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May 4, 2002

Diagnosis and Symptoms

Question from Wichita Falls, Texas, USA:

I am 40 years old, and for about eight months, I have experienced many physical ailments, including "hypoglycemic"-like episodes (heart palpitations, extreme tiredness, mood swings, weight gain, memory and concentration problems, etc.). I'm 66 inches tall, and weigh 157 pounds. I'm always cold, and I've recently begun taking my basal body temperature which is always below 97.3 F. My blood sugars, which I've been monitoring, never go above 168 mg/dl [9.3 mmol/L] and will dive as low as 48 mg/dl [2.7 mmol/L], leaving me shaky, dizzy, and with blurred vision. My "norm" is around 90 mg/dl [5 mmol/L], and if I follow the Atkins diet to a "T," I do quite well. If I "cheat," my body wreaks havoc on me. I know, however, that this diet is not the best long-term solution for me. I had a glucose tolerance test which was normal, and because I have a family history of thyroid problems, I requested a thyroid work-up, and my TSH and Free T4 were normal, the Free T3 was elevated. I am scheduled for an echocardiogram this week for the arrthythmias, which are mostly noted on changing position. My blood pressure and heart rate sometimes take a plunge when these palpitations occur (an example is 105/47, pulse 46; another 92/38, pulse 72). My "norm" is 110/70, with pulse in low-mid-80's. My doctor feels there is no need for further thyroid testing, and that if the diet's working (he put me on it), then I should stick with it. I'm ready to request a referral to an endocrinologist, but I'm not sure if that's my answer. I'm certainly not satisfied with where things are right now. Can you point me in some direction?


Nothing really sticks out to me as a red flag. This medium does not allow for diagnosis. I would say that it sounds like your physician is being careful. I do not put any faith in basal body temps to diagnose thyroid disease. You may have postprandial hypoglycemia. As long as the diet controls the symptoms, I would not change. Make sure your lipids don’t go up on that diet. This is a problem with high-protein diets because you also increase your animal fat intake.