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Symptoms of hypoglycemia like dizziness. Weakness if food is not eaten. Blood sugar low. Why?

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Internal Medicine Specialist
Practicing since : 1975
Answered : 1329 Questions
Ok, have a problem that has be going round in circles.
I am a 50 yr x very active person that used to swim, surf, do triathlons and or otherwise just be very active. About 4 yrs ago I started getting hypoglycemia type symptoms, dizziness light headed, if I did not eat more regularly. This progressed to several post surf or work out episodes where I felt so bad and nearly passed out. Once I felt so out of it spatially I thought I was having a stroke, 1 dextrose bag and I was fine ( now can manage really bad episodes within 10 min with coke or other simple sugars or if not too bad eating takes about 1 to 1 ½ hrs to stabilize)
As long as I eat regularly every 2-3 hrs I seem to b fine. That said I can go from 10 pm to 6 am but need to eat a little something on rising. Don’t feel bad when I get up but will within 2 hrs if I don’t get something in me. Peanut butter on toast seems to sustain me better than most other things. Sadly this has got me out of the surf, off the bike and almost paralyzed me in fear of these dips that are common and scary enough that one wants to avoid at all costs. Over vacations or celebrations as long as I have a positive caloric intake I feel great. Every time I try to lose weight or increase activity even slowly I feel like shit. This has resulted in me slowly putting on weight and being too afraid to exercise the result of which is 40 plus lbs. Now moved from the healthy club to the obese club
I have had several full physicals, done extensive blood work, EEG’s and EKG’s all normal. I have used a blood glucose meter and the feeling dizzy, light headed, confused and even slurred speech are all consistent with blood sugar below 70 which I thought was not that low. Normal is around 80 and it never gets over 140 after meals. Glucose tolerance test also normal.
Hypoglycemia or the symptoms associated with lower blood sugar seem to be discounted in the medical community and I am at a loss as to who to see to help manage and resolve this. Desperately looking to see how I can lose the weight return to activity and get my life back.
This is not a case of overeating because I love food I eat so I don’t feel like shit and have tried multiple diet recommendations. As soon as I miss a meal or try a calorically negative diet to lose weight the symptoms develop. If I just eat like I used to when I was an active person then I feel great don’t even have to have a snack between meals but keep gaining weight. If I don’t eat I feel like shit. Now feel like a negatively reinforced pavlovian dog rather than the independent active athlete I used to be.
Ii is as if when I eat storage is no problem and if I exercise or don’t eat all I have for reserves is muscle glycogen that runs out fast. Somehow it’s like the livers ability to keep replenishing glycogen is or used stored deposits fat etc is not being utilized.
Would appreciate any assistance and or direction

Posted Tue, 8 May 2012 in General Health
Answered by Dr. Geeta Sundar 1 hour later

Thanks for posting your query.
There can be several causes for the hypoglycemic attacks that you have been experiencing. These include:
a. Adrenal insufficiency
b. Insulinoma
c. Hepatoma
d. Medications

I would suggest that you consult your physician who can perform certain basic investigations like an ultrasonography of the abdomen and Adrenocorticotropic hormone stimulation test.

I hope I have answered your query. Please accept my answer if you have no further queries.

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