Can anyone help with hypoglycemia?

[BlueEyedStarling]

I'm hoping you can help me.
My daughter has been suffering badly from fainting episodes since the age of 12. It starts with a 'sinking', queasy feeling in her tummy, she becomes shaky, her breathing becomes rapid, everything goes black, and she passes out. Sometimes she comes around quickly but as she's getting older (now 16), she's out of it for longer; seemingly more disoriented and extremely fatigued. She's currently experiencing this approximately once a week. We called the paramedics at the weekend and her blood glucose level was 4.7 which they said was pretty low, especially given that she had eaten dinner (KFC, don't judge me 😬🤣), and hour or so, beforehand.
She also sometimes suffers from excessive sweating, fatigue and brain freezes/difficulty concentrating (disassociation?).

A friend of mine has suggested she might be hypoglycemic. We have had her tested for diabetes, Addinsons Disease, thyroid issues etc etc and more recently, a consultant has suggested that she is probably suffering from an anxiety disorder, potentially linked to ADHD. But no-one has mentioned hypoglycemia to me before.

I am going down the route of getting her an assessment for inattentive ADHD, but in the 3 months whilst we are waiting for her appointment, do you think it would be worth buying a Libre or Dexcom 3 to monitor her blood sugar levels?
Does 4.7 sound low, given her age and time of eating? She is tall at 5'10" and weighs 12 stone. She is academic and sociable and in her GCSE year at school and she is having to take quite a bit of time off school because of all of this, and it's really bringing her down.

I am so confused and would just like to hear from others. We have been told it could be hormones (checks have been fine), her age, autism, ADHD and low blood pressure (this used to be very low when fainting first started, but not so much now). Looking at the symptoms, they do fit with HG, but so do many other things!!

Thank you 😊

It seems extreme to buy a monitor to monitor levels and likely to over medicalise things and induce further anxiety in her and you. 4.7 is not massively low and shouldn’t cause fainting. I’d push for further investigation into the fainting episodes and encourage her to have a carton of orange juice or something in her school bag incase she feels an episode coming on.

To clarify “hypoglycaemia” is not a condition in itself but is a presentation for many conditions, most of which you say have already been ruled out. A blood sugar of 4.7 a while after eating a normal meal shows good insulin response - unless she was semi comatose before eating I wouldn’t worry that a level of 4.7 seems too low.

No real advice except to say that I was EXACTLY the same as a teenager. It still happens occasionally now I’m 30 but never found a definitive reason. Just seems to be one of those things for me.

Could it be pots? www.nhs.uk/conditions/postural-tachycardia-syndrome/

I wondered pots too

Is there anything that seems to trigger the episodes? Because it could be vasovagal syncope but they usually have a trigger such as blood, being too hot, fear, bowel movements. It's to do with the vagus nerve. My son has it.

That's interesting. Thanks for your reply. Have you figured out the triggers for your son? I have definitely noticed that DD feels more faint, following a shower, although this isn't always the case. Such a minefield!

Thank you. This is reassuring. I'm pleased to hear that it seems to have mostly, resolved itself for you. I do think her age and stress levels re exams etc, are exacerbating things.

Thanks for your replies. She has been seen by a pediatric consultant who ruled out POTs. She is booked in for an ADHD assessment in a few weeks time, so at least we can rule that in or out. I didn't realise though that having inattentive ADHD could cause fainting episodes (so much to learn!) and so I'm looking at other possibilities. If anyone has experience themselves of having fainting episodes due to ADHD, I'd love to hear from you. X

Yes my son's triggers have always been blood and fear.

I’m a fainter, i apparently have a sensitive vasovagal nerve so it overreacts to certain triggers, my triggers tend to be illness, very hot or cold food, going too long without food and standing up too quickly.

Me and my dad are exactly the same with low blood sugar
as a teenager I used to carry lucozade tablets at school

I spent years wondering what this was - also started when I was about 12. Thought it was low blood sugar but you can't eat your way out of it.

Eventually I had one of my fainting episodes at work (in a hospital) - had incredibly low blood pressure and had to deter my colleagues from taking me straight round to A+E.

Not POTS but postural hypotension. Apparently classically starts at puberty in girls. And I'm neurodiverse as well, there's a symptom cluster with hypermobility too.

It got better as I got older, but also when I got more alert to triggers and avoiding them - for me they are not drinking enough, hot weather and sudden overwhelming stress. The type of fitness activities recommended for POTS also help - I can't do anything with arms over my head for example or I start keeling over.

I'm also completely uninhibited about just putting myself on the ground with my feet up if I need to.