Dealing with Nondiabetic Hypoglycemia

Taking a closer look at Non-diabetic Hypoglycemia.

Perhaps you are tired all the time. Perhaps you have sudden bouts of the shakes and you just assumed it was being tired or just forgot to eat something.



But what if there was a chance it was something far worse then what or when your last meal was?



In 2017 I took a trip to the doctors office for what should have been a routine checkup. I was feeling like a bug on a windshield most days. I fought to stay awake and regularly found myself passing out at the strangest times.



As I went through the normal process of the doctors visit, everything seemed to the going ok. My blood pressure was good. Vitals seemed ok, after all I had a pulse and was still breathing when I got to the office.



I was feeling like crap and told the doctor but he chalked it up to getting older. Hell I am going to be 47 this year, but damm I was in pretty good shape just a few years ago. Sure I know what is considered good shape?



Well I was cycling at minimum 25 miles per day. This was just for my daily rides. A 50 miles or more ride every so often if I had the energy. I have been a competitive athlete much of my life, having playing semi-pro football, as well as being a distance runner, and swimmer. I had even planned on training for triathlons for the enjoyment of the competition and for the personal achievement.



So when the doctor became dismissive by telling me I was "just out of shape" I told him we would see when the lab results came back. At first there was nothing even remotely that would explain why I was feeling the way I did.



When the initial blood work came back I figured it would be the one thing I was most likely to get, diabetes runs in the family, so it had to be that right? Well, I was pleased to see that it was not diabetes.



After a long sigh we moved into the unknown territory of what could be causing the problems. This meant more blood work. In total I must have had around 80 vials of blood drawn over the several weeks that followed.

What the Doctor Found?

To be honest, I am not sure he found anything directly. It was my own research after looking at the blood work that I found I had elevated liver numbers.



Ok, so what did that mean. Well, there are a couple numbers they read for a liver enzyme test. As I am not a doctor I will give the textbook explaination of these:

The blood tests most frequently used for liver disease are the aminotransferases (alanine aminotransferase or ALT and aspartate aminotransferase or AST). Normal levels of ALT ranges from about 7-56 units/liter, and 10-40units/liters for AST.

https://www.emedicinehealth.com/liver_blood_tests/article_em.htm

According the the printout I had been given it would seem that my liver numbers had been elevated. Not by a ton, but none the less they were upwards of where the "normal range" fell.



So being of sound mind and body, with no concerns of being overly paranoid about my health issue, (not looking for health problems that aren't there, just want to fix the ones I actually have), and not being a hypochondriac, I began researching what could raise my liver numbers.



Not surprisingly the top cause of elevated liver values, can you guess it, that's right: Alcohol abuse.



Ok, ok, I have a beer every few months. Maybe a glass of wine at special occasions, but alcohol abuse is the leading cause. So I phone the doctor back and ask him about the numbers and made sure to tell him that I have not been drinking any alcohol.



Since this was true I found it kind of odd that he did not mention it in the first place. Not even a cursory "Hey, your liver numbers are up, have you been drinking lately?".



Several more weeks of testing to track down the cause and the severity of what might be going on with my liver found out just what was going on, maybe?

Trouble with the Liver

For those who do not know much about the liver, check out Liver Wikipedia Page.



In short, the liver is pretty much needed by the body. I does some pretty impressive things to be honest. According to WebMD, the liver:

The liver's main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines.

So jut imaging all those toxins we place into our bodies and you might just see how important your own liver is.



Mine however was not being shocked into submission by gallons of vodka, least that would have been enjoyable. See for me the problem with my liver centers around the topic of the post, Non-diabetic Hypoglycemia.



You see the liver does something extremely important, although it is often mentions almost as an after-thought.

During a meal, your liver will store sugar, or glucose, as glycogen for a later time when your body needs it. The high levels of insulin and suppressed levels of glucagon during a meal promote the storage of glucose as glycogen.

https://dtc.ucsf.edu/types-of-diabetes/type1/understanding-type-1-diabetes/how-the-body-processes-sugar/the-liver-blood-sugar/ 

Within a few short months I had gone from "just being out of shape" to nearly needing a liver transplant. This could have easily been overlooked or missed if I was an active or heavy drinker. Turns out that was not even going to be the problem that is the hardest to deal with.



If you were to check out the characteristic symptoms of liver disease, well I have almost all of them.



They include fatigue, nausea, passing out, loss of appetite, easily bruised, itchy skin and a host of others.



As I braced to visit the liver specialist I had been assuming the worst case scenario. But I was astonished and relieved when she told me no liver transplant was needed.



Was I out of the Liver "Woods" yet?



Nope. The truth is that the liver being problematic was the least of the actual issues that you have to deal with. I fully expected to be diagnosed with Diabetes. When I kept getting the clean bill on my sugar A1C level I could not believe it.



Well it seems that the amount of sugar I was drinking, MT Dew was my favorite (show me a computer geek who doesn't drink MT Dew), I had not noticed that it was in fact hiding the liver problem.



In my case the absence of sugary sweets has shown  that my liver is no longer processing blood glucose properly.



This is causing my Blood Glusoce levels to drop all the time. In fact having a low sugar episode is what prompted me to write this post.



When my sugars drop, and they can do so at any time, without warning, it becomes a race to eat something that will bring the sugar levels to a reasonable level.



Any diabetics out there will attest to having high sugars easily approaching the 300+ ranges on a glucose meter. Myself on the other hand can barely keep it above the 100 range.



When the blood sugar in your system drops below a certain value you get hungry. this triggers your body's response to eat. The average non-diabetic can easily go several hours before they "feel" hungy and could often go multiple days without actually triggering a dangerously low sugar level.



You see the body will attempt to convert any excess body mass, including fat and even muscle into energy in order to keep the body alive.



This is why you can watch shows like Naked and Afraid and they have lost 20 pounds over a few day. If I were to attempt that show in my present condition I would likely be off the show within the first 5 hours.

The Dangerous issues with Hypoglycemia.

Ok, so how does having a low blood sugar really cause a problem?



Let's look at the numbers:





As you can see the normal ranges for blood glucose at between 72 and 108. Assuming that there will be some variation from person to person, consider the values at the two extremes.



Anyone getting over the 170 mark consistently would likely already be considered to be a diabetic. Having several diabetics in my immediate family I have seen the numbers skyrocket over the years.



The lower end of the range is where I spend my days. About 30 minutes before I wrote this post my sugar level was 55.  At first glance you might simply dismiss that as "hey maybe you forgot to eat breakfast".



I wouldn't blame you for thinking that. Perhaps I overslept or didn't eat a healthy breakfast. But the truth so far worse then you might consider.

My daily eating habits keep me alive.

For most diabetics to control their sugars all they really need to do is cut back on a lot of the junk they might eat. Eating a fast food meal, some cake, a gallon of soda, and then a snack can obviously take a toll on ones body.



Many diabetics are non-compliant, meaning they know what to do to lower their sugars but often just refuse to change their habits.



At the other end of the spectrum though is far less choice about what to change and when to do it.



My eating habits are now no longer my own. It would appear that I am now eating almost eight meals a day.



Whoa... before you say thats way too much food. Consider that my portion sizes have been cut down considerably in order to proportion out the same caloric intake for the day.



Where the average person might have a piece of chicken, (thigh), some mashed potatoes, and green beans for dinner, I can rarely eat a normal sized plate of food. To top things off, I ALWAYS have to have some form of carbs or sugar with every single meal.



There in no exception to this rule.



If I miss a meal, my sugars drop, I begin shaking like a chihuahua on crack, and I become dysfunctional. Ever tried to make a sandwich when your twitching uncontrollably.



I have never been a person to overly stress about many things but the feeling of having a dangerously low sugar is enough to throw me right into full blown panic mode. This is not something I care to repeat if I can avoid it at all costs.



It is not as easy as you would think to eat as often as I have to. There have even been occasions where my sugar has continued to drop WHILE I am in the process of eating. Another concern is the type of food. Not all sugars or starches are created equal when it comes to processing them into your blood stream.



Glucose tabs, while great, barely even scratch my sugar level, I find a good old spoonful of honey works a lot better for me. I have to avoid eating left overs unless they have carbs in them. I love a good salad. How many cards can you stack onto a salad and still make it a salad? Croutons just don't cut it. The dressing is often only marginal at best.



I am putting in between 25 and 40 grams of carbs at almost every meal. Just to maintain my average sugar level of 130.



If I eat the salad and don't eat some carbs then withon an hour of that meal I will have to eat some form of snack, either carbs or sugar, such as an apple, oranges, or snack bar. Sometimes these may not help nearly as much as I would like to or need them too. This is an absolute balancing act to keep my sugars in a range where I can stay functional through the day and not risk sudden drops of blood glucose level.



This has gotten to a point where I cannot even sleep through a complete night without both eating before bed and during the night. A full nights sleep has greeted me with shockingly low 50's first thing in the morning. There have even been numerous occasions of walking into the walls trying to get to something to eat fast enough.

What can you do to deal with Nondiabetic Hypoglycemia?

First off. Don't read this and panic. Not everyone will have these kinds of issue. Make sure you are getting regular checkups from a professional doctor, or three if needed. If you are experiencing health problems make your doctor listen to you.



Even though doctors do not like it when people research their own health issue, in truth you are your own best advocate. Doctors get busy. They see tons of people and there is no guarantee that your health symptoms are even going to happen when your at the doctors.



Make sure to take your health seriously and not just to be a hypochondriac. Some symptoms are legitimate, others are not. Take an accurate assessment of what you might be doing to compound any issues you might think you are having.



You might be surprised how many health issues are self induced. For example, don't drink caffeinated coffee and soda all day, a couple of monster drinks a day and then complain to your doctor that your heart is racing and you can't sleep. That's just being a dumb ass...



If your causing the problems of your health then make changes to your habits and life patterns and fix what you can. This will make it much easier for the doctors to find the stuff that could be seriously wrong with your health.


It turned out I have Autoimmune Liver Disease. Turns out that my body decided to take out my liver on it's own. Seems like there is some form of internal skirmish going on inside my body. So I take meds to help get my immune system back on track. It sucks that this medication makes me want to eat even more often and in considerable quantity then I already do.



For More on the suject check out:
Nondiabetic Hypoglycemia | Hormone Health Network: Non-diabetic hypoglycemia is low blood glucose in people who do not have diabetes. Find out the cause, symptoms, and treatment of this rare condition at hormone.org.