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Suggest Treatment For Hypoglycemia And Fibromyalgia

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Posted on Tue, 18 Oct 2016
Question: Hello, i had some tests done a while ago. My crp was 9.6
My diabeties test was 5.6 and fasting insulins were 11 and 8
I have fibromyagia and i have hypoglycemia episodes which are becoming worse. Im not sure whats going on.
doctor
Answered by Dr. Shehzad Topiwala (24 minutes later)
Brief Answer:
Tests

Detailed Answer:
Sorry to learn about your bothersome symptoms. Certain important hormone related conditions must be ruled out. Examples are pheochromocytoma and thyroid problems. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this checks your thyroid too)                                                                                    Plasma Free Metanephrines
25 hydroxy Vitamin D   levels   (ideal range 40 to 60 ng/ml =  100 to 150 nmol/liter)     

None of these tests require any fasting and can be done at any time of the day

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (2 hours later)
Thank you for your answer.
My tsh level is 2.0
My t4 is 14
(Im not at home right now so i cant reply with what i have to most of those)
My HbA1c was 5.6 i know cut off for this is 6.5%
I dont think ive had electrolytes done
I have had my 3 months glucose average done and i believe it was with in the normal ranges
I dont think ive had vitamin d levels done.
My estrogen and progesterone are low
I also get chronic hives
Daily headaches, sometimes migranes, cant loose weight
Sensitive to cold
Ive had swelling in my fingers but my rheumatoid factor came back negative
doctor
Answered by Dr. Shehzad Topiwala (33 minutes later)
Brief Answer:
Follow up

Detailed Answer:
I see.

You need prompt evaluation for the possibility of pheochromocytoma. As mentioned above a good test to start with is

Plasma Free Metanephrines

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (20 minutes later)
Thank you so much. My blood pressure can go up and down. I forgot to mention this. When i sit its normal. When i stand and walk around it can go up like my heart beat. My doctor did not order me this test. Ill be sure to ask next time.
Do you think it could possibly be pots?
Or that it goes up because of the pain levels in my body? Thank you again.Oh, and according to my saliva cortisol test i have two high cortisol levels and a high dhea
But according to blood samples they are fine
doctor
Answered by Dr. Shehzad Topiwala (7 hours later)
Brief Answer:
Second follow up

Detailed Answer:
You must also get checked out for Cushing's syndrome by running a test called 1 mg Overnight Dexamethasone Suppression test
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest Treatment For Hypoglycemia And Fibromyalgia

Brief Answer: Tests Detailed Answer: Sorry to learn about your bothersome symptoms. Certain important hormone related conditions must be ruled out. Examples are pheochromocytoma and thyroid problems. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH (checks your thyroid) Free T4 (this checks your thyroid too)                                                                                    Plasma Free Metanephrines 25 hydroxy Vitamin D   levels   (ideal range 40 to 60 ng/ml =  100 to 150 nmol/liter)      
None of these tests require any fasting and can be done at any time of the day