So I did the fasting test. Was admitted to hospital for 3 days while doing the fast. It went fairly well. I mean, I didn't go nuts over it. My endo had warned me about possible extreme hunger and emotional effects.
They drew blood twice a day and checked my bg every 2 hours with a glucose meter.
I started with a bg of 64mg/dl which they thought was lowish. The first day/night was the worst. I wasn't extremely hungry but had hot/cold flashes, sweating, restlessness and was feeling fatigued. My levels stayed within the 60 mg/dl range for a day and dropped to 55 mg/dl by the next morning.
It went up and down a bit. But after that my bg stayed at 55mg/dl for a least 10 hours straight. Surprisingly I felt quite 'good'. I mean, I had some weakness when I got up or walked around the room but the other symptoms had disappeared. Both the endo and nursing staff thought it was kind of weird. But apart from some muscle soreness, I felt very calm and wasn't hungry. I actually felt better than the previous day and wondered whether the low but very stable levels had something to do with it.
My bg dropped to 47mg/dl twice but went up again into the 50 range after that. Had some slurred speech but wasn't feeling too bad.
By the end of day 3 I started feeling hungry for a few hours. They stopped the fast at midnight and my bg was back up to 65 mg/dl by then. Weirdly enough I was starting to feel worse again. They made me eat which was hard because I felt nauseous and wasn't hungry. I had whole wheat bread with a cheese spread and half a yoghurt and they drew blood again at 2 am. Afterwards I heard that my bg was at 180mg/dl then which I thought was too high but my endo ensured me this is normal because of the fast. It's normal to have these sort of spikes when you first start eating again. The rest of the night I was back to feeling restless and I woke up 2 hours later sweating. By morning I asked the nurse to check my bg once more as I wasn't feeling well and it had come back down to 68mg/dl. My emotions were all over the place and I felt quite fatigued and weak the rest of that day.
The good news: I didn't have a hypo below 40mg/dl which rules out insulinoma.
The not so good news: my other levels (insulin, cortisol, etc.) were within normal range. Both my endo and her colleague think my blood sugar is going quite low and told me that even with a fast they don't normally see levels that low (unless they end up confirming insulinoma with high insulin levels and bgs below 40mg/dl)? But they can't tell me why it's happening?
Considering the fact that I felt worse after I started eating again and was already back down to 68mg/dl by morning my endo thinks it may still be somewhat reactive and started me back on Metformin. Surprisingly she also suggested I try a lower carb diet as she agrees that for some people it works.
So yeah, I don't know. I'm confused. I'm eating less carbs and spread them throughout the day and I'm trying to give it time and another go. But after 10+ years of debilitating fatigue and not getting answers I don't feel that confident anymore.
Hi, I'm glad you have learned quite a lot, it's not a great experience is it?
The good news is you have a type of hypoglycaemia, maybe a different one than me!
But it is great news, you haven't got insulinoma or other pancreatic conditions.
I had the same experience during my fast, finding that not eating was somehow better for me. That continually eating was what was causing me to be ill!
Weird!
Well, yes, it is weird, that a diet that is supposed to be healthy, isn't that healthy for you, and not eating is better, eh?
Weird!
I still don't get the metformin tho!
I can only go by my experience.
The fasting is good for you, so try some intermittent fasting or only have food at certain times like I do! When it suits you.
Yes it is weird, not to eat regular, but we can't eat a so called healthy diet because it makes you and me ill!
So think outside the box, think and experiment about how food affects you, think about which foods send your bloods up, which is the trigger for insulin, which we don't want. Think about how some foods don't give you that spike, because as I have found out, no hyper, no trigger, no hypo! No fluctuations in bloods.
They should never have given you that bread, because even low GI or complex carbs still have too many carbs, which triggers the hyper.
We have to avoid them, you have to discover a balance of protein and fats to satisfy your body needs, which is the way forward.
The reason why your insulin was normal was because you have done quite a bit of low carbing, and fasting before the insulin test, but once you eat carbs, it starts again.
It is not easy, once you get started and find that you can do it and get that feeling as you did in your fasting test, your lethargy will go and your energy levels will increase.
I don't believe that your endo has much experience with Hypoglycaemia, as most don't, because as does mine, he still believes a certain amount of carbs is necessary.
I have been in ketosis, (which is where your bloods where after a day into your fasting test) very low carb for four years nearly. My health has improved dramatically! He won't interfere with my diet because it is working and it suits my lifestyle.
If you don't know why it happens, I will try and explain a little bit more.
When you eat you trigger hormones to get your digestive system working. These hormones process the food in your stomach, your gut biota helps with sorting out what goes where, glucose is derived from the meal to use as a primary energy source.
This triggers the insulin response, if you have like me, a weak initial response of insulin, the glucose doesn't get used to be turned into energy, so your glucose levels rise very quickly as the amount of insulin is too low. So, a secondary response of insulin is required, as our brain is telling your body to use the glucose, convert your glucose into energy, however, this second response, is too much, it is called an overshoot. This overshoot sends your blood levels down into hypo. Your brain tells you because you are going low, that it needs more glucose or energy, so you get that hunger. You eat again, you trigger the hyper, because you have too much glucose again, another secondary insulin response, another low. A viscous circle of hyper, then hypo. Fluctuating blood glucose levels all the time, which is not good!
Too much insulin is not recommended and won't get your health back.
The only way to stop the viscous circle is by eating very low carb and as I do, fasting intermittently.
You can eat very small meals every couple of hours to offset hypos, but you soon get fed up (pun) doing this, it is too much food that you don't really need or want.
You don't need carbs, there are plenty of members on this forum who have improved their health so much by going very low carb.
There is no cure, but if you take control and get your balance of foods right, you will see the difference. Learn from your fasting test, like I did.
And admit, that not being ill, is far better than being ill, and avoid what is causing your condition.
If you are not sure, keep asking, let us know how you are doing.
Best wishes