Ever heard of these symptoms before?

[constantlylactating]

Might be a long one, apologies in advance!

I had my second baby last year, and during the pregnancy developed gestational diabetes for the first time. Before the diagnosis I did experience some symptoms which I assumed were GD related. During mid to late morning, if I hadn't eaten since breakfast I would get hot sweats, feel shaky, go dizzy (room spinning) and feel sick. This usually abated around 30 mins after eating, so coupled with the GD diagnosis I assumed they were symptoms of low blood sugar.

Once the baby was born, they tested me for actual diabetes, which came back negative. Baby was 1 in spring of '25, I was tested again (annual testing now) which also came back negative (not borderline, well in the range).

Since then, on and off, but more frequently recently, the symptoms have returned. I had them for several days in early october, so I called my GP and asked for a blood test, explaining I was concerned that diabetes had developed.

Finally got my test results on the 30th October, diabetes test normal (same as last time, well in range). Dr also did a few other tests, all normal apart from low iron/b12 (have had both of those all my life, pretty much) and weirdly, raised TSH. Only slightly, 5.6, but that's up from 3.6 in March.

GP surgery have been very unhelpful, saying I needed to speak to a GP, but only the GP who ordered the tests would do. That GP was unavailable/on leave/couldn't be bothered and my appointment to speak to them is on the 26th November.

I keep having the symptoms and I just don't know what I can do to help myself in the meantime, dr google says it sounds like low blood sugar, but can you repeatedly have low blood sugar without being diabetic?

If it helps, I am 38. I will be asking my GP for a retest, and maybe to check some other hormone levels in case it is peri menopause related.

Well as you might be able to tell from my username - I had v similar symptoms for a long time (regular feeling "hypos" exactly as you describe and needing to eat something fast to feel better) and eventually was diagnosed with autoimmune thyroid disease (Hashimoto's). It was these "hypos" that got me diagnosed though with hindsight I had other symptoms. When properly medicated = symptoms go away. (I also follow a high fibre, low glycemic index diet which helps a bit too). But I need my Levothyroxine to be optimised or those symptoms come back. Your TSH is actually elevated at 5.6 and I suspect you are developing something similar, though in the UK they sometimes wait till TSH goes quite high at which point you can be quite unwell. They would probs call it "subclinical" at the moment - but you are having symptoms so there is an argument to begin treatment. Push your GP for further testing, not just TSH but T4 and autoimmune antibodies. And consider getting private bloods done (Medichecks etc) if your GP won't do it. If you have antibodies it confirms a diagnosis and it's not going to go away unfortunately.

That's really useful thank you. The lab did a T4 check as standard following the elevated TSH and that is normal. On the NHS App, under the TSH test it says subclinical, so I imagine that is the route they want to go down.

So I guess what I'm saying is, when I speak to them later this month, they have already said they will repeat the TSH test, but I can ask them to check autoimmune antibodies?

I just want to know what I'm asking, really.

Yes I think you could ask them to test for antibodies for autoimmune thyroid disease ((TPOAb) and thyroglobulin (TgAb)) assuming it's underactive as the elevated TSH suggests. If you have elevated antibodies you then know you have it and will ultimately need treatment. Also your T4 may have been "normal" but is it on the low end of the scale? This would also suggest you are becoming Hypothyroid although they are currently defining it as subclinical. There's an argument for starting treatment anyway because you do have symptoms - maybe look into it in case you recognise you actually have other symptoms too and take in a list.

Btw some folk on a thyroid forum I'm on recommend getting bloods done first thing before eating so TSH is at its highest - not sure what evidence there is for this as I've not looked into it myself but worth a try!

Thank you yes, because it was primarily for Diabetes it was a fasting test anyway, so I'll make sure to do the same next time just for consistency.

Free T4 11.7 so that does seem pretty well in the range, at least according to my NHS app.

If you suspect it could be low blood sugar/ or low iron then there are two things you can try.
Buy a CGM (Continuous glucose monitor), it works of an app on your phone and you can directly track your blood sugar live and see if it is tracking with your symptoms.
Eat more red meat, especially beef liver, to get your iron up. Women need more iron in their diet, but are more likely to eat less red meat, which is the best source. A steak a day for a week and see how you feel. Liver for lunch and steak for dinner, if you can face it.

Best wishes.

T4 of 11.7 is probably towards the bottom of the range (ranges vary slightly), which could also suggest your thyroid is beginning to struggle.