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Dr. Andrew Rynne

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Are fatigue, hair thinning and mood swings indicative of insulinoma?

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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 1817 Questions

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Posted on Mon, 7 May 2018 in Diabetes
Question: Ate my normal foods, but went 14-16 hrs per day without food, intermittent fasting for 6 weeks...normal a1c XXXXXXX 26th. 5.3 or so. hi fat lo carb diet for 6 weeks, returned to my normal hi protein, hi carb, occasional fast food, low veggie diet... high a1c 10.1 or so Oct 30th. insulin low at 1.9, test for C peptide low at 0.71 doc said type 1 diabetes, but when i checked my blood sugar i was getting great numbers, mostly 78-85 with a few post meal scores in the low 100s. 24 hr monitoring convinced doc i am not diabetic, but now she thinks i may have insulinoma... what do you think? i have fatigue, grumpy side showing more, thinning hair, occasional rash on nose looks like an X but does not last long, have had transient rash on upper right thigh as well. i asked if that could be lupus, told no because my blood test for that was negative. i have arthritis in hips knees elbows and ankles. how do you explain all this?
doctor
Answered by Dr. Mirjeta Guni 54 minutes later
Brief Answer:
About your symptoms;

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern!
Your case sounds very interesting. I can't agree with your doctor who thinks about insulinoma because insuline level and can peptide are low.
They should have been high if insulinoma was the cause of the lowering glucose levels even though you putted on weight.
I would suggest to check about 2 pathologies:
-An under active thyroid
-Adrenal insufficiency
These are the 2 most common causes of lowering glucose levels in a patient that has Diabetes ( of course when he does dot respect the diet and physical activity).
The rash is just an allergic reaction.
Hope the information will help.
kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Mirjeta Guni 58 minutes later
i may have more info after Wednesday's appt. I know she said that she wants me to get more tests done, but i may have to wait a bit for insurance to cover them. once upon a time i did have my thyroid checked and it was great... it was also checked either in XXXXXXX or October of this year and the result was normal, but i don't recall if it was on the low or high side of normal range. My sister has lupus and adrenal fatigue, so sounds like that is a good thing to check, just for any family inheritance issues. did you know lupus is so named because the rah looks like a wolf bite?? i still don't see how a butterfly rash all across the face fits that description! At any rate, thank you for your kind analysis. just a word to the wise it should be "you put on weight" and not "...putted on..." but i know that autocorrect does funny things to out typing sometimes, so no worries! it is a PA i am seeing btw.
doctor
Answered by Dr. Mirjeta Guni 14 hours later
Brief Answer:
Adrenal insufficiency to be ruled out:

Detailed Answer:
Hi again,
A TSH level within the normal levels ( even though at the upper limits) can not affect glucose levels.
If it is checked in October, of course thyroid pathologies are excluded.
Adrenal insufficiency will be the next to rule out. A synacten stimulation test would be of help.
Thnx. for the interesting information regarding to Lupus name even though clinically it has the typical shape of butterfly.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Prasad
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