there have been cases where insulinomas could not be "provoked" by the 72-hour fast, but definitely showed themselves during a GTT. I feel like I am in that category. A couple of weeks ago I had very lightly sweetened tea first thing in the morning with my thyroid med, then an hour later oatmeal, then an hour later a handful of pistachio nuts, and 30 minutes later my blood sugar was 50. That was after a whole grain breakfast and protein from the nuts! I just can't seem to control the drops.

I wish everyone that has blood sugar issues would at least say "me too!" so we could see how many POTS people do. I know people with undiabetes urinate alot, so are probably in the long run, getting somewhat hypovolemic. Maybe there is something similar happening with these weird, chronic hypoglycemic episodes.

[vemee]

I have been looking for an article that I read a while back that tried to link reactive hypoglycemia to increased sympathetic tone. I can not find it but I believe it was stating that increase sympathetic tone can cause hypoglycemia which would put pots patients at risk. However, the main purpose of the article was to discount reactive hypoglycemia as a psychological problem and that real reactive hypoglycemia does not exist. Fortunately this is not the predominate opinion. I may have the facts of this article wrong but I have seen articles saying that some think reactive hypoglycemia does not exist. There are also those who say that those who have reactive hypo never have their glucose levels go below the norm. I personally know that is not the case.

I have had glucose tolerance tests in the past and have had varied results. I also did a two day fast 6 years ago when I had levels of 38 at work ( I was a firefighter and felt weird so I used the glucometers at the station which showed me low). Dr.s were not concerned of course and changed their minds about giving me a 3 day fast test but I went ahead and did it on my own. Basically whenever I brought it up with a doctor it was ignored after a fasting morning glucose test was given. If I can prove that I still have problems with low blood sugar while on precose and low carbs with no fruit I think I can get the doctor to give me the tests you suggested. It is hard to get some doctors to seek the cause of something instead of just treating the symptoms, I think my endocrinologist is not like that.

[sue1234]

"I know people with undiabetes urinate alot"....

What the heck?!? Sometimes my brain just is off in its own little world! Sorry for that wrong word. I meant to say "prediabetes".

Vemee--did you mean that your blood sugar dropped to 38 in your own 2-day fast? That is definitely low and should qualify you for a 72-hour fast(supervised) to look for an insulinoma.

I just read(I'm going to get the name wrong!) nmorgen's post about her new cardiologist in Switzerland, and besides him thinking she justs needs exercise, she mentioned him talking about changing diet. I am going to post to her and ask if the diet change involves carbs/sugar.

[Dizzysillyak]

Thanks for the interesting thread ... Here's a blurb on high glucose and urination. A freind had already told me this but I found it immediately when googling "urination high glucose".

http://kidshealth.org/teen/diabetes_basics...lood_sugar.html

Signs and Symptoms of High Blood Sugar Levels

The signs of high blood sugar include:

?Peeing a lot: The kidneys respond to high levels of glucose in the blood by flushing out the extra glucose in urine. People with diabetes need to urinate more often and in larger amounts.

?Drinking a lot: Because a person is losing so much fluid from peeing so much, he or she can get very thirsty.

?Losing weight even though your appetite has stayed the same: If there isn't enough insulin to help the body use glucose, the body breaks down muscle and stored fat instead in an attempt to provide fuel to hungry cells.

?Feeling tired: Because the body can't use glucose for energy properly, a person may feel unusually tired

One other reason I know that makes me go more often is from having a minor UTI. If I take a B complex or eat too many oxalates, I'll have to go more often. Both cause minor UTIs for me. Taking 2 AZO helps this though ...

I was wondering what role menopause plays in this too. This has gotten much worse in the last few years ... The new belly fat is a testament to how this is affecting me.

[vemee]

"

Vemee--did you mean that your blood sugar dropped to 38 in your own 2-day fast? That is definitely low and should qualify you for a 72-hour fast(supervised) to look for an insulinoma.

During my two day fast my glucose did fine. The 38 reading is what caused me to go to the hospital in the first place it happened on normal circumstances and all that week I had readings below 60 every now and then. but since it did not act up later that week the doctor just passed it off as one of those things. The hard part of reactive hypoglycemia is catching it; if you just take one reading when you feel symptoms and take the reading it may show that you are in the normal range. You have to keep taking it every few minutes to see if it is jumping up and down which uses up a lot of test strips. I have had several readings in the 30s but the doctor thinks it can be controlled by limiting carbs. The latest reading of 34 was after eating a low carb meal and 3 gluten free chocolate chip cookies, I was confused and thought gluten free meant glucose friendly so it was a goof on my part.

The thing is that as a firefighter I dealt with people with diabetic hypoglycemia and I know that it really isn't something to play with. I don't know if you can go into a hypoglycemic coma with reactive but the effects on the brain are the same as for diabetic hypoglycemia. Some pass out, some act drunk, some pass out but their body continues to act awake without their controlling their actions or even recognizing their spouse. Some act obscene and I met one who mimmicks my symptoms of just getting mean, I wanted to see how low his level was but he attacked us before I could so we went straight to treatment. Most of the time reactives bounce back on their own but from my experience there have been 4 times in my life when it lasted for hours and light snacks did not help, it took a full meal and could reoccur later that day. These 4 incidents I would definitely say that I put too much insulin into my system even though I did not have a glucometer to take my levels.

Also there have been times I have had sugar in my urine; my father had the same thing. Years ago when I thought I had diabetes I bought test tape that would tell if if there was sugar, every time I was in a foul mood I was passing sugar.

[sue1234]

I agree that I believe that us dropping into the 30s and 40s in reactive is just as serious as a diabetic dropping. This can't be normal to drop soooo far below 60 everyday if I don't eat every two hours. That is just not normal!

I know the people I've talked to that had insulinomas, some for years, were just like me. We carry food in our purse, in our car, can't go anywhere without having just ate something and then having the extra food packed away! That can't be normal.

They all said that when their tumors were removed that they could get busy and just forget a meal. I can't imagine doing that outside of the hospital.

I know that going hypo triggers the autonomic system, so I'm wondering if that has somehow played a part in my DYSautonomia now. Maybe some center should investigate this aspect of it.

[vemee]

The way it was explained to me, reactive hypoglycemia happens when sugar and simple carbohydrates are digested quickly and sends a surge of blood sugar into the blood stream. Normal people have something that prevents this from happening, they are not sure what perhaps glucagon. When the surge happens the body over reacts and stops dumping sugar through the kidneys and pumping insulin into the blood. When the sugar levels drop the body over reacts again and starts trying to prevent hypoglycemia by infusing adrenalin into the blood to raise sugar levels thus giving some of the shaky symptoms. For some reason the body does not quickly start this process quick enough and the person can go into actual hypoglycemia. I would guess and this is just my layman's opinion, that since pots patients also use adrenalin surges to control blood pressure that they might also affect sugar levels. The research should be done on what we lack that prevents the control of our blood sugar.

[Dizzysillyak]

http://dinet.ipbhost.com/index.php?showtopic=15350

Here's some info on adrenals and blood glucose ...

We were talking about this a month ago too .... boy, time flies when you have to keep laying down every few hours ...

[sue1234]

I found some interesting information while looking around about hyperinsulinemia. I found a few articles that talk about insulin's effect on blood vessels--specifically vasodilation!! I will post one of the links, even though it's not the whole article, but an abstract:

http://www.ncbi.nlm.nih.gov/pubmed/9774373

Okay, I have had low blood sugar for 20 years, documented high insulin a couple of years ago, insulin causes vasodilation , I have vasodilation, then my body starts having trouble getting my blood to come back up to the brain, then the sympathetic system goes in overdrive...I might have put MY puzzle together!

This is getting curiouser and curiouser.

I have so much that preceded my POTS that I didn't really look at those factors. Now I have a couple to talk over with my doctor when I see her in a few weeks.

[Dizzysillyak]

Sue,

Wow ... great find ... thanks for looking at this further. I copied this in from that article ...

Our findings suggest that insulin-mediated vasodilation is not due solely to a direct stimulatory effect of insulin but involves additional mechanisms activated only during systemic hyperinsulinemia.

Do you know what this means ?

I've noticed in the last few weeks that when I eat anything sweet, I just don't feel well. After getting my GTT, I could see how eating too many carbs or sugars at one time was a problem. I may have to back off all carbs and fruits for now ...

I've also been hypoglycemic for at least 20 years ... and I found out that I'm a celiac in 2005.

Sorry, I haven't been much help but my OI has been horrible lately ...

[Chaos]

Thanks for starting this thread. I just got the results of my 3 hr. GTT

Baseline- 68

1 hour-167

2 hour-131

3 hour- 37

Unfortunately they didn't draw insulin levels.

I had very similar symptoms after the GTT as I had after my 3 TTTs. It also wiped me out for days afterward just like the TTTs.

Haven't gotten to read your links yet but am looking forward to doing so.

I too have had reactive hypoglycemia for at least 20+ years. This is the first documented proof of it though. Like all my other symptoms it seems to wax and wane with periods where it's much worse and other times it's not so bad.

Given how similar my symptoms were between the GTT and the TTTs it certainly made me start thinking hard about how the hypoglycemia could be related to all the other dysautonomia stuff.

[Birdlady]

Hey Chaos! 68 as a baseline is way too low in my opinion. Anytime I am in the low 70's I feel like crud. Unfortunately though it just appears your body is having a hard time regulating blood sugar levels in general. You might want to get a fasting insulin done first thing in the morning and see what that is. Even with the hypoglycemia and reactive hypoglycemia these results are inching you very close into the "pre-diabetes" category. Most natural websites say you should never hit 140 any time during the test. Then you have mainstream sites saying you should be under 140 2 hours after a meal.

Personally I think it's best to be under 140 for the entire test, but that's just my opinion of course! Some really hardcore doctors say you shouldn't be above 120! haha

[vemee]

Well this is an interesting possibility. My first thought would be that insulin mediated vasodialation would be constant and not just when standing. However, since all of the mechanisms that cause it are not known it could very well happen. I will have to ask my pots Dr. about this.

[delphicdragon]

My three hour test was even stranger.

Start --74

1 hour - 60

2 hour -84

3 hour -80

I was feeling like crap throughout the whole test. Granted it was years ago. I was told it was reactive hypoglycemia and that I would get diabetes, but I never went high. I've had readings of as low as 12 for blood glucose-- most of my low readings are in the 30s. I carry food with me at all times and eat throughout the day. I usually can't go 90 or more mins without eating / getting mean and can drop up to 4 pounds a day if I don't eat. Thoughts?

Sara

[sue1234]

I find it interesting that I am not alone in my history of reactive hypoglycemia.

I know that my 2 and 3 hour glucose goes a little high, but if the theory is that this leads to diabetes, we are all about 15 years behind on getting it! I have read that theory in many places trying to figure out about my high insulin.

I would like to say that when our blood sugar drops into the 30s and 40s, that is too low, and it is definitely NOT normal for someone not taking any outside source of insulin. Delphicdragon, you seriously need to get tested for an insulinoma!! Ask your doctor about a fasting glucose, insulin, and proinsulin, and probably a c-peptide. That would be a great start. You were at coma-range with a glucose of 12! And you do have a very strange GTT.

From what I've gathered about the few articles about insulin causing vasodilation, one of them referred to how it affects the nitric oxide levels. Okay, where is Ramakentesh when we need her--NO is her specialty!

Referring to that article I posted above, it seems that vasodilation did NOT occur when they administered insulin locally to the forearm, However, it seemed that a systemic release of insulin causes peripheral vasodilation. I could see where this could become a chronic event alongside the chronic b/s issues. Then it would reach a point where the vasodilation is too much for an upright posture, and POTS develops. I don't know, anymore thoughts or ideas on this?

I really am surprised to find that some of us have a long history of such wild blood sugar swings. Are any of you a diagnosed diabetic? I am not a diabetic and don't foresee being told that I am. My sugars may go high during the test, but my fasting b/s are almost always(this year) between 75-80, which is excellent. And with losing 20 lbs., I thought my body would handle sugar easier, but no.

[mountain girl]

While I have never had a GTT and never would agree to one, I have always been shall we say sensitive to not eating frequently enough and it has been much worse I would say since having pots. My last blood work was supposed to be fasting at 815 a.m but I felt "bad" like i had low blood sugar at 730, and ate a piece of dry wheat toast and felt better. I think my glucose report was 109, and I told the dr I had eaten the toast and why I had felt the need to.I also feel bad if I eat sweets and have not had a meal,but do not really notice a reation to eating fruit. I prefer vegetarian meals, and eat meat occassionally. I find it just works best for me to eat something every 2 to 3 hours, that way I feel I am never allowing my blood sugar to get too low and feel bad, and for pots I know it is best to eat smaller meals anyway. I go for the common sense approach to eating, whole grains, fruits and vegetables, and limited fats and sugar anyway. I guess due to middle age and less activity I actually gained 10 pounds the last two years since having pots. I have been working at losing it and swithed to G2 instead of regular gatorade but so far it has not made much difference.