Blood sugar dropping when I stand /lightheaded

[Bailee]

I’m trying to see if my blood sugar is dropping when I stand/walk around. Was trying to do some holiday organizing/cleaning. Got lightheaded, shaky/tremor, hot flashes, confused. I checked my vitals blood pressure wasn’t dropping. I know with pots you can feel lightheaded despite vitals but can the irregular autonomic nervous system be affecting my blood sugar. Or is this just Orthostatic intolerance?

[MikeO]

@BaileeI do have the same questions that you do.

One cheap way to maybe test this is when you are having symptoms is to take in about 15 grams of carbohydrates and wait 15 minutes to see how you feel. Carbs can come from 5-6 pieces of hard candy, 4 oz of orange juice, 8 oz of milk etc...

A glucose meter would be better to see what is going on but can be a bit pricey.

Right now i have a CGM put on and i can tell you when my blood sugar goes low i become symptomatic despite seemingly bp's.

[Sarah Tee]

I had the same question for many years. As well as occasional episodes on standing/exerting myself, I also had "slumps" each day about an hour after eating breakfast and lunch. I wondered whether I had reactive hypoglycemia or whether my blood sugar was dysregulated somehow.

My old GP (now sadly retired) gave me the same advice as MikeO has written above. I also purchased a basic blood glucose meter and checked my levels just to be sure. In my case, the levels were always in normal range or just near the lower end of normal. Having a carbohydrate snack helped a little but did not resolve my symptoms as it would have with actual low blood sugar.

I think that orthostatic intolerance can feel a lot like low blood sugar, either when you are exerting yourself and your circulation can't keep up, or after meals when blood is diverted to the abdomen/bowel leaving the rest of the body a little low.

I have plain old orthostatic intolerance, so when I have these episodes my BP and HR are normal. I have read people with POTS say that they sometimes have an episode like you describe even when their HR is normal.

Having said all that, there is no harm in purchasing a basic meter and checking for yourself. And your GP/primary care doctor could order some blood tests to look into it too.

[Pistol]

19 minutes ago, Sarah Tee said:

I think that orthostatic intolerance can feel a lot like low blood sugar, either when you are exerting yourself and your circulation can't keep up, or after meals when blood is diverted to the abdomen/bowel leaving the rest of the body a little low.

@Sarah Tee for me there is one big difference that I can immediately tell whether I am having low blood sugar or OI: weakness. When my sugar drops I become so very weak! The sweating is also a dead give-away for me. When I become faint I start to sweat just on my upper lips at first, but with hypoglycemia I start to profusely sweat all over. 

I barely have hypoglycemic events anymore since I started to avoid all concentrated sweets, eat every 2 hours and do not eat large carb-loaded meals. And as soon as I can feel the sugar drop I consume a juice and a protein ( mostly cheese ) and that usually stops it pretty fast. 

[Sarah Tee]

@Pistol, that's interesting. Maybe I have never actually been hypoglycemic and it was OI all the time, as I can't identify two distinct patterns and snacking doesn't really fix things. (I think it's the sitting down and resting while having the snack that creates the small improvement that I've noticed.)

I'm glad to hear you've got this aspect under control with diet.

[MikeO]

On 12/19/2022 at 3:53 AM, Pistol said:

with hypoglycemia I start to profusely sweat all over. 

I am starting to get the feeling that i have become hypoglycemic unaware. I use to be able to recognize it but i suspect it has been going on for so long my body is no longer presenting the cluse it should be.

[Bailee]

Thank you to everyone for the suggestions. I have been checking my blood sugar with a meter everything has been relatively stable/normal. So I’m thinking it’s just unfortunately the Orthostatic intolerance/pots.

[MikeO]

1 hour ago, Bailee said:

Thank you to everyone for the suggestions. I have been checking my blood sugar with a meter everything has been relatively stable/normal. So I’m thinking it’s just unfortunately the Orthostatic intolerance/pots.

Hi @Bailee glad to hear your blood sugar readings are stable (that's a win). Unfortunately i am in the same boat when it comes to the orthostatics. one other suggestion is to try pyridostigmine with the midodrine. the pyridostigmine does help me as long as i take it. i just can not take other drugs due to other issues.

Keep with it!

Mike