Intense Sleepiness After Meals

If I have already posted about this, please forgive me. I couldn't find a post, but my brain fog is so bad I can't remember if I've already posted.

Within the past 3-4 weeks, I have been getting extremely sleepy after meals. I pretty much take a nap after every meal. And a 15 minute nap isn't enough. It's usually more like 30 to 75 minutes. It doesn't matter what I eat. High protein, high carb, high fat, they all cause intense sleepiness. My lunch time meal is worse, but I find that I get sleepy an hour after breakfast and an hour or two after dinner as well. I am working from home right now thankfully, but it's interfering with my work. My neurologist has put me on Adderall to hopefully wake me up during the day. She's blaming it on the concussion that I got on 3/6/21. Not ideal, but I am hoping it can get me by until I can figure out what is causing these issues.

I know that I had high fasting insulin levels last time we checked, but my HbA1c and blood sugar are all within normal range when fasting. My doc doesn't think it's metabolic syndrome based on blood work. I do have hypoglycemia symptoms after going a while without eating, but it doesn't make sense to me why I am so sleepy after I eat. I would think that eating would help my blood sugar and make me less sleepy. Any ideas?

It's entirely possible that the concussion caused some sort of hypothalamus issue or some other brain thing that is making it difficult for my body to regulate blood sugar and insulin, but I've had metabolic issues for a while, it just seems to have gotten worse after the concussion. I am overweight, but can't lose weight because of whatever is going on metabolically. I started DIM complex for metabolic support a few weeks ago but haven't seen much of a difference. I'm also on a comprehensive Apex Energetics gut repair protocol. I have no clue. I've thought of every possible scenario. I'm hoping you can give me some insight. Thanks, everyone!

I experience intense sleepiness after meals that are high in histamine. Have you ruled out mast cell activation syndrome or other issues with histamine intolerance? I know you said that it doesn't matter what you eat, but such a variety of foods are high in histamine, so perhaps it's not an easy pattern to detect if your'e not specifically looking for it.

From what you have said, blood sugar issues do sound likely, I just wanted to throw this idea out there, just in case.

Walkingbhfaith, that’s funny. I even commented on that post in 2019 that it was happening then. Hmm.

MCAS is a strong option. I’ve become extremely reactive to a lot of things. But I am taking cromolyn sodium and ketotifen consistently. I would think they would help control the symptoms. Like you, my worst meal now is lunch.

Yes. I lived in an extremely moldy apartment for five months last august through December. We cleaned all of our stuff so I was heavily exposed. I know that MCAS is there, but I can’t find a rhyme or reason as to which foods could be causing the sleepiness. It’s all food. Anything I eat for lunch and sometimes breakfast. Dinner doesn’t seem to bother me as much anymore. Is there a good list of common histamine offenders?

Dude, thanks so much for your thorough reply. You’re correct. I’ve noticed the sleepiness more after the concussion on the 6th, but I have had this symptom for a long time. It has just gotten significantly worse the past month or so. I’m not able to function anymore.

What you’re saying makes a lot of sense, and is really on point for what I’ve been theorizing. My theory was that the insulin is already high, so when I eat it goes higher, thus pushing my glucose lower, and so I am actually getting low blood sugar from eating.

As for your questions, I haven’t gained weight per se. It’s mostly bloated weight because I introduced new foods from an elimination diet that I just finished around March 16. I had gotten to the lowest weight I have been for a while prior to introducing the new foods. I wouldn’t necessarily say excessive hunger, but I do wake up extremely hungry every morning and sometimes in the middle of the night. Again could be that low glucose level thing. I haven’t had any intense cravings for sugar or carbs, but they have been higher than before the diet. My diet is usually pretty clean. Minus the holiday where I had more of the cheat foods, but generally it consists of meat, non-starchy vegetables (I eat root vegetables occasionally), low amounts of fruit, and seeds. Really no nuts, grains, fruit, sugar. What I eat doesn’t explain the issue to me. Every doctor I have ever seen for this says that I am fat and need to lose weight, but no one ever tells me how to do that since I eat super clean, and still gain weight. We figure it’s mold that caused all of this to begin with, but I am in a much cleaner environment now. My functional medicine doctor has been the one monitoring the insulin levels recently, but she failed to draw them this time. I see my lyme doc next and will get her to draw them.

Do you know any causes for high insulin levels? Thanks so much for your answer.

It's my pleasure, friend. You're in a tough spot and if anything we discuss helps you, I would be thrilled.

Thanks for taking the time to respond to my questions. It seems you were already thinking along similar lines to what I hypothesized. Either we're both wrong...or, brilliant. Let's hope it's the latter. That would be a first for me.

The symptoms of waking up extremely hungry and sometimes in the middle of the night might be related to:

1. not eating enough food in general
2. not eating the right foods FOR YOU
3. stress hormones (for the middle-of-the-night waking, anyway)
4. polyphagia (also called hyperphagia) which is "excessive hunger"

Hypoglycemia is listed as a possible cause of polyphagia. (Interestingly, so is hyperglycemia.) Since you mentioned you wouldn't refer to your hunger as "excessive," then it's probably not polyphagia.

It's good that you've not had any intense cravings for sugar or simple carbohydrates, even if your desire has been a bit higher than before your diet.

As for causes and risk factors for high insulin (hyperinsulinemia), there are a few:

* Insulin resistance is one. If a person's cells don't respond normally to insulin, their pancreas produces more insulin to help the cells uptake glucose. Over time, if the insulin resistance progresses, the person's blood glucose will rise and they will be diagnosed with prediabetes. If the condition advances further, the person will likely be diagnosed with type 2 diabetes.

What causes insulin resistance? Excess weight is believed to be one cause. Another is believed to be increased levels of fat (free fatty acids) in the blood. Some argue that excess fat in the cells (intramyocellular and hepatocellular) is another cause. High intake of fructose (this does not include whole fruit), inflammation, inactivity, infection, and a perturbed microbiome are other factors believed to be possible causes.

* genetic predisposition and family history of high blood pressure are two other possible causes of hyperinsulinemia. There are a couple of other possibilities, but they're pretty rare.

As for diet...

Historically, this has been my favorite subject to rave about. Luckily for you (and, everyone else), I've lost a lot of steam on the topic. So, I'll try to keep my comments brief.

Basically, YOU are the only one that can know which foods work best FOR YOU. It seems you're somewhat on this path, since you noted an elimination diet. But, if something isn't working for you, ditch it!

For example: Is shellfish a healthy food? A lot of people incorporate it for its variety of benefits like protein, iodine, zinc, and others. So, obviously, it's a healthy food. Unless, of course, you're like me and have a shellfish allergy. Whoops... "Dr. Smith, please report to the ER immediately! Being an EpiPen!"

This advice is coming from a serial (and, cereal) dieter. My interest began around 1999, but it was mostly casual and didn't really ramp up until 2009 when I read Mark Sisson's "The Primal Blueprint." Since then, I've been through a variety of diets -- Primal, Paleo, Vegan, Carnivore, LCHF, HCLF, HED, EIEIO...oh wait, scratch the last one.

Some I did strictly, others not so much. Some I did for a while, while others lasted for only several weeks or maybe a month or two. Initially, I liked the lists of "good" and "bad" foods. But, like people tend to do, I figured "Well, if some restriction is good for me, then surely restricting even more is better!"

No, it isn't...and, don't call me Shirley.

Instead, I ended up having disordered eating. (Not an eating disorder, as they appear to be two different issues.) I was also exercising a lot. Too much, in fact, considering what I was eating -- or, not eating -- at the time. But, I couldn't see this. Instead, I just listened to the "experts" and doubled down. I mean, if something isn't working, clearly I just need to do more of it! Just listen to the guy with six pack abs.

If you buy watermelons for a quarter and sell them for a nickel, a bigger truck won't help.

Live and learn, right? Yes. Luckily, I'm a quick learner. It only took me about 10 years. If I could go back in time (Sherman, prepare the Wayback machine), I'd do things differently and I'm pretty sure I'd have some better outcomes. In hindsight, my body was giving me very clear signals. But, I wasn't able to recognize them.

Okay, I promised to keep this short, but I'm getting off into the weeds. I've been awake since yesterday, so forgive me.

In closing, find which foods work best for you. This will take some time. And, the foods may (will probably) change over time. Stay focused on how you feel, how you sleep, how much energy you have, etc. Your body is always talking to you. Do your best to recognize the feedback. Remember that food is fuel and nourishment. We need macronutrients and micronutrients. Food is complex. It's not simply protein, carbs, or fat. There's more to a tomato than lycopene, more to a carrot than beta carotene, and more to a lime than vitamin c. And, while diet is important, it's only one component of health.

Some parting questions, before I try to get some sleep:

* Have you had an increase in thirst, recently?
* How about an increased need to urinate?
* Do you know if you have high blood pressure?
* Do you know if you have high fasting triglycerides?
* Do you like movies about gladiators?

If you made it this far, thanks for reading. Please reward yourself with some Visine.

Be well,
Dude

Cignet, thanks so much for giving me info about the fasting. I want to try it. I’ve been doing some research about it this weekend. I just have to figure out the best schedule for me. The nighttime hunger in the middle of the night will be difficult at first. So will the morning hunger. Because I’m so hungry when I wake up. But surely with a bunch of water I should be okay. Can you have anything like green tea with MCT oil added into it before your fasting hours are up? Thanks!

Okay, great! Thanks, Cignet. I think I am going to do 7:30 to 9:30 am. So that’s 14 hours fasting and 10 eating. I’ll just try it at least and see how I do.

Hey, MA10:

You're quite welcome. And, thank you for taking the time to read my posts and answer my questions.

When I wrote my last comment, I was pretty tired and got a bit silly with my comments. Lately, I've been sleeping every other day, so I get a bit loopy. However, in no way did/do I find your challenges to be funny. It doesn't appear you took my comments that way, but I felt it was worth stating directly.

Also, considering your young age (happy belated birthday), my two references to the 1980 movie "Airplane!" may not have made sense. Or, if you've seen the movie, then my references to "movies about gladiators" and "don't call me Shirley" were recognizable.

If it's your intention to try fasting, I think Cignet offered wise advice about having the majority of it occur while you're sleeping. We (humans) should be doing this anyway, I believe. It's unnatural -- though, not uncommon -- to be eating from waking until sleep, under normal circumstances. Right now, though, you may need to eat more frequently.

Should you try fasting, I urge you to be flexible in your approach.

Some of the things you or I might be able to do when we're healthy will be different than what we can handle while chronically ill. Years ago, I completed a 7-day water fast, while still going to work and leading a normal life. These days, I wouldn't even consider doing that again on my own. I now understand that extended fasting can be very powerful, but it should also be done with medical supervision.

As for short-term fasting, it's probably fine. But, I've read that its benefits are exaggerated. It all depends on the duration. If you're going to do short-term fasting, don't overthink it. Remember, simply skipping a meal is fasting. Also, don't commit to some draconian plan with no escape clause. If you need to eat, do so! If you have to drive somewhere, bring along some appropriate snacks and/or drinks.

All that stated, I question whether fasting is the right strategy for you right now.

Borrowing from psychology, think about Maslow's Hierarchy of Needs. At the base of the pyramid, there's the physiological needs like food, water, warmth, and rest. If we go higher up the pyramid, the next level is the need for safety and security. Those two levels of the pyramid are our basic needs. Thus, I would urge you to focus on your basic needs. This may be the time to add things, rather than subtract.

Fasting stresses the body, and, by doing so, you may be throwing more fuel (cortisol and catecholamines) on a fire that's already raging -- especially considering you're already waking during the night with intense hunger. But, ultimately, I'm just guessing. If you try it, again, be flexible and willing to change your plan or abandon it altogether.

As for your weight gain, I encourage you to push your doctor(s) to find the cause of your high fasting insulin. To me, that's the first step. As an analogy, if your sink were overflowing and the faucet were still running, you wouldn't worry about getting a mop, right? No. You'd first turn off the faucet. If you can pinpoint and resolve the cause of the high fasting insulin, the downstream effects (body weight, etc.) may self-correct.

With weight management, calories absolutely do matter. However, there's much more to the equation. The body has feedback loops with hormones such as insulin, leptin, ghrelin, glucagon, and others playing a part. It's not simply "calorie math" or the failed "eat less, move more" advice. It's complex. Seek cause, not effect.

Finally, I'm glad to hear you've not had any increased thirst, no increased need to urinate, and that your blood pressure appears to be perfect. The next time you're having a lipid panel performed, maybe ask about checking your fasting triglycerides. I'm not sure if there's a need to ask for any out-of-cycle testing, but I would check all lipids at regular intervals and track them over time with any other labs.

I hope to hear more about what you find and how things are going for you.

Best of luck!

Dude

I have the same thing - it has nothing to do with insulin, etc

the thing is glucose spike itself is highly pro inflammatory during chronic toxemia and this leads to temporary brain shut down effect from cytokines release.

white rice being the worst

Dmitry, I'm re-visiting this topic after trying a few things the past few weeks. Have you found anything to help those symptoms? After being on blood sugar herbs, etc., and still having the symptoms, I'm wondering about the cytokine connection. It makes sense in that my body already has a lot of inflammation related to Lyme but now also related to the concussion. I'm just curious if you could give me more information about this. Thanks.

How long have you had these symptoms?

Walkingbyfaith, safer at least. My roommate brought some big offenders with us like a mattress and linens that didn’t get cleaned. But I have an air doctor in my room, and we have an I-wave in the HVAC trying to reduce as much possible exposure to me as possible. I’ve created a safe space in my room. Most everything was cleaned thoroughly when we moved in. I would say 90% of our things. Just a few things that I am worried about.