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fasting hypoglycemia

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I am a 35 year old 121 pound female. A couple of doctor's have suggested that I might have fasting hypoglycemia. I was on 300mg of Diltiazem (calcium-channel blocker) for about 10 years to control possible hypoglycemia and atypical migraine type symptoms. During that time I was hospitalized in an attempt to do a 72-hour fast, but I became so ill and the symptoms were so severe after 24-hours the test was stopped, my blood glucose had only dropped to 55 during the 24 hour testing period. They did not prove "fasting hypoglycemia" but did give me a diagnosis of hypoglycemia. Which I think meant relatively nothing, especially since the endocrinologist had only conducted one other 72-hour fast.

I still struggled with symptoms like numbness in my extremities and lips, vision disturbances, severe headaches, shakiness, tearfulness, tachyardia, speech and coordination issues and on an on when I would have an "attack". So I went back to the Dr. (still on high doses of Diltiazem) and had an insulin suppression test done. The test was stopped prematurely because my blood sugar fell to 40 during the test. As my blood sugar fell...I experienced the vision disturbances, anxiety and tearfulness that had been labeled hypoglycemia. The result of the c-peptide suppression test came in just below normal, but I can't help but wonder what effect the Diltiazem had on the test.

I was preparing for re-constructive knee surgery at the time so I did not pursue further testing when a different endogrinologist suggested that another 72-hour fast (properly conducted) would need to be attempted. I was pretty sure it would kill me if I tried that again...so I stayed on the Diltiazem and tried to manage the symptoms with diet. UNTIL 9 months ago when I had a TIA. More tests were run only to find that I have an insignificant PFO and the results of the holter monitor showed insignificant arrhythmia and 5 other insignificant events during the 24 hour period (i.e. extra beats or skipped beats). So nothing came out of that, my heart was fine, and I was told that it was unlikely that I would ever have another TIA, it was probably just a fluke.

That time in the hospital made me think and I decided that it was time to try going off the Dilitazem after 10+ years just to see what would happen. I continued to watch my diet carefully and did not have vision disturbances, shakiness, numbness, headaches, etc... the only remaining issues seemed to be tachyardia. I have remained on a "low-carb" hypoglycemic diet, but stopped testing my blood sugar levels because most of my symptoms seemed to be gone with the exception of tachyardia. Except that since I have been off the Diltiazem I have very gradually developed symptoms of anxiety that I quickly blamed on job stress because I thought that the absence of most of my systems meant I was healthier than ever!

My nickname has always been "sunshine" because I am usually very happy and bubbly, and things don't drag me down, but I don't feel like I really know who I am anymore. A few nights ago I was so anxious that I headed to the medicine cabinet to see if I had anything that would help calm me, anything at all....when I saw the blood sugar monitor and wondered if my anxiety, tearfulness and tachyardia could be related to blood sugar even though most of other my symptoms were gone. (I had completely stopped testing due to what I perceived to be lack of symptoms) So I tested, and sure enough my blood glucose was 64, not terrible but very possibly the cause of the anxiety tearfulness and tachyardia. So I've been testing for the last few days. I'm waking up anywhere from 64-68 but during the night I struggle with waking up with my heart racing, and gasping for air. I can't help but wonder if it's dropping further at night but recovering some by morning? If that's even possible. After I eat during the day it climbs to 77 or 80. I CAN get my blood sugar up to 90 by drinking 2 shots of expresso with probably 8 ounces of half and half and whipped cream. I limit myself to one, but I crave how I feel when I finally get to 90. I feel happy, like I'm the person I used to be....but that doesn't last long and I drop back down into the 70's and return to being tearful and more and more anxious every day. I wish I could have an expresso IV!!!

With the Diltiazem my waking sugar was 85 and I would be up as high as 116 sometimes after I ate. I know that 60 to 120 should be normal for a non-diabetic, but why do I struggle in the 70's with anxiety followed by tachyardia in the 60's if that's supposed to be normal???? I want to get my range up to 85-110 where I'm actually HAPPY and normal, but for the life of me I can't seem to and I don't want to resort to diltizem cause that clearly causes other issues. And no one seems to know why that increased my glucose in the first place.

I manage well on the low-carb diet...very stable.. no yo-yo's. I'm stable, but too low to be comfortable. From what I'm reading 60's and 70's for non-diabetics isn't even hypoglycemia at all!!! I'm SO CONFUSED!!!!

Does anyone have any suggestions? Is it possible to have fasting hypoglycemia if my waking blood sugar is in the 60's? What can I do to increase my average blood sugar by about 20 points without eating sugar or something that would cause my levels to yo-yo throughout the day and drop overnight. I have to get my glucose average back up (whatever the diagnosis is hypoglycemia or not) because the resulting anxiety and tearfulness has become unmanageable! My diet consists of things like chicken breasts, salad, celery, green beans, beef, atkins bars, espresso drinks - only once a day so that I can feel normal for a while, half and half, cheese, nuts, etc. and I eat every two to three hours. Please help....

P.S. it is now 1:20am and my blood sugar is on it's way down for the night...it's 66 now. It was 77 at 10pm.
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replied April 6th, 2008
Doctor
Hypoglycemia is a clinical condition that occurs when blood glucose level goes under 3.0 mmol/L (54 mg/100ml).

Does your blood glucose level drop under that value, and if so, does it happen immediately or 8-9 hours after the meal?
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