I have read another post in this forum on potential causes of why does Hypoglycemia occur in some (unfortunate ) people like us ?

This is a question I had been pondering for a long time. In my case, now at least I seem to have got an answer - that the medicines I took for foot treatment contained this ingredient that can play havoc with a person's sugar regulation mechanisms. (Incidentally, I also found that this chemical is NOT approved by FDA in US for prescription as medicine for humans). But I live in another part of the world where such measures are not in place.

How about others here - have anyone of you wondered why did you get this sugar dis-regulation in the first place ?

Please be careful when diagnosing yourself from the internet, I would advise anyone to NOT do this. I know it's frustrating when blood tests don't reveal anything useful, but you have to take everything you read on the net with a grain of salt, and keep in mind that sets of symptoms are common to hundreds of conditions. It's very important that you stick with your doctors so tests can continue, the problem may not be what you think it is at first. By all means read up, but keep an open mind and don't diagnose yourself.

Cases of actual reactive hypoglycemia are rare. The cause will vary from person to person and is usually unclear.

I've heard about glucosamine possibly causing problems with glucose metabolism, but I wouldn't have thought it would cause reactive hypoglycemia over a year later. Remember, hypoglycemia is a symptom, not a condition in itself. I find it hard to imagine these pills would cause such permanant damage to the body's metabolism. You should mention the pills to your doctor and see if there could be a connection.


Many questions. First off, have you documented a hypoglycemic blood sugar reading of 2.4mmol or under?

Hi,

Thanks for your response and your advice. I also have come to realize now that self-diagnosis and that too on basis of reading in Internet can not be reliable. However, I would also like to point out few things:

a) Glucoasmine did not cause me the hypo over a year later. When I started on the glucosamine pills, my problems started immediately after 1.5 months when I had been on these pills on daily basis for 6 weeks.

Initially, I started getting bouts of fever which could not be diagnosed for couple of months. Then gradually fatigue started and my fatigue would kick-in after breakfast and around afternoon. Then it became all persistent.

b) Secondly, I don't think these pills caused the permanent damage just on their own. My poor diet habits and sedentary lifestyle were already setting up the ground for this. I had been always heavily fond of sweets and sugary items and my diet had been a high-carb for all my life. Also, now I know, I was consuming far too much calories /carbs than my desk job would require. This together with lack of any physical activity were all setting me up for troubles with my metabolism. The glucosamine pills just triggered or worsened the problem. May be something that was to happen 5-8 yrs down the line got ‘triggered’ immediately. (E.g. if my body was developing insulin resistance due to my poor diet/sedentary habits, I could have ended up with diabetes in 10 yrs !!)

c) I don't have a documented blood sugar reading because none here would administer a blood glucose test. I have visited several doctors (including a gastro-entomologist and an endocrinologist) but they ridicule me when I mention the word hypoglycemia. The doc told me hypoglycemia can occur only in diabetic persons and the cure for that is to eat sugar. He said hypo is no disease as such in a non-diabetic person and I must be crazy to get such ideas in my mind. He even suggested my problems may be because of being stressed out thinking about my symptoms and hence the issue may be psychological/mental.

d) Even in absence of measured readings, I have multiple observations to support that I do have problems in response to sugar. On taking glucose, I get weird headaches in few hours - this has happened many times. On 3 occasions, when I ate rice/bread with refined sugar, I felt extreme nervousness, shivering, weakness etc. in few hours. On one instance, I imemdiately went to sleep and woke up with terrible headache. On another occasion, when I was consuming bread with a liquid crystallized-sugar syrup (part of local diet), within 15 min, I got extreme symptoms and felt as if I would go in coma.

Once when I was very low, drinking a mango-shake laden with sugar immediately gave me a high followed by a low in terms of energy. I have seen that eating a sweet fruit on empty stomach give me dizziness & weakness within 20-30 min.


e) In the worst case, even I did not have any reactive hypo, I think I am not hurting myself in any way by doing what I am doing now - taking a balanced diet, abstaining from refined sugar, eating more green vegetables. In fact, if all of my family and friends took such a diet, I assume they would all benefit in terms of health. Besides, I am not taking any drugs/medicines on my own, I have just started to take occasional Vitamin. B-complex and Vit-C.


In summary, even though no doctor would formally diagnose me with reactive hypo, I think if I am eating a balanced/nutritious diet than before, my body would benefit. And if this diet can cure hypo or other diseases, all the more better.

Any advices would still be welcome. Thanks !

Well your experience with the medical world isn't uncommon...What country are you in?
Hypoglycemia in non diabetics isn't recgonised in a lot of places, and even if you found a doctor who believed you, he wouldn't diagnose you without concrete evidence. It's a big can of worms for a doctor. From experience, they think you're mentally ill until they have a documented low blood sugar, then they're like stunned sheep.

The problem is, without actual low blood sugar, hypoglycemia isn't happening. Hypoglycemia IS the low blood sugar regardless of the symptoms. Many people experience these sets of symptoms without having a low blood sugar, see my thread on "Postprandial Syndrome". Fatigue is a nasty one, and unfortunately common to hundreds of conditions. Where it does seem your problem is diet related, it could still be any number of things. It could be a food intolerance, it could be insulin resistance,it could be a metabolic issue or it could be a problem with enzyme/hormone imbalance even.

The best thing for you to do is what you've done, change your diet to something that helps lift the symptoms.

There is a difference between insulin resistance and reactive hypoglycemia too, they're not the same condition. On the net a lot of conditions get mashed up into one, like reactive hypoglycemia/insulin resistance/hyperinsulinemia/syndrome X/carb sensitivity/intolerance and so on.

Insulin resistance is something you may well have developed, and of course you've read of it's links to type 2 diabetes. High blood sugar, fluctuating blood sugar, both present symptoms which include fatigue.

Do you have access to a blood glucose monitor? If not are you in a position to pick one up? Chemists usually sell them. Use the sticks wisely, they're more expensive than the machine(!). Monitoring your blood sugar before/after meals, in the morning, before bed etc will give a better idea of what, if anything, is going on with your blood sugar.

Hi VictoriaGB,

Thnx again for your response - it was soothing to read your advice and explanation, I almost felt like I was listening to a concerned physician in a clinic (In fact, the docs I visited should have consulled me in this manner instead of calling me a psychiatric case, that is why we visit them, but only if they could grasp my problem in the first place).

I also have some more observations:

a) My fasting blood glucose last year (before my current troubles started) was 103 mg/dl. As of now (i.e. after I supposedly developed full-fledged reactive hypo), the fasting as well as Post-prandial sugar have come at around 77 & -83 respectively. Though all are within normal ranges but is somewhat puzzling to me - I don't know what to make out of a drop of 30 points in blood sugar levels within 1 year.

b) I got a number of blood tests done, including insulin/thyroid/lipid profile/minerals, Hepatitis-B and C, Elisa, Wilson's disease, CRP etc.
The only documented abnormalities were :
- all the liver enzymes and bile were mildly elevated outside normal ranges (which puzzles my gastroenterologist)
- my HDL (good cholesterol) has fallen below normal at 32.6 mg/dL.
- the abdomen ultrasound shows a fatty liver

From what I have read , both the HDL and fatty liver problems above can be caused by insulin resistance and bad-diet habits. So I highly suspect I was developing insulin resistance which was worsened suddenly by the glucosamine pills and then reactive hypo resulted.

c) I am even somewhat afraid of undergoing the standard Glucose Tolerance test for Hypo now because the symptoms it can produce are too bad. I can say have (unknowingly) undergone the glucose test 2-3 times at home, when I consumed liquid sugar syrup (as part of meals) and it caused violent, extreme symptoms to result in my self like trembling, shakiness, weakness – I was howling like an animal in pain and almost felt as if I would collapse. The after-effects lingered on for many days.

I don't have a blood glucose monitor yet but intend on picking up one, only the strips are said to be expensive.

d) I can see there would be a difference between reactive hypo and insulin resistance, but I have also read that insulin resistance may well be on the leading causes of reactive hypo. Also, I think hyperinsulinemia would occur as a fall-out of body's response to cope with insulin resistance.
As for Syndrome X, that has insulin resistance as one of the components.

e) Even though hypo has not been diagnosed in my case thru medical results, I have seen benefits from the hypo diet. Eliminating refined sugars has made my (weird) headaches, dizziness, shakiness etc. all vanish. My main issue now is the fatigue that lingers on (my arm biceps and thighs pain and feel sore on doing even the small chores even ). I had to even severely restrict walking and stop all exercising due to the fatigue now. May be I will cure this fatigue also some time soon, because the docs won't help.


As you mentioned, my problem could also be food intolerance, metabolic issue, enzyme/hormone imbalance. I don't know how to get them diagnosed/tested and I feel the docs would not listen to me on this also.

I will read your post on postprandial syndrome and see if I gather something useful. And if there are any more suggestions, pl. do offer. (Sorry for bothering with my long post , but I wanted to get out all the issues/facts).

I'm not sure if this will help you but I also suffered terrible fatigue once my diet got really bad and I switched to a good diet. I was (and currently am) restricted to 30 minutes walking 3 times a week. I've been on the diet 3 months. I used to do 25 miles walking a week as well as train twice a week for lacrosse.

I think I'm improving ever so slightly week on week. It's tough when your mind kind of wants something quickly but the body is slow.

I haven't read your earlier posts but if you haven't already you might want to consider an adrenal stress test. Fluctuating blood sugar can play havoc with the adrenals and abnormal cortisol/DHEA levels could be the cause of the fatigue.

Good luck! Your not alone and on the right track

Hi,

I am not sure which one is the adrenal stress test and what to tell the laboraryory for. I did mention to an endocrinologist that I am concerned about any issues with adrenal and he asked me to get the serum cortisol test done. That came ou within range...(I could not get the DHEA tested though as that was pretty expensive compared to Cortisol).


Thanks for your suggestions...

See the doctors question on Adrenal Fatigue at the top of the forum.

Adrenal fatigue can result in hypoglycemia, but hypoglycemia doesn't cause adrenal fatigue.

I had a theory myself once that fluctuating blood sugar levels could cause adrenal fatigue (and hence the prolongued symptoms experienced in reactive hypoglycemia even when blood sugar isn't low). But apparently this isn't the case.

With regards to your previous post(!)

You can take two fasting blood sugar tests one day after another and get two different results - I wouldn't worry about the difference. My fasting blood sugar varies between 3.8 and 4.7 depending on my diet/lifestyle the days before.

The fatty liver could be something worth looking into, or at least keeping an eye on. HDL heads to the liver for cholesterol to be broken down, so liver function would be doing ok I'd assume. Did you have a result for the LDL?

A postprandial blood sugar of 70-80 is fine, that doesn't indicate insulin resistance. (For comparison, my postprandial sugar is 14-15mmol (252 mg/dl), before it drops to 40).

The strips can be expensive, use them wisely. It would be worth having the GTT, it helps doctors no end. But be warned, unless it's an extended GTT (4 hours rather than the usual 2 hours) then is probably won't catch the hypoglycemic reaction.

This problem with fatigue, you find much worse after activity? Severe fatigue after exercise/activity is one of the main indicators of ME, one of the symptoms of ME is hypoglycemia too. My father has this condition and it's terrible. Don't be alarmed, but again bare in mind this could be any number of things.


It is likely that whatever IS the problem, has been caused/irritated by bad diet. If I was you I'd concentrate more on the cure than the cause, or you'll drive yourself mad looking for answers. These symptoms are so common it's very hard to even know where to look let alone diagnose (which is why doctors give you the brush off).

Stick to your diet, it can take a while for the effects of bad diet to be reversed. And have a look around for a different set of doctors who may be more pro active.


How much carbohydrate are you eating?

Hi,
Thnx for your explanations. Here are my comments/responses on some of the items:

Adrenal Fatigue If hypo does not cause adrenal fatigue, so then what causes those symptoms to prolong even after the blood sugar has returned to low? I don’t see any reason there.
Also, are there any lab tests to diagnose if one had adrenal fatigue. My serum cortisol, serum insulin and thyroid tests were within normal range and I can’t think of an other tests.
I have read on the web about self-tests like Ragland’s sign etc. but they were normal for me and I don’t know how reliable they are. So then how can one diagnose adrenal fatigue?

Cholestrol Levels
- My HDL (good cholesterol) is 32.6 mg/dL which is less than what the normal body needs (HDL is good cholesterol, so more of it is needed. And HDL < 40 puts one at risk of Metabolic Syndrome)
- My LDL was at 93 mg/dl which is ok

Postprandial Sugar Levels
I think that would depend on when the sugar is taken. (Mine was taken 2 hrs after breakfast).
It could still be insulin resistance in progress, I don’t know. Else, I don’t have any explanation for what I have been suffering from.
And if the pancreas are indeed secreting excess insulin, the sugar could drop quickly to come to a lower level like 70-80 probably??.

Fatigue
My fatigue worsens after activity and that includes trivial activities like walking/standing, cleaning my cupboard etc.
ME is synonymous with Chronic Fatigue Syndrome (CFS). In fact, for initial one yr (out of the 1.7 years I have been suffering from this ailment), I was under the impression that I have CFS – that was when the docs couldn’t diagnose or find anything wrong with me. In fact, quite a few but NOT all of my symptoms matched with CFS. Again, for CFS, there is no diagnostic test to detect if one indeed has CFS.
But when I happened to notice on 3 occasions consecutively that having consuming liquid refines sugar directly caused my severe reaction, that pushed me into exploring and I went hunting and reading on the Web. And when I found reactive hypo, bingo – almost all symptoms matched. I was amazed to discover that there are several other people around the whole world who not only suffer from something very similar to what I have. Although by reading your posts now, I realize I may not necessarily have hypo. But some meatbolism/sugar/carb related problem does exist.

Diet/Carbs
Irrespective of whether I have reactive hypo or something else, I have started gradually implementing the diet changes because I know that is a diet healthy for ANYONE, not even the normal types who supposedly don’t have an ailment like mine.

I don’t know how much carbs I am eating because I have never calculated as such computing but I will try to do so (once I find what food has how much carb). What I do now I realize is that all my diets so far were heavily carbohydrate oriented and I was probably consuming much more carb/calories than my sedentary lifestyle would have required. e.g. I used to eat upto 6 white-flour breads at any meal (with some vegetable/protein), was very fond of potaotoes and sweets.

And for 30 years, I was never aware that all I am eating excess carbs, refined flours and sugar. (What a pity of, inspite of all the medical advancements – no one ever explains you such things and the bad effects they can have. The media only advertises soft-drinks, sugary items, processed and refined foods and all the bad-for-health things that food companies sell)

As I said, many questions are as of yet unanswered. I'm on the case myself but it's a long process, and very tiring after years of pushing(!)

Adrenal fatigue can be diagnosed with lab tests and of course your GP, I'm not sure which exactly but I can find out tomorrow. I should imagine it would be cortisol and DHEA.

Fatigue can be caused by any one of literally hundreds of issues, it's one of THE most common symptoms. It's the one symptom that drives me insane (that and brain fog) and would love nothing more than an answer for. Even when blood sugar levels are normal, these symptoms still persist. There are theories, but nothing is proven and I doubt it will be for a long time yet - considering reactive hypoglycemia isn't even recognised by most.

Something to consider on the subject of fatigue - type 1 diabetics suffer much more severe blood sugar fluctuations than us, yet they don't suffer the persistant brain fog and fatigue for days after a low/high blood sugar. My husband is type 1, he suffers fatigue for a few hours after a bad hypo, but that's it. I'm down for a week or more after a bad day.

At the moment my theory is that whatever is causing fatigue (and accompanying symptoms), is also causing the fluctuating blood sugars. Remember hypoglycemia is a symptom, not a condition in itself - it could be that both the fatigue and the hypoglycemia episodes are symptoms of the same underlying problem.


Your HDL/LDL ratio may reflect bad diet. It'll take time to change, although it doesn't look too concerning.


You're right about the postprandial blood sugar. You need to get a reading at 30 minutes, and 60 minutes at least. After two hours my blood sugar is in perfect range so doesn't show how high it was or how low it's heading. And glucose is one of the best things to use for the test for a better idea - energy drinks are good for that, particularly Lucozade (not sure if you have that in the states but you should have something similar).


"meatbolism"?? HAHA That tickled me...

I wouldn't rule out CFS/ME. One of the symptoms is blood sugar control (or lack of). Don't try to match up ALL your symptoms, everyone is different. My father has both ME and low blood sugar problems - doctors think they're linked but he's had hypo problems from around 12, same as me, so I don't think they are. It's also possible you have more than one condition underlying. Or maybe bad diet caught up with you!


6 slices of bread ay, you sound like me. Definitely need to kick that habit, hopefully you didn't get the cravings or anything.
It sounds like you do needed/need a diet change and a shake up physically. (and less time on Google :p).

The media is a pain in the butt, anything for a story. The best guidelines are published by the government, the good old balanced diet that everyone has forgotten about in the heat of low carb/high fat/cabbage only/lose 100lb a week diets.The biggest gripe with the recommended daily allowances is carbohydrate is said to be a little high, but taking another look just this week I actually agree with the RDAs. Carbs should be between 150g (which really isn't high at all) and 280g depending on energy needs. (if you work it out, you may have been consuming at least double that in bread and savoury/sweet - I know I was at one point!).

It actually sounds like you're a carb monster (my husband calls me a bread monster). Whatever diet you're on, make sure you have good amounts of all food groups, don't eat too much carbohydrate in one meal, and split your meals into 6-8 very small balanced meals. That was the key for me.


As for what is causing your symptoms - you may never find the answer. Unless you do a few degrees and get into the medical world (not what I'm doing honestly...)

Oh and don't forget fibre, no more than 35g a day though or it can interfere with mineral absorption. Make sure you're getting your vitamin/mineral requirements too, all these symptoms can result from deficiencies.


Everything in moderation.

Though I have no way of proving it, I'm pretty certain one of the causes of my hypoglycemia was a long used prescription of Acutane when I was younger. That stuff puts a heavy burden on the liver and anything that does could cause a problem later on by making it more sensitive. It was roughly after this that I started to notice, when I think back on it, symptoms starting to come on so I wouldn't be surprised.

Stan, your response adds confidence to my suspicion that my ailment was also triggered by the medicinal glucosamine pills (in my case). Although my not-so-good eating habits and sedentary lifestyle could have also played a part in this, but there had to be triggering factor still which led to sudden blow-up of symptoms.


There could be many other people who would not know this but some drug was creating a side-effect and contributing to their problems like reactive hypoglycemia or insulin resistance.

Also, this does show that modern-medicinal drugs cause side-effects that are either not known fully to medical science or are withheld/suppressed from public domain.

It's not unusual, look what just happened to Chantix. It was on the market awhile and then some people took their own lives. Oh yeah, should have mentioned and made it more clear that this drug CAUSES PEOPLE TO COMMIT SUICIDE. Touchy subject, of course, I mean, you have to decide to do it, but it was found to cause the tendencies. In addition, some people ended up with diabetes and sugar problems. Makes you think what the 'suicidal' symptoms were really caused by, doesn't it? Interestingly, suicidal thoughts were also linked to Acutane a few years ago and sugar problems. Pretty clear to me. Any drug that they require liver tests for should be used only if absolutely necessary, in my opinion.

BTW, on the lines of above posts, I came across an article on NY Times
that says something similar about allopathic drugs producing horrible/bad side-effects and this information being suppressed.

Just out of curiousity, read this:

http://www.nytimes.com/2008/11/22/health/2 2radio.html?_r=1&ref=business

Clearly these symptions and reactons are real, even if they are not diagnosed by standard laboratory practices. I experienced an onset of symptoms in this order: food intolerance (wheat, corn), irritable bowel syndrome, fibromyalgia, "reactive hypoglycemia". People who do not experience these conditions will think you are a hypochondriac, so I've learned to keep my mouth shut. Doctors will try to help but likely do not have a solution because the tests tell them nothing and allopathic medicine isn't advanced enough in this area to provide an accurate "cause and effect". Whatever the case, these symptoms are very real.

I have found significant relief from the fatigue and pain of fibromyalgia by changing diet to eliminate gluten and corn. Taking phosphatidyl serine (soy-based) helps sleeping at night. A good stress vitamin, six small meals a day (very low carbs, no sugar or caffeine) and daily excersize all help the hypoglycemia-like symptoms. I'm a woman over 50 and natural progesterone cream (wild yam) has helped a great deal with hot flashes and sleeping, as well as fibromyalgia pain. It seems like a lengthy routine just to feel good but without a diagnosis we must use empirical evidence to each find our own treatment.

It's important to be careful using the internet, and it's use for diagnosis is clearly flawed. However, it's comforting to find others with similar symptoms and complaints, and to understand that you are not going crazy or a hypochondriac. This is clearly real.

The bottom line is to treat your body right. Take care of it, nurture it, but don't dwell on it. We need the discipline to make the healthy changes that make us feel better and then the wisdom to move on (mentally and emotionally).

Good luck to all of you, it's a challenging road.

I am replying to an old post but want to share. I have been diagnosed by my doctor with reactive hypoglycemia in my late 30s and suffer from debilitating fatigue especially after any activity like exercise. I am sorry to hear that doctors dismiss you that it could not be this condition. In my case, my sugar dropped to 47 after two hours during the testing and I almost passed out in the bathroom of the clinic. The doctor originally was checking for diabetes with me being overweight and was surprised by the results. He and another doctor told me it was very rare having this condition without being a diabetic. He is currently looking into the cause. My liver enzymes are elevated also. When I eat sugar, my body gets a high feeling and then I will crash by going to sleep. If I eat a carb and protein together, it is a little better but every 2-3 hrs, the fatigue hits, blurry vision and sometimes headaches set in. It then takes 30 minutes to an hour to feel a little better. It is crazy feeling this way but knew something was wrong when I was a kid after drinking a shake and then passing out in the car when I was 8 years old. I spent my school years nervous, tired and was treated for depression/anxiety with no help from medicines. I wish I could get my medical records expunged when it was really the hypoglycemia that was going on.

I hope you can get the help you need and someone to take you seriously. It is very real. All I can say, is always take a snack of protein/carbs to anyone who has this with you because driving and passing out are real possibilities.

I have been diagnosed with it. Maybe I was fortunate because my doctor was willing to listen. If your Doc doesn't or won't do the tests, then GO TO SOMEBODY WHO WILL. Gastro specilaist is a must.

You have to have not only all the tests talked about above, including GTT 5 hour, but I also had ultrasound and barium CT scan. Don't worry the berry flavored barium doesn't taste that bad as long as it's cold. He also did a HIDA scan (gallbladder) to make sure.

Long and short, no cancer, no stones, no organ issues, blood tests showed what they should and all the pictures were good. I'm 50 so that was a relief. The GTT however showed at 3hrs my blood sugar was 40. But at about 3hrs and 25 mins I thought I was going to pass out.
(Doc thought it probably bottomed at around 25-30) By the 4th hour I was already starting to recover. This is good news because that showed that everyhting was able to stabalize, there is some form of cancer that can cause a steady high insulin level.

So, what to do - diet change. You gotta eat something every 2-3 hours, and it needs to be non-processed sugar. Processed sugar is very bad for you so NO SUGAR, NO SUGAR, NO SUGAR. Limit carbs so no processed food. i.e. crackers and snack foods and crap like that. Get things that have complex sugar without sugar added. GOTTA READ LABELS. No caffeine, and no alcohol (not good for you anyway)

Basically I started following a modified Atkins diet. I say modified because after a couple days going strict Atkins, I noticed I started feeling poorly, by cuttin back on too many carbs. I lost 10lbs in the process, (yeh) and now have stabalized at probably 70g carbs per day.

Feel better than I have in years.

Reactive hypoglycemia is over production of insulin due to too much at sugar, and you body counters this by dumping adrenaline; that's why you get a jittery rush. Even out your sugar intake by eating smaller, better food, mor often, and don't do big sugar boosts.