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Is this Hypoglycemia?

David Jackson

Senior Member
Messages
195
Hi everyone,

This will be my first post on Phoenix Rising... have had CFS for 4.5 years now. Hypoglycemic symptoms are one of the things I get...

Just wondering if there are any people on this forum who keep track of their blood-sugar levels with one of those machines that Diabetics sometimes use? If so, can you please tell me what level your blood-sugar is at when you start to notice symptoms of hypoglycemia?

I have been having symptoms of hypoglycemia for about five years now. It is reasonably bad at the moment, and I need to eat every three hours. I must also wake at night to eat.

My blood-sugar just before eating is usually around 90mg/dL (5.0mmol/L), and it around this level that I start to get the typical symptoms of hypoglycemia... agitation, cognitive difficulties, low energy etc. These are all fixed after I have a meal.

After digesting a meal, my blood-sugar hovers around a healthy 100mg/dL, sometimes going a little over but not much. But three hours after eating it will drop to around 90 and I must eat again.

At the moment I am wondering if I really am hypoglycemic if I am getting symptoms at just 90mg/dL, or if there is something else happening here. I highly suspect that CFS and this blood sugar thing is linked in some way. CFS has a few theories that includes hypoglycemia, and a few that include your cells not being able to produce ATP... so I am trying to understand what is going on here.

My GP is not someone who really knows all the ins and outs of CFS, and she admits as much. She hasn't really been of any help with this blood-sugar thing.

BTW, I am vegetarian, and usually include whole grains, protein and fat with each meal. I have little or no sugar.

Thoughts and comments are appreciated.
 

South

Senior Member
Messages
466
Location
Southeastern United States
I have symptoms of hypo off and on, although no testing done. (I don't have ME though, so not sure if anything I have to say is useful).

I'm talking about the classic hypoglycemia "sudden onset" symptoms, not a constant thing - a sudden onset to where I'll be shakey, slightly sweaty, weak, and crave sugar and salt. Sudden onset for me is about 15 minutes from feeling fine to the onset of these symptoms.

They are only off and on in my life, not all the time. There was only one point in my life where I woke up at night with them, that lasted about a week, and I'm not sure what I did to get rid of that nasty part of it. (that night time thing was years ago)

Something that helps keep daytime sugar crashes away, for me, is including soluble fiber (very different from INsoluble fiber) with at least some of my meals that have carbs - and by "carbs" I mean even healthy carbs like brown rice. (most whole grains do not have much soluble fiber, only insoluble) Soluble fiber slows down the digestion of carbs, preventing sugar high and subsequent sugar crash later, in many people.

I use psyllium as my soluble fiber for this, mixing it into some of my more carby meals.

Foods that are listed as high fiber often only have insoluble fiber, so don't assume that a healthy diet has lots of soluble fiber in it.

On a different, related subject, You might want to read the first post in the following thread, about resistant starch. I haven't tried much resistant starch, but some people say using it to help your gut bacteria eventually leads to more steady blood sugar.

http://forums.phoenixrising.me/inde...ge-is-it-the-key-weve-been-looking-for.26976/
 

JamBob

Senior Member
Messages
191
Hi David

I have T1 diabetes so use a monitor every day. I find that my hypoglycaemic symptoms occur relative to how high my BS has been running. eg. If I run high for a few days, I can start to get shaky at 4.5 - 4.8 whereas if I am aiming for tight control, I get hypo symptoms more around 3.8 - 4.0. So it really isn't fixed although I think medics define hypoglycaemia as around 3.8 - 3.9.

Your symptoms could be hypoglycaemia but I also wondered if you are experiencing symptoms of dysautonomia as eating is one of the things that triggers this and dysautonomia is very common in CFS/ME.

I think the only way you could work out if it is hypoglycaemia (apart form pursuing official testing) is to try eating a very low carb diet to see if this evens things out for you. It's worth bearing in mind that from a BS point of view, it's not just sugar that makes your BS rise, it's any carbohydrate.

You could try eating a more Atkins style diet for a week or two as a trial, though this is somewhat hard when you're vegetarian (think: cream, cheese, eggs, lo carb veg eg. celery, green veg). This would even your blood sugars out and it's something you could do yourself.
 
Messages
15,786
I think the only way to know is via testing. If you don't have a friend with a kit you can use once or a spare that you can borrow, they're quite cheap to buy. Alternatively, it's a pretty basic test which any doctor can offer and is often even part of a yearly physical exam. Just be sure to fast beforehand.

Going off symptoms is far too vague, especially when testing is so cheap and routine.
 

A.B.

Senior Member
Messages
3,780
90mg/dL is definitely not hypoglycemia but a normal level. Clinically significant hypoglycemia is at around 45 mg/dL or lower. There may be some symptoms at <65 mg/dL in sensible people. Anyway, if there is a clear repeatable improvement within a short amount of time after eating then there might be a problem getting glucose into cells or something similar, but the problem is not a scarcity of glucose in the blood.

I know very little about diabetes but it sounds like it should be ruled out.
 
Messages
170
Location
Hippietown
@David Jackson what's your fasting blood sugar in the morning if you don't get up and eat during the night...at least 8 hours without eating?

I check my blood sugar regularly and the only time it was really low was after a big crash last September when I was getting fasting glucose in the mid 50s to low 60s and I felt just awful.

If you are really concerned about it, I would suggest having your doctor order an A1C blood test, which will show your average glucose level for approximately the past 3 months.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
@David Jackson -

One of the illnesses I had that I believed led to ME was like this. I had to eat every three or four hours or I would be in terrible pain, dysautonomia, nausea, etc... but now that I've also had hypoglycemic episodes (joy, rapture, the heterogeneity of ME symptoms!) there is a definite difference between the two.

I was in graduate school for alternative medicine at the time, and I ended up:
  • Eating no refined sugars - no honey, no white sugar, no brown sugar, and definitely no HFCS
  • Eating no artificial sugars - no aspartame, no xylitol, no sorbitol, no sugar alcohols
  • Eating no grains - except one serving a day
  • Eating no fruit - except one serving a day
  • Eating high lean protein - fish, chicken, nut butters
  • Eating lots of anti-infective bitters - dark leafy greens, particularly dandelion greens, lots of veggies
  • Drinking GSE (grapefruit seed extract) a full dose in a bottle of water, drink 'til it's gone, repeat. 'Herbal antibiotic'.
  • Drinking at least 2-L of water a day, always with GSE in it
This made me feel absolutely awful at first (starving whatever bacteria were causing the problem? Maybe, and killing a few too, with the bitters and the GSE). I joked to everyone I knew I was going through sugar withdrawal, but it was definitely more than that. I was dizzy and sick and weak-limbed for about three days.

The fourth day was my turning point. After that, my well-being was so great I felt almost euphoric out from under the weight of all that awfulness. It was awesome.

I kept to it for a month or two until the convenience of packaged food lured me away, but by then I was feeling much better and besides, I had never intended to be on a diet that low-carb forever (though perhaps I should have. Hindsight!)

I am not saying our situations are identical. Honestly, from what you have told us so far, I have no idea what could be bothering you.

I do, however, agree with @A.B. that a blood sugar of 90 is totally normal and it is not likely that this is what is causing your problem. It is a possibility that an infective organism is causing your problem, instead, and the symptoms you are experiencing are caused by first a proliferation of, then a die-off of some infective organism. That is what I assumed in my own case, and treated myself accordingly.

Just a thought. Even if this weren't the case, a high-protein, low-carb diet would help someone with swinging blood sugar, and anti-infectives can't hurt, especially if you take them with some decent-quality probiotics.

Oh, a final thought. I always thought I had low blood sugar because I would go through period of weakness, brain-fog and dizziness, even as a child. My blood sugar always tested fine, and even a glucose tolerance test revealed nothing. There are things that make you feel this way that have nothing to do with blood sugar, or at least not directly. I have very low GH and don't have the ability to produce much cortisol at a time. Your problem may be endocrine in some other direction.

-J
 

David Jackson

Senior Member
Messages
195
Hi everyone,

Firstly, thanks you very much for all the replies. I posted something similar on a Hypoglycemia forum a few months ago, and it was 46 days until I got one reply... I should have just some straight to PR...

I didn't think that getting symptoms of hypoglycemia at a level of 90 (or 5.0) was proper hypoglycemia... my doctor told me my blood sugar levels were normal, and one other diabetic also said these levels were too high for hypoglycemia. And now I am hearing this again...

My guess, then, is that there is sufficient glucose in the blood, but wither a problem in the hormone cascade prevents the cells from using it, or a breakdown in the cell respiration is happening.

I had a referral to an endocrinologist some months ago, but was too smashed to go to it (I'm house bound) and the hospital refused to reschedule it. Once I am able to leave the house again, I'll make a point to get another referral.

Aaron, my blood sugar is usually around 5.0 after not eating for 8 hours, or slightly under.

Jamie, when you say "a full dose" of GSE, how much is that, exactly?

Thanks again for the quick responeses!
 

caledonia

Senior Member
I've had this for many years (decades actually).

My suggestion would be to do a trial of eating meat or seafood with every meal. As a vegetarian substitute you could try eggs. You should know within a short time if this is going to work.

You need to have a balance of real protein (not beans in other words), carbs and fat with every meal or snack. The fat will help hold you longer.

My hypoglycemia has virtually disappeared sometime after starting methylation treatment. Note that I also eat balanced meals. If I cheat by eating carbs without protein or if I eat refined sugar, my hypoglycemia will return. I can fix an episode by getting some protein or a good balanced meal.

When I've checked my blood sugar either at the doctors or with a diabetic blood sugar meter, it's around 90.

ps. I know you didn't ask about this, but you're on here with hypoglycemia and ME, so I feel I should mention this. Please forgive me if you already know this information or find it annoying.

I hope that you're supplementing with B12. Vegetarians often become deficient in B12 (only available in animal products) after some time. This is not a healthy diet for everyone, especially those with B12 SNPs (genes that block intake and recycling of B12). B12 deficiency can mimic the symptoms of many serious diseases, and I would add ME to the list on this website:

http://chriskresser.com/b12-deficiency-a-silent-epidemic-with-serious-consequences/

Many (most?) people with ME do best with a "cave man" or Paleo type diet. I find that I must add some starches as well to help with hypoglycemia.

Note that methylation treatment includes supplementation with B12. Many people on here (including myself) have benefited from methylation treatment.

There is also a connection between hypoglycemia and hypothyroidism. My hypothyroidism was cured some time after starting methylation treatment.

http://chriskresser.com/thyroid-blood-sugar-metabolic-syndrome/

So you can see how it all sort of fits together.
 

halcyon

Senior Member
Messages
2,482
I tend to get hypoglycemic symptoms when I drop below 80. Keep in mind that the home meters aren't perfect and can be off by around 15. I have noticed though that I get identical hypoglycemic symptoms sometimes when my readings are normal. I think this is interesting in the context of some recent research that shows we might have some problems with glucose metabolism. One wonders if it is actually still hypoglycemia due to the blood sugar not getting into the TCA cycle properly and so the cell is starving for energy. It's there but can't be utilized which would have the same effect as not enough being there (true hypoglycemia).
 

GONZ0hunter

Senior Member
Messages
131
Location
Fragelle rock, USA
You should get you ahi checked. It shows your avg over a 2-3 month period.

I became t2 diabetic the day I got sick. I wasn't 3 months prior.

Talk to your dr get a device, they are $20 with supply's. Maybe cheaper with insurance
 

David Jackson

Senior Member
Messages
195
Thanks again for the further replies.

Although it seems that I am not hypoglycemia, it is still confusing: three hours after eating, I start to get the symptoms of hypoglycemia, so presumably my cells are not getting enough glucose even though it is probably there in the blood. But then, after eating, my blood sugar goes up... so eating temporarily fixes the problem, whatever it is.

In reply to the questions/comments above:

I checked my blood work, and have had a HbA1c test twice already, and both were around the 25mmol/mol level, which pretty much excludes diabetes, apparently.

My B12 levels are totally fine. I've supplemented it heaps, and now there is loads of it in the body.

It's interesting that the Methylation treatment has helped people... can someone please give a very brief description of it, or paste a link to what they know has worked? Is there a test involved with it? A short time ago, a friend of mine was telling me about a Methylation test that he was looking into (I am down in New Zealand).

Am going to be adding some yogurt (made from raw cows milk) to each meal to see if there is any difference.

Otherwise I am the kind of person who, even if it were proven beyond any doubt that eating meat would completely cure me, most probably wouldn't do it.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Although it seems that I am not hypoglycemia, it is still confusing: three hours after eating, I start to get the symptoms of hypoglycemia, so presumably my cells are not getting enough glucose even though it is probably there in the blood.

Ugh, @David Jackson , you are stepping into the middle of a very long conversation with this statement. I wrote a blog post discussing a study in which it is stated that people with ME have disordered glycolysis mechanisms. Julie Newton's study also points to disordered glucose uptake during exercise. So stating that despite having 'normal blood sugar' you're having problems with glucose uptake - well, there's certainly some data to support that point of view.

It's interesting that the Methylation treatment has helped people... can someone please give a very brief description of it, or paste a link to what they know has worked? Is there a test involved with it?

Aaaand another VERY LONG conversation. Weirdly, I was about to ask for something similar, though. This Module, my chem students learned about methylation and the methylation cycle, and they're all asking me for a condensed version of how it affects human health and I'm all o_O:D:rofl::rofl::rofl:.....No, no, I really should find some way of explaining it simply....:(:cry:

IT'S ALL SO MUCH, EVERYONE. IT'S ALL SO MUCH.

So, I would appreciate some help in this arena as well!

My B12 levels are totally fine. I've supplemented it heaps

That doesn't necessarily mean you're absorbing enough, if you've got dysbiosis.

I understand your objections to meat and that's fine. I doubt anyone here is going to shake their finger at you! Just make sure you are getting all the necessary nutrients that you might be missing from meat.

-J
 

caledonia

Senior Member
Thanks again for the further replies.

Although it seems that I am not hypoglycemia, it is still confusing: three hours after eating, I start to get the symptoms of hypoglycemia, so presumably my cells are not getting enough glucose even though it is probably there in the blood. But then, after eating, my blood sugar goes up... so eating temporarily fixes the problem, whatever it is.

In reply to the questions/comments above:

I checked my blood work, and have had a HbA1c test twice already, and both were around the 25mmol/mol level, which pretty much excludes diabetes, apparently.

My B12 levels are totally fine. I've supplemented it heaps, and now there is loads of it in the body.

It's interesting that the Methylation treatment has helped people... can someone please give a very brief description of it, or paste a link to what they know has worked? Is there a test involved with it? A short time ago, a friend of mine was telling me about a Methylation test that he was looking into (I am down in New Zealand).

Am going to be adding some yogurt (made from raw cows milk) to each meal to see if there is any difference.

Otherwise I am the kind of person who, even if it were proven beyond any doubt that eating meat would completely cure me, most probably wouldn't do it.

In my experience, yogurt is too glycemic. It there any objection to eggs?

Click on the link in my signature which will take you to my methylation links. The Methylation Made Easy video series explains about methylation in an easy to understand manner.
 

David Jackson

Senior Member
Messages
195
My replies to the responses:

1. Thanks for consistently replying. I joined Foggy Friends a while back, but they censored me every time I tried to discuss things that had given me benefit... they said I was giving medical advice... I think I am going to like Phoenix Rising a lot better...

2. Jamie: interesting to note about the messed up glucose uptake. What a thing to have, on top of all the other problems... there is not much that actually works correctly, is there?

3. Yep, it's all too much, alright. I've put off learning the details of Methylation (and other things) because it all just gets too confusing, confounding and frustrating. And also because it's so damn hard to concentrate most of the time...

4. My B12 levels are good on blood tests; I can say that much at least.

5. Thanks for pointing out the link, Caledonia.

6. Eggs: one reason is that I'm a Hare Krishna, and eggs are not part of the diet. Another reason is the animal cruelty involved in the egg industry. Another reason is that I don't fancy eating an animal's menstruation, which is what eggs are, really.

Again, thanks for the replies. It's good to know that there is a forum where CFS pool their experience an knowledge together and help each other out.
 

caledonia

Senior Member
4. My B12 levels are good on blood tests; I can say that much at least.

5. Thanks for pointing out the link, Caledonia.

6. Eggs: one reason is that I'm a Hare Krishna, and eggs are not part of the diet. Another reason is the animal cruelty involved in the egg industry. Another reason is that I don't fancy eating an animal's menstruation, which is what eggs are, really.

You're welcome.

I had a couple more ideas for protein - tofu or protein powder. There are many kinds of protein powder - soy, whey, egg, hemp, rice, pea, maybe more?

Unfortunately, the serum B12 test is not accurate. If it's low, your B12 is low, but beyond that, if it's normal your B12 may be low, or if it's high your B12 may be low.

As far as B12 supplementation being effective, it has to be the right form and the type of administration. The right form is either methylcobalamin or hydroxycobalamin. The right type of administration is either injection or sublingual.

In other words, taking an oral pill with cyanocobalamin is basically the same as nothing.

If you have signs and symptoms of B12 deficiency, then consider that it may be low.

Since your vegetarianism is tied up with a religion, I can see where it would be very difficult to change. Is there such a thing as an exemption for health reasons?
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Jamie: interesting to note about the messed up glucose uptake. What a thing to have, on top of all the other problems... there is not much that actually works correctly, is there?

@David Jackson , if you want someone to be alerted because you are replying to them directly, the way we do it on these forums is to use the @ sign and then follow it with that person's moniker (the name below their pic). That ensures that who you are talking to will see your message. :)

Here is the methylation explanation I eventually started giving to my students. It's still comically short and incomplete.

....methylation in simple terms. Ohhhh boy, you know not for what you ask!

So basically, methylation as a chemical concept is the addition of a methyl (CH3) group. That's simple enough.

Methylation as a biological process is a whole other ball of wax.

Methylation is involved in the cycle often called 'one-carbon metabolism'. Methylation involves homocysteine and methionine as well as some of the B-vitamins:

upload_2015-7-13_14-12-6.png

(Niculescu & Zeisel, 2002)​


People will discuss the methylation cycle (in which case they are usually discussing 1-carbon metabolism) but they will also discuss methylation of DNA (the influence of your environment on your genetics via methylation, e.g. an aspect of epigenetics.)

Like in all cycles of any kind, it's important you start off by understanding that prodding one of these components has a profound effect on the presence of the others. Decreased homocysteine means decreased methionine, etc. "When animals and humans are deprived of choline, they use more methyl-THF to remethylate homocysteine in the liver and increase dietary folate requirements. Conversely, when they are deprived of folate, they use more methyl groups from choline, increasing the dietary requirement for choline" (Niculescu & Zeisel, 2002).

In the human diet, most methyl groups needed to fuel the cycle come from methionine, one-carbon metabolism via methylfolate, and from choline. Choline is also necessary to produce the phospholipid bilayer for cell membranes, is a neurotransmitter, and transports lipids and cholesterol (Varela-Moreiras, Selhub, da Costa & Zeisel 1992).

Since the utilization of choline is so important to the human body, errors in one-carbon metabolism and methylation can potentially lead to a whole host of illnesses, including but not limited to chronic fatiguing syndromes, cancers, and (unsurprising, given the nervous system involvement) mental illnesses such as schizophrenia, major depressive disorder, Alzheimer's and obsessive-compulsive disorder (Liu, Chen, Elrich, Walton, White, Perrone-Bizzozero et al., 2013; Turksoy, Bilici, Yalciner, Ozdemir, Ornek et al., 2014). Choline-DHA is often given to pregnant and nursing mothers in order to encourage healthy brain development in the child.

The importance to nutrition is to be aware that this cycle requires chemicals called 'methyl donors' in order to function properly - that is, chemicals that can give up a CH3 group. Methyl donors include SAM-e, B12, CoQ10, curcumin... the list goes on, but you get the idea. Note SAM-e's position right before the 'methylation' in the diagram above.

There is somewhat shaky science on methylation in nutrition in the form of Amy Yasko's methylation protocol, a protocol that looks at the SNPs (single nucleotide polymorphisms) that have an impact on 1-carbon metabolism and suggest supplements to help combat the problems created by these aberrant SNPs. The issue is, Yasko is right about some SNPs but has no scientific foundation for her opinion on others. The other issue is that the process of supplementation according to her protocol is long and complicated, allowing for a lot of time for coincidental improvements to give the impression of success.

I do want to emphasize that many of her recommendations are sensible in context, and some of it may even be a case of 'right protocol but illogical reasoning'. As in, the suggestion is correct, but the rationale used to explain why it's correct makes no sense. As a practitioner with a science background, it will be your job to help the client make some sense out of the protocol and determine whether it is right for them.

-Jaime



References:

Liu, J., Chen, J., Ehrlich, S., Walton, E., White, T., Perrone-Bizzozero, N., … Calhoun, V. D. (2014). Methylation Patterns in Whole Blood Correlate With Symptoms in Schizophrenia Patients. Schizophrenia Bulletin, 40(4), 769–776. doi:10.1093/schbul/sbt080

Niculescu, M. D., & Zeisel, S. H. (2002, August 1). Diet, Methyl Donors and DNA Methylation: Interactions between Dietary Folate, Methionine and Choline. The Journal of Nutrition, 132(8), 2333S -2335S. Retrieved from http://jn.nutrition.org/content/132/8/2333S.long

Türksoy, N., Bilici, R., Yalçıner, A., Özdemir, Y. Ö., Örnek, I., Tufan, A. E., & Kara, A. (2014). Vitamin B12, folate, and homocysteine levels in patients with obsessive–compulsive disorder. Neuropsychiatric Disease and Treatment, 10, 1671–1675. doi:10.2147/NDT.S67668

Varela-Moreiras, G., Selhub, J., da Costa, K. & Zeisel, S. H. (1992) Effect of chronic choline deficiency in rats on liver folate content and distribution. J. Nutr. Biochem.3:519-522.
 

David Jackson

Senior Member
Messages
195
@JamieS - thanks, got it. And thank you also for the Methylation explanation :)

@caledonia - I took methylcobalamin orally for quite a while and my last blood test, about a month ago, read:

Vitamin B12:>1450 pmol/L ( 130-650 )

Seeing that, I just stopped taking it.

In terms of changing the diet, I have heard that it is OK to eat meat if it is a matter of starvation because there is nothing else to eat, but I have never actually heard of anyone needing to do that. But because it might help my hypoglycemia a bit... I don't think so.

If I ever find out more about my "hypoglycemia", which may not even be real hypoglycemia, I'll come back to this thread and add my findings to it.