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August 16, 2005

Diagnosis and Symptoms, Hypoglycemia

Question from Leavenworth, Kansas, USA:

Ever since I was very little, I can remember getting light headed, sick to my stomach, and moody. My mom would have me quickly eat some toast with honey and I would feel better within minutes. It didn't change as I got older. When I was a teenager, I would have the episodes, grab a Coke and candy bar, and feel better within minutes. I also got dehydrated many times as a teen and had to lay in the hospital with an I.V. I didn't worry about it much until I was 23. I can't really say that I passed out because I was aware of everything, I just couldn't move AT ALL. I could hear everything around me, but I couldn't even open my eyes. When I was finally able to move, I threw up, and then had severe mood swings. I went from uncontrollable laughter to uncontrollable crying. For days after that, I was exhausted. I went to my regular family practice doctor and they did a glucose tolerance test. He said he felt that I am hypoglycemic and was concerned that my glucose dropped to 40 mg/dl [2.2 mmol/L] at one point. He just told me not to skip any meals and that should take care of it. I'm not convinced. I think there is an underlying problem here. I am not overweight and never have been, and I don't have any other health problems that I'm aware of. Where do I need to go from here?

Answer:

Hypoglycemia is not diagnosed from an oral glucose tolerance test. It is made on the basis of symptoms. The symptoms should correlate with low blood sugars, at least relative to other times of the day. My concern is that the lows are not the answer. I would consider seeing an endocrinologist first. See if they can find any true abnormalities of glucose metabolism. If not, they may have additional recommendations based on your evaluation.

JTL