Mysterious hunger bouts

March 16, 2006 4:54 PM

In relation to this fpp about food and mental health, I have recently been getting drastic bouts of hunger, confusion and depression when I eat late (even an hour later than usual), or don't eat enough at a meal. These bouts last about 3 hours, and once they start even stuffing myself won't help. Has anyone had this, know what it could be, or know how I could try to solve it?

Here are my symptoms: I tend to have a full lunch around 1 o'clock. By 5, I often start to get light-headed and find it difficult to concentrate. I usually have some nuts or fruits around this time, but they don't really help for long... if I don't have a full dinner by 7 or 8 (and some days I have so much to do that this is difficult), I will often get this terrible hunger, an overpowering feeling of emptiness and lethargy; I can't think clearly, and I start to feel down and depressed. I usually don't feel like eating at this point, but I know I have to, and so I try to eat to the point of stuffing myself, but it doesn't go away. If I eat before the symptoms start, I can usually prevent it from happening, but once it starts, it lasts for about 3 hours no matter how much, or what, I eat.

Sometimes this happens even after I eat a big meal: whatever I had isn't enough somehow, and this feeling sets in until I find the "right" food to fill the gap. Fish, in particular, will leave me feeling empty an hour later, no matter how much I eat. White bread usually does not help, either.

This has been happening on and off for about 3 years now. I've spoken to doctors about this, had tests for hypoglycemia (negative) and diabetes (negative), and even seen a neurologist, but no one has any clue what this could be. Their current theory is anxiety/depression, but I'm sure it's distinctly related to food and eating. Is there some nutrient I'm not getting or not absorbing?

FWIW: I'm white, male, just under 30, and not over- or under-weight. I am lactose-intolerant.

posted by purple_frogs to health (15 comments total)

I had a serious case of your same symptoms. I started to think maybe I was pre-diabetic. So I made up a formula for myself of cinnamon, turmeric and ginger. the cinnamon and turmeric are supposed to help normalize blood sugar. the ginger I take because I read that it has ibuprofen-like activity and I am achey all over. Plus I think it is a good all around nutritive herb.

The main symptom I wanted to change was constant hunger. And it works. I'm not hungry all the time anymore. I had this for about two years. Started working the first day. I take one capsule in the morning and one in the evening.

I also do not eat any sugar or high glycemic foods. But that alone was not enough to stop this hunger, apparently.

(disclaimer: may be the placebo effect. which I highly reccomend, by the way, cheap and effective.)

As a side note - people who have celiac disease and don't stay on a wheat free diet have a higher incidence of schizophrenia. (basing this statement on one study I read about)

I am not a doctor. This is what I do for myself. See a doctor for medical advice.
posted by 9000.68 at 6:17 PM on March 16, 2006

You might try essential oil supplements, such as one that contains flax, fish, and borage oils. Lack of essential oils can cause a lack of energy. Also, some 5-HTP supplements might help; I find it helps mightily with cravings and mood.
posted by kindall at 8:09 PM on March 16, 2006

I used to have similar problems, it seemed that my blood sugar would get completely out of wack, and I would get so sleepy that I felt drugged. I found out that I had a low thyroid. Now I am taking thyroid hormone and my hypoglycemia has disappeared.

Now, I need less sleep, have more energy and feel like a fog has lifted from my mind. It wouldn't hurt to get your thyroid level checked. If that's your problem it is easy to fix. I don't think blood sugar problems are usually listed as symptoms of hypothyroidism, but they certainly were for me.
posted by rintj at 8:18 PM on March 16, 2006

Another nod towards getting your thyroid function checked.

Alternatively - do you do any regular cardiovascular exercise? Jogging/running/___-machine?
posted by PurplePorpoise at 10:38 PM on March 16, 2006

What test did you have for hypoglycemia? Was it a Glucose Tolerance Test (GTT)? If so, did you get these symptoms during that or were you ok?
posted by jwells at 5:13 AM on March 17, 2006

The reason I ask is because I'm about 5 years in to troubleshooting these symptoms. A doc finally leveled with me that the definition of hypoglycemia is generally reserved for folks who have it very bad, as in they are passing out. Some folks don't have it that bad but do get the symptoms, and the list above is just about all of them. My GTT said I wasn't hypoglycemic too, but it also triggered all of the symptoms in me and that is the part that matters. We're just not built to handle all of those simple carbs at once.

I'm sorry for self-linking but I came up with two documents talking about managing blood sugar (1, 2) as a sort of lessons learned for me. I strongly want to note, however, that folks should only look at these after the docs have screened for thryoid/blood/neuro/etc problems. And I'm not a doctor, so take all of this with a grain of salt.
posted by jwells at 6:07 AM on March 17, 2006

I have to second what jwells said regarding low sugar levels. I was diagnosed with mild hypoglycemia, but my levels don't have to go into the danger zone for me to really, really feel like crap. That includes the emotional lows and problems with concentration.

Definitely keep doing your best to dig out the reason for these symptoms, but in the meantime, try adjusting your eating habits and diet. It may surprise you how much better you feel. Jwells's links look very informative. What is generally recommended, and what works for me, is:

- avoiding sugars and simple carbohydrates where you can, or keeping your consumption to small portions of them at a time,
- including plenty of protein and complex carbs throughout the day,
- eating smaller meals often or incorporating snacks with a nutritional punch between your larger meals,
- exercising.

I also purposefully incorporate some healthy fats (my diet overall tends to be almost too low in fats) and plenty of water. Never underestimate the effects of water.

Pay attention to what you're eating and how it makes you feel one or two hours down the line to help you pinpoint what to eat and what to cut down on (or supplement). Keeping a temporary little meal journal may help with this.

Good luck.
posted by moira at 8:55 AM on March 17, 2006

The GTT usually checks for rebound hypoglycemia which occurs within 2-3 hours post glucose load. However, a significant fraction of the population only gets the rebound around 5 hours after loading. Thus, if you are going to do a GTT, you should insist on having your blood sugar measured for up to six hours post loading.

My personal experience has been that 35 mgm% is usually how hypoglycemia is defined, but both my wife and I get very "loggy", lethargic and slow-witted at around 40 mgm%. She turned out to be seriously hypo-thyroid, while I prevent the problem from occurring by being sure to eat a "snack", such as a power bar or a couple of butter cookies no later than 4 hours after a meal.

I too noticed that if I get into a low blood-sugar episode, it takes a surprising amount of time to recover, even after eating a full meal. The trembling, sleepiness and bad humor can persist for at least an hour after eating.

I once asked Prof. Best (Banting and Best - co-discoverers of insulin) why rebound hypoglycemia occurs. He explained that the release of insulin from the Pancreas is keyed to the rate of increase in blood sugar. A simple sugar, Glucose, is absorbed by the gut very rapidly and so elicits a disproportionately large insulin release compared with Sucrose, which must be broken down before absorption. The purpose of the insulin is to place the Glucose in storage until it is needed. Since there is so much insulin secreted, it scours the blood for the very Glucose that you are using to fuel your metabolism, leaving you "running on empty".

The best thing is to avoid eating a lot of sweets. In addition, if you are going to eat fruit such as oranges or apples, you should only consume them in conjunction with a full meal. Most fruits are at least 1/3 Glucose, which is very rapidly absorbed and which triggers hypoglycemia. When the glucose is part of a meal, the other sugars are being absorbed at the time the insulin triggered by the glucose is peaking, and so there is no rebound from high blood Glucose to too low.
posted by RMALCOLM at 9:01 AM on March 17, 2006

Thanks, jwells, your documents are very helpful. I think we have the same thing -- the "tunnel vision" and difficulty in thinking are familiar to me. I will try your 2-phase solution - I've generally tried either sugary foods or complex/proteins, but not both at once so much.

I didn't get any tests related to taking sugar and measuring the results afterward. My doctor didn't think that it would be necessary. The test I got involved getting my glucose level tested after a 10-hour fast (which included sleeping, so this was basically just a morning without breakfast). I tested negative, and didn't get the symptoms -- because it normally doesn't happen to me until late in the day. But the doctor said that if I was really hypoglycemic, it would be happening no matter what the time of day. (I guess that would be the passing-out kind.)

PP, I have not been exercising much at all this winter. Generally, the only time I could do it would be after work, and by that point I am usually starving. Jwells, has exercise worked for you? I guess it could help to burn excess blood sugar.

9000.68, are you saying that this sounds like celiac disease, or was that just a side note?
posted by purple_frogs at 9:25 AM on March 17, 2006

there is some very good advice here. i am also hypoglycemic. i had a couple years of feeling awful before i knew what was wrong. i had several doctors administer tests for hypo and diabetes always coming out negatively. i later read ALOT of books on the subject and learned that doctors generally dont take hypoglycemia seriously... and since i didnt seem very severe they thought it was a passing episode. i finally had a doctor confirm that i was in fact hypoglycemic right before i went crazy. blood sugar affects mental function so much that it can change your life.

he then told me to eat a candy bar when i feel low.

something about that didnt seem right to me so i hit up the book store and did some research. i learned alot and changed my lifestyle. i cut out refined sugars completely. they cause more problems then people realize with the natural function of your body. i eat natural sugars but in small portions. complex carbs are what your body needs in the way of sugars. stay away from the 'whites' white bread, pasta, rice... eat whole wheat bread that isnt overly processed with no added sweeteners.

eat small meals throughout the day. make sure you start your day off with protein.. some sugar free peanut butter on a whole wheat bagel is a GREAT breakfast for healthy blood sugar. dont oversleep because you sugar will drop and you will feel like crap.

once your blood sugar drops good luck feeling better because it takes some time to stabilize.

also very important.. exercise regularly. it will help teach your body to use to right amount of blood sugar and will help to stabilize you.

stimulants and depressants affect blood sugar. im very sensitive to tobacco, alcohol and caffeine.

ALSO something i learned. do not eat overly large portions of meat based protein. your body turns unused protein into fats and sugars. the healthy amount of protein to be consumed is 4 oz in a meal with 4 oz complex carbs and a smaller portion of good fats. eat like a european.. dont overeat those animal proteins you dont need. it will make things worse.


i would absolutely try changing your life to see if these things and the above mentioned help you to feel better.. if nothing else it cant hurt.

if you have any more questions feel free to ask.

(also expect sugar withdrawals when you first give it up, your body treats it much like a drug, because it becomes depedant on it in an unnatural way.)

good luck feeling better!

(definitely have your thyroid checked)
posted by trishthedish at 9:38 AM on March 17, 2006 [1 favorite]

I'm glad to see others know what I'm talking about... although it is a bit sad too. Anyway, my fiancé works at the hospital I had the GTT taken at, so I had access to the numbers as I was taking the test. I kept a journal so I could pinpoint what symptoms went with the blood sugar readings:

7:20:00 AM Blood drawn. Start. Feeling groggy, burning hot (comes and goes). 93.
7:58:00 AM Blood drawn. Temp ok, not groggy but no abstract thinking abilities. 154.
8:26:00 AM Blood drawn. 140.
9:25:00 AM Blood drawn. Concentration difficulties. Gave up reading a magazine - couldn't concentrate on it. 123.
9:40:00 AM First thoughts of food (fried onion rings).
10:00:00 AM Very hungry, loud stomach. Started drinking water.
10:30:00 AM Blood drawn. VERY HUNGRY. VERY HOT. Sweating. Shaky hands. 67.
10:46:00 AM Giddyness. Visual distortions (floor is bubbling). Are symptoms worse due to walking for tests? Estimated glucose extrap. from Δ123-67: 53.
11:27:00 AM Blood drawn. Feeling better. Not hot. Still a little hungry. 83.
12:22:00 PM Blood drawn. Feel fine, though hungry. Thinking a little easier. 87.

That 53 would have got me a hypoglycemia diagnosis but because I didn't have the blood drawn it doesn't count. I had to extrapolate it from the rate of decline beforehand. The specialist actually wanted to send me again with instructions to get blood drawn when I was getting the worst of it. No thanks. My PCP took one look at all this and leveled with me, telling me what I said above and in the articles on my site.

What is scary is the up tic at the end of it. RMALCOM will know better than I, but I believe the pancreas sensed how low I was and instructed the liver to flush some sugar to stablize things. Really awesome system honestly. The scary part? I knew this test was going to be bad so I took two Excedrin migraines beforehand. So all of those observations are with 500mg Acetaminophen, 500mg Aspirin, and 130mg caffeine. I think the caffeine is what caused the grogginess in the begining. I can't handle it :-)

The best solution is to avoid this situation in the first place. The GTT is done with 75g of glucose and tastes like an orange crush. Its even carbonated. Sodas have roughly 40g of sugar in them so each one is like taking a mini GTT. I didn't realize how much sugar that is till I made root beer one day. 1/4 of the liter size bottle was sugar. 1/4!

Purple_frogs: the test you had was probably a simple blood test where they test your sugar once. The GTT is the same idea except they do it once an hour (ish) for 5 hours. And RMALCOM was right about the 6 hours. I believe the standard is 4 and it just isn't enough to get a full picture of what is happening. After 10 hours of fasting you were fine. I would have been too thanks to my liver and pancreas. What they are looking for there is fasting hypoglycemia... a different beast than this. For some reason docs just don't get that.

Exercise seems to make the whole system operate more efficiently. Its weird because you'd expect it to just drain calories and cause crashes quicker but instead the system draws less calories (because your healthy) so things operate better. It's all about the metabolism.

I hope things work out for you. Drop me a line if you want. Please keep working with your doctors though. You can learn all this and do all of this on your own but if you do really have something wrong with you they are the folks that can help, so it makes sense to keep up with them. Just look at the number of times people mention 'thyroid' in here.
posted by jwells at 10:55 AM on March 17, 2006

I saw a very interesting talk a couple of years ago. It might have been The Role of the Glycemic Index in the Management and Prevention of Diabetes by Dr.Thomas M.S. Wolever.

The speaker pointed out that glycemic index doesn't always follow conventional intuition. Pasta has a lower GI than you would expect from its flower content, and potato salad has much lower GI than the same potatoes eaten immediately after cooking. He suggested a rule of thumb way to tweak the intuition, if it dissolves very easily in water like a piece of bread, it should be high, if it holds together like pasta, it won't be as high.

So I searched and found this table of GI's, which doesn't list potato salad, but does show that the macaroni in Kraft Dinner is much higher than regular macaroni from a bag (Primo, or whatever). I've noticed that they cook very differently, and it is cool to see that in this case the rule of thumb works.
posted by Chuckles at 7:07 PM on March 17, 2006

Good point. The other thing I've seen that was helpful was the idea of caloric density or energy density. It is similiar to the glycemic index but focused on calories rather than rise in blood glucose. Fats and proteins cause blood glucose to rise more slowly than carbs, especially simple carbs, so fats and proteins may be over represented on the glycemic index, whereas energy density shouldn't do that. This was one of the things discussed in the Okinawa diet.

So logic says let's combine the lists and we'll have the perfect diet... which sounds great till one does that and sees cabage is just about all that is left. :-) Between understanding both though, folks should be very well armed to control their blood sugar levels. And remember, low blood sugar isn't the goal. That'll just kill your metabolism! I try to focus on steady blood sugar, hopefully between 100 and 120. If I flub it up I get a migraine... powerful motivator.
posted by jwells at 8:58 AM on March 18, 2006

Thanks, everyone, for your advice. I will talk to my doctor about getting a GTT and thyroid test. In the meantime, I'll work on keeping my blood sugar steady. It is a tough job -- I sympathize with you all for what you've gone through.

I'm off to a good start - I don't drink soda and I tend not to eat sugary foods. The tough part will be dealing with processed foods like white rice and bread, especially in take-out which I depend on more than I like to admit, and eating at the right times to stave off the attacks.

I've heard this could be a precursor to diabetes -- that essentially the pancreas conks out after producing so much insulin -- does anybody know if this is true?
posted by purple_frogs at 1:55 PM on March 21, 2006

Purple_frogs, I have read that reactive hypoglycemia is considered to be a "pre-diabetic" condition, and that it "may be a frequent precursor" to type 2 diabetes (this from some pretty reliable sources).

I was just diagnosed with gestational diabetes today. I don't know if the two (hypoglycemia and gestational diabetes) are related.
posted by moira at 6:12 PM on March 21, 2006