Seeking info about how to get assessed for reactive hypoglycemia/ hyperinsulemia..

[KOF_78]

Hi, I believe that I have reactive hypoglycemia. Can anyone tell me how best to pursue getting assessed?.
Specifically what I'd like to know is if any one can give me recommendation for a London or South-East England endocrinologist with an interest in reactive hypoglycemia/ hyperinsulemia that I can ask my GP to refer me to?. Also what test(s) should I ask for other than glucose tolerance test?.
Thanks in advance for your help


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[AndBreathe]

Hi, I believe that I have reactive hypoglycemia. Can anyone tell me how best to pursue getting assessed?.
Specifically what I'd like to know is if any one can give me recommendation for a London or South-East England endocrinologist with an interest in reactive hypoglycemia/ hyperinsulemia that I can ask my GP to refer me to?. Also what test(s) should I ask for other than glucose tolerance test?.
Thanks in advance for your help


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Hello there KOF_78 . I don't have RH myself, but I'll tag @Brunneria , and @nosher8355 who do, and should be able to offer you some insight, from "the inside".

Good luck with it all, and welcome aboard!

 

[AndBreathe]

Hi, I believe that I have reactive hypoglycemia. Can anyone tell me how best to pursue getting assessed?.
Specifically what I'd like to know is if any one can give me recommendation for a London or South-East England endocrinologist with an interest in reactive hypoglycemia/ hyperinsulemia that I can ask my GP to refer me to?. Also what test(s) should I ask for other than glucose tolerance test?.
Thanks in advance for your help


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@KOF_78 - I have tagged a couple of folks with RH on your other thread. If you feel this post is a duplicate, I would be content to remove it for you, but if you think you are asking for other information, I'll leave it.

Could you let me know? Thanks.

 

[Lamont D]

Hi, I believe that I have reactive hypoglycemia. Can anyone tell me how best to pursue getting assessed?.
Specifically what I'd like to know is if any one can give me recommendation for a London or South-East England endocrinologist with an interest in reactive hypoglycemia/ hyperinsulemia that I can ask my GP to refer me to?. Also what test(s) should I ask for other than glucose tolerance test?.
Thanks in advance for your help


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Hi there, welcome to our forum.
If you believe you have a form of hypoglycaemia, and you need a bunch of tests to rule out other conditions, the only way forward is to get a referral from your GP.
Your GP can find an endocrinologist, who has specialist knowledge in Hypoglycaemia.
As it rare, then the tests you need are a hba1c to see if you have normal glucose levels. Unless your insulin resistance is high that distorts your test.
Then a prolonged OGTT (oral glucose tolerance test) (5hours) which will show how quickly you spike, then if you hypo after more than two hours. During this test other blood tests should be done, including GAD and c-peptide. If that shows that there is a possibility of you having RH. Then the next test is probably a breakfast tolerance test (you are given bread, butter jam and a drink, then they monitor your blood glucose levels and take blood for tests for other conditions.
The last tests are to eliminate insulinoma or pancreatitis or pancreatic cancer, which is a 72 hour prolonged fasting test in a hospital.
That will give a definitive diagnosis of wether you have RH or not.

Can you give us the reason why you believe you have RH?

You can do something about it, today!

If you have hyperinsulinaemia, the test is usually one of the ones that has been mentioned above during either the OGTT or breakfast test.
Most GPs cannot afford to get these bloods done unless he has a decent enough reason to.

The symptoms these conditions have, mirror a lot of diabetic conditions.
Hence the confusion and conflicting diagnosis.
I was misdiagnosed T2 for quite a few years.

Also my first endocrinologist and all my GPs didn't have a clue.

Keep us updated on how you get on.

Best wishes.

 

[KOF_78]

Thank you AndBreath . please leave post up. Thanks for you help

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[KOF_78]

Hi nosher8355,
Thank you very much for that info.
My reasons for thinking that I might have some kind of hypoglycemia & possibly hyperinsulemia are symptoms such as feeling really knocked out (to the point of falling asleep at my desk/ needing to sleep for a couple of hours if I eat sugary or starchy food (i've only noticed this in recent years but wonder if i may have been experiencing this in a less obvious form since childhood); brain fog; tendency to sweat excessively (more or less full body from the scalp down) without obvious cause; night sweats if I eat a carb heavy meal same evening or if I drink alchohol; temporary muscle weakness most noticeable in legs & sometimes in arms (i think consistent with the 'leaden paralysis' described as being symptomatic of atypical depression but also sounds to me like insulin resistance); problems with depression & anxiety since childhood; problems with emotional dysregulation since childhood; crying out in my sleep; unrefreshing sleep; yo-yoing weight (mainly over weight), difficulties with focus, concentration & low energy since childhood; greatly underachieving at school & work in relation to my potential; repeating cycles of burn out during which my thinking slows down, my recall & short term memory gradually pack up & I end up unable to think seem to be developing dementia. Frequent difficulty ordering my thoughts into words in a coherent manner & difficulties with sequencing. Have lost an enormous amount of productivity at work & elsewhere due to this & have taken a lot of sick leave due to it.
I have been diagnosed with AD(H)D without hyperactivity + dysthymia (chronic, mild depression) with episodes of severe clinical depression + 'complex fatigue' (if that last one counts as a diagnosis at all) + the very beginnings of autoimmune thyroid disease. None of these conditions taken together or separately fully explain/ describe the range of my symptoms.
I've noticed that I do function much better & experience a significant decrease in symptoms if I eat & live by what I understand to be guidelines for managing reactive hypoglycemia, I.e. eating low carb/ high protein/ high fat (grain free, alcohol free, starchy root veg free, limiting/ cutting out most fruit; low caffeine); eat small frequent low carb/ high protein/ high fat meals & snacks; exercise frequently; keep to a set sleep rountine; incorporate relaxation techniques. Eating low carb/high fat/high protein seems to be by far the most crucial factor.
According to my GP my blood glucose readings (from lab results) are slap bang in the middle of the normal range.
I've been self testing my blood glucose on & off since early May this year using a SD codefree metre. The first fasting test was 6.4 (in the T2 range). Other than that my morning fasting readings have been in the region of 4.7-5.6 with readings of between 5.1-5.6 two hours after eating.
My hypothesis is that I may produce too much insulin in response to carbohydrates & that this may be either the root cause or at least a partial cause of my symptoms over time & that I am likely heading for T2 diabetes if I don't take charge now.
Please accept my apologises for long, long post!.
What do you make of this?.
What data or information would you recommend that I gather to work this out & to bring to GP to pursued them of nessecity of referring me?.
Thanks for your help.


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[Lamont D]

Hi nosher8355,
Thank you very much for that info.
My reasons for thinking that I might have some kind of hypoglycemia & possibly hyperinsulemia are symptoms such as feeling really knocked out (to the point of falling asleep at my desk/ needing to sleep for a couple of hours if I eat sugary or starchy food (i've only noticed this in recent years but wonder if i may have been experiencing this in a less obvious form since childhood); brain fog; tendency to sweat excessively (more or less full body from the scalp down) without obvious cause; night sweats if I eat a carb heavy meal same evening or if I drink alchohol; temporary muscle weakness most noticeable in legs & sometimes in arms (i think consistent with the 'leaden paralysis' described as being symptomatic of atypical depression but also sounds to me like insulin resistance); problems with depression & anxiety since childhood; problems with emotional dysregulation since childhood; crying out in my sleep; unrefreshing sleep; yo-yoing weight (mainly over weight), difficulties with focus, concentration & low energy since childhood; greatly underachieving at school & work in relation to my potential; repeating cycles of burn out during which my thinking slows down, my recall & short term memory gradually pack up & I end up unable to think seem to be developing dementia. Frequent difficulty ordering my thoughts into words in a coherent manner & difficulties with sequencing. Have lost an enormous amount of productivity at work & elsewhere due to this & have taken a lot of sick leave due to it.
I have been diagnosed with AD(H)D without hyperactivity + dysthymia (chronic, mild depression) with episodes of severe clinical depression + 'complex fatigue' (if that last one counts as a diagnosis at all) + the very beginnings of autoimmune thyroid disease. None of these conditions taken together or separately fully explain/ describe the range of my symptoms.
I've noticed that I do function much better & experience a significant decrease in symptoms if I eat & live by what I understand to be guidelines for managing reactive hypoglycemia, I.e. eating low carb/ high protein/ high fat (grain free, alcohol free, starchy root veg free, limiting/ cutting out most fruit; low caffeine); eat small frequent low carb/ high protein/ high fat meals & snacks; exercise frequently; keep to a set sleep rountine; incorporate relaxation techniques. Eating low carb/high fat/high protein seems to be by far the most crucial factor.
According to my GP my blood glucose readings (from lab results) are slap bang in the middle of the normal range.
I've been self testing my blood glucose on & off since early May this year using a SD codefree metre. The first fasting test was 6.4 (in the T2 range). Other than that my morning fasting readings have been in the region of 4.7-5.6 with readings of between 5.1-5.6 two hours after eating.
My hypothesis is that I may produce too much insulin in response to carbohydrates & that this may be either the root cause or at least a partial cause of my symptoms over time & that I am likely heading for T2 diabetes if I don't take charge now.
Please accept my apologises for long, long post!.
What do you make of this?.
What data or information would you recommend that I gather to work this out & to bring to GP to pursued them of nessecity of referring me?.
Thanks for your help.


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Hi, again.

First I would start a food diary including doing sample tests of interval testing.
That way you can record every different food you experiment with. You can change the timing of testing and do a thorough review of how your body reacts to foods.

This can lead to you having evidence of you having episodes of hypoglycaemia or hyperglycaemia. By your symptoms you do have some imbalance in your insulin response and though I can't diagnose you, your symptoms suggest that something other than normal is happening.

You theory of hyperinsulinaemia is not unusual or uncommon as the symptoms are very similar to what you describe and mimic type T2 in so many ways.
But only a blood test can diagnose this.

If you have had chance to read some of our forum, we do have a diversity of different symptoms and how we react to different foods. But the only viable treatment is diet.
You have already said that you are eating low carb, and I can see you are doing as good as someone who has had to find out by himself what helps alleviate your symptoms. I have found that very low carb, as low as possible, is the best way to control your condition whatever it is.
If you don't spike, you don't hypo, you don't create the excessive insulin, therefore, the glucose is stable in your blood. Having normal bloods longer in the day, keeps your blood more balanced and free of the excess insulin. And you feel better.
With us carbs are carbs, and they, no matter how you label them, will trigger the insulin you don't want. Carbs to me are poisonous and I have so many intolerances to a lot of foods that it has took me quite a while to get my head around and get it right.
I am still learning and discovering new ways to be really healthy, I've got my life and health back thanks to getting my very low carb diet right.

Then again, I might just be wrong because of your thyroid problems.
But I believe a low carb diet will alleviate some symptoms.

Best wishes.

Let us know how you get on.

 

[chalup]

Hyperinsulinemia can be present years or decades before glucose levels start to change. The c-peptide test will tell you if your levels are high, low, or normal. If they are very high the solution is a low carb diet as every time you eat carbs your pancreas releases insulin to deal with them. High levels of insulin cause insulin resistance to go up and insulin resistance means you need more insulin to be produced. This is an escalating feedback loop and the end result if you are prone to it is weight gain and diabetes. Low carb seems to also be the solution to RH but others here know a lot more than me about that as I do not have it. Good luck to you.

 

[KOF_78]

Thank you Nosher & chalup.
I will let you know how I get on.

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