Extreme Issues While Driving And After Eating. Help!

[Kris4444]

Hi everyone,

It's been a while since I've been on as I've been trying to obsess less about my health issues but I have a major thing going on and I don't think the doctors are going to be able to figure it out.

I was diagnosed with glucose intolerance so they started me on Metformin to help lower my blood sugar. The REASON I was diagnosed is because I have extreme fatigue that comes on suddenly and makes me feel confused and out of it. We started measuring my blood sugar at meals and it does spike up into the 200 range at times.

At first we thought it was the highish blood sugar after eating. I don't eat breakfast before I hit the road for work because of my medications, I have to wait to get to work to consume anything. I started noticing about 20 minutes into my 40 minute drive that I could barely keep my eyes open. I have had moments where I felt I should have pulled over because I was afraid I was going to lose consciousness. The same thing happens after lunch. This is EVERY day. I have fallen asleep at work after lunch.

The medication has not changed this. My blood sugar is stable now but I'm still having this issue. I read that the autonomic nervous system can have an issue where it releases epinephrine instead of glucose after eating. Even though I am not eating before I leave the house, I am consuming about 20 pills with a glass of Miralax so I DO have to digest something. I have very high nor-epinephrine levels. I don't know if this has anything to do with it or if I'm just grasping at straws.

Part of me feels that it is my messed up digestive system that is the answer rather than ANS or diabetes. Does anyone have a clue what this is? My GP threw his hands up, I am seeing the Endo on Monday but he is never much help. I see the Immuno on Friday and will mention it to her too but I'm at a loss here.

Any ideas would be great. Thanks.

[MomtoGiuliana]

So sorry you have been feeling so badly.

When my POTS symptoms were very bad I had high blood glucose after meals also. A doctor tested this once to confirm it, anyway. I had many glucose tolerance tests tho and it did not show diabetes--but for some reason I just had these bg spikes right after eating. I also felt very badly after eating--sometimes very tired, but also I would feel wired and shakey and weaker, and my hr would elevate. For a long time I could only eat very small, protein rich meals for the first part of the day when it was worst. I never really got a good explanation for this, but one theory I guess was that eating caused blood to pool more in my abdomen and also the process triggered epinephrine release. So again, small meals, protein-rich, and also a lot of fluid (and salt) helped to reduce these symptoms, for me. Anyway it seems somewhat similar to what you are experiencing.

I hope your doctors have some ideas.

[Kris4444]

Thanks for the reply. I have gastroparesis as well as colonic inertia (my colon doesn't work at all) and I wonder if when I put the pills in my gut that everything pools there and since it has a hard time digesting I have the issue I have described. I have asked my GI guy the question today and I'm waiting for a reply.

My fasting glucose has been a tiny bit high even before going on metformin (112-116). I had blood work run last week but haven't gotten the results yet. It will be interesting to see if it is still the same now that I'm on the metformin.

None of it makes sense. Sometimes I still spike into the 180's on the metformin and sometimes I stay level. Either way I STILL get the fatigue so bad that I can't stay awake. So scary when driving!

[spinner]

Thanks for bringing up this topic. I cant add much to it but i want to study it. Food can either send me to a flare, or it

can relieve one coming on.

I notice a meal containing processed flour (white) causes serious problems.

BORING is best. Oatmeal, fish, turkey burger, bananas, etc. I tend to thrive without problems on a light

meal of these.

[Kris4444]

I would love to eat cereal of any kind but I bout go into a coma! It's terrible.

[spinner]

Yeah, i tested out big time for milk, so gone. But almond milk seems ok with shredded wheat.

Yogurt, surprisingly, completely destroys me into a flare. Must be another ingredient there im working against.

Can you eat cereal dry? For something salty or crunchy maybe some of those rice cakes or pork rinds.

[looneymom]

Can you drink milk or eat yogurt? I have a good recipe for a fruit smoothie that may son likes and would love to share if you think it might help. Sorry that you feel so bad. Since this POTS diagnosis, my son does eat smaller meals. He can tell a difference when he eats a large meal. Hope you feel better soon.

[Kris4444]

It doesn't matter what I eat. ANYTHING that goes into my digestive system is causing this extreme fatigue. I get up at 4:00 and take my first round of meds and then either go back to bed (depending on if it's a work out day) or get up and do 5.2 on the elliptical. My next set of meds is around 7:00 and I can't eat anything for a 1/2 hour after so I drive to work. It takes about 20 minutes for the switch to flip and that is exactly how it feels, like someone said "lights out!" and BAM I'm struggling to stay focused and awake.

This was happening before they started me on Metformin and none of the other drugs caused this feeling in the past. I can't figure it out. It didn't used to happen every day but now it's almost daily and for sure after lunch, same thing, 20 minutes after whatever I have eaten.

I avoid carbs as much as possible as they convert to glucose. I have an Atkins protein drink and a cup of coffee once I am at work at 8:00. I have a banana at 10:00 and then usually an Atkins frozen meal at noon. By 12:30 I am trying hard to keep my eyes open. Coffee doesn't help. Usually by about 3:00 I am feeling much better however, within those couple of hours I am confused and can't think straight. I just don't understand.

I read that when your ANS is messed up the body sometimes releases epinephrine rather than glucose after eating. I wonder if there is a way to get that tested.

Of course I still worry that I have some sort of endocrine tumor lurking with the high NE and flushing. My flushing has gotten much better recently and I think it's because I got off the SNRI that I had been taking for my colon. Who knows.

[brethor9]

Kris I have the exact same episodes! I always say it is like getting hit with a tranquilizer dart.....or narcolepsy. I definately feel it is tied into diet and glucose somehow. I also have those mornings where I cannot wake and feel like I have been drugged....scary sensation. I used to work in a diabetic clinic and once I had an episode and the nurse did my blood sugar and it was really low not high.....she called it reactive hypoglycemia. None of my specialists have been able to explain why they happen but I have found if I eat any type of carb or certain types of sugar it will bring one on without fail...... which I had an answer for you ..... hang in there!

Bren

[dpeeps]

My first major flare- about 1 month before diagnosis of POTS - I felt the worst after meals. I dropped 20 lbs over that month. I never knew what was causing it, but I felt like I was going to pass out.

Also, I stopped driving for a while because I had the same feelings while driving. But now that I think about it, it was more like a sudden feeling of falling asleep, not so much the clammy, sweaty sick feeling before syncope. More like a "curtain" of unconsiousness overcoming me, and there was no stopping it - my head would actually drop sometimes. The ensuing panic would then cause an adrenaline rush. It got so bad that I just stopped driving for a while. I had never considered narcolepsy....?

Things have improved a lot since that time (about 15 mos out from dx)

[Katybug]

Hi Kris,

This was one of the symptoms that made me have to stop working. And made my PCP send me for both nighttime and faytime sleep studies. The daytime sleep study showed severe daytime hypersomnia. If you do a search on the Inspire forum at ednf.org, there was a long thread on there a few months ago regarding hypersomnia and narcolepsy. As scary as bringing up those diagnoses sound, it's worth looking into. Before POTS/EDS/MCAS, I didn't know one person that suffered from either of these issues, but there seem to be tons at the ednf forum with one or the other . It makes me think it has a genetic link to one or more of the syndromes we have. You may also want to look up cataplexy which I am kind of borderline on but it might fit what you are experiencing. Hope you get it figured out.

Katie