T Nation

Glucose Problem?


#1


I?ve had problems with constant thirst, frequent urination, and insatiable hunger for going on almost a year now. Doctor can?t find anything wrong, blood work comes back routinely with glucose in the high 70s. Using a meter at home I get morning readings in the 80-90 range consistently. It doesn?t matter what I eat, or how much, I am consistently hungry/thirsty almost immediately afterwards. I?ve tried all different macronutrient combinations to no avail.

Here is an example from this morning:

6:00 Wake-up.
6:30 Fasting Glucose 92 mg/dl
6:30-7:00 Breakfast:

1c Oats, 1/3c Grow!, 2T Ground Flaxseed, Splash Milk; Coffee (1T Light Creamer/ Splash Milk); (2) Servings Baby Carrots; (3) Fish Oil Capsules (850mg, 440mg EPA/DHA).

636 cal, 17g Fat, 82g Carb (15g Fiber), 39g Protein.
(24% Fat, 51% Carb, 24% Protein)

7:30 Glucose 86 mg/dl (+1/2 hr)
8:00 Glucose 104 mg/dl (+1 hr)
8:30 Glucose 106 mg/dl (+1.5 hr)
9:00 Glucose 89 mg/dl (+2 hr)
10:30 Glucose 82 mg/dl (+3.5 hr)

By 8:00am I?m already hungry again & ready to eat. By 9:00am I?m absolutely starving and would normally eat something to stay coherent; I only waited to get further readings today.

Can anyone shed any light on this? It appears my body clears the carbohydrates out extremely fast with minimal rise in blood sugar. It?s 10:30am and I?ve already HAD to use the restroom 6 times today. Any ideas? I?m not sure where to turn at this point.


#2

That's a tiny breakfast.


#3

I am no doctor and am not offering medical advice, however I'd be curious to see your hematocrit, plasma osmolality and urine osmolality from a 24 hr collection as well as uric acid levels, just for shits and giggles.


#4

Even if I bump up the calories another 500 by adding Peanut Butter & 3-4 Eggs, same problem.

I'm scanning what bloodwork I have now, will have up shortly.


#5

My most recent blood work is from 10-08-2005:

Also have:

Iron, B12, & Folate from 11-05-2004: http://plaza.ufl.edu/tomblin/running/iron%20-%20b12%20-%20folate%2010-29-2004.gif
CBC 10-29-2004: http://plaza.ufl.edu/tomblin/running/bloodwork%2010-29-2004.gif
Blood Work 10-15-2004: http://plaza.ufl.edu/tomblin/running/bloodwork%2010-15-2004.gif

Hemocrit values from the 3 records I have are: 37.4%, 39.8%, and 42.5%. Can?t help you with the rest of the tests, my doctor doesn?t seem interested in running anymore. He thinks the problem is depression, while he maybe right, I believe depression is a side-effect of the problems, not the cause.

I first went to my doctor in October 2004 complaining about constant hunger, thirst, frequent urination, lack of energy / concentration. After running blood work he didn?t see anything interesting. Most interesting to me, WBC, RBC, and Platelet count were all below the reference range. Triglycerides came back at 60, with cholesterol at 121 (HDL 55).

Two weeks later I repeated the CBC. Again, low WBC, RBC, Hemoglobin, Hemacrit, etc. Did an iron, b12/folate panel a week later, if anything B12 came back high because I?d been taking a B12 supplement.

In March 2005 he finally talked me into trying anti-depressants. Sure I was depressed, I felt like shit, was lethargic & couldn?t concentrate. This is also when I took up lifting, which is one of the only things that brings joy and pleasure into my life. Before that I was an underweight endurance athlete. I?ve given up running for the most part because of constant injuries. I still ride, which I refuse to give up, in 2005 I logged 4300 miles.

So far I?ve tried Prozac, Lexapro, Wellbutrin, & Effexor, they have helped somewhat but each one I?ve had to quit due to side effects. I gained 40 lbs on Lexapro: http://plaza.ufl.edu/tomblin/running/ssri-snri.jpg during which I was lifting, unfortunately all the gains visually were fat. For 10 weeks straight I gained ? lb / day. My strength went up almost nil during the time. Ended up going from an extremely man-arexic 135 lbs to a still man-arexic170 lbs with a little belly & bitch tits.

My problems all date back to Christmas 2003. I got a Tantia Bodyfat scale for Christmas and started weighing myself & recording my weight. At first it was a source of amusement, then it got me to start eating healthier, taking better care of myself. For the first 6 months in 2004 my weight was fairly steady in the 155 range. From that summer to March 2005 it had dropped down to 134 lbs. The weight loss wasn?t unexpected, I took up running in early 2004, ran a marathon in October. I was averaging around 35 miles a week running along with cycling.

March 2005 I was sick & tired of feeling like shit, so I started eating more. For the first month or two I started gaining slowly, but surely. Then I started gaining rapidly, which finally settling around 170 lbs: http://plaza.ufl.edu/tomblin/running/weight%202004%20-%202005.jpg For the past 5 months or so I?ve just been maintaining.

I realize the evil of my ways. I have paid for them in more ways than you can ever imagine. My health, school, family, finances, and relationships have all suffered.

The above is a little bit more than you needed to know, but it?ll let you know where I?m coming from. I just want to be healthy.

The question at hand is still: WTF is up with the constant thirst, frequent urination, and insatiable hunger?

What additional tests should I demand & why? I need to be better educated before I go back to the doctors.


#6

If it were my body I would seek a second opinion.


#7

what do you drink throughout the day?

what color is the urine?

how much urine do you make?

what meds are you on right now?

When did this all start?

What medical problems do you have?


#8

This is wierd but here are my ideas:

1) Perhaps see a nutritionist?

2) Is this a recent probhlem? It seems like you may naturally be skinny...I know a guy who's 5'10" 130. The guy eats like you wouldn't believe...a Normal lunch for him is 4 regular hot-pockets, 2 regular sodas, 12 oz hershey bar. He eats multiple meals a day like this and I've never seen the guy put on a pound...he complains that he only sees his weight drop if it ever moves.

Good luck


#9

1 lg cup coffee in the morning, water & green tea throughout the rest of the day.

Slighly yellow first thing in the morning, clear otherwise throughout the entire day, except after taking a b-complex vitamin.

A fairly decent amount. First thing in the morning is always significant, but other than that no good 30 second jobs throughout the day. Most urinations are about the same amount, just enough to that you know you needed it, but not enough that you wouldn't think I couldn't have held it longer. Hard to quantify without measuring / timing.

Regularly: 150mg Effexor XR, (2) Acidolphilous, 150mg CoQ10, B-Complx, Basic Multivitamin, Zinc/Magnesium, (10) 850mg Fish Oil Capsules (440mg EPA/DHA), 5g Creatine (on lifting days).

Occasionally: Adderall (just started; for energy), Bean-O, Gas-X, Allegra-D

This all started about a year ago now, after losing too much weight then gaining it back & more.

Other than being somewhat depressed, none.

I did fracture two ribs in a bike crash a week ago, but that's another story. I hate having to lay off the lifting for a couple of weeks.


#10

1) I've been seeing a nutritionist for almost a year now, hasn't helped.

2) Its been going on a year now.


#11

Have you been supplementing with any b-complex, vitamin C, vitamin A, zinc, selenium, or manganese, in any way the last few years? Including a multi-vita-mineral?

All these nutrients can ramp up adrenal and thyroid metabolism too high and can precipitate reactive hypoglycemia. If you have a naturally fast metabolism these nutrients can make you feel much worse. A thyroid panel may be a good idea.

Eating larger amounts of fats, and protein can help slow down gastric emptying, which in turn may slow your metabolism. The supplements, calcium, magnesium, copper, boron, and vitamin D, will help slow your adrenals and thyroid down if that is in fact your problem.

Increased thirst and urination can be caused by an overly acidic metabolism. To help lower your metabolic ph your body uses calcium to buffer the acidity resulting in calcium lactate. It's then flushed out of your system to maintain the optimal 7.4 blood ph homeostasis.

This can result in a calcium deficiency, which further exacerbates the problem.

Supplementing with the above supplements will create less acidic by-products as well as facilitate a more alkaline medium resulting in less hypoglycemia, thirst, and urination.

If it's in fact what I think it is, I've had the same problem myself and have spent the last few years doing a lot of trial and error and extensive research on the subject.

At one point I was eating 7000 calories a day for maintenance and still feeling hunger. Not a nice feeling if you ask me. I also have limited my exercise volume as to not exacerbate my fast metabolism. Exercising twice a week was all I could handle for a while.

If you have any questions, feel free to pm me as I don't always check in here every day.

Regards,

Brian Hildebrandt


#12

The real puzzler to me in your blood work is the elevated potassium. Doesn't make a whole lot of sense to me.

Did you have a history of heat casualties (heat stroke, heat exhaustion, etc) when you were an endurance athlete?


#13

For a couple of month's I've been taking a b-complex, ZMA, and One-a-day Multivitamin. However this is all new in the last few months, haven't been doing it very long at all.

Interesting, once I figure out the right questions to ask, I'll send you a PM. Thanks.


#14

No problems with heat exhaustion. I did bonk quite regularly on rides, however once I started making a concious effort to take in at least 300 calories an hour and gained some weight it hasn't happened since.

Sometimes lifting I'll have to call it short because I get all the symptoms of low blood sugar, although I don't know that to be the cause.

I'm always thirsty and drinking. On long rides where it's hilly when climbing I can both hear & feel all the fluids bouncing around in my stomach. Yet I still want to drink more.


#15

Taking additional zinc may cause a copper deficiency if it's not taken in conjunction. Most people don't.

Zinc can also exacerbate depression if the adrenals are already whipped which it seems like they are. Excess zinc lowers aldosterone which is a hormone responsible for retaining sodium and water. Zinc also facilitates insulin production which can make hypoglycemia problems worse.

B-complex vitamins are antagonistic to copper as well which is something you don't need. For people with slow metabolisms b-complex will give them more energy. It's the opposite for fast metabolisms. You need to slow things down, not speed things up. It may sound counter-intuitive since you most likely are very fatigued.

An analogy with respect to your adrenal glands:

It's like driving at a 60 mph pace in second gear. You're almost redlining the rpm's. Adding B-complex, zinc, manganese, etc... just pushes the pedal down even further, going even faster and causing exhaustion. What you need to do is shift gears up, and/or put the brake on so that you're burning energy at a more efficient rate.

That's what supplementing with calcium, magnesium, copper, boron, and vitamin D, will do... Slow things down a little and provide more adrenal reserve.

Once your metabolism is in balance then you can supplement with zinc, and b vitamins in small amounts. At the moment though, it's just setting you back.

Multi's aren't very favourable in that they contain appreciable amounts of metabolism boosting nutrients. Most common one's have:
15mg zinc
5mg manganese
Selenium
B-complex vitamins

Most fruits are also a no no. They are high in potassium and fructose which are hard for a fast metabolizer to handle. Bananas are one of the worst offenders.

It was hard for me. I love/loved fruit, but feel so much better since not eating them anymore.

Brian Hildebrandt


#16

I have days where I get so fatigued that standing up, or walking across campus are absolutely excruciating. Yet the next day I can get up & ride 166 miles in 9 hrs.

Looking back at my food diary I wrote 12/9/2005: "Hungry after & during dinner, never satisfied, stomach very full.", "Tired, Lethargic, even just after walking across campus".

Yet the next day I got on my bike & rode 166 miles in 9 hrs. (not a regular occurance mind you)

I'll ditch the multi, b-complex, zinc/magnesium. They're obviously not helping so going without them can't hurt.

This one hits hard. I just went and cleared out all the fruit in my fridge and it looks nearly bare. I was actually suprised I had so much: 5 lb bag apples, 4 bananas, 1/2 gallon grapefruit juice, whole cantalope, oranges, tangeries, grapefruit, kiwi, bag cherries. Plus numerous frozen fruit: blueberries, blackberries, raspberries, strawberries.

Had you said I had to give up something like alcohol or chocolate I wouldn't have had a problem, but fruit, that's hard. I just threw the majority of the fresh stuff out, or I would have eaten it.

I drew the line at the cherries, I absolutely couldn't find it in my heart to throw them away, so I finished the bag and won't get any more. We'll see if I wake up sweating tonight, which I do somewhat often, which I know is also a symptom of low blood sugar.

All told, I eat a LOT of fructose, and haven't tried giving it up yet. It's worth trying, so like I said I just emptied the fridge and will give it a shot. Anything is better than what I've been going through.


#17

Hey Ben,

I thought you might like to be filled on the purpose of the supplements a little better, especially the copper and boron. I know I don't like to take things I don't know much about.

This info isn't exhaustive...

Copper is related to calcium metabolism in that it allows the tissues of the body to better uptake calcium. The amount of calcium in your tissues is directly associated to bioavailable copper stores. Copper is also the "break" for the thyroid and adrenal glands. Copper reduces tissue potassium which is associated positively with cortisol levels, as well as producing more adrenal reserve in fast metabolizers. Zinc on the hand reduces the adrenal reserve in fast metabolizers. By reducing zinc and increasing copper you should notice more "kick" from your adderall. It means your adrenals should be healthier and better able to withstand the "stressors of life". These same conditions don't hold with respect to slow metabolizers though. It's not a one size fits all approach.

Boron acts similar to copper in many ways. Boron allows for an increased ceruloplasmin level(protein transporter for copper which makes it bio-available). Boron reduces excretion of calcium from the body as well as pinch hits for some of magnesium's functions. Boron has also been implicated in increased cognitive function, relief from osteoarthritis, osteoporosis, depression, and improved energy via increased adrenal function. Boron is also implicated in the synthesis of vitamin D, and reduces insulin levels while keeping glucose constant. Not bad for one supplement. Most people only know about Boron regarding it's 15 minutes of fame in the 80's as a failed testosterone booster. It's functions are much more diverse than a possible testosterone increase with some populations under certain conditions.

Vitamin D increases absorbtion of calcium and phosphorus from the intestinal tract. Is a cofactor in the synthesis of the neurotransmitter dopamine as well.

Magnesium helps keep calcium in solution within the body. Acts as an electrolyte used in nerve trasmission, parasympathetic nervous system activation, and used in countless enzymatic reactions.

Calcium helps neutralize an overly acidic environment within the body. Involved in nerve transmission, bone matrix, sympathetic nervous system activation, etc, etc...

Hope that helps. If you're interested in buying these supplements especially the copper and boron they may be harder to find. Your typical GNC or healthfood store might not stock them. If you look hard enough though, you should be able to find them in your area... perhaps a specialty healthfood store, and most obviously the internet if it is no where else to be found. A months supply for all five supplements should be less than 50 dollars. They are all quite cheap. There's no real money to be made from some unscroupulous huckster.

Brian Hildebrandt


#18

Seen a lot of... interesting info posted. Couldn't read the info on the pic you posted, everything was kinda distorted, but that's probably just me.

Have you had an direct tests for kidney function? Like Conor mentioned, clearance rates, urea concentrations, levels of glucose in urine? Forgive me if you posted any results for those, I'm posting at night when I can't sleep :slightly_smiling:

Have you been tested for anything hormonal, the factors directly affecting fluid intake and retention, like ADH?

Offhand, it sounds like you may have diabetes insipidus since you mentioned the constant raging thirst and urination. Hallmark signs. Not sure about the hunger, I'm not an expert in the condition, but even if it's not directly related it could be a seperate condition. Not a diagnosis obviously, but ask a good doctor about it. If your doctor is no longer interested in running any tests and tells you you don't need any, punch him in the face, report him, and get a good doctor. You're still in pretty bad shape from what you've said, don't compromise.

Your doctor actually said he thought these things were going on because you're depressed? Seriously, was he pointing at cause and effect?

-Dan


#19

Can we assume that you doc has tested you for diabetes?


#20

Not yet, hopefully when I get a better doctor he will.

Diabetes insipidus could be the problem, unfortunately there's nothing I can do about it until I get the appropriate tests run.

Yup. I even showed him the chart with my weight going from 160 -> 140, and his comment was "impressive" as it was something to be proud of. Doctor doesn't seem to wan't to do anything until the depression is cleared up. He thinks it's causing the problems. I think the problems are causing the depression.