Postprandial reactive hypoglycemia/again

Hi everybody: I read a post a while back about postprandial reactive hypoglycemia and can't find it now. I found it interesting related to afib and have tried to search for PRH. Is that right? I was trying to relate it to myself. I was admitted once to a hospital for some reason unrelated to afib and they ran a battery of tests on admission. One was a chem profile. My blood glucose was 43. The doctor didn't believe it since I was asymptomatic. and he asked them not to rerun the test not on the same blood, but to redraw it. So they stuck me again and it was 41. No one ever worried about it or did further testing, I suppose since I was asymptomatic. It is my recollection that people with blood sugars in the 40's usually feel dizzy and fainty and start to get clammy. Then I was thinking about blood sugars in the past usually being low, like between 40 and 80. Perhaps I should check it out. Thirty years ago, when I saw an internist about palpitations, he ordered a six hour glucose tolerence test that, I guess turned out OK. Maybe that can change. Any ideas?

Pam

Pam - I believe I was told that anything under 50 on one of these tests is indicative of hypoglycemia. However, when one does the test that just consists of chugging a bottle of 75 grams of pure glucose, the results are not necessarily accurate.

Post prandial means after a meal.... not a bottle of glucose.

I'm sure that when your blood glucose measured in the 40's you were exhibiting all of the classic symptoms of hypoglycemia. Depending on how long ago it was, many doctors did not recognize that hypoglycemia was a symptom or even a condition.

Yes - you get clammy - diaphoretic -(perspiring as in cold sweat) and often you are disoriented, spacey, shaky, heart palpitations very common. , and on top of that you feel awful... really awful.

It is now acknowledged that hypoglycemia can trigger afib. It is from the adrenaline rush that comes when the body's mission is to get glucose to the brain at all costs.

An individual's metabolizing of glucose can change within a period as short as six months or less. When a person begins to develop dysglycemia, reactions to sugar intake (or high carb) vary all over the place - changes from time to time. Tests are never the same.

Current testing involves fasting - a blood draw - eat a full meal with dessert - and then do hourly blood draws to measure both blood glucose and insulin to determine how that individual processes glucose and what is the insulin response. This is the true test to rule out hypoglycemia or detect insulin resistance.

Jackie

Pam,

Here's the link to an article that has been referred to frequently on this BB regarding PRH

[www.alfediam.org]

It states that the oral GTT should not be used for the diagnosis of PRH. Rather the simultaneous demonstration of low blood glucose and typical symptoms, e.g., sweating, anxiety, etc., is required.

This article does not address PRH as a trigger for AF, although this is well documented elsewhere in the literature.

PC v54

Pam,

There are many cases linking hypoglycemia (Reactive or PRH). Some experts think that the hypoglycemia or hyperthroidism contributes to the actual causing of the episode and others believe that the reactive hypoglycemia is a symptom of the occurance of atrial fibrillation.

I myself definetly experienced this first hand. When I first started my AFIBS, I had normal blood pressure normal sugar levels and just about nomral everything, then it happened my system went into orthomolecular shock....everything went out of wack. Crazy blood pressures, Low Blood sugar, high blood sugar, fast heart rates, slow heart rates, GAS pains, No Gas Pains, insomnia, oversleeping. This no doubt was caused by lack of a homestatic state among my systems.

I first suspected, hypoglycemia when I would get dizzy, and then hyperglycemia when I was ready to "jump out of my skin"... I went out and bought a glucose meter.

According to the (NIDDK), National Institute of Diabetes and Digestive and Kidney Diseases, the ideal goals for most people with diabetes when finger-stick testing using a blood glucose (sugar) meter are:

Before Meals: 80-120 mg/dl
At Bedtime: 100-140 mg/dl

Patrick Holford of ION, says that they probably should be at th 80-120 mg/dl all the time. However that gives you a guage.

I found that my sugar was quite erractic less than 60 sometimes and more than 170 sometimes! No doubt I was in some kind of metabolic spiral. I then told my doctor I wanted a GTT (Glucous Tolerance TEST) of which I passed. (BARELY) I least I didn't have diabetes! I then started to try and regulate my protein/carbohydrates and continue to regulate simple sugars. This has worked very well for me.


Hypoglycemia effects Heart Contractility. Contractility is the inherent ability of the myocardium to develop force and/or shorten. Hypoglycemia effects the myocardium oxygen levels. Other factors that decrease contractility include acidosis, hypoxia, hypocalcemia, hypokalemia, hyperkalemia, toxins, sepsis and primary myocardial disease.

An abnormally low plasma glucose level leads to symptoms of sympathetic nervous system stimulation or of CNS dysfunction. This is perhaps very bad news for Vagal Afibbers, since the sympathetic side of the CNS seems to be the main problem. However the gulcose levels may also effect the adrengic side as well.

Hypoglycemia has two distinct patterns: (1) Adrenergic symptoms include sweating, nervousness, tremulousness, faintness, palpitations, and hunger attributed to increased sympathetic activity and epinephrine release (they can occur in adrenalectomized patients). (2) CNS manifestations include confusion, inappropriate behavior (which can be mistaken for inebriation), visual disturbances, stupor, coma, and seizures. Hypoglycemic coma commonly causes an abnormally low body temperature. Adrenergic symptoms usually start with acute, less marked decreases in plasma glucose than those that cause CNS manifestations, but the plasma levels at which symptoms of either type develop vary markedly among individual patients.

Interesting enough some classes of drugs, including Lopressor, and all Beta-adrenergic blockers may reduce signs and symptoms of acute hypoglycemia, thus hiding a very serious problem! However this will not mask the actual results of a GTT or Stick test.

So to answer your question, I think that if it will relieve your mind, you should have another GTT, they are not nearly as bad now! Or you could get yourself a glucouse monitor, they are very inexpensive and very reliable (Wal-Mart). I am not sure which comes first, the afib or they hypglycemia, but they have been showned in numerous studies to be correlated, you can no doubt, do no hurt to yourself, to try and correct any signs of by controlling your levels by proper diet and nutrition. This has relieved me of many of my symptoms of the, sugar imbalances that is.

Joe

Clammy, cold sweat, shaky, heart palps, feel really, really awful? That sounds like me when i'm having an afib attack. PRH symptoms sound real familiar.

I'm seriously overweight and a binge eater. If i eat a lot of sweets, my heart races. That sounds like PRH, too. Hmmmm.

Peggy

Thanks to all the Brainiacs for their wonderful replies. Since my stroke, and short term memory loss, I will have to read it 4 or 5 times. Microphysiology and chemistry blow me away. Another question: Do you think that perhaps having frequent (perhaps constant) hypoglycemia would affect a persons symptomatology? Maybe a person adjusts to it over time and then would have less symptoms. In my experience, blood sugars of 41 to 43 would definately be symptomatic, and yet I had no symptoms!!!

"Current testing involves fasting - a blood draw - eat a full meal with dessert"
Jackie - Do you know what kind of desert????????? (sorry Fran).

Well, it's going to take me awhile to digest all this and look up those links.
My thanks to all of you for your wise assistance. I will also ask my doc. about having another GTT.

Be well,
Pam

Peggy - you probably know all this, but binge eating and all the wrong foods set you up for insulin resistance - where the sugar consumed makes the body call for more insulin, but because of the damaged insulin receptors on the lipid layer of the cells, it can't get in and just calls for more while storing as fat the excess insulin. When the body can't get the glucose it is calling for, you get that adrenaline rush...which can (does) trigger the afib events. It's a vicious cycle.

Until you clean up your lifestyle of eating all the wrong foods and especially refined sugar products, you will not lose weight and you will continue to be insulin resistant which is the precursor to full blown diabetes, Type II.....guaranteed....it's only a matter of time.

It could take as long as a year to reverse insulin resistance and it will take a complete revamping of lifestyle which includes eating and exercise. Additionally, along with this Metabolic Syndrome X, you have undoubtedly damaged the adrenals so they are either poorly functioning or functioning not at all. This takes additional measures.

The grim reality is that there is no sense trying to fix afib when you are sabotaging your body at every turn.

I'll be happy to provide you with a list of books to read so you can become conversant with MSX and so you can search for a doctor who understands how to manage the problem and hopefully reverse it. Email me privately.

I'm in your corner! Jackie

Pam - and sorry to Fran - the dessert can be anything with lots of sugar - you know...junk or poison....and it's only for this one time.

Just remember it isn't the standard GTT.

Have you tried ginkgo biloba for memory (circulation)- also Phosphatydl Serine is showing very good results with memory... (if you are on Coumadin - don't take ginkgo)

Phosphatidylserine (PS) is one of the key human brain phospholipids and is essential for normal neuron structure and function. PS, along with other essential fatty acids, may also play a critical role in cognitive function, including maintaining concentration.

Last, blood glucose levels in the 40's will definitely make the person feel symptomatic - basically feeling really badly all the time.

This is a food handling (glucose) issue - metabolic dysfunction and if you can find a doctor who is knowledgeable in functional medicine, that would be the solution. Feel free to email me privately if I can help with refrences, books, and a method to find a functional medicine physician.

Be well, Jackie

Peggy,

I have to concur with Jackie on this. I agree with her wholeheartedly. "The grim reality is that there is no sense trying to fix afib when you are sabotaging your body at every turn." Although exercise and supplementation are good things, the entire health picture of every individual must be examined to determine what direction one must go in order to start to correct these problems. What type of exercise, what type of supplements...how about my overall nutrition from foods? These are questions that can only be answered after you take stock in your own lifestyle and evaluate the prepoderance of nutritional evidence availalbe.

No doubt you are on the right track already, just by your keen interest in all of the subjects here. Jackie, in my observations, seems to have a very sharp eye fro this type of detail. I have gleaned much information from her over the months of posting and would be a great help and comfort, as she is willing to help.

Best wishes to you,

Joe

Jackie - By no coincidence i have been studying syndrome x with relation to myself for about a year now. I am presently eating a more paleo-oriented diet and getting as much exercise as possible, my knees are in real bad shape, but i do what i can.

About finding a doctor, i think i will have to be my own doctor for a while. I do not have medical insurance. My part of the country is poorly supplied with doctors to start with, and my ability to pay is quite limited. In 4 more years i will be old enough to get medicare and then we will see how things go in the doctor department. At present, i see a doctor if i think i might die, but otherwise not. Knowledge is power, and i am getting quite a lot of knowledge here.

You are exactly right about a vicious circle. I am aware of it and am coping to the best of my ability. I appreciate your kindness and helpfulness. I think i picked up in passing that you have to do with a wellness newsletter, do i have that right? What a lot of keenly knowledgeable people post to this board.

Oddly enough, my afib seems to be improving. About a week ago i had a few minutes of it in the middle of the day, subsequent to having used a season salt with msg in it, but that was the first peep from it since i added lowsodium v8 juice to my supplement regimen, must be 4-5 months now. All in all i am cautiously optimistic.

I follow the entries on this forum intently and have found it quite educational and of practical use. I am more grateful than i can properly explain. When i first found the board i read thru the archives back to i think january of this year, and learned a tremendous amount from it. In the process i gained enough familiarity with the regular respondents to feel they are old friends. I think Michael from San Fran was right when he said this is the cutting edge of afib research. I hope i too may be able to contribute something useful to this discourse.

Sincerely,
Peggy

By all means provide me with the book list. My volunteer job is at the local public library and they can order books from other state libraries. Email me privately if you wish, or provide it here for all to benefit.

And the very best of everything to you too, Joe Pisano. Your posts are a pleasure to read.
Peggy

Do Brainiacs do voodoo medicine? Sorry, just couldn't help myself.
Peggy

Pam

Just not a desert with aspartame in it!! (smile).

It was not till I came off meds that I discovered I had PRH (I believe the meds were masking it). I displayed more CNS symptoms at this time - eg "confusion, inappropriate behavior (which can be mistaken for inebriation), visual disturbances, stupor", and even collapse, legs just gave way. It made me wonder if my past seizures had been tied up with PRH as glutamate toxicity plays havoc with blood sugar also.

At first I did not know what was causing my symptoms as the Afib had stopped and I was eating whole foods. For this I was so thankful. I then discovered that it was the high amount of carbs and low fat I was eating - even though I was eating what I thought was a good proportion of protein.

I discovered PRH and learned how to change it through borrowing a glucose monitor from the Dr. For me all I had to do was to take a fasting reading first thing in the morning. Then eat a typical breakfast - which at this time was a bowl of museli and some toast made with home made bread and honey. Then every half hour I would take a BS reading. Within 2 hours my BS had plummeted well below my fasting. In UK we have different numbers but my fasting was at about 6 and I dropped to 2 point something. It is not normal to drop anywhere below your fasting level and even smaller drops than mine are considered PRH.

I think for all of us who suffer BS problems the best way to understand how to eat properly for good BS is to eat normal meals - no need to add a pudding if you don't normally have one) - after all it is the normal diet you eat that contributes towards the symptoms you have. Then forearmed with knowledge of how protein and fat steady bood sugar you can then adjust your diet accordingly so that your BS does not crash.

This is what led me to the paleo diet and a full conquering of my health (cross fingers nothng else comes along).

Best of luck

Fran

Fran - not to worry - a dessert with aspartame won't give the results required by the test since aspartame isn't sugar..... but it could give alot of other results if anyone would take the time to look for them,

Jackie

Joe - You wrote:

" Interesting enough some classes of drugs, including Lopressor, and all Beta-adrenergic blockers may reduce signs and symptoms of acute hypoglycemia, thus hiding a very serious problem! However this will not mask the actual results of a GTT or Stick test."

Beta blockers are known to reduce insulin sensitivity - (or create insulin resistance).... when a person is insulin resistant, blood glucose is almost always normal to high normal because the glucose in the blood isn't getting into the cell for utilization.

At least that's how it worked for me. As soon as I normalized the insulin receptors and got off the beta blocker, I began to feel a whole lot better and both my blood glucose and insulin levels normalized.

Jackie