Is HYPOglycaemia common in ME/CFS sufferers?

[PatJ]

If you were to try you may find the weight loss stabilises after you've finished adaptation, I pee'd/burnt off 5kg in 2 weeks when I started it but have now put a kilo or 2 back on with BMI of 22.

If I ever give it a try then it will have to be after gained more weight since I'm close to emaciated. A couple of weeks ago I weighed 106 pounds, at 5' 10" tall, male, which is a BMI of 15.2. Since I've increased my carbs so much I now weigh 112lbs, BMI 15.8 (or 16.2 according to another calculator).

 

[xrayspex]

yes---diagnosed with testing years before had significant CFS as young adult....

 

[alex3619]

I suspect a lot of people are making incorrect assumptions based solely on symptoms. I tested my own levels (fiance is diabetic so I have the proper equipment) intermittently when feeling cruddy, and my glucose levels were always normal.

I have had both false incidences of low blood sugar, and real crashes. For a few years in the early 2000s I would get apparent hypoglycemic incidents, and then one day I tested my glucose. It was, if I can recall correctly, 3.9 or 3.8 on whatever units we use here. Normal is 5. Usually I didn't test my blood glucose because I was racing to get some carbs. I do not recall if I was on Metformin at the time.

On the other hand when in hospital a few years back I had many such episodes but my blood glucose was slightly high.

I am considered diabetic but my secondary blood tests look nothing like a diabetic, such as glycosylated hemoglobin.

We now know that ME includes problems with glucose and fat metabolism. The symptoms of hypoglycemia could often be due to problems in energy production. We just don't know enough yet.

So a sudden energy crash might feel like hypoglycemia. This might be due to signal changes or even insufficient dietary protein. We need the science to advance.

 

[David Jackson]

I know of one thing that my herbalist told that really helped me out once, and it might be worth mentioning it here:

Sage tea will fix a certain type of cell metabolism. Don't ask me more about it than that, because I don't know anymore than that; all I know is that it worked well for me once. It felt like my hypoglycemic symptoms had gone crazy: I would eat, and then I was hungry again just 15 minutes later. My herbalist measured me with his divining rods, and said I needed 6 cups of sage tea over 3 days; sure enough, that fixed it up. To a degree, at least. Back then, I needed 4 meals per day, so it wasn't a complete cure to my hypoglycemic symptom thing, but it helped a great deal. Never have more than 6 cups over 3 days, because Sage tea will mess with you, apparently. All you need to do is boil the jug, put a few Sage leaves in a cup and pour on the boiling water. Leave it for 10 minutes and then drink. Always use the jug and never the microwave for this.

There is a similar thing for cell hydration. It is all well and good to drink 2 liters of water per day, but if your cellular hydration is poor, then you stay dehydrated no matter how much you drink. 6 cups of Rosemary tea over 3 days will fix this - another one of the simple remedies my herbalist taught me.

 

[Forbin]

In the first years of the illness, I had three different glucose tolerance tests. They all came back normal... even though I had very noticeable symptoms during the tests (i.e. pounding heart, shaking hands, feeling like crap). Much later on, I began to suspect that these symptoms were being brought on by the release adrenalin. I believe it's known that if your body senses a severe drop in blood sugar it may try to compensate by releasing adrenalin. The thing is, my tests did not show the kind of significant drop in blood sugar that would bring on such an adrenalin release.

My current guess is that "signaling" gets screwed up in ME somehow and the threshold for releasing adrenalin is much less of a glucose "dip" than usual (at least for me).

I don't really know of any research that would back this up, but I don't find it hard to believe that ME might decrease various thresholds. Lack of sleep alone can do this in regard to things like light and sound sensitivity.

 

[A.B.]

The thing is, my tests did not show the kind of significant drop in blood sugar that would bring on such an adrenalin release.

That can just mean that you are able to compensate, unlike a diabetic that can no longer compensate without external help.

And the problem may have less to do with actual blood sugar levels but with energy status inside cells.

I know I can reach clinical hypoglycemia, but have also often observed the same symptoms, just of lower severity, with normal glucose levels, and feeling better by eating something. And I'm not diabetic. It seems to be some other problem.

 

[Mel9]

I know of one thing that my herbalist told that really helped me out once, and it might be worth mentioning it here:

Sage tea will fix a certain type of cell metabolism. Don't ask me more about it than that, because I don't know anymore than that; all I know is that it worked well for me once. It felt like my hypoglycemic symptoms had gone crazy: I would eat, and then I was hungry again just 15 minutes later. My herbalist measured me with his divining rods, and said I needed 6 cups of sage tea over 3 days; sure enough, that fixed it up. To a degree, at least. Back then, I needed 4 meals per day, so it wasn't a complete cure to my hypoglycemic symptom thing, but it helped a great deal. Never have more than 6 cups over 3 days, because Sage tea will mess with you, apparently. All you need to do is boil the jug, put a few Sage leaves in a cup and pour on the boiling water. Leave it for 10 minutes and then drink. Always use the jug and never the microwave for this.

There is a similar thing for cell hydration. It is all well and good to drink 2 liters of water per day, but if your cellular hydration is poor, then you stay dehydrated no matter how much you drink. 6 cups of Rosemary tea over 3 days will fix this - another one of the simple remedies my herbalist taught me.

I'm going to try these!

 

[PatJ]

In the first years of the illness, I had three different glucose tolerance tests. They all came back normal... even though I had very noticeable symptoms during the tests (i.e. pounding heart, shaking hands, feeling like crap). Much later on, I began to suspect that these symptoms were being brought on by the release adrenalin. I believe it's known that if your body senses a severe drop in blood sugar it may try to compensate by releasing adrenalin. The thing is, my tests did not show the kind of significant drop in blood sugar that would bring on such an adrenalin release.

GTTs are well known for being unreliable because they don't continuously measure blood sugar. It's possible to pass out from low blood sugar, wake up, have your BG tested and found to be normal because your body has raised it since passing out. Then the doctor says 'You don't have blood sugar problems because you passed the test and we didn't find any abnormalities when we sampled your blood sugar.'

An analogy is: a doctor tests your ability to stand upright for two hours straight. You enter a room with the doctor who looks at you and notices you are standing upright, makes a note on a chart and leaves. You then pass out but a few minutes later stand upright again. The doctor comes in, notes that you are standing upright and leaves. After the test you tell the doctor that you passed out during the test but because the doctor wasn't there to see it and didn't note it on the chart s/he discounts or dismisses your account of events. As far as the doctor is concerned, you passed the test.

This is the way a GTT often works. You can pass out, even have a seizure from low blood sugar, but the only thing that many doctors will note is the BG value at the few times that they test it during the duration of the GTT. The only way I would trust a GTT is if they did continuous blood sugar monitoring.

 

[ryan31337]

I think it goes further than just sample timing too, your body isn't likely to respond to shots of glucose in the same way it does to your normal food. I assume its for that reason mixed-meal tolerance tests are favoured (but still imperfect for the reasons you give).

 

[ryan31337]

Oh and my experience today might interest some, n=1 of course...

Had routine 24hr BP monitor on, normal 135/70 all morning. Ate my usual ketogenic lunch but then surprisingly felt my old nemesis, the postprandial hit, coming on an hour or so after. Sleepy, hot, suddenly unable to deal with noise/stimulus, unable to concentrate, blurred vision etc. BP reading at that point dropped to 118/58 (low for me). Half an hour later I had bucked up a bit when the reading was 150/90... go figure

Presumably I dropped out of ketosis, my pee is no longer smelling of ketones (overshare, sorry ). The immediate difference in energy and general symptoms is staggering!

 

[Forbin]

GTTs are well known for being unreliable because they don't continuously measure blood sugar. It's possible to pass out from low blood sugar, wake up, have your BG tested and found to be normal because your body has raised it since passing out. Then the doctor says 'You don't have blood sugar problems because you passed the test and we didn't find any abnormalities when we sampled your blood sugar.'

Yes, this is what the nurse told me when I mentioned that I was feeling those symptoms, i.e. that the sampling might be too infrequent to catch a transitory plunge in glucose. The only reason I question this is because the test never captured such as plunge any of the three times that I took it. The plots they showed me at the end of each test looked perfectly normal. If the test is actually is missing such an excursion that frequently, it makes me wonder just how useful it is - - or if something might be causing a release of adrenalin while glucose is in the normal range.

 

[caledonia]

Adrenal fatigue is also related to high stress lifestyles, excess sugar and refined foods that stress the adrenals with sugar spikes and associated extra insulin to compensate, and internal stresses such as the disregulated HPA axis as found in CFS/ME. I'm not arguing against mercury toxicity, just pointing out other possible causes.

Yes, probably many sources - too much coffee or Red Bull, overtraining, etc.
HPA dysregulation is also a symptom of mercury toxicity. Or more technically, HPAT - hypothalamus, pituitary, adrenal, thyroid.

 

[caledonia]

I agree with you but for me the Zone diet has just a bit too much carbohydrate. I do well with my diet being about 55% fat and only 20 % or so of carbs.

Pam

Yes, you would want to adjust that to whatever ratio works for you (I do better with some starches).

But the point is to get some good protein, carbs and fat together in each meal and snack. In other words, don't eat an apple by itself, get some protein and fat with it. That will help keep your blood sugar more steady, and help you go longer between having to eat.

 

[GodGenghis]

I have used the chinese medicine herb Bupleurum off and on for the better part of a decade. In terms of Chinese medicine lingo it remedies liver qi stagnation. Essentially it is a liver tonifying herb, with some action on the gallbladder and spleen. On several occasions, seemingly out of nowhere, it has triggered what felt like a sudden blood sugar crash. I go from my normal baseline to becoming incredibly weak and ravenously hungry for the most accessible sugars possible. This has happened enough times for me to be confident that it is caused by this liver herb. I dont understand the biology involved in this, and I also haven't had my blood sugar levels checked during an episode, but I wanted to mention this since others here have also suggested the possibility that what feels like hypoglycemia could be mediated by the liver.

 

[alex3619]

Yes, you would want to adjust that to whatever ratio works for you (I do better with some starches).

That is an issue with all of us. Diet has to fit our personal needs, not just short term but long term needs. That is why its often so hard to get it right. Its also a problem with optimization. In the short run I did pretty well on ultra high carb (slow release, basically just vegetables) and higher protein lower carb. In the long the high carb led to steady decline, and the higher protein did not give me enough energy to compensate for the energy needed for cooking that way.