I need help with my worst symptom

My worst symptom is hypoglycemia ONLY after my first meal. My LLMD ordered a glucose/insulin response test. My fasting blood sugar was 91. I then drank a 75 gram sugary drink given to me by LabCorp. After 1/2 hour blood sugar was 151. After 1 hour blood sugar was 168. After 1.5 hour blood sugar was 159. After 2 hour blood sugar was 149. After 3 hour blood sugar was 39. Yes 39. This happens everyday but I don't let it get it to the extent that it got because while I was doing the test I could eat anything. This is making my life miserable. No matter what I do and what I eat, when I eat my first meal, this hypoglycemia event always occurs. Any idea how I can fix this. This got worse on abx I think. I even switched abx and still it happens. Im stuck, my doctor doesn't know what it is besides saying reactive hypoglycemia which has no treatment. Please help

I forgot to mention, if you do check your cortisol levels, make sure to have it tested several times throughout the day.

A one-time cortisol test is very limited in being useful.

There used to be a lab that would send you a test kit.
I tested cortisol, estrogen, progesterone a few times that way.
You would spit into the tubes at different times of the day/evening.
Then send the kit back and they mail you the results.
It was 7 years ago and I can’t recall the name of the lab.

Anyone?

Edit: I found it : ZRT Labs

https://www.zrtlab.com/sample-types/saliva/

i think Rainy makes a good point - it seems most likely that something like this is going on

high cortisol causes sugars to be dumped into the blood ( to be available for fight or flight ) and there can then be a overshoot and over correction on the other side of the surge

the salivary cortisol tests seem to be the best way to try to get a handle on this cortisol profile - it should be highest in the morning ( but not too high) then gradually degrease during the day and lowest in the evening

many people with lyme end up with completely dysregulated or even reversed patterns which become habituated

you may need to prepare to do the test carefully to get the most out of it:
-pick one that has at least 4 samples through the day - more would be better
-plan to make sure that day i typical for you in terms of diet and routine
-stick to the prep advised by the lab for the test re things like eating, drinking before sampling and ref and supplements or medications that might interfere with the results
consider doing it more than once on different days to ensure you get a representative result - esp if you suspect some gross dysregulation ( ie it could be different on different days )

I should probably explain why verapamil is used to treat diabetes (and why too much vitamin D is a problem).

The insulin release mechanism in the pancreatic beta cells is calcium dependent. Too much of this leads to excessive insulin release and transient low blood sugar, then to insulin resistance and injury to the pancreatic cells. Verapamil is a calcium-channel blocker which actually reduces insulin release initially, but this ultimately allows the islet cell function to recover. Excessive vitamin D raises calcium levels, so is counter-productive in this case.

Ultimately I was successful with valproate instead, so I don't have much experience with verapamil, but it was on my list of things to try.

Quin said...
I should probably explain why verapamil is used to treat diabetes (and why too much vitamin D is a problem).

The insulin release mechanism in the pancreatic beta cells is calcium dependent. Too much of this leads to excessive insulin release and transient low blood sugar, then to insulin resistance and injury to the pancreatic cells. Verapamil is a calcium-channel blocker which actually reduces insulin release initially, but this ultimately allows the islet cell function to recover. Excessive vitamin D raises calcium levels, so is counter-productive in this case.

Ultimately I was successful with valproate instead, so I don't have much experience with verapamil, but it was on my list of things to try.

Interesting and details you will not find on the glucose/diabetes forum here. One reason I stick around on the lyme forum!

Ok I did a cortisol test and waiting for the results. My insulin is also very high during that time. So im predicting that my body for some reason is producing WAY too much insulin which causes that blood sugar crash. Anyone know if Lyme causes over insulin production. And what I can do to stop this overproduction?

Ashwaganda is an adaptogenic herb for the adrenals. Do you use it? If not, you may want to start it and keep tabs on your sugar while taking it and see if it starts to change for the better.

Cortisol is a stress hormone isn’t it? What positive changes could you make to lower stress? Think about what you normally do at night to prepare for sleep. Can you make changes to reduce stress?

Some examples:
- turn off phone, tv, internet, wireless routers an hour before bed
- turn off all lights that are visible before going to sleep; if there are visible lights on machines or clocks, cover them where the light won’t be visible
- don’t do vigorous exercise at night before bed
- do things you find calming and relaxing
- practice laughing out loud daily - it releases endorphins
- take an epsom salt bath
- have a family member give you gentle massages before going to sleep
- if pain at night interferes with sleep, talk to your doctor to find something appropriate to take
- establish a bedtime routine that gives you 8-9 hours in bed, even if you are initially unable to sleep that long

When you wake up in the morning, do you feel anxiety, tremors, adrenal surges? I have had this before, especially if I don’t get enough sleep.

NOTE: I just did a search on how to reduce morning cortisol levels. I found something linking it to antidepressant withdrawal. Have you been on antidepressants? Also mentioned that cortisol rises with daylight. Suggested sleeping with blackout curtains in the bedroom and eye mask and working on improving sleep.

rifampin increases the rate at which the body excretes cortisol - by speeding up the pathway in the liver through which this and other hormones are metabolised

the result is low plasma levels of cortisol - and often more trouble with fatigue etc

Dr M supplements with hydrocortisone to try to increase the levels again - he often finds them low in any case with Bart patients - and thinks we need a certain amount in order for our immune system to fight bart - even with multiple antibiotics.

hard to know till Bro's cortisol results come back - but from the signs so far it seems likely that he has too much rather than not enough.

bro123 said...
Garzie, this symptom got a lot worse after starting rifampin now that I recall.

Walkingbyfaith, I do take ashwaganda and Eleuthero. I am going to start rhodiola soon.

Is there anyway I can reverse this if it is due to rifampin treatment? I think it has to do with the adrenal gland. I can't really handle bad news anymore. Also sometimes when I wake up, my heart is racing. What could I do to ease this adrenal fatigue besides what I am already taking?

the thing is though - ref rifampicin - by "increases the rate at which the body excretes cortisol" i mean speeds up taking it out of the system - not putting it in - so that would not seem to fit this picture very well.

it could just be some kind of dysregulated limbic system thing - lyme et al can do that - and its the limbic parts of the brain that ultimately drive the stress reaction and hence the cortisol release from the adrenals.

lets see what the cortisol test says and then we should be in a better position to try to make sense of it

yep - that pattern is not reversed or anything too extreme - the peak is about the right height - just more offset - with perhaps a little too much cortisol at night -

https://ibb.co/k8kpyyr

are you typically getting up late and staying up late - ie having an offset day - as that would fit with this pattern ( i have this issue also ) - especially if you are active late at night

getting your sleep / wake cycles synched with normal / daylight is a good first step
making yourself do stuff earlier in the day helps also over time adjust your cortisol spike earlier

getting daylight early in the day also helps reset your melatonin cycle - which is the reverse of your cortisol one - they work hand in hand to help set you circadian rhythm
so avoiding screen before bed and going to sleep at the right time also helps

hydrocortisone is an option - one i have looked into also - but i would only do so in combination with the above lifestyle changes - as otherwise one will be fighting the other

in any case you don't have low cortisol - just out of synch pattern vs daylight hours

Post Edited (Garzie) : 3/4/2022 1:22:37 PM (GMT-7)

did the hypoglycaemia event happen on the day of the cortisol test - if so what time ?

If you're gonna do extensive cortisol testing, usually you want to do a 17-hydroxyprogesterone test too. This can detect a genetic defect in cortisol synthesis which is found in around 1% of the population.