Reactive Hypoglycemia - Do Beta Blockers Help?

[Jules]

Like many of you, I have had reactive hypoglycemia for ~ 14 yrs. Seems that few endos understand blood sugar outside the insulin/glucose paradigm. I went to really well known Endos in Houston, only to hear them say that they've never seen anything like this before. Blood sugar dropping to 30-40's range within 1.5 hrs., with normal insulin. Thank goodness for Dysautonomia research.

Those who are on beta blockers, who suffer from reactive hypoglycemia, have you noticed any improvement with glucose/fructose intolerance?

[sue1234]

Jules, I am literally going to Mayo tomorrow for that very reason!! I have ALSO been to Houston (at UT) with no luck in that endo helping me. You're right--no one understands this.

I have been very hesitant in taking a beta blocker as I was afraid it would "blunt" my counterregulatory system. It's a catch-22. You NEED the adrenaline to pump out and act in your body to get your glucose back up. In my thinking, but not sure, taking a beta blocker wouldn't let the adrenaline do it's job.

What all have your endos done as far as testing your glucose, pancreas, etc.?

[Jules]

I think taking a beta blocker would possibly help. I think the adrenaline is the 3rd party that's causing all of the havoc. Your pancreas is actually having to do extra work to get your sugars back up from when the adrenaline smashed them in the ground. My insulin levels were normal, so there was another element that was causing the critically low levels, hence adrenalines role. In a normal person adrenaline is there to get things moving quickly when systems have dropped too low. With our bodies, the adrenanline kicks in each time we eat which disrupts the entire system, making the pancreas work extra to get out sugars back up.

Each endocrinologist told me that my pancreas was working correctly on each of my glucose tolerance tests. My blood sugar eventually regulated within a couple of hours, though I felt like I had been run over by a bus.

Having your insulin levels testing at the same intervals that your glucose levels are tested is a must. I've also read where the patient's Adrenaline and Noradrenaline levels were tested at the end of the test. It appears that these levels are high in POTS patients with Reactive Hypoglycemia.

They wanted to test my fasting levels (glucose and insulin) to be sure I didn't have an insulinoma, basically a tumor producing insulin, resulting in low blood sugar levels. All my fasting levels were normal, so that was ruled out. The system goes chaotic only when I eat sugar and it's worse with fruit.

They also did a CT scan of my pituitary gland to make sure there was no tumor there. One wanted to throw the Insulin Resistance label on me, which made absolutely no sense at all. I took Byetta, and Metformin, which made me so completely weak and lethargic. Was clear that this was not the correct diagnosis.

Hope this helps.

[kalamazoo]

I have this same problem, especially right after I eat and in the morning. Sue, let us know how the Mayo visit goes!

[sue1234]

Jules, during my OGTT, my insulin went high along with my glucose, then glucose crashed. When my glucose crashed, my insulin was inappropriately still elevated. I'll attach this article that I had sent to Kalamazoo the other day:

http://jcem.endojournals.org/content/91/12/4733.full

It basically shows that there are people that can have an insulinoma that don't go low fasting, but crash after eating. That is more my problem.

If you don't have high insulin at all, maybe you have some kind of problem with your liver's ability to go through gluconeogenesis(?) to supply extra glucose when needed. It's a thought.

I don't know all your history, but pheos can raise glucose when they "turn" on, and then I assume could cause a crash when "off".

[vemee]

This is a topic that is near and dear to me since hypoglycemia almost got me put in jail and I was misdiagnosed as bipolar. I took the 72 hour fast and was told that I was normal except that I was insulin resistant. However, during the fast there was a time when I felt euphoric and took my glucose with my glucometer. It read low. I called the nurse but she could not come right away and by the time she arrived it was back in the normal range. The reason I was taking the test is because the same thing had happend on a 2 day fast previously. I was fasting to get rid of a stomach bug and caught a glucose drop during the second day.

I have thought that perhaps adrenalin raises the blood sugar because there have been times when I was hypoglycemic that a sudden surprise would start me thinking properly. For example I got excited in the hospital when I saw that my sugar was low and that they might find the cause of the problem. I have been thinking that the excitement raised my levels. I had not thought about norepinephrine being involved. My levels of norepinephrine are high especially standing which was measured over 2100.

I recently asked Vanderbilt if they had ever studied the relationship between pots and hypoglycemia. No response to that question. Does anyone know if any studies have been done on this matter?

In response to the main question of the thread. I am on kerlone which is a beta blocker. It keeps my heart rate down but does not help the hypoglycemia. Metformin has helped immensley as well as a high protein diet.