All About Low Blood Sugar Issues

[Dizzysillyak]

Before I forget, my orthostatic intolerance didn't get worse during my GTT w/ insulin when I had it done in June 2010 ...

My bgl and insulin ...

fasting bgl was 86, <2

1 hr ... bgl = 113, 81

2 hr ... bgl 61, 29

So far the only thing I know of that increases my OI is if I push myself for too many days in a row and am dealing with PEM (post exertional malaise). If I rest up for 1 - 3 days after exerting myself, aka running errands in my case, I'm still affected by it but not the extent that I have to lay down every few minutes ...

[Dizzysillyak]

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

I felt the way you're describing even a year after I'd eliminated gluten, etc due to what we think was celiac disease ... I couldn't break down the foods I was eating. I was very low on iron and B12 at that point too. Have you seen an integrative doctor and / or had your food intolerances, gut bacteria and all of your nutrient levels tested ? IMHO, this would be a good place to start .. It turned out that I was low on quite a few nutrients when I finally saw an integrative doc who had them tested for me.

[Dizzysillyak]

I hope you don't mind me posting this here too ... it's another great discussion on chronic hypoglycemia. I'm dense so the more I read about this the better I understand it ...

http://www.forums.aboutmecfs.org/showthrea...ht=hypoglycemia

[sue1234]

Dizzy--thanks for posting that link to your other board. I enjoyed their conversation, as I am the type to like to discuss the scientific possibilities of what causes these unkown health problems. I like to see them thinking it through about CFS/ME. That is such an "unknown" like POTS and other health issues. I think doctors are just trying to research on what to do for symptoms instead of the root cause.

Your GTT was odd, too. Apparently you have excess insulin driving down your sugar levels too.

[juliegee]

Wow, I was researching norepinepherine for something else and stumbled across this gem on Wikipedia:

As a stress hormone, norepinephrine affects parts of the brain where attention and responding actions are controlled. Along with epinephrine, norepinephrine also underlies the fight-or-flight response, directly increasing heart rate, triggering the release of glucose from energy stores, and increasing blood flow to skeletal muscle. Norepinephrine also has a neurotransmitter role when released diffusely in the brain as an antiinflammatory agent.[3]

I know many of us have elevated norepinepherine, especially when standing. Seems to exactly describe what happens to me. My blood sugar will be fine. Something stressful will happen (especially when I'm standing) & BOOM, my blood sugar drops like a lead balloon. Anyone else relate?

[sue1234]

Mack's Mom--I am exactly like that! All I have to do is get nervous and I have to eat. I don't test my b/s, but I can just feel it happen. If I know I have to be in a situation that will cause me to be nervous, I eat beforehand.

HOWEVER, the logic behind norepi. causing glucose release is the opposite of what we feel or have happen. Maybe with the release of glucose comes an accompanying release of insulin, and BAM!, everything happens so fast, our sugar is dropping again. I just don't know, but I do know it is complicated!

[juliegee]

Mack's Mom--I am exactly like that! All I have to do is get nervous and I have to eat. I don't test my b/s, but I can just feel it happen. If I know I have to be in a situation that will cause me to be nervous, I eat beforehand.

HOWEVER, the logic behind norepi. causing glucose release is the opposite of what we feel or have happen. Maybe with the release of glucose comes an accompanying release of insulin, and BAM!, everything happens so fast, our sugar is dropping again. I just don't know, but I do know it is complicated!

Maybe our norepinepherine is so high that our glucose stores are slim to nonexistent at times? Maybe our insulin gets that same message & over-compensates? Maybe our sympathetic overdrive causes our glucose to be used up immediately?

One thing my endo did when my blood sugar dropped to 50 (at the end of my GTT) was made me wait until it ROSE. I almost ate my arm until we got a reading of 52 . He said that was proof that I had some glucose stored and available. I actually use that memory to keep me calm when I can't get to food and I feel the dreaded drop .

[erik]

In the theme of "All About" low blood sugar, I'll throw this article into the mix. It is from the 60's and strikes me because the symptom cluster has solid crossover with dysautonomias.

I have also read that those with POTS tend to respond more quickly to the rapid drops in blood sugar that follows a spike, causing hypoglycemia symptoms even where standard measure of hypoglycemia wouldn't be seen. Also, I think you all mentioned this, but a drop in sugar can (should) cause an adrenaline-like spike... and an adrenaline spike can eventually lead to another subsequent crash later (making a rough cycle that dysautonomiacs could fall in to easily from various causes). Here is the article:

Relative Hypoglycemia as a Cause of Neuropsychiatric Illness

HARRY M. SALZER, M.D.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2611193/

One can download entire as PDF or view pages piecemeal. Here is an excerpt related to associated symptoms:

Psychiatric symptoms: depression, insomnia, anxiety, irritability, lack of concentration, crying spells, phobias, forgetfulness, confusion, unsocial or antisocial behavior, and suicidal tendencies.

Neurological symptoms: headache, dizziness, inward and external tremulousness, numbness, blurred vision, staggering, fainting or blackouts, and muscular twitching.

Somatic symptoms: exhaustion, fatigue, sweating, anorexia, tachycardia, cold hands and feet, obesity, chronic indigestion, bloating, abdominal spasm, muscle and joint pains, backache, muscle cramps, colitis, and convulsions.

(I think I've had 90% of these symptoms... and 100% of the neurological ones on a pretty regular basis. Of course, they are "non-specific" as they say, meaning they can come from many different causes... but the crossover with dysautonomias is certainly interesting.)

[Chaos]

Interesting article Erik. Thanks for posting it.

I found it interesting today when I saw my cardio and showed him my 3 hr GTT, his response was that "no one really believes such a thing as reactive hypoglycemia even exists anymore but you may actually have it." In light of his comments this article was even more interesting to read and certainly seems apprapos to the symptoms so many of us have even if our blood sugar levels don't always look like they should be the cause of the symptoms.

[Chaos]

Sorry...double post....

[vemee]

I have read a couple of articles that have said reactive hypoglycemia doesn't exist; it seems the medical community always is quick to push something off to the psychiatric community. I know I have reactive hypoglycemia and that it does dip below 60 and even in the 30's as well as the rebounding adrenalin caused spikes that are in the normal range. It is a pity that dr.s believe they know better than we what our symptoms are.

I had a colon bug the past week and went on a 2.5 day fast. My blood sugar levels were pretty steady I thought until I did catch it down at 38 but it quickly rose again to 77. I wrote my doctor to tell her but I don't think it is from an insulinoma since it was just a blip. Yet I don't know how many times it had dipped down before and after that. I was only drinking diet coke, tea sweeten with a sugar substitute and water, no food. It had been a while since I had had a caffeine drink but before it those drinks had not bothered my sugar. Since the purpose of the fast was to get rid of the colon flu I was not concerned about the caffeine affecting my blood sugar, however, it is interesting that I still dipped without having any carbs or sugars for 2 days.

[issie]

I've known I've had hypoglycemia since I was about 10 years old. Back then, they did do the 6 hour test and mine went down into the low 30's. I have had issues with this my entire life. Even though I feel it is connected, I don't feel like it is the cause or reason for my POTS. I feel like I got POTS when I was around 12 after an unexplained illness. I did pretty good with life, still having issues - but never really knowing what was wrong. Then in my 40's I got almost totally disabled with what has finally been diagnosised as POTS. I think the hypoglycemia can be a part of the syndrome, but not the main reason for it.

But, as a suggestion for blood sugar issues. Since hypoglycemia can and often does turn into diabetes, my doctor told me to use GTF Chromium. It has nearly balanced me out completely. I take one in the am and one in the pm. Not too many issues now. Occasionally drops with going too long in between food. But, not waking up at night with drops and munchies.

[sue1234]

Bumping this up for It'sMyLife to read through.

[vemee]

I mentioned in a post above about going on a fast due to an intestinal bug and that I had a quick drop in my glucose levels to 39 which rebounded back into the 70's. My doctor told me that the caffeine from the diet cokes and the tea would not affect me and she is going to put me in the hospital for an official 3 day fast. I don't plan on going until September but my wife wants me to go now. I figure that if I have anything then I have had it for at least 30 years so a few more weeks won't hurt. I hope they find something correctable.

[sue1234]

Vemee--I'm glad your doctor took that seriously! It needs to be checked out thoroughly, and the 72-hour fast is the "gold standard" for doing that. Please post back and let us know how it went.

I'm like you, in a way, as I've had this for almost 20 years.

[jimells]

This is a real interesting thread. I've never thought about blood sugar at all until the PCP told me last week that recent blood tests showed slightly high blood sugar and I'm supposed to get a fasting glucose test. But I have to drive 100 miles round trip to get the test, and I don't have gas money to drive that far. I can barely get up in the morning, even with coffee and a light breakfast, so I don't see how I can go all night without eating, then safely drive more than an hour to get blood drawn.

It sounds like most POTS people have low blood sugar - am I reading this right? Or is it more correct to say the glucose levels are bouncing all over the place - like blood pressure and heart rates?

I read someplace that stress can raise blood sugar. Since I am always anxious and agitated when at a doctor's office, I'm thinking that could explain above normal readings for me.

I have a friend with type 2 diabetes. He's going to bring his sugar meter to band rehearsal tonight, so I haven't eaten since 9:30 AM (it's 12:30 pm now). My stomach is already digesting itself - it's going to be a really looong time until 7 pm!

[MomtoGiuliana]

Yes, I believe that is true that stress hormones cause blood glucose to rise as part of the fight or flight response.

I remember having a high fasting bg reading taken when my POTS was very severe.

Since then I've had no signs of high (or low) bg. But I do sometimes get symptoms of low bg.

[juliegee]

Joe-

Regarding using your friend's meter- great idea BUT you don't have to fast until then. EAT, Man!!! I bought a meter at Wal-mart, store brand, cheap w/o a prescription. Taking it first thing in the AM, after eating & anytime you're experiencing symptoms of low blood sugar will give you a good amount of info. I HATE that you have to travel so far (FASTING !!!!) for your test. Sounds like your doc suspects diabetes and is trying to rule it out.

Let us know what you find out.

Julle

[jimells]

Well I did the test last night and the meter said 83. This was after fasting about 10 hours. According to Wikipedia, it's supposed to be 70 - 100 after 12 hours.

I ate a banana right after the test - it sure tasted good.

The technology of those little meters is amazing. I don't understand why they don't use them in the doctor's office instead of ordering an expensive blood draw and expensive hospital lab tests. I probably just saved the State of Maine $150 by doing it myself.

If the doctors keep after me about my blood sugar, I will get one of those machines. They used to lecture me about my blood pressure, until I got a home machine, wrote down the readings, and quit taking the pills that were raising my BP.

[juliegee]

Sorry, Joe. I misunderstood. I didn't realize you were trying to simulate a fasting glucose test. I hope that # satisfies your doctor & you are cleared from further testing. I could NEVER have gone all day w/o eating like that. I would have passed out .

I still think it's a good idea to get your own meter & take readings throughout the day IF your docs are concerned. I think I got my meter free at Wal-Mart just because I bought the store brand strips. No prescription needed.

All the best-

Julie

[Elegiamore]

Please excuse my ignorance, but my brain is chocked full of POTS and CFS/ME info, so I'm out of it on blood sugar.

BUT...I am having terrible morning/wake up during the night, NE rushes, very high bp and anxiety similar to a previous post. Would this be from eating before bed or NOT eating before bed? In the last two months (unable to walk downstairs to the kitchen and depend on my hubbie to feed me), I often don't see any food from him until 11 a.m. or later.

I have gained 70 pounds in two years and I am CONSTANTLY STARVING. Correction: I am not very hungry at all UNTIL I eat. Then, within 15-20 minutes, I am starving and have to keep eating. This just keeps going on and on. My diet varies from excellent, low-glycemic, to junk food, depending on if I can fix myself and my hubbies meals or I have to eat the crap he serves from the fast food places when he is "making a meal for me."

Isn't this low blood sugar? I have asked my PCP a million times about this, as I have noted that my fasting blood sugar has risen 10 points in the last two years. He refuses to give me any further testing. Or address the severe hunger.

My last glucose tolerance test was in 1983 before I knew that I had POTS. I had major physical reactions but a normal test (probably was from the NE).

Again, please note that I weighted exactly the same amount for eight years until this started. So stress doesn't seem to be an answer for the weight gain, as my health and personal stress is about the same or some better. Any other ideas why I am constantly hungry with POTS and CFS/ME? Thanks, Elegiamore

[sue1234]

Found this back in the history. I want to see if any "newcomers" have this issue.

I have been having BIG problems for about 2 months now with daily off/on vasodilation. I have read another place that talks again about hyperinsulinemia causing systemic vasodilation. My worst part of the day is anytime after I haven't eaten in a few hours--that means all evening and all night, until I put something in my mouth in the morning. It's getting very difficult to handle, as it makes me more lightheaded and definitely going to give me bigger issues with the oncoming summer heat.

[juliegee]

Sue-

I have been through this as well. It comes in cycles for me. I have a weird observation to make that sort of plays into Ellie's comments above. Over years of being sick and taking oodles of antihistamines (appetite stimulants)- I had slowly gained weight- till I was 20lbs heavier than I am now. I was having the exact same experience you described. It was like my extra weight released it's own hormones that played havoc on my whole system. I was constantly hungry & had adrenaline-type surges that only resolved with food. I made a huge concerted effort to lose the weight & the blood sugar issues improved. If I eat small meals, I don't get as hungry. As long as I keep any extra body fat off, my blood sugar issues are vastly improved. Easier said than done

I know you know all the rules for managing blood sugar. No caffeine, no alcohol, no sugar, no fruit, nothing refined: white pasta, bread, rice, potatoes. Lots of lean protein, vegs, and whole grain carbs, brown rice, etc. Try a few bites of low fat cottage cheese to stave off low blood sugar rather than a large snack between meals.

Have you had any testing by an endo yet?

Hugs-

Julie

[sue1234]

I learned that I can't give up caffeine because it must vasoconstrict!! I found this out in December. My cardio told me to get off caffeine and I did for about 5 days. By the 5th day, I was, like, just sitting there staring. I felt like my brain wasn't getting any blood, even sitting. It was a very eerie feeling--I checked my blood sugar many times, but it wasn't that. So, I broke down and drank an iced tea, and literally within 20 minutes my brain was "working" again. It was like a switch had been turned on by the caffeine. And by the way, I didn't even get a headache from getting off caffeine cold turkey--how weird is that!

I am seeing my endo soon to go over all this new vasodilating. It really is a game-changer in my POTS. I only encountered this if I got hot for the last five years, but now it's a daily occurence, even here during winter.

[Guest tearose]

wow sue 1234, an endo can help with this?

I too need my "caffeine" to treat and raise my bp and have no heartrate issues with it, only better bp.

Let us know what the endo says please!

best regards,

tearose