May 27, 2003
Diagnosis and Symptoms, Hypoglycemia
Question from Lynchburg, Virginia, USA:
My four and a half year old son is allergic to several foods, and at about the age of three and a half, I noticed that he would eat and in an hour he was hungry again. If he did not eat promptly, his demeanor would drastically change to being weepy and emotional, and disoriented. He would eat, and within 15 minutes, he would be normal acting. Of course the doctor thought it could be a tantrum to get what he wanted, but for us it was not, it was a definite mood altering change.
He would also act this way when he woke up from a very hard solid sleeping nap, and when he had a very active day in pre-school, if he did not eat immediately when he came home. Again, food would calm the mood change. The doctor agreed that it could possibly be hypoglycemia and told us to make sure he ate meals including the snacks. Of course, sometimes it is hard to get him to eat, but most of the time he is always hungry. The pattern has continued for the last six months.
I finally asked the doctor for a glucose monitor, and we have been checking his blood sugar levels for two weeks. His morning reading has averaged around 90 mg/dl [5 mmol/L], and each time he has had a severe mood change, we have checked his blood. which has been 77-83 mg/dl [4.3-4.6 mmol/L] every time. Again, food has relieved the symptoms. I know this in not considered low, but could be could this be a low for him?
I have heard that food allergies could interfere with insulin production, is that possible? If so, how? His diet is mainly fruits, vegetables and meat-without any thing added. He eats very little bread, when he does it is rice based. My son is average height, not underweight but he has very little fat on him. He is very active and bright. I am trying to educate myself and find ways to help us deal with this situation before he begins Kindergarten this fall. I think he has a great pediatrician now, but the more insight I can get into this is helpful.
Answer:
Perhaps, but I don’t think so. Maybe it is not the absolute glucose value but rather the rate of how fast the glucose level is decreasing. How about a simple maneuver of changing the meals at home by cutting out simple and processed sugar (juice, soda, Gatorade, frosted cereals, Kool-Aid, etc) and adding more protein and complex starchy carbohydrates? Talk with you regular pediatrician.
DS
Additional comments from Dr. Donough O’Brien:
Mood changes that respond to food are quite common in children. However I personally don’t think that the blood sugar levels you report would justify a work up for usual metabolic and endocrine causes of hypoglycemia. In the meantime I would continue to respond with snacks as needed and perhaps check a blood sugar as near as possible to one of the mood changes just in case earlier blood sugars are indeed low and the levels you have been getting have been taken after the body’s normal response to low blood sugar has taken effect
It is of interest that in pursuit of explanations for the increasing problem of obesity it has come to be realised that there is a very complex network of hormones secreted in the stomach, the upper bowel and the hypothalamus of the brain that govern appetite, feelings of satiety and to some extent mood. Sometime in the future I expect that it will be possible to define your son’s problem in greater detail although I doubt that treatment will be simpler.
DOB
Additional comments from Dr. Stuart Brink:
If one checks blood glucose levels and the results are normal, then, by definition, this is not hypoglycemia.
SB
