Fasting Reactive Hypoglycemia

[vemee]

I just finished a 3 day fast at the hospital where I was being tested for an insulinoma. I was tested because in July when fasting trying to get rid of an intestinal bug I had an incident where my glucose dropped to 39 and then jumped back up to 77 on retest. The same thing happened in the hospital only more extreme. It was well over the 48 hour mark when I started feeling fuzzy headed and mildly euphoric, this lasted several minutes before I took my glucose on my own glucometer. My reading was "lo" which meant the glucose levels were below 20. I called the nurse and she came in after a minute or two and used the hospital monitor: her reading was 85. As the nurse left the room I took my glucose again thinking that if my glucometer was not working there would be a big difference between her reading and mine. My level was at 76. Right after that I went into dry heaves and a wave of heat ran up and down my body and I felt shaky for a half hour afterwards and just wrung out the rest of the day. With me dry heaves usually are related to a pots event (possibly due to a rise in norepinephrine levels) like standing too long. My blood sugar after the event was 85 so the dry heaves were not caused by another sugar drop.

The most obvious suspect is that my glucometer does not work. However, I tested it with the in date testing solution and it passed. Also while in the hospital I always took my blood sugar when the lab drew venous blood and compared their readings with mine; I found that I was no more than 5 points higher than the lab. I have found that my blood sugar acts like a yo yo jumping and falling sometimes as much as 50 points in just a couple of minutes. I do have symptoms when this happens even though the values do not always fall below 60. During the fast my glucose was normal (except for the above mentioned drop)and only moved around smoothly in a range of 71-85.

The doctor ruled out an insulinoma causing the drop because the glucose corrected itself without eating something and I went through the fast without going hypoglycemic. I also had a glucagon stimulation test which I think I passed; I won't know the results of all my tests for about 2 weeks. Carbs had nothing to do with this drop because I had fasted for over 2 days and in fact my last meal was eggs and turkey sausage which are less than 10 carbs so there were no carbs in my system to influence my glucose. The doctor did not know what could have caused the drop in glucose or the sudden rise. I forgot to ask the doctor that if the surprise of the low reading (I got excited that a cause might have been found) could have stimulated enough adrenalin to shoot the glucose back into the normal range.

It is possible that the above events could be evidence (not proof) of 2 things: 1. reactive hypoglycemia is not caused by food even though it is definitely aggravated 100 times by what we eat. 2. There may be a link between reactive hypoglycemia and pots. Most of us already believe there is a link anyway. The doctor may come back in two weeks and be able to explain what happened but it isn't likely since the blood went back to normal before it could be drawn.

[sue1234]

Oh, I can definitely empathize with you! I had the same experience in January, but never felt hypo the whole 3 days, and never went below 62. I did, however, have some crazy stuff go on with my body! I vomited the first afternoon. Beginning the second day, my heart rate would shoot up to 130 within 2 minutes of getting out of bed. This is not my norm at all. And, the whole three days, I was sooo hot, even though my temp was my usual below normal. I just felt like my adrenaline was at a consistent low level to keep my glucose at a consistent level. My 3-day range was a high of 110(on 2nd day) and 62(last draw).

I agree. The reactive hypo is super sensitive in me. Right after that fast, I thought it would be a good time to kick start my weight loss. I dropped almost all sugar(I didn't really drown in it before) and ate smaller amounts every two hours. I subsequently lost 24 lbs. I am not one of those people that feels "great" after they lose weight. I do know it is better for me, and have about 15-20 lbs. to go. I have read many places that reactive hypo could be related to insulin resistance. Well, I didn't think I had that problem, and I proved it. Dropping my weight did not make me handle sugar any better. I still drop into hypo if I don't eat every two hours for most of the day. By nighttime, my body can handle it. I still think it is related to too many insulin-producing cells in the pancreas, whether by small insulinoma or otherwise.

They did not do the glucagon test on me, I wish they had. How did that feel? Did they do it at the very end?

[vemee]

They did the glucagon test at the end of the fast. Initially I thought I felt a little dizzy but that passed quickly. My blood sugar only move up 10 points. 30 minutes after giving me the glucagon I had the mixed meal test where I ate a high carb breakfast. My blood sugar shot up to 300 then dropped to just over 200 within the first half hour. At the end of the test which was 3 hours after eating, my blood sugar was 126. I don't know how the glucagon affects the meal test so I don't know if the normal range for the meal test would be the same as for a glucose tolerance test. I think that if the reference range for the test I took is the same for glucose tolerance I have another issue to contend with. My morning blood sugar is always in the 80s.