Reactive HypoGlycemia Case....

[PegLeg2000]

I’m a 42 year old 182cm 80kg, fit muscular man. Have had symptoms of depression anxiety fog dizzy apathy depression zero sexual function for my whole life. I remain muscular and lean without exercise and going through periods of eating loads of junk. Can never explain my mood, its mostly down but I do have short periods where I feel kind of happy but then its often eating that takes that away from me. No stress or anything, im a very fortunate man in my circumstances.

I tend to feel my worst after eating where I have to just lay when out of fatigue weakness fog. Often my heart feels like it’s beating really hard after eating but BP and HR is ok.

I’m non diabetic and my fasting sugars and A1c always fine.

I failed a OGTT many years ago in a hospital where my sugar went down to 1.5mmol after the 100g glucose drink. The hospital referred me to an endocrinologist (UK) who disregarded it saying this happens in normal people and pushed me towards mental health issues.

I recently got a CGM and at the time I was eating low carb. The smallest amount of carb (a few grams) would spike me. I kept eating more carb testing it - and the more and more carbs I eat eventually my blood sugar wouldn’t even rise anymore and my libre cgm would show almost a continuous redline line around 2 mmol even when drinking lots of orange juice....

Went to doctors with these results and when my cgm was showing 2mmol in the doctors office, the doctor did a finger prick test in the surgery and it showed 6.6mmol making me feel like an idiot. Why was the results so different? Are cgms known to be that inaccurate?

Don’t know what to do or try but feel like my life is a wasted hell hole that I spend mostly lifeless in bed. I often feel a bit better when I wake, but shortly after eating any positive energy goes and im back to feeling like death.

Have had periods where I felt eating low carb helped, but even watching my carbs id get really bad. Looking back however I was training quite hard and working physcially which I understand will make it harder for my body to keep my blood sugar up. I want to try low low carb again but being sedantary to make it easier for my body to regulate.

Does my story resonate with anyone? Any advice? Ive loads of symptoms like nausea which I have given up going to the doctors about as they keep trying to give me anti depressants and get me our of their surgery.

 

[PegLeg2000]

Forgot to mention, when I failed the OGTT and was not helped by NHS ENdo, I paid to see one privately who tested fasting insulin which was normal. He put me on Metformin, which did absolutely nothing for me.

 

[EllieM]

Hi @PegLeg2000 and welcome to the forums. Cgms can be inaccurate some of the time, particularly when readings are out of range. I am wondering whether you have a glucometer that you could check when you think your readings are low?

 

[PegLeg2000]

Hi @PegLeg2000 and welcome to the forums. Cgms can be inaccurate some of the time, particularly when readings are out of range. I am wondering whether you have a glucometer that you could check when you think your readings are low?

Hello, thanks. Unfortunately I did not have both at the time. I sort of left the doctors at that point feeling like my life was over and that I had a mental health disorder that ive already tried every treatment and therapy without much improvement.
What your saying makes sense though, perhaps I should try again with the meters. I re read my post, it makes it sound like like my cgm was showign constant 2, it wasnt, it was waving between 1.7 and 2.7, and would react to food just very minimally. Like drinking a pint of orange juice would make it just above normal briefly before crashing to a lower point than before the drink.
Can I just be sanity checked, if I have a hospital OGTT where my lowest recorded point was 1.5, then I must have reactive hypoglycemia? For the private endo to prescribe Metformin, he must of agree to a blood sugar abnormality?

 

[EllieM]

Can I just be sanity checked, if I have a hospital OGTT where my lowest recorded point was 1.5, then I must have reactive hypoglycemia? For the private endo to prescribe Metformin, he must of agree to a blood sugar abnormality?

My limited understanding is that there can be a number of medical reasons for low blood sugars, and you need an endocrinologist to look at the results and make the diagnosis. But as a T1 diabetic whose bg can go too low from injected insulin, I would definitely regard 1.5 as a seriously low level, not sure I'd be conscious or rational if I went that low.

Tagging @Lamont D who knows quite a lot about RH.

 

[Lamont D]

I’m a 42 year old 182cm 80kg, fit muscular man. Have had symptoms of depression anxiety fog dizzy apathy depression zero sexual function for my whole life. I remain muscular and lean without exercise and going through periods of eating loads of junk. Can never explain my mood, its mostly down but I do have short periods where I feel kind of happy but then its often eating that takes that away from me. No stress or anything, im a very fortunate man in my circumstances.

I tend to feel my worst after eating where I have to just lay when out of fatigue weakness fog. Often my heart feels like it’s beating really hard after eating but BP and HR is ok.

I’m non diabetic and my fasting sugars and A1c always fine.

I failed a OGTT many years ago in a hospital where my sugar went down to 1.5mmol after the 100g glucose drink. The hospital referred me to an endocrinologist (UK) who disregarded it saying this happens in normal people and pushed me towards mental health issues.

I recently got a CGM and at the time I was eating low carb. The smallest amount of carb (a few grams) would spike me. I kept eating more carb testing it - and the more and more carbs I eat eventually my blood sugar wouldn’t even rise anymore and my libre cgm would show almost a continuous redline line around 2 mmol even when drinking lots of orange juice....

Went to doctors with these results and when my cgm was showing 2mmol in the doctors office, the doctor did a finger prick test in the surgery and it showed 6.6mmol making me feel like an idiot. Why was the results so different? Are cgms known to be that inaccurate?

Don’t know what to do or try but feel like my life is a wasted hell hole that I spend mostly lifeless in bed. I often feel a bit better when I wake, but shortly after eating any positive energy goes and im back to feeling like death.

Have had periods where I felt eating low carb helped, but even watching my carbs id get really bad. Looking back however I was training quite hard and working physcially which I understand will make it harder for my body to keep my blood sugar up. I want to try low low carb again but being sedantary to make it easier for my body to regulate.

Does my story resonate with anyone? Any advice? Ive loads of symptoms like nausea which I have given up going to the doctors about as they keep trying to give me anti depressants and get me our of their surgery.

Hi @PegLeg2000 ,
Great name by the way.
I have the condition known as Non diabetic Late Reactive Hypoglycaemia.
What this explains is obviously not diabetic.
But after certain foods I have a reaction. Or as you have described an eOGTT, with the glucose drink (yuk).
The reaction is abnormal spike of blood glucose.
Because of this, my pancreas reacts, I have an overshoot of too much insulin and my BG levels plummet into hypoglycaemic levels.
The certain foods are carbs and sugars.
The reason for the abnormal spike is, I have a weakened first phase hormonal response to carbs and sugars.

I control the condition by having a low carb diet.

There are more conditions similar to mine in the Hypoglycaemia area or type.
That are non diabetic.

If you don't mind other than the ogtt and bloods, what other diagnostic tests have you had?
C-peptide, GAD, fasting, mixed meal, allergy, intolerances?
The reason I ask, is because, the glucose test especially the two hours test doesn't do nothing much for diagnosis. And the tests for hypoglycaemia, any kind, or even pancreatic disease are a series of tests which are elimination tests. There is no specific diagnostic test for hypoglycaemia.
There is also no magic pill or cure for hypoglycaemia, just management.
I was diagnosed over a decade ago, and I am still in control. (Ish)

My first endocrinologist was very similar to your experience, and I would want a refund because his decision on metformin and saying that it's normal. Wow!

Even though, there can be symptoms of anxiety and of course mild depression with a good intolerance condition such as RH or hypoglycaemia, it is not necessarily a mental issue. How could it be?
You are going through so much and doubting your doctors. You haven't got a Scooby, what is happening.
And you feel awful, ignored, powerless.

Are you in uk?
I never had a CGM, I used a glucometer, and experimented a lot, a food diary, kept records of everything.

For now, read, the RH forum. Start accepting that there is always something to do. Something more about your choices.
I will help and guide as others do.
It's not easy.
Keep asking.
Best wishes.
I have been where you are, but I got lucky with my endocrinologist who recognised the overall symptoms that led to me having hypos.
I called this period before diagnosis was my hypo hell.
I hope the helps.

 

[PegLeg2000]

Hi @PegLeg2000 ,
Great name by the way.
I have the condition known as Non diabetic Late Reactive Hypoglycaemia.
What this explains is obviously not diabetic.
But after certain foods I have a reaction. Or as you have described an eOGTT, with the glucose drink (yuk).
The reaction is abnormal spike of blood glucose.
Because of this, my pancreas reacts, I have an overshoot of too much insulin and my BG levels plummet into hypoglycaemic levels.
The certain foods are carbs and sugars.
The reason for the abnormal spike is, I have a weakened first phase hormonal response to carbs and sugars.

I control the condition by having a low carb diet.

There are more conditions similar to mine in the Hypoglycaemia area or type.
That are non diabetic.

If you don't mind other than the ogtt and bloods, what other diagnostic tests have you had?
C-peptide, GAD, fasting, mixed meal, allergy, intolerances?
The reason I ask, is because, the glucose test especially the two hours test doesn't do nothing much for diagnosis. And the tests for hypoglycaemia, any kind, or even pancreatic disease are a series of tests which are elimination tests. There is no specific diagnostic test for hypoglycaemia.
There is also no magic pill or cure for hypoglycaemia, just management.
I was diagnosed over a decade ago, and I am still in control. (Ish)

My first endocrinologist was very similar to your experience, and I would want a refund because his decision on metformin and saying that it's normal. Wow!

Even though, there can be symptoms of anxiety and of course mild depression with a good intolerance condition such as RH or hypoglycaemia, it is not necessarily a mental issue. How could it be?
You are going through so much and doubting your doctors. You haven't got a Scooby, what is happening.
And you feel awful, ignored, powerless.

Are you in uk?
I never had a CGM, I used a glucometer, and experimented a lot, a food diary, kept records of everything.

For now, read, the RH forum. Start accepting that there is always something to do. Something more about your choices.
I will help and guide as others do.
It's not easy.
Keep asking.
Best wishes.
I have been where you are, but I got lucky with my endocrinologist who recognised the overall symptoms that led to me having hypos.
I called this period before diagnosis was my hypo hell.
I hope the helps.

Thanks for the kind response.
Indeed I feel like im going, mad. Have isolated myself because I cannot cope with life, cannot make plans as I never know if im going to feel awful or not. Trying to work out what is wrong with myself when I am anxious, depressed, foggy, under the influence of adrenaline is really hard. Doctors not being interested in what you have to say just makes you feel crazy.


Not familiar with C-peptide, GAD etc. Are these tests I Can do myself, can you give me an idea how I can find a endo who knows about these tests and related conditions?

My bloods are relatively normal other than high out of range prolactin, creatitinine (no protein in my urine) and SHBG. My SHBG is twice the upper limit for a man, it is higher than many womens. It has to do with binding testosterone apparently causing low testosterone symptoms. Testosterone Replacement did not help my symptoms at all, even at super levels I felt nothing from it at all.

If I eat a bunch of junk carbs, sometimes after having abstained for some weeks while I get high, and the effect can last for a day or two of eating **** sometimes. I think this is an affect of the adrenaline short term. In this experience have to eat more and more carbs to feel good, sometimes a ridiculous amounts like buckets of pasta and orange juice like a junkie trying to get high before it goes and I go back to not eating or eating little. I can eat thousands of calories of junk and still look lean and muscular.

I have done keto, low carb diets extensively and life was a bit better generally, a bit more stable. Have tried all sorts of elimination diets.

Recently I have given up all exercise and focusing on relaxing and strecthing and have felt a few more brighter moments, which always seem ruined by whenever I eat. Exercise always seems to make my symptoms worse, sort of like an intolerance but I am thinking it might be because it lowers blood sugar (by a non insulin action).

My previous attempts of low carb I was lifting weights, training, walking for hours or doing my hard physcial job as a cleaner.

Im going to try again with the low carb diet but limiting physical activity and see where that gets me.

From your experience it seems thats all I can do anyway...

 

[PegLeg2000]

I forget I also have high cortisol. No stress in my life whatsoever.
Perhaps related to my body keeping my blood sugar up, fighting against the insulin action.

 

[Lamont D]

Thanks for the kind response.
Indeed I feel like im going, mad. Have isolated myself because I cannot cope with life, cannot make plans as I never know if im going to feel awful or not. Trying to work out what is wrong with myself when I am anxious, depressed, foggy, under the influence of adrenaline is really hard. Doctors not being interested in what you have to say just makes you feel crazy.


Not familiar with C-peptide, GAD etc. Are these tests I Can do myself, can you give me an idea how I can find a endo who knows about these tests and related conditions?

My bloods are relatively normal other than high out of range prolactin, creatitinine (no protein in my urine) and SHBG. My SHBG is twice the upper limit for a man, it is higher than many womens. It has to do with binding testosterone apparently causing low testosterone symptoms. Testosterone Replacement did not help my symptoms at all, even at super levels I felt nothing from it at all.

If I eat a bunch of junk carbs, sometimes after having abstained for some weeks while I get high, and the effect can last for a day or two of eating **** sometimes. I think this is an affect of the adrenaline short term. In this experience have to eat more and more carbs to feel good, sometimes a ridiculous amounts like buckets of pasta and orange juice like a junkie trying to get high before it goes and I go back to not eating or eating little. I can eat thousands of calories of junk and still look lean and muscular.

I have done keto, low carb diets extensively and life was a bit better generally, a bit more stable. Have tried all sorts of elimination diets.

Recently I have given up all exercise and focusing on relaxing and strecthing and have felt a few more brighter moments, which always seem ruined by whenever I eat. Exercise always seems to make my symptoms worse, sort of like an intolerance but I am thinking it might be because it lowers blood sugar (by a non insulin action).

My previous attempts of low carb I was lifting weights, training, walking for hours or doing my hard physcial job as a cleaner.

Im going to try again with the low carb diet but limiting physical activity and see where that gets me.

From your experience it seems thats all I can do anyway...

You admit yourself, that doing low carb and going into keto helped initially.
And, it was hard to do, I'm not surprised.
it's not.
but I can only imagine, how long you tried?
The reason being that it does vary how long it takes to become fat adapted. Which means your energy is derived from muscular fats and not from carbs.
it could take two weeks to a month to be in keto.

have you tried fasting?

What your post tells me with the cortisol and other hormonal issues you have, can complicate so much.
it's a wonder you are not on meds for it.
However, what is happening should be looked at.

If you are in the U.K., I can recommend my specialist. But I'm not sure he does hormonal imbalance conditions.

Exercise at your age is still vital to your health. Even if it is just walking. I can't do strenuous stuff but I am still active, and I'm an old codger.
Yes, relax, but just doing nothing is not good.
Keep annoying your doctors, get another referral.
Even I as a layman can see there is something going on.
My best wishes.
Don't let the b...... Get you down.

There is something causing the readings, get proof, get the tests. Get battling. That is what I had to do.

BTW, my daughter suffers with some issues with hormonal imbalances. Hashimotos and celiac and more.
My daughter learned from being a nuisance and still is.

 

[MrsA2]

Went to doctors with these results and when my cgm was showing 2mmol in the doctors office, the doctor did a finger prick test in the surgery and it showed 6.6mmol making me feel like an idiot. Why was the results so different? Are cgms known to be that inaccurate?

The CGMs run about 20 minutes behind. The stress of going to the doctors could have raised it in that time easily, and I've seen many spikes of mine caused purely by stress (which can also be excitement, adrenaline etc not just bad stress).
Always check particularly low or high reading with finger pricks.
In your case you might want to do them both for an extended period just to see what your body does.
We are all different

 

[PegLeg2000]

You admit yourself, that doing low carb and going into keto helped initially.
And, it was hard to do, I'm not surprised.
it's not.
but I can only imagine, how long you tried?
The reason being that it does vary how long it takes to become fat adapted. Which means your energy is derived from muscular fats and not from carbs.
it could take two weeks to a month to be in keto.

have you tried fasting?

What your post tells me with the cortisol and other hormonal issues you have, can complicate so much.
it's a wonder you are not on meds for it.
However, what is happening should be looked at.

If you are in the U.K., I can recommend my specialist. But I'm not sure he does hormonal imbalance conditions.

Exercise at your age is still vital to your health. Even if it is just walking. I can't do strenuous stuff but I am still active, and I'm an old codger.
Yes, relax, but just doing nothing is not good.
Keep annoying your doctors, get another referral.
Even I as a layman can see there is something going on.
My best wishes.
Don't let the b...... Get you down.

There is something causing the readings, get proof, get the tests. Get battling. That is what I had to do.

BTW, my daughter suffers with some issues with hormonal imbalances. Hashimotos and celiac and more.
My daughter learned from being a nuisance and still is.

You are right a more focused attempt at low carb is in order. I recall id feel more stable and ok and want more so id try and shortcut it with introducing some carbs which always had a sort of short term boost as I described in another post.

I am in the UK, in Hertfordshire so a doctor reccomendation would be welcome.

Have fasted alot, it does bring some releif to the worst of the symptoms but it is quite short lived. Perhaps worth experimenting more when fat adapated.

I didnt eat my normal carby dinner last night and I did not get the sensation of heart palpitations being so great in bed last night and I didn't wake in the night either, so some positive observations already.


Thanks again for your time.

 

[lovinglife]

Just a gentle reminder from mods that we can’t name or recommend individual HCP, hospitals, GP practices etc on the open forum, thanks for your understanding

 

[Lamont D]

Just a gentle reminder from mods that we can’t name or recommend individual HCP, hospitals, GP practices etc on the open forum, thanks for your understanding

I wasn't going to.
I have done so before in a pm message.
Thanks.

 

[Lamont D]

You are right a more focused attempt at low carb is in order. I recall id feel more stable and ok and want more so id try and shortcut it with introducing some carbs which always had a sort of short term boost as I described in another post.

I am in the UK, in Hertfordshire so a doctor reccomendation would be welcome.

Have fasted alot, it does bring some releif to the worst of the symptoms but it is quite short lived. Perhaps worth experimenting more when fat adapated.

I didnt eat my normal carby dinner last night and I did not get the sensation of heart palpitations being so great in bed last night and I didn't wake in the night either, so some positive observations already.


Thanks again for your time.

I will pm you shortly.

But I'm glad that you have taken on board that you can do something to alleviate the symptoms.
Low carb will help with so much, especially your health, and many reasons why.
If like me, alleged healthy food, is not healthy for me.
I have a lot of intolerance to certain food.