What causes fatigue, exhaustion, pain in chest, ribs and upper back?
Sorry to learn about your bothersome symptoms.
I can easily see they are most frustrating to you.
Here are my suggestions:
1 Purchase a glucose monitor. Next time you suspect you may be having a low sugar reaction, see if you can manage to check your blood glucose level using the glucometer.
If you are too unsteady to do so at that time, see if you can have someone around you do it.
If you live alone, I understand this can be be a challenge.
A true low glucose level is one below 60
2 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 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D
Serum Cortisol at 8 am
None of these tests require any fasting and can be done at any time of the day
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