Alcohol induced reactive hypoglycemia???

Reactive

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Hi everyone,

I’ll give you the short version of my story:
Been drinking 4 beers a day for weeks. A little overweight, otherwise healthy male aged 40.
Last week drank 12 beers and did not hydrate. The next day woke up ok (a little hungover). ~1 hour after breakfast had a hypoglycemic attack (I know it for sure).
Had another the next day and another the day after.
I wake up with nausea, and feel fine after i have a breakfast with an omelette. No issues for 5 hours (no food intake), eat 1 apple and peach, then 2 hours later eat fatty mozarella cheese and bamm another hypo attack measured at 5.1 mmol after 10 minutes.

Question 1: Is this reactive hypoglycemia?
Question 2: Can you have it overnight after binging alcohol?
Question 3: Shouldn’t it be normalised by now?
Question 4: Any recommended tests, solutions?

I feel perfect without episodes, and feel weak and light headed and like about to die a few hours post episodes.

Hemogram, electrolytes, renal functions normal.
Other tests pending
Any help is appreciated.

Thanks a lot!
 

JoKalsbeek

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...5.1 mmol/l isn't a hypo. It could be a false hypo though, which feels exactly the same as a real one. Test before a meal, and at one and 2 hours after the first bite. So three tests. See what happens. Then again if you start feeling hypo-ish. And if the results do include a hypo, especially after eating a lot of carbohydrates (RH is your body overreacting with its insulin response, so it's not the alcohol, it's the carbs in the beers. It's not called liquid bread for nothing. The fruit would be an issue too.), you should ask your doc for an Oral Glucose Tolerance Test. And request the long version, because some people tend to hypo after a short one while on their way home, making the test absolutely useless.
 

Reactive

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...5.1 mmol/l isn't a hypo. It could be a false hypo though, which feels exactly the same as a real one. Test before a meal, and at one and 2 hours after the first bite. So three tests. See what happens. Then again if you start feeling hypo-ish. And if the results do include a hypo, especially after eating a lot of carbohydrates (RH is your body overreacting with its insulin response, so it's not the alcohol, it's the carbs in the beers. It's not called liquid bread for nothing. The fruit would be an issue too.), you should ask your doc for an Oral Glucose Tolerance Test. And request the long version, because some people tend to hypo after a short one while on their way home, making the test absolutely useless.
Thanks for the reply, but I measured it 10 minutes after the attack, could it have increased by then? And also I see posts with 5.2mmols or more defining hypo feelings.

My problem is I did not have this reaction before last week and I am not diabetic. This just came up after a day of binge drinking. And I am not an alcoholic.
 

JoKalsbeek

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Thanks for the reply, but I measured it 10 minutes after the attack, could it have increased by then? And also I see posts with 5.2mmols or more defining hypo feelings.

My problem is I did not have this reaction before last week and I am not diabetic. This just came up after a day of binge drinking. And I am not an alcoholic.
No-one said you were an alkie. ;) If your bloodsugars are low, normally, your liver dumps glucose to compensate. But it can't multi-task. It's either filtering alcohol, or dumping glucose, but it can't do both simultaniously, and filtering alcohol trumps dumping... So that could infuence your going low, but it's a bit long after the binge, -which wasn't hard liquor either- so that's slightly remarcable... You'd've had to have had a lot of it to still be filtering days later, I mean. And RH doesn't mean you're diabetic per definition, though some people with RH do develop T2 later on. Usually when someone mentions feeling hypo -feeling hypo and being hypo are different things- in the fives they are commonly recently diagnosed T2's whose bloodsugars are dipping into the normal range for the first time due to a diet change or medication. Their body will freak out because they're used to higher bloodsugars, which is why it's a false hypo: you'll feel the exact same way as you would with a proper hypo (Under 4), because your body honestly believes it IS hypo. So tremors, hair standing on end, confusion, dizzyness, nausia, palpatations, rubbery legs, the whole 9 yards. It just needs a little time to get used to the new normal. A five is what your bloodsugars should ideally be, after eating. What did you do when you felt hypo? You didn't mention eating anything other than the cheese. Cheese doesn't spike bloodsugars, (too few carbs), so that wouldn't bring your bloodsugars back up into the fives. Now, if you'd had orange juice, coke, or something else sugary that hits the system fast to fix it, then yeah.... Maybe. That's why it'd be interesting to see what your bloodsugars do around your meals. Do you spike, or not, does your insulin response go a little overboard etc... You want to know whether there are spikes and dips. Those few fingerpricks could tell you a lot, in combination with writing down exactly what you ate and drank to go with it.
 
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JoKalsbeek

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The symptoms then its repeating in the next 4 days all 1-2 hours after eating something.
I did not eat for 10 hours now and i am fine (only headache which is normal).
As explained, the symptoms don't confirm a hypo, the numbers do. A false hypo can't be distinguished from a real one without a meter.
 

Antje77

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As explained, the symptoms don't confirm a hypo, the numbers do. A false hypo can't be distinguished from a real one without a meter.
And as you're not diabetic or take hypo-inducing medication (I suppose) it would be very strange if you started having hypo's all of a sudden. Not impossible but not very likely either. There are many ailments that come with hypo like symptoms, why do you think it's low blood sugar?
 

JoKalsbeek

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The symptoms then its repeating in the next 4 days all 1-2 hours after eating something.
I did not eat for 10 hours now and i am fine (only headache which is normal).
Please, test the suggested times around a meal. You could well have reactive hypoglycemia, or some other bloodsugar-related issue, but you won't know unless you test. Though we can't diagnose on hre, we can try and help you interpret the numbers.

As for the possibility of RH: The treatment for that is pretty much the same as T2. Carbs are what spike bloodsugars. A T2 wants to avoid spikes, but someone with RH does too. Because the amount of insulin released is disproportionate, and results in a hypo. If you don't spike, you don't have the reaction (hence the "reactive" bit), so no hypo. That means switching to low carb eating and drinking, as that's pretty much the only thing that'll solve it. And if you do have RH, that would also explain why you don't go hypo when you don't eat, but do, 2 hours after a meal. You really, really need to know and log what your bloodsugars are doing.

It doesn't have to be your bloodsugars, it could be something else entirely, but it's the quickest one you can rule out with just a couple of finger pricks around what is, to you, a regular meal. And if results are abnormal, you take them to your GP, and educate him/her on RH, because most doctors have never heard of it. (Some specialists neither).

Good luck!
Jo
 

Lamont D

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Never heard of alcohol induced Hypoglycaemia.
I would have thought that even without the alcoholic, you would have noticed these hypoglycaemic episodes. In my own case, I could never drink very much at all despite trying!
However, as has been said, without testing you just don't know.

Beer has been referred to as liquid bread, because of the high amount of carbs.
So if you're susceptible to high and low ranges in blood sugar levels after beer, maybe that's why you are getting these hypo like episodes.
 

Reactive

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At first I thought it was hypotension.
But it carried on for 3 days and while I was in bed with normal BP and fatigue, I thought of it being hypoglycemia, ate a peach and was jumping up and down in 10 minutes. Which resulted in another, lighter episode a few hours later.

When I have the “attack” I begin to feel anxious, irritable, don’t want to talk to people around me (remember I was normal 1 week ago), have palpitations, sweat all over my body in just a few seconds, dizzyness, nausea and light headedness. I can’t read well at those times and my speech is also effected, I slur or cut sentences short. I just feel like lying down and die. After the “attack” lightheadedness, weakness, feeling as if dying continues for 1-2 hours.

Today my waking up blood sugar was 6.3mmol/L after 5 hours of sleep and 6 of fasting.
I had one apple with cinnamon on it and a cheese omelette with 2 eggs.
Post 1 hour measurement: 8.1
Post 2 hour measurement: 6.1 which looks perfectly normal? I felt a discomfort in the first 40 minutes after eating but I guess it was anxiety.
This breakfast did not cause me trouble for the last 3 days but peaches did. Should I try to see if I am beter today by eating peaches and following my blood sugar?

My liver function tests came up also fine. A little increase in LDH which was still deemed normal. My lipase level is also in the normal range.

When the “attack” happened yesterday I was able to measure my blood sugar 10 minutes after as 5.1mmol/L but it increased to 5.5mmol/L 15 minutes after that measurement without eating anything in between. Is this normal? Could my sugar be below 4 when the attack happened and it went back to 5 in 10 minutes like it did?

This is something acute I could eat however much and whatever I wanted last week. I wonder how much of it is related to the anxiety I felt at the first episode :(

I don’t know what’s wrong with me and feel desperate...
 

Rokaab

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Could my sugar be below 4 when the attack happened and it went back to 5 in 10 minutes like it did?.
The only way to tell is by doing a blood test at the time, that is the ONLY way to know, blood sugar levels can move quickly but unless you test at the time there is no way to actually know, anything else would be pure speculation.
 
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JoKalsbeek

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At first I thought it was hypotension.
But it carried on for 3 days and while I was in bed with normal BP and fatigue, I thought of it being hypoglycemia, ate a peach and was jumping up and down in 10 minutes. Which resulted in another, lighter episode a few hours later.

When I have the “attack” I begin to feel anxious, irritable, don’t want to talk to people around me (remember I was normal 1 week ago), have palpitations, sweat all over my body in just a few seconds, dizzyness, nausea and light headedness. I can’t read well at those times and my speech is also effected, I slur or cut sentences short. I just feel like lying down and die. After the “attack” lightheadedness, weakness, feeling as if dying continues for 1-2 hours.

Today my waking up blood sugar was 6.3mmol/L after 5 hours of sleep and 6 of fasting.
I had one apple with cinnamon on it and a cheese omelette with 2 eggs.
Post 1 hour measurement: 8.1
Post 2 hour measurement: 6.1 which looks perfectly normal? I felt a discomfort in the first 40 minutes after eating but I guess it was anxiety.
This breakfast did not cause me trouble for the last 3 days but peaches did. Should I try to see if I am beter today by eating peaches and following my blood sugar?

My liver function tests came up also fine. A little increase in LDH which was still deemed normal. My lipase level is also in the normal range.

When the “attack” happened yesterday I was able to measure my blood sugar 10 minutes after as 5.1mmol/L but it increased to 5.5mmol/L 15 minutes after that measurement without eating anything in between. Is this normal? Could my sugar be below 4 when the attack happened and it went back to 5 in 10 minutes like it did?

This is something acute I could eat however much and whatever I wanted last week. I wonder how much of it is related to the anxiety I felt at the first episode :(

I don’t know what’s wrong with me and feel desperate...
That fasting blood glucose test was a tiny bit on the higher side than what it should be. That could be due to a variety of reasons, like disturbed or lack of sleep, anxiety, nightmares, Dawn Phenomenon. Still, considering your symptoms, I do feel like you'd do well to make an appointment with your GP and request a HbA1c test as well as an OGTT. Something's going on, and you shouldn't let it pass. Your attacks, as you call them, do resemble hypo symptoms, which you could experience even if you're not actually hypo. But a false hypo would occur if your blood glucose is normally too high. A true hypo (-4) would posibly indicate RH. Also, I'm pretty sure it has absolutely nothing to do with your alcohol-intake, except that it was carby, as in, beer, and might have spiked you.

Make an appointment and get sorted. You're not running super-high levels or anything, but if something's going on, now's the time to do something about it.

And as for desperate: If there's something up with your bloodsugars, there's thousands of people on this forum living with it, and we're talking all types of diabetes and related issues. We can help you get back into the normal range, if you're not already there. So breathe. You'll be okay.
Jo
 

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The only way to tell is by doing a blood test at the time, that is the ONLY way to know, blood sugar levels can move quickly but unless you test at the time there is no way to actually know, anything else would be pure speculation.
The attacks happen like in an instant so it is tough to have it tested at that instand unless i am on a constant monitor.
So far the docs don’t believe itis going below 5 because I can’t prove them.
 

Reactive

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That fasting blood glucose test was a tiny bit on the higher side than what it should be. That could be due to a variety of reasons, like disturbed or lack of sleep, anxiety, nightmares, Dawn Phenomenon. Still, considering your symptoms, I do feel like you'd do well to make an appointment with your GP and request a HbA1c test as well as an OGTT. Something's going on, and you shouldn't let it pass. Your attacks, as you call them, do resemble hypo symptoms, which you could experience even if you're not actually hypo. But a false hypo would occur if your blood glucose is normally too high. A true hypo (-4) would posibly indicate RH. Also, I'm pretty sure it has absolutely nothing to do with your alcohol-intake, except that it was carby, as in, beer, and might have spiked you.

Make an appointment and get sorted. You're not running super-high levels or anything, but if something's going on, now's the time to do something about it.

And as for desperate: If there's something up with your bloodsugars, there's thousands of people on this forum living with it, and we're talking all types of diabetes and related issues. We can help you get back into the normal range, if you're not already there. So breathe. You'll be okay.
Jo
Going to see an internal medicine specialist tomorrow and will beg for extended OGTT. HbA1C levels are tested results not in yet but I think they will be normal.

This morning’s blood sugar was a little on the high end but I think it is due to the low quality, short, stressful sleep of last night.

Is there any other tests I should mention the doctor and make them more angry :)
 

Reactive

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My other results came and confirms my suspicions.
Both Lipase and Amylase are slightly lower than normal levels which shows damage to pancreas. But not like acute pancreatitis as they are not elevated.
My LDH is also slightly above normal.
 

JoKalsbeek

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Going to see an internal medicine specialist tomorrow and will beg for extended OGTT. HbA1C levels are tested results not in yet but I think they will be normal.

This morning’s blood sugar was a little on the high end but I think it is due to the low quality, short, stressful sleep of last night.

Is there any other tests I should mention the doctor and make them more angry :)
I think you're good with these. Unless you want to toss in a set of tyroid function tests because of the palpatations. ;)
 
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Reactive

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I think you're good with these. Unless you want to toss in a set of tyroid function tests because of the palpatations. ;)

I think this might have been a series of panic attacks may be coupled with some level of insulin resistance. I behaved like a hypocondriac and when I realized that I began to feel just fine.

Will follow up on tests, make healthy lifestyle changes but I think the bottomline of my story is: DO NOT SEARCH YOUR SYMPTOMS ONLINE!

Sincerely thank you to all of you who tried to help and I hope you all get/keep the better health status for yourselves.
 

Lamont D

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Before your last post, I would have suggested panic attacks, because of the sudden onset, along with the other symptoms.
But, also, there are many other pancreatic conditions that give those results and until you get the right sequence of tests, nobody knows.
After a full blood panel, an eOGTT and insulin tests including c-peptide, and possibly a fasting test, further tests will eliminate other conditions. It could be allergies or like me, intolerance to certain foods.
A food diary is always helpful, which must include blood glucose readings.

Best wishes
This may take time and you will probably be asked to
 

JoKalsbeek

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I think this might have been a series of panic attacks may be coupled with some level of insulin resistance. I behaved like a hypocondriac and when I realized that I began to feel just fine.

Will follow up on tests, make healthy lifestyle changes but I think the bottomline of my story is: DO NOT SEARCH YOUR SYMPTOMS ONLINE!

Sincerely thank you to all of you who tried to help and I hope you all get/keep the better health status for yourselves.
Ah, panic attacks... I live with those myself. Still, better to have those than actual T2 or RH. ;)

I hope you'll be back to good from here on in!
Jo
 
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