Am I a medical mystery?

[medicalmysterymachine]

For years I thought everyone felt like this... and now I realise they don't!

If I skip lunch or eat low carb (e.g. an omelette or bowl of soup), I feel not just hungry but shaky. I can physically shake - my hands will tremble. I feel vaguely nauseous and very ill-tempered. (The ill-temper I think is normal for hunger.) I feel that I need to have carbs and will reach for e.g. crisps, crackers, toast as a quick fix. I assumed this was the "low blood sugar" people talk about, but a quick fix like a can of Coke or a handful of sweets doesn't put me right. It has to be something bready, potatoey or sort of heavy-carby.

Additionally, I get this feeling sometimes even when I have eaten a normal carby meal, and then I know a migraine is on its way. It's not an aura exactly, but when I feel that weird, hungry/shaky/sick feeling even after a decent meal, I know that I'll be getting a migraine later. I can't treat the migraine yet, as my migraine meds only work once the pain has kicked in.

I've been like this for as long as I can remember, so I don't think it's anything acute.

I had my cholesterol measured recently (high side of normal) and they did a diabetes test at the same time, which came back normal too. My BMI is 21, so I'm not overweight (though am perhaps a couple of kilos heavier than is ideal for my body). I'm 43.

I've Googled but can't find anything that fits. I guess if anything, it's a decent excuse to eat chips? Medical necessity?

Interesting you say this. Some diabetics say that white carbs (bread, pasta etc) raises their blood glucose as quickly as plain sugar. I suppose we're all different, definitely not the case for me.

You can buy blood glucose meters fairly cheaply (around £20) at pharmacies. It's the strips that are expensive, but there's usually a small amount included with the meter.

Rather than a fingerprick glucose monitor try a continuous glucose monitor eg Libre. You wear it for 2 weeks and it will send data direct to your phone in a graph, then you’ll get a really good idea of what’s going on, you can check your reactions to carbs/proteins/fasting etc much more easily, and you only need to prick yourself once!
AFAIK you can get them on Amazon.
I wouldn’t use this to diagnose yourself but it will give some valuable information.

Insulin resistance? How old are you? Do you have PCOS? Are you on any medication?
There's a lot of things that affect blood sugar levels. Maybe a GP would help?

Pretty normal, I know a few people who get like this when hungry. I'm fit and healthy, gym 3 time a week, healthy weight, lots of energy.

Sorry, except the migraine, I just get shaky, no migraine

I feel the same, it just means you haven't eaten enough!
Carbohydrates are an essential part of our diets. Just eat normally and you'll be okay.

I sometimes get this. More so if my diet is high in processed carbs. Oats, salmon, pulses are your friend.

I Can very rarely get and keep my sugars above 4, it just depends what I eat but I tend to find Evan if I eat the right diet and raise them above 4, the highest it seems to go is about 4.5 and it drops quickly. I have to manage by snacking constantly.
I usually start getting very mild symptoms when they drop below 4. When I feel utterly shit and about ready to conk out I'm usually around the 3.2 mark if I test. I couldn't tell you what they are when i do pass out as I've luckily managed to avoid that happening now for over 6 years so I don't remember.

Never had that test or heard of it, I'll have a Google. All I've had was the usual blood tests, and i had one (not sure what it was called but i do have that info somwhere if it could be relevant) that tested for diabetes I believe. That ruled out diabetes and I was eventually referred to the endocrinologist after finding myself in a&e weekly for glucose drips because of passing out again and sugars always being low at the time. The endo diagnosed hypoglycemia, he had me see the dietitian during that appointment and I was just told to stick to a lo gi diet, have a bit of lucozade if I pass out again then Sent on my way with a leaflet of lo gi food and an appointment made for a short synacthen test. Since then nothing else has been done or tested and I've just had to plod along and learn to manage.

To be honest I'm not sure how I'd manage a 72 hour fast. I had an operation booked and couldn't eat after midnight. I passed out by 10am waiting for the op and had to have a glucose drip before they'd do the op. I had 2 more ops and they were made aware of the previous problem so they said they'd have me in first. Same thing happend again both times.

Just remembered, I did have an issue last year. I had a seizure, first time ever. Sugars were tested then and I know the paramedics said it was a low reading but I can't recall what the reading actually was. That's the only time in a good 6 years that I've found myself needing help and sugars testing low at the same time.

To be honest I'm not sure how I'd manage a 72 hour fast.

They test your blood as you go and as soon as it drops below 2mmol (could have been 2mmol) the test stops and you get fed. The blood also goes off to be tested for the presence of insulin. If there’s hyperinsulinaemia at the same time, that’s pretty much diagnostic of an insulinoma.

Presumably the endocrinologist thinks it isn’t an insulinoma. However my friend’s first endocrinologist said it wasn’t, but it turned out to be, after he was assertive and got referred to a specialist pancreatic centre. They are very rare, but rare things do happen of course.

Have you tried using a cgm? My hba1c was normal at 37 but I was still getting big peaks and dips when I tracked it myself