Help! Could this be RH?

[Waleria -I'm from Poland]

Hello! For over a year (maybe couple years) I have this weird symptom. In general I almost never get hungry (except for in the morning), instead I just keep going when suddenly usually after around 4 hours from my last meal I get overwhelmed with nausea, lightheadedness, I feel dizzy and nervous, I may even start trembling a little. With time I figured out that when I actually eat something (it can be either something small and sweat or an actual meal) this symptoms go away. I did the blood test and tested my fasting glucose level and then the glucose level 2 hours after eating breakfast. My fasting BG was 77 mg/dl (around 4.2/4.3 mmol/L) and two hours after eating breakfast it went down to 64 mg/dl (3.6 mmol/L). For these two hours I was just sitting in the clinic and was asked not to do any physical activity so as to not to mess up with the test. At the time of the second test I still felt okaish because I usually get above descripted symptoms not 2 but more like 4 hours after eating and I generally am active at the time, so I wonder what my glucose level has to be then since it dropped after just two hours of not doing anything. When I tried to find an answer to what these episodes may mean I came across reactive hypoglycemia and it sort of made sense. Especially that in the last year I ate a lot of white rice, pasta, bread because I also had problems with my stomach and tried to keep it simple, no wonder it got worse.

I went with this to my GP but he generally dismissed it and said that the glucose levels are normal. Well...he didn't actually say that he dismisses it, he didn't even use the term "reactive hypoglycaemia", he generally was not interested at all in my health, I will never fo to him again. But I don't feel normal - especially not at the times of these episodes. I also suffer from Hashimoto (at this moment at the hyperthyrodism end of the hormonal swing) and I am post anorexia recovery.

I don't know what to do with this. In your experience can this be RH and is it worth looking into even though my GP dismissed it? Will be very grateful for your help. I live in Poland and maybe that's the reason why doctors are not educated enough in this matter and reluctant to help.

 

[EllieM]

Hi @Waleria -I'm from Poland and welcome to the forums.

Do you have a blood testing meter of your own?

While 3.6mmol/L is definitely on the low side of normal, it's not that unusual for non diabetics to go that low. It would be really interesting to know what your blood sugar level is when you get the severe symptoms.... (I have a non diabetic family member whose levels occasionally go that low before meals)

Here is an interesting article about what happened when non diabetics wore a continuous glucose monitor

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...

www.ncbi.nlm.nih.gov

I also suffer from Hashimoto (at this moment at the hyperthyrodism end of the hormonal swing) and I am post anorexia recovery.

I would tentatively suggest that anorexia can cause low blood sugar so in your case I would want to be very sure that you had completely recovered from the anorexia before worrying too much about the hypoglycemia (I am not a doctor, so this is based on personal observations of a relative who has now recovered from an eating disorder). I stress, that is just my opinion and I am not a medical professional.

Having said all that, if you get readings significantly lower than the 3.6mmol/L then my comments might be very different.

 

[Waleria -I'm from Poland]

Hello, thank you for your reply and your advice! I bought a glucose monitoring device yesterday (the one for the finger-prick test) I decided to try to observe myself for some time. My BG before breakfast was at first 55mg/dl but I was still figuring my way around this device so I rechecked it instantly and it was 60 mg/dl but I read that there may be a 15% deviation between lab results and results from the glucometer. I will check it regularly and especially when I will experience for the next time these episodes.

When it comes to my AN I am fairly sure that body-wise I am recovered. It's been over ten years now, my menstrual cycle is back and very regular and generally my lab results are normal though low.

 

[Lamont D]

Hello! For over a year (maybe couple years) I have this weird symptom. In general I almost never get hungry (except for in the morning), instead I just keep going when suddenly usually after around 4 hours from my last meal I get overwhelmed with nausea, lightheadedness, I feel dizzy and nervous, I may even start trembling a little. With time I figured out that when I actually eat something (it can be either something small and sweat or an actual meal) this symptoms go away. I did the blood test and tested my fasting glucose level and then the glucose level 2 hours after eating breakfast. My fasting BG was 77 mg/dl (around 4.2/4.3 mmol/L) and two hours after eating breakfast it went down to 64 mg/dl (3.6 mmol/L). For these two hours I was just sitting in the clinic and was asked not to do any physical activity so as to not to mess up with the test. At the time of the second test I still felt okaish because I usually get above descripted symptoms not 2 but more like 4 hours after eating and I generally am active at the time, so I wonder what my glucose level has to be then since it dropped after just two hours of not doing anything. When I tried to find an answer to what these episodes may mean I came across reactive hypoglycemia and it sort of made sense. Especially that in the last year I ate a lot of white rice, pasta, bread because I also had problems with my stomach and tried to keep it simple, no wonder it got worse.

I went with this to my GP but he generally dismissed it and said that the glucose levels are normal. Well...he didn't actually say that he dismisses it, he didn't even use the term "reactive hypoglycaemia", he generally was not interested at all in my health, I will never fo to him again. But I don't feel normal - especially not at the times of these episodes. I also suffer from Hashimoto (at this moment at the hyperthyrodism end of the hormonal swing) and I am post anorexia recovery.

I don't know what to do with this. In your experience can this be RH and is it worth looking into even though my GP dismissed it? Will be very grateful for your help. I live in Poland and maybe that's the reason why doctors are not educated enough in this matter and reluctant to help.

Hi @Waleria -I'm from Poland and welcome to our forum.
You have so much going on, that any advice may be completely wrong.
But the benefits of blood glucose monitoring will help you.
For RH the lowest normal BG levels is around 3.5mmols but that may not stop the symptoms.
I know from my daughter with her issues with her thyroid that those are typical symptoms.

With RH your fasting BG levels should be in normal levels. This can be higher if you have glycaemic issues that are not in hormonal balance. It is important to realise that the many factors can give you mixed messages from your feelings and what symptoms you have. Hormones are important, just as food is to RH.
Starting with a lower carb dietary balance that will not impact your other conditions, will maybe give you a chance to relieve some of the symptoms.

Is there a way to see a specialist in endocrinology?
As in the UK, we can only get certain diagnostic tests that our GP's just can't order.
Can you get help from your other conditions doctors to help?

Your English is very good. Can you read some of the other threads, especially the ones that have not just the straightforward RH as I have!
There are many reasons for reading the threads, as you do have some aspects of RH, but you need diagnostic tests to verify.
Have you from your anorexia, any food issues that are similar to an intolerance or an allergy to certain foods?
I have lactose intolerance, so dairy is completely out for me.
Carb intolerance is typical RH. Even though the level of intolerance may vary.
Hope this helps.
I started with a g food diary and monitoring my BG levels before and after meals. This knowledge along with more readings at times after food, gave me precious information to which foods to avoid and more importantly what I could eat!
Best wishes, keep asking.

 

[RobynV]

Good to read of pple talking about combination issues. I have Tremor problem. Low thyroid/Hashimotos - I assume induced by psoriatic arthritis (PsA). 11 mm thyroid nodule. My readings not dreadful, feel terrible when in 4s and high 8s. Once had 14. Jump fm 6. FBG and range ‘normal’ most of time but recently had low conscious/ unconscious episode. Lying down. Lost ability to move or speak properly in evening. About 2 hours. Not TIA. I don’t think. My tremor is in feet/legs most of time - sometimes trunk. Worse in pm. Less in am. Sleep not great. Is new in last 6 months. Could this be RH or more likely LADA? GP uninterested bcz bloods close to ‘normal’. Thinking of trying to see neuro psychiatrist as endocrinologist not v interested either. No one listening. Get terrible brain fog. Headaches. Have cPTSD. Could it have been a small seizure? Took years to get Hashimotos diagnosis. I’ve moved to low carb recently (own initiative) but worried fats in such quantity will hike cholesterol again. So mostly plant. I’ve had decreasing iron and platelets through this year - but not yet completely out of range. Hence docs’ disinterest. Plse someone tell me who to see/ do. Esp if you have / had tremor. It’s getting worse. Not in hands. Earlier in life always had low BP. BG never measured (I did lots of sport) but now realise maybe had hypo symptoms often. Often got close to fainting, or did. Ate sugar! Pregnancy was worse.

 

[Lamont D]

Good to read of pple talking about combination issues. I have Tremor problem. Low thyroid/Hashimotos - I assume induced by psoriatic arthritis (PsA). 11 mm thyroid nodule. My readings not dreadful, feel terrible when in 4s and high 8s. Once had 14. Jump fm 6. FBG and range ‘normal’ most of time but recently had low conscious/ unconscious episode. Lying down. Lost ability to move or speak properly in evening. About 2 hours. Not TIA. I don’t think. My tremor is in feet/legs most of time - sometimes trunk. Worse in pm. Less in am. Sleep not great. Is new in last 6 months. Could this be RH or more likely LADA? GP uninterested bcz bloods close to ‘normal’. Thinking of trying to see neuro psychiatrist as endocrinologist not v interested either. No one listening. Get terrible brain fog. Headaches. Have cPTSD. Could it have been a small seizure? Took years to get Hashimotos diagnosis. I’ve moved to low carb recently (own initiative) but worried fats in such quantity will hike cholesterol again. So mostly plant. I’ve had decreasing iron and platelets through this year - but not yet completely out of range. Hence docs’ disinterest. Plse someone tell me who to see/ do. Esp if you have / had tremor. It’s getting worse. Not in hands. Earlier in life always had low BP. BG never measured (I did lots of sport) but now realise maybe had hypo symptoms often. Often got close to fainting, or did. Ate sugar! Pregnancy was worse.

Hi and it's really positive that amongst every other thing going on, you now have your monitor, to see what is going on with your blood glucose levels.
I do think that all the other health issues are a bit of a blind to your symptoms and possibly, hypoglycaemia in some form or other. Especially the thyroid issues. Hormone imbalance can alter your response to most symptoms.
I have read that gestational can have similar symptoms as hypoglycaemia. As well as actually having hypos!
The one thing that I always recommend to see if it is RH or food intolerance with being non diabetic, is the need to record your blood glucose levels around meals. Pre meal and two hours after, plus, three hours, four hours, plus when you get the symptoms really severely.
This will give you information about your intolerance to certain foods.
This will give you information for your doctor as well.
I always recommend low carb for every endocrine hormone imbalance because it will help symptoms, lower the blood glucose spikes, and improve health including cholesterol. Good saturated fats are healthy.
I have the condition, Essential Tremor Disorder. Shaking and other symptoms are my every day. And a neurologist can help.
But in the end a referral to a specialist endocrinologist, when you have the information in your food diary, will get you the tests necessary, for a diagnosis.

Keep asking, keep safe, keep testing.
Best wishes.