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Really weak, shaky and nauseous/burpy feeling comes over me - what could be causing this?

3 replies

Holeinmywellies · 15/11/2024 16:39

Around once a week/fortnight I will experience this weird feeling. It comes over quite quickly and can take several hours to get over. It usually occurs between 3-5pm.

I have suffered from this for years and no GP can tell me what could be causing it. I used to think it was related to my many years of anaemia but following iron infusions and a uterine ablation in 2022 my iron levels are all normal now.

So, all of a sudden (regardless of what I have eaten or how long I've gone between meals/eaten) I will suddenly feel very very weak, I still have physical strength but inside I will feel very weak and shaky as though I haven't eaten for hours. I will also feel very nauseated and will start burping loads, I will have this internal shaking and will often either feel like I have diarrhoea coming on or will just simply need to poop. I have no idea what causes it but it makes me feel so rough. Strangely, this issue often comes on after I have given my dog his afternoon walk, yet I never experience this after his morning walk.

Now I do have a 25 year long history of IBS and functional dyspepsia which I struggle with on a daily basis (especially since perimenopause hit 6 years ago). I follow a low fodmap diet avoiding my triggers such as diary, gluten/wheat, onions, garlic etc. I have a super sensitive digestive system and have to avoid artificial sweeteners, caffeine, fatty foods etc. I only drink water. Over the last few years I have had two colonoscopies, an gastroscope, a pill camera endoscopy, a bile acid malabsorption scan. Had fit tests, tested for h pylori and coeliac disease - all ok. I did test positive for Small Intestinal Bacterial Overgrowth last year but I couldn't tolerate the antibiotics and my gastro said to move on a concentrate on the management of the IBS because there is not enough research on sibo atm.

I also have endometriosis and adenomyosis (on a waiting list for a laparoscopy).

Am 51 and am in perimenopause although I suffered with this way issue before peri.

I had a ct scan in 2019 and amongst some of the incidental findings one was a tiny nodule on my adrenal gland, no one seemed concerned about this but I often wonder if it could cause any issues?

I have often wondered if I have thyroid issues but my last full blood panel taken in the summer showed my thyroid levels to be normal. Also normal were my B12 levels, full blood count, Vitamin D etc. I don't think I have ever had my blood sugar levels checked though.

What the heck could this be? I am sitting here typing away but feel exhausted, shaky, so burpy and gassy and as though my guts may fall out of me any moment!

I am fed up to the back teeth with all of this tbh.

OP posts:
Holeinmywellies · 15/11/2024 16:39

Should add that if I eat anything after this feeling comes on I end up feeling even worse.

OP posts:
RedHotWings · 15/11/2024 23:47
  1. Reactive Hypoglycemia

Supporting Features:

  • Afternoon timing
  • Post-activity occurrence
  • Internal shakiness
  • Weakness without strength loss
  • Eating makes it worse
  • GI symptoms concurrent

Mechanism:

  • Delayed insulin response
  • Post-exercise glucose utilization
  • Autonomic nervous system activation
  1. Autonomic Dysfunction

Supporting Features:

  • Exercise relationship
  • Time of day pattern
  • Multiple system involvement
  • GI symptoms
  • Historical IBS

Mechanism:

  • Autonomic dysregulation
  • Altered gut-brain axis
  • Postural/activity trigger
  1. Adrenal Involvement

Supporting Features:

  • Known nodule
  • Diurnal pattern
  • Exercise relationship
  • Multiple system effects
  • Stress response pattern

Investigation Recommendations

Immediate:

  1. Blood Sugar Monitoring:
  • Pre and post afternoon walk
  • During episodes
  • Continuous glucose monitoring if possible
  1. Cortisol Testing:
  • Diurnal pattern
  • Specifically during episodes
  • Post-exercise levels
  1. Autonomic Function:
  • Heart rate variability
  • Blood pressure changes
  • Post-exercise response

Secondary:

  1. Endocrine Workup:
  • Full adrenal panel
  • Repeat thyroid with antibodies
  • Insulin and C-peptide levels
Holeinmywellies · 16/11/2024 08:25

RedHotWings · 15/11/2024 23:47

  1. Reactive Hypoglycemia

Supporting Features:

  • Afternoon timing
  • Post-activity occurrence
  • Internal shakiness
  • Weakness without strength loss
  • Eating makes it worse
  • GI symptoms concurrent

Mechanism:

  • Delayed insulin response
  • Post-exercise glucose utilization
  • Autonomic nervous system activation
  1. Autonomic Dysfunction

Supporting Features:

  • Exercise relationship
  • Time of day pattern
  • Multiple system involvement
  • GI symptoms
  • Historical IBS

Mechanism:

  • Autonomic dysregulation
  • Altered gut-brain axis
  • Postural/activity trigger
  1. Adrenal Involvement

Supporting Features:

  • Known nodule
  • Diurnal pattern
  • Exercise relationship
  • Multiple system effects
  • Stress response pattern

Investigation Recommendations

Immediate:

  1. Blood Sugar Monitoring:
  • Pre and post afternoon walk
  • During episodes
  • Continuous glucose monitoring if possible
  1. Cortisol Testing:
  • Diurnal pattern
  • Specifically during episodes
  • Post-exercise levels
  1. Autonomic Function:
  • Heart rate variability
  • Blood pressure changes
  • Post-exercise response

Secondary:

  1. Endocrine Workup:
  • Full adrenal panel
  • Repeat thyroid with antibodies
  • Insulin and C-peptide levels

Thank you so much. I will look into this further, makes a lot of sense.

OP posts:
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