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Addicted to sports. Now depressed. Test done and said reactional hypoglycemia. Second opinion?

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Internal Medicine Specialist
Practicing since : 2001
Answered : 2272 Questions
Hi doctor,

I am writing with an act of desperation..

I have always been a sport addict boxing, gym, swimming...
About a year ago while training I felt nauseous dizzy an went pale. They took me to emergencies they did tests, ECG, tension, blood pressure.. nothing.
The day after I started having panic attacks anxiety, fatigue, pale face... and few days later depression for 4 days. Started to really worry so went to visit doctors. Had fatigue a anxiety red eyes mood swings issues sleeping morning fatigue, sometimes tinglings and muscles shaking for about 5months then things went better(took magnesium supplements) I remember. After that started going gym again training well sleeping well (was never perfect but better) then lately it came back... always worsen by physical activity any (running climbing stairs gym or even sex). Saw so many specialists : neuro, XXXXXXX medicine, sport doctor, endocryno, psychiatrist etc... each one of them doesn't find anything and says its stress visit a psychologist. Well I know it is not, I live in dubai, lot of sun, nice job, nice environment, and if it was I would be in a bad shape all the time!! Well why is it most of tbe time triggered by physical activity?

I went to visit another endocrinologist who told me you have diabetes in your family (grand ma grandpa, dad) you must have bad genes!! Well I always eat healthy for 6 years now as I used to compete, proteins complexes carbs, fruits veggies... he said you have reactional hypoglycemia do a test : 4 blood test in the morning while fasting : 1 blood test result was 90 - 2nd after hyper sweet drink result 120 -then 3 test and hours after that result 70. He concluded I was reactional hypoglycemic. I am not a doctor but I am sorry this is not bad results they seem normal to me.

I beg you if you can doctor help me cause I am desperate no sports no physical activities and above all living with something no one seems to understand.

Many thanks in advance.
Posted Sat, 11 May 2013 in Depression
Answered by Dr. Ram Choudhary 2 hours later
Welcome to healthcare Magic!
Thanks for putting up a nice details of the illness, it's work up and your expectations and fears.
I agree with you that it is not diabetes or hypoglycemia and the test results of blood sugar in your case are within normal ranges and should not be the cause for the symptoms.
Two possibilities are there that may be behind your symptoms.
One is a cardiac problem called Hypertrophic Obstructive Cardiomyopathy where there is abnormally thick heart muscle and it causes problem in the blood flow when you start exercise, even patient may loss consciousness at times in severe cases. Popularly it is termed HOCM. An Echocardiography and an ECG should be done to detect it.
Another possibility is of Anxiety state and depression which is affecting your well being. It is quite possible in today's world to have happy looking persons but very sad from inside.
An exhaustive interview with a psychiatrist may be helpful.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by
Follow-up: Addicted to sports. Now depressed. Test done and said reactional hypoglycemia. Second opinion? 2 hours later
Hi Dr Choudhary,

Thanks lot for your quick answer and time.

I have to admit that I do not really agree with what was said for 2 reasons.

1. I already did an Eco and an Ecg and both were negative.

2. If supposedly it is an anxiety or depression state why would I get worsen by sport or physical activity? Every doctor would ask his patients to do sports in case of depression or anxiety. Plus a depressive state wouldnt want to do things as oppose to I have fire in me but cannot physically.
Also why would alcohol worsen my anxiety when anxious people forget their anxiety when on the effect of alcohol?

It just doesn't make sense for a depression state. I saw depressive people and I am far from being that I am actually a happy person, have aspirations for the future like everyone but I am definitely not sad from the inside.

It has to be something else that physical activity worsen, anxiety has never been bad because of anxiety it heals it!!!

Thanks in advance
Answered by Dr. Ram Choudhary 36 hours later
Welcome back.
Thanks for putting up your concern clearly.
I have given the two most prominent possibilities in your case.
There are may complex problems like the one you have, where reports apparently come normal but the patient continues to suffer till we can get a clue. Perception of the patient is very important.
I would like to advise you to still get an ECHO repeated and get a focused ECHO for possibilities of HOCM or symptoms when person goes for exercises.
There may be some transient cardiac arrhythmia which may be the cause od the trouble and the solution to detect it is a continuous ECG while person is doing an exercise. This method of test is called TMT.
Also get a Thyroid profile that is early morning sample of freeT4,T3 and TSH.
With your additional input I also believe that depression is not a factor but the anxiety can not be rule out and hence you are still advised to be evaluated in this regard by a psychiatrist because having Panic attacks does not happen without axiety overlay.
I hope you would be benefited with my cosultation.
Above answer was peer-reviewed by
Follow-up: Addicted to sports. Now depressed. Test done and said reactional hypoglycemia. Second opinion? 1 hour later
Thanks doctor.

I will try that again.

I am actually on holidays very relaxed no stress at all. So tried exercising yesterday little by little did 35 push ups.
Alteration of mood started then red and glassy eyes then fatigue which took me to my sofa for about 45 min to an hour then I was operational again.

The same night I was watching a movie on tv and had 4 episodes of tachicardia or to describe it : your heart is resting 58b/m then all of a sudden boum boum faster 4 palpitations then stops. Then when falling asleep I wake up breathing as if I had sn adrenaline rush. Happens 4 5 times before I can sleep. Then morning fatigue follows and irritability because of the frustration.

I know its complicated but you seem to be very good doctor. Thanks for your help.
Answered by Dr. Ram Choudhary 34 minutes later
Welcome back.
Thanks for the compliment.
Enjoy the holidays right now.
Such sudden tachycardia & palpitation again go in favour of either anxiety or more like a Cardiac arrhythmia.
Go as planned, have an ECG, TMT & ECHO, also get a 24hours continuous recording of ECG(called Holter Monitoring) to catch the episodes of sudden tachycardia and palpitations.
I hope it would be helpful.
Above answer was peer-reviewed by
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