If your feeling fatigued and have not eaten for that long it is likely that your liver will have released glucose in order to compensate.
Aha... yes...hit the nail on the head..! I had assumed it was the tramadol, plus ibuprofen tablets taken at 4am that was responsible. Taking these due to painful tingling left leg and both feet that wakes me up. I also take 1 x 10mg nortriptiline before bed to help with the pain. Last night, this obviously wasnt enough, hence the other tabs. I'm due to upgrade to 2 tablets of the nortriptiline at night from tomorrow; then to 3 times a night after another 7 days. Will this upgrade have a better effect on the pain...?? If so, I feel like upgrading to the 3 a night from tonight, instead of waiting....
Used to be on 1 x 25mg amitriptiline at night before this, but told doc it didnt seem to be having much effect, since most nights I needed to supplement with tramadol. So stopped this, and went onto the nortriptiline straightaway.