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Food Coma / Postprandial exhaustion / Postprandial somnolence

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by pattismith, Jul 2, 2017.

  1. pattismith

    pattismith Senior Member

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    The two/three links that I found to be informative about this problem that some of us do experience,
    for us it's a kind of worsening/crash of our CFS disease after almost every food intake.

    https://selfhacked.com/blog/revealing-6-unknown-reasons-get-tired-eating/ (Joe Cohen selfhacked website)

    https://en.wikipedia.org/wiki/Postprandial_somnolence

    I suffer a lot from it, and I came to the idea that stop eating would be a good alternative, but of course not so effective to maintain life on the long run, so I wish to find another solution.:lol:

    Maybe each of you could give the tips that worked to fight this problem?
    I have no idea for the moment about the origine of my food coma, as it happens with all kind of food, and seems rather associated with the volume of the meal than composition.
    It seems to me that a slow walk just after eating helps me and that drinking a warm tea with a lot of lemon juice is helpful too.

    The slow walk after eating is called in french "promenade digestive", and is often advised to keep a good health. It helps the gut function and the glycemic regulation. It must be done very slowly, for about 20 to 40 mn.

    One cause seems genetic and more prevalent in African people:

    http://postprandialhypersomnolosis.blogspot.fr/

    "History and Genetics

    Postprandial Hypersomnolosis originates from sub-Sahara Africa. Sub-Saharan Africans would often rest after eating instead of trying to hunt or participate in other physical activities because they'd be more at risk from being injured by the animals and other dangerous elements of their surroundings. Their behavior was due to a polymorphism in the gene for the large neutral amino acid transporter small subunit 3 found on chromosome 11 [11p11.1-p11.2]. Those who had the polymorphism causing PPHS could produce enough melatonin and could survive though they had to sleep after eating. Those who didn’t have the polymorphism could not produce sufficient amounts of melatonin because of over exposure to sunlight. Those people would often suffer fatal injuries during hunting or illness due to drowsiness or lack of sleep. Those affected with the polymorphism would produce sufficient amounts of or often overproduce melatonin and thus would have no difficulty sleeping. Thus they would be more alert during hunting times and have stronger immune systems. According to theories of Charles Darwin, these people had better survival rates and thus perpetuated the polymorphism in future generations.
    Inheritance
    PPHS is an autosomal co-dominant trait. If a person receives two PPHS genes from both parents, they will have a more severe form of PPHS. Someone who only inherits one gene will have a lesser form; the condition may even have such mild effects that individuals will not realize they’re afflicted with PPHS

    Epidemiology
    One-third of all indigenous inhabitants of Sub-Saharan Africa carry the gene for postprandial hypersomnolosis. . The prevalence of the disease in the United States is approximately 1 in 500 African-Americans, according to the National Institutes of Health. Other populations: 1/100,000 Hispanic, 1/100,000,000 Caucasian, 1/100,000,000 Asian."
     
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  2. raghav

    raghav

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    @pattismith Have you got OGTT (Oral glucose tolerance test ) done ? I too have this problem. Vielight Neuro Alpha has eliminated this problem in me.
     
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  3. pattismith

    pattismith Senior Member

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    yes, thank you raghav, I did it years ago and realized at that time that eating glucose/fructose was bad for me, especially in the morning;
    I do no eat sugar/honey any more and I try to eat fruits after 5PM.

    I tryed meals with carbs or no carbs, fibers and no fibers, and didn't find any difference. Seems to me that the bulk of food matters more than composition, I may do more investigations about post prandial potassium/glucose curve in order to rule out problems with one or another
     
  4. kangaSue

    kangaSue Senior Member

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    Digestion is a complicated process that can go awry if gastrointestinal blood flow doesn't increase after meals as it should do, a phenomenon referred to as postprandial or functional hyperemia.
    https://www.ncbi.nlm.nih.gov/books/NBK53094/
     
  5. ryan31337

    ryan31337 Senior Member

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    You might find this presentation interesting if you have any suspicion of autonomic dysfunction (probably most of us, even if we've not been told it). Specifically slides 6-10 and 16.
    http://www.potsuk.org/UserFiles/File/Prof_Q_Aziz_Gut_and_PoTS.pdf

    I have had 'food comas' for as long as I can remember. During healthier times it was only really noticeable as a cognitive slow-down after lunch or being a little quicker to tire/become breathless when exerting - I don't think this would be considered unusual enough to warrant treatment, with simple advice usually being effective: don't eat a big bowl of pasta and/or cake...

    However, a couple of years ago with general decline in health & increased autonomic problems it became much worse and very debilitating. I don't know if this was a worsening of previously noted postprandial syndrome, or a new overlapping problem. I gradually started exhibiting symptoms of both hyper and hypoglycemia, without any change to fasting blood glucose. When you added in the GI symptoms, the picture was that of dumping syndrome (see presentation), flip flopping between early and late.

    An endo that see's a lot of POTS patients immediately recognised it and put me on a keto diet, which made a huge difference. I would guess that reduction in carbs makes a big impact, but also interestingly high fat supposedly slows dumping, which may be important too if you have tried simply lowering carbs without success.

    If it is a single continuum of dysfunction and not overlapping issues, I'd look out for warning signs that its become more than postprandial fatigue. Stuff like increased thirst, urination, constant hunger, blurred vision, temperature changes, BP & heart rate changes etc. And don't discount glycemic issues just because a fasting blood glucose test comes back normal...
     
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  6. PinkPanda

    PinkPanda thebiochemcorner.com

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    I was on a low-histamine diet for a while and also looked at food intolerances and avoided the problematic food. That helped some with fatigue after meals, although it was far from a cure.
     
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  7. pcmenten

    pcmenten

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    @pattismith In the last year or two, I started to experience this post-prandial malaise. I recently tried using an OTC remedy for Candida albicans (Candex, Candibactrin). It has resolved the malaise and vastly improved my gut function, but I've lost my appetite.

    Note that I'm back on an antibiotic for Lyme and I'm also taking Sacromyces boulardii to stabilize my gut. The Candida remedy is taken on an empty stomach. The S. boulardii is taken with food.

    Paul
     
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  8. kangaSue

    kangaSue Senior Member

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    Abdominal artery or vein compression syndromes are not uncommon in POTS patients too which can cause postprandial complications, MALS, SMA Syndrome or Left Renal Vein Compression.
    http://forums.phoenixrising.me/index.php?threads/pots-and-mals-abdominal-vascular-compression.52518/
    http://forums.phoenixrising.me/inde...e-–-linked-with-pots-and-childhood-cfs.48793/
     
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  9. pattismith

    pattismith Senior Member

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    you are brilliants! I think you may have pinpoint what is going wrong with me. :woot:
    This mecanical hypothesis would perfectly fit with what I do observe (exhaustion associated to stomach dilatation), and it would also fit with my high postprandial blood lactates (vascular compression can cause hypoxia, and hypoxia increases lactates).

    I am going to explore deeper in this direction and see how I can manage it.
    I doubt if doctors will be interested in doing more investigations on me to check this, as I am not fainting and do not feel really painful in my stomach after eating, so I will have to manage it myself, most probably!

    Edit: I found that the Coeliac artery compression is released by erect position, this is consistent with the fact that my post prandial exhaustion is improved if I stay standing and gently walking, whereas it is worse if I stay lying down after eating!

    @kangaSue , let me kiss you because today you added one piece to my puzzle!


    "Wolfman et al. suggested that the celiac artery should be investigated not only in full inspiration and expiration, but also with the patient in the erect position. Abnormal findings with CACS revert to normal during inspiration, as the celiac artery descends into the abdominal cavity during inspiration. This results in a more vertical orientation of the celiac artery, which often relieves the compression. With the patient in an erect position, the celiac artery descends further into the abdominal cavity, resulting in an even more vertical orientation, and as a result, the ligament relieves of compression.[3] Our patient showed a narrowing at the origin of celiac artery in the supine position. In the erect position the celiac artery origin showed a normal caliber and the celiac axis assumed a more vertical orientation."


    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419433/
     
    Last edited: Jul 4, 2017
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  10. kangaSue

    kangaSue Senior Member

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    @pattismith Consider me kissed and I'm happy to see that my two bob's worth is helpful to someone else but I have to warn you that it is an uphill battle to get this given serious consideration by doctors when symptoms deviate from classic text book presentation, something which is often the case with there being a wide spectrum of clinical presentations.

    It doesn't help that erect position testing is often not done by technicians unless they are familar with the ins and outs of abdominal compression syndromes.

    I have had contact with quite a few people with either MALS or SMA Syndrome, many don't have fainting as a symptom and for some, the pain is not severe so not having either is no criteria to rule these out. A simple test that any doctor can do is listen to your abdominal sounds for any sign of a bruit (sound made in an artery when blood flow is meeting a point of resistance) but again, not everyone has one and healthy people can have one too without it causing symptoms, so a Doppler Ultrasound is the best way to go.
     
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  11. pattismith

    pattismith Senior Member

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    in fact I really doubt I will find a doctor to even considering testing the vascular compression on me, I am so tired, I don't have the strengh left to run after the good one.

    The only things that would be a motivation is to prove my problem to my family, because I believe that my grand mother and my mother were affected as well, and it may be that my half sister could be either.

    But for the moment the hurry is to find quick solutions to alleviate my symptoms.

    After reading your precious informations, I started to monitor my blood post prandial lactates
    -while resting supine
    -while walking

    I found a gap between it!

    for example I did the test with 500 ml water + a small salad. It (only a few vegetables and oil) filled my stomach, and then I staid supine.

    my lactates raised from 1.9 mmol/l preprandial to 3.4 mmol after 75 min postprandial....

    In the evening I eat a small volume but rich meal (rillettes/pickles/apple puree) without drinking, and then went for a very slow walk 40 min and stayed standing

    My blood lactates went from 2.3 preprandial to 1.8 at 80 min postprandial, which was amazing!

    I never had a postprandial blood lactates lowering in my previous testing!!

    My thinking is that my ancestors survived until today, and that there may be something hurting us in our modern life.

    In our case, it shall be that we are not walking enought.
    Human species is a walking specie that is supposed to walk all the time to find food, water, etc, so it may be part of the equation.

    I started to feel discomfortable and tired after eating when I was a teen, but the problem got worse and worse when I started to lay down systematically after eating. And the more I was painful, the more I was going to lay after eating, because it was the only time in the day where I could take some rest, immediatly after meals.

    My grand mother was doing exactly the same thing. She was so painful in her back/vertebrae, so tired and so uncomfortable after eating, that she was systematically laying down after each meals.

    She never improved and got worse and worse her whole life...

    I can see that my road is very parallele to hers, but I will fight to reverse it.

    by chance, I got rid of my vertebral pains and muscle pains with antibiotics and supplements, and now, with your informations, I made a plan to stop the vicious circle. Here is my program :

    -never eat and drink at the same time (I think about waiting 1 hour after a drink to start a meal, and two hours after a meal to start a drink)
    -always walk after a meal (20/40 min), very slowly. If walking is not possible, stay standing.
    -always eat small meals (best is more small meals than a bigger one), avoid bulky food, (so not too much raw vegetables).
    -always taking long time to chew the food
    -last meal at 18h00/19h00, then no more food.

    I started yesterday and my blood lactates stayed in the normal ranges!!

    At the same time, I monitored my potassium blood levels, and I realized that each time my blood lactates have a postprandial increase, my potassium go below the minimum blood range...
    It may be that my symptoms (fatigue/dizzyness/orthostatic intolerance, nausea) may be related also to this potassium issue, so I will pay more attention to take a potassium supplement when I eat.

    I have not yet investigate the link between lactates and potassium, so can't explain it for the moment...
     
    Last edited: Jul 10, 2017
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  12. kangaSue

    kangaSue Senior Member

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    The other problem here is that doctors will generally adopt a wait and see what happens attitude when any artery stenosis measures less than a 70% flow reduction but there are many opinions in the medical literature suggesting that microvascular intestinal ischemia can be just as much the problem for many people and likely the reason why compression release surgery doesn't always relieve symptoms.

    According to my GI motility specialist (but disputed by some other specialists) I have this microvascular problem and I was getting good relief from gastroparesis symptoms and completely stopped the postprandial abdominal pain for a couple of years using nitrate meds (nicorandil mostly).
     
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  13. pattismith

    pattismith Senior Member

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    @kangaSue ,
    I am really glad you found this rare specialist that was able to recognize the problem and to help you.
    I will see if my program gives any improvment in the following weeks, and if not I will fly to your specialist in Australia, it will be quicker than find the rare pearl here in France :lol:
     
  14. Daffodil

    Daffodil Senior Member

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    I did not read this thread but for years and years, I was so tried after eating that I needed to nap. I always thought it had something to do with insulin or something...
     
  15. kangaSue

    kangaSue Senior Member

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    All is not as it appears. It was only from my own research and pushing this specialist along to at least rule this out that got a result, not their out of the box thinking.
     
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  16. pattismith

    pattismith Senior Member

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    I admire the ability you had to open the mind of your doctor, but I won't be able to do so.
    35 years of chronic fatigue/brain fog didn't let me developp the social interactions, and the persuasion power in front of them.

    I draggled myself 6 times to specialists doc (4 rhumato and 2 neuro), and I miserably failed to have a diagnosis done, so I doubt to be more successful with a gastro... I have learnt to only count on my own small strengths to get me out of my problems...But I do not complain, because many people are worst than me, and I can still walk a bit, stand on my legs most of the time, sleep well, and I didn't stop working a single day.

    Thank you again for sharing your knowledge with us
     
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