My wife's struggle with hypoglycemia, advice needed

So I will be reading up on what I can about adrenal fatigue. We have also made an appointment with an endocrinologist in 2 weeks. In the mean time, if anyone has any comment or advice, it will be much appreciated.

Hopefully you'll get more information from the endocrinologist!

If she had adrenal fatigue, wouldn't her cortisol levels be off? Others will know better.
 
Some updates:

We have got the blood test results back, and they are all within normal range, or very close to nornal range. Some of the most important ones, in my opinion, are
* Glucose 5.7 ( 3.6 - 7.7 )
* S-Insulin 13 ( 3 - 15 )
* HbA1c (NGSP) 5.1 ( < 6.5 )
* HbA1c (IFCC) 32 ( < 48 )
* TSH 1.4 ( 0.3 - 3.5 )
* Cortisol am 331 ( 100 - 535 )

Hi Bobo08. Aside from the above markers, did she have a lipid panel done which includes triglycerides and HDL cholesterol?

The insulin is fairly high but still within the reference range. She could have some mild insulin resistance, although the hbA1c is not massively elevated.
 
Hi Keyhole. The Lipid Profile test results are below

* Cholesterol: 5.3 ( < 5.6 )
* Triglyceride: 2.3 ( < 2.1 )
* HDL: 1.59 ( > 1.09 )
* LDL: 2.7 ( < 4.1 )
* Chol / HDL Ratio: 3.3 ( < 4.6 )
* Non HDLC: 3.71 ( < 3.81 )

There are many more markers, but I don't know what are important so please ask if you want to see them.
 
@Bobo08 Question: Does your wife have allergies or allergic like symptoms, including any of the following:
Watery eyes, sniffles
Phlegmy cough
Hives, eczema or itchy skin
Breathing problems
Stomach pains or vomiting
Digestive problems
Migraines or other headaches
 
Bobo08 said:
Hi Keyhole. The Lipid Profile test results are below

* Cholesterol: 5.3 ( < 5.6 )
* Triglyceride: 2.3 ( < 2.1 )
* HDL: 1.59 ( > 1.09 )
* LDL: 2.7 ( < 4.1 )
* Chol / HDL Ratio: 3.3 ( < 4.6 )
* Non HDLC: 3.71 ( < 3.81 )

There are many more markers, but I don't know what are important so please ask if you want to see them.

Ok so I have done a few calculations for you. These measurements are generally more accurate than HbA1c, because there are several factors which can affect HbA1c to make metabolic health look better or worse than it actually is.

  1. Her HOMA-IR score is 3.3 (anything above 2 is insulin resistance, and above 3 is significant). This calculation is done by
  2. Her TG:HDL ratio is also 3.3 (anything above 1.9 indicates some insulin resistance, and above 3 is significant)

Based on the calculations, it could be said that she currently has moderate-to-severe insulin resistance.

Bobo08 said:
My current working hypothesis is that my wife is suffering from adrenal fatigue. The reasons for that are 1) She has a strong tendency to anxiety most of her life, 2) She suffered from a few months of exhaustion when we tried to transition her to a keto diet, and 3) Sugar helps to alleviate her bouts of dizziness.

So I will be reading up on what I can about adrenal fatigue. We have also made an appointment with an endocrinologist in 2 weeks. In the mean time, if anyone has any comment or advice, it will be much appreciated.

I can understand why you would think that, as her symptoms are similar to what is commonly thought of as "adrenal fatigue". I'd caution against using that as a working hypothesis however, because the condition is not actually a real thing. That is definitely not to say that many people don't have the symptoms, but what I mean is that the causes are usually nuanced and different in different people, and generally have nothing to do with the adrenal glands failing to work ( as was previously believed to be the case ).

In many cases, the adrenal glands increase their output. If eventually cortisol levels flatline, it is thought to be more of an adaptation of the HPA axis, rather than a problem with the adrenal glands per se (ruling out Addison's and other genuine hormone disorders). I don't want to get bogged down with the details, but if you want to understand what I am referring to I explained it here:



Despite her bloods not falling under the category of full-blown diabetes, she 100% has metabolic signs of the intermediate stages of developing this condition. Insulin resistance could theoretically explain short periods of reactive hypoglycemia, which would not usually show on blood tests unless one has a continuous glucose monitor installed. Here is a paper titled "Hypoglycemia as first presentation of insulin resistance - A case report" which documents similar findings.

Hopefully the endocrinologist can help you find out what is going on and rule out any other underlying conditions.

In the meantime - a few things that might come in handy to enhance insulin signalling and reduce resistance (with references if you want to read about them) -

- Benfotiamine - 300mg-600mg per day
- Alpha lipoic acid - 300mg-600mg per day
- Myo Inositol - 2 grams per day
- Chromium Picolinate - 500-1000 micrograms per day
 
Thank you so much for your post, Keyhole! That clears up many things for us. I will ask my wife to start on ALA right away and order the remaining supplements.

Zzartemis, my wife frequently has headache, but not migraine. She occasionally has breathing or digestive problems. She is also very sensitive to chemicals. So you raised a good point about allergies. Thank you for that! We did discover during diet experimentation that she doesn't tolerate walnut. I think in the next visit to the GP, we will ask for a food allergy blood test.
 
Great news on the lab results!

Another idea is: Are the dizzy spells related to postural changes? The reason I am asking is that it could be a weird form of essential postural (or orthostatic) hypotension.

The other thing that comes to mind is an issue with mitochondrial energy production - a thing you could try is to give your wife d-ribose, which is a sugar that a) increases mitochondrial efficacy, but b) doesn’t trigger insulin. I use it with glycine in my tea.

D-ribose has a caramely, burnt sugar taste, and that tends to get more pronounced with time (the powder also starts to get yellowish). But I kinda like it …
 
Hi Nicklebleu. I don't think the dizziness is related to postural changes. It usually happens when my wife has to expend mental energy (sitting through a meeting, trying to solve a problem, etc.)

Thank you for your suggestion about D-ribose. I will order it as well.
 
Zzartemis, my wife frequently has headache, but not migraine. She occasionally has breathing or digestive problems. She is also very sensitive to chemicals. So you raised a good point about allergies. Thank you for that! We did discover during diet experimentation that she doesn't tolerate walnut. I think in the next visit to the GP, we will ask for a food allergy blood test.
Hey there @Bobo08 thanks for your response. I didn't want to mention this unless you gave a yes to any of my questions. You can ask for allergy tests, but if they are negative and she continues with the symptoms, she may be histamine intolerant (HIT). This is a genetic mutation and darn hard to figure out, unless you know what to look for. It is an impaired ability to clear excess histamine from the body and I have it.

HIT runs in families and occurs in about 1% of the population. However, I do believe a greater percentage are suffering from symptoms due to medicines taken and other dietary and/or environmental factors. I cannot take most meds with the exception of anti-histamines...even then carefully as a last resort because the body will continue to pump histamine without clearing...there is a rebound effect from use. And many medications are either histamine raising or creating. The same goes with foods which I will get to.

For years I had strange symptoms and allergy like reactions, sometimes thinking I was getting sick, but never getting but never getting sick in the end. Also things like bloody noses, stomach aches, occasionally passing out, dizziness, bouts of eczema, multiple miscarriages, and many other symptoms. For many years these were more like a nuisance than something full blown. Until my early 50s, when I suffered physical and emotional trauma from violent attacks.

You mentioned your wife's low threshold for stress. Has she had a trauma or severe injury or perhaps witnessed anyting traumatic? Because HIT's physiological symptoms, some of them, can be very similar to ptsd, especially in the sense of overwhelm.

HIT is hard on the adrenals. It tends to give one a type A personality, very driven. Others here were wondering if she had adrenal fatigue, why would her cortisol levels be relatively high? They would be at higher levels because cortisol squashes histamine; so her body here would be trying to bring balance. I also noticed her cholesterol levels were at upper limits and there would be a reason for this also; adrenal hormones are manufactured from cholesterol. So, this would be another area where the body was trying to bring balance. In the earlier stages, cortisol levels will remain high until adrenals are so taxed that hormones are not produced at normal levels. In comes severe fatigue. She will also most likely have low blood pressure and this could/would be the cause of dizziness and or fainting. If so, here's a time when salt will be good for her. I use Celtic salt.

You cannot really test for histamine intolerance; but you can use a food elimination test. You can find lists of histamine Foods online, but look up a few because they tend to differ, and none are all inclusive. For years I was eating things I thought good for me like: spinach, citrus fruits, pineapple, tomatoes, bananas, many types of nuts including walnuts, yogurt and other fermented foods, the list goes on. All these Foods are on high histamine lists. Things like yogurt and kefir contain organisms that increase histamine levels. If she has histamine intolerance she will do better with soil type organisms, like those in baby probiotics. Other Foods would be: aged Meats, canned meats and fish, beer wine and alcohol, and leftovers. But please do check the list for more.

I said, HIT tends to run in families where you will see asthma, hay fever, or other allergies. Actually one would call them pseudo allergies because the effects are not seen until hours after ingestion, sometimes not until the next day. Also, what bothers you one day may not at another time. This would depend on how high histamine levels are at the time of ingestion. Other factors which can raise histamine levels are any type of stress. This stress could be emotional or physical. Types of physical would be pushing past endurance, extreme hot or cold temperatures, loud noises, shocks of any type, and so on.

The symptoms of histamine intolerance are many and varied. It can attack any part of the body systems. Respiratory, severe pain, skin, stomach, intestines, even the brain causing inability to focus, irritability, or what is called brain fog. I have also suffered bouts if temporary amnesia. When my levels are high my complexion is very rudy and my palms are red, pupils can be dilated.

If you do find compelling evidence towards histamine intolerance, I will advise you that I had absolutely no cooperation with doctors on this issue. I did years of research on my own and none would look at it. If you are in Europe, you may find doctors that are familiar with it. A functional medicine doctor would also be a good choice. However, they are expensive and your insurance may not cover tests they run or even the visit itself. I could not afford them so I used and experimented with many supplements to help me and they did up to a point. What I found was that I could go no further and was at what you would call your Baseline. I hope this helps in your search and if it is decided that she is histamine intolerance please feel free to contact me, ping me in a post and I will see.
 
Here's a short video on adrenal fatigue and what you'd be up against if suggested to your doctor. True is they say it doesn't exist because there is no medical code for it. It's the same for a lot of the mystery illnesses of today.

He also mentions JFK having Addison disease. He also had HIT and was subjected to a severe trauma while in the Navy. Just highlighting that causal factors are usually multiple and varied among different ppl and that there can be one last factor that pushes past the limit of the body and causes that perfect storm to happen. It was trauma in my case. One of my brothers developed diabetes, which does not run in our family, and he thinks when he got electrocuted, that it pushed his body into that state of illness...I agree that this is a possibilty. My, upto that point very regular, female cycle stopped completely, never returning.

As you said, your wife has liitle or no threshold toward stress; I would look at that very seriously and her lack of endurance....encourage her to stop and rest. Even reading or talking requires energy. It took me years to regain my ability to focus and stop 24/7 crushing pain (I used the idea of neuroplasticity and visualizing to free myself from central pain syndrome). I never regained my stamina and must lay down frequently and/or sleep through out the day. I cannot stand for very long.


edited to add video
 
I'm posting an excellent video here from Silicon Valley Health Institute (SVHI), an interview with Sarah Myhill, MD from over a year ago. The first part is about simple measures for avoidance of C-19. Next comes general health and antiviral strategies, issues with the health system, etc. At the section between 50 and 60 minutes in, there is some discussion about which kinds of people with hypoglycemia do poorly on ketogenic diets and why, suggested diagnostic approaches, etc. Hope you find something useful here.

Sarah Myhill's general health site:
DoctorMyhill

Here is some info on SVHI:
About Us - Silicon Valley Health Institute
 
I don't know why that video is reported as unavailable. I'm watching it right now. Try this:

_
 
“Maintaining Optimal Health” is the presentation given by Sarah Myhill, MD at the June 30th, 2020 Zoom meeting of the Silicon Valley Health Institute.
Maybe you can find it on the SVHI site.
I don't know why the video is reported as unavailable. I'm watching it right now.
 
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