The vapors

February 9, 2008 9:15 AM

Am I "making myself sick"? Or am I hypoglycemic?

Yesterday around 3:45, I was working quietly at my desk when I thought: I can't take it, I can't take it, I'm going to fall over, I'm going to have to fall asleep right now. My head swam, I couldn't focus mentally, and I had to be careful to avoid hyperventilating. But I knew very well that I wasn't about to faint; I have fainted before, and that comes with vision symptoms that I wasn't having. I was just "not responding" like an app in Vista. I had been drinking a diet Coke, and although I kept drinking the caffeine wouldn't make an impact. Finally I made a short run for a Snickers. That helped -- whether by moving or by giving me some sugar -- but the symptoms returned afterward, if not so severely.

What's worse is that the more I think about it, the more I realize that this has been happening for ages, to a lesser degree, and I have just been shrugging it off under the theory that I am a total puss for noticing, and am way too well-fed and healthy to have "spells." I remember episodes I had several years ago, in classes, when I would poke my eyelids repeatedly with a pen cap to avoid falling over. It often happens when I'm hungry, or when I ate a small lunch. Although I do have weight issues, I am not obese, and I am physically active (at my job, if not in the gym, unfortunately).

At the same time, I'm keeping in mind that when these things happen, I am generally under stress. Not the kind of stress that would excuse fainting, but still, stress. Is it possible this is a psychological thing? People can do amazing things to themselves with their minds.

I'm going to the doctor for other reasons, and will bring it up at my appointment, but I have a couple of weeks to get along until then. Do you have any experience with this?

posted by anonymous to health (13 comments total)

This sounds a little like what happens to me when my Addison's Disease kicks up - maybe an endocrinologist can check your thyroid and adrenal function? Stress and trauma are the #1 things that cause my Addisonian crises (well, and fucking up my meds too much.)
posted by tristeza at 9:31 AM on February 9

What is your breathing like? Are you sitting in a position that makes your breathing very shallow? Does being stressed out make your breathing shallow? It's possible that you're just not letting yourself get enough air.
posted by hermitosis at 9:45 AM on February 9

This could be as simple as a nutrition issue exacerbated by stress or bad sleeping or something else. Before I started eating for exercise [a lot more protein and careful attention to labels generally] I would eat small meals that basically had nothing good in them -- a lot of empty calories and not enough protein. The starchy meals would sometimes just make me super sleepy, all the more so if I had some sugary dessert or fruit juice. Basically as I've aged I've become a lot less tolerant of sugary stuff and my explanation has always been that it messes up my blood sugar, though tests to see if I was hypoglycemic haven't turned up anything. However, for me, this was something that was easily dealt with by eating better. I paid attention at meals, made sure I was eating something with protein and tried to switch the starchy stuff I ate to more whole grain forms (brown rice instead of white rice, whole wheat bread instead of white) and with the additional change of pretty much ruling out sweet desserts and not taking any sugar in my coffee, this falling asleep after lunch feeling -- yes the way you describe it "I just CANT stay awake" -- pretty much went away. I'd suggest paying close attention to your diet and becoming a bit of a label reader until you see your doctor to see if you can offer any additional information to him or her.
posted by jessamyn at 9:52 AM on February 9

Classic hypoglycemia. Get your thyroid checked too, even if it's marginally off, ask for treatment, it can make a world of difference.

Hypoglycemia is dangerous. Try eating 6-7 small meals a day, ones with protein and complex carbs, like peanut butter on whole wheat crackers, cottage cheese and whole grain bread....not candy, cookies or anything that has "-ose" on the end of it, thay are all simple sugars that, while making you feel fine it's only temporary. Your sugar will go up (thus making you recover quickly with the candy bar) but will send it plummeting shortly thereafter and taxing your adrenal glands. In the long run you can suffer Adrenal Fatigue Syndrome. http://adrenalfatigue.org/

Make sure you eat a large, protein filled breakfast-eggs, chicken, fish and whole grains, the lunch should have protein, beans and rice, chicken, tofu, vegetables and whole grains like brown rice or sweet potatoes, and of course the ubiquitous vegetables!) always eating the combination of the two....for dinner have whatever you wish but limit your simple sugar desserts (chocolate, candy, ice cream, pie, cakes etc) until right after the meal, your body will thank you for not taxing it so much with the glycemic load. In between, eat those combo snacks, ie: mid morning and mid afternoon.

I've been dealing with it for decades, once hospitalized with a blood sugar of only 18 (normal is 90-100), I almost died.

A drop in blood sugar CAN cause panic attacks too, so what you experienced may have been a double-whammy...caffeine+hypoglycemia=panic attacks.

Try that for a week and see if it doesn't make a world of difference. And ditch the diet colas, the chemicals in them are deadly.
posted by ~Sushma~ at 9:55 AM on February 9 [6 favorites]

Are you eating protein at your meals or are you doing just carbs? Sounds like it's hypoglycemia, especially if you respond to sugar and then crash again.

I would perhaps do a little experimenting to see if you can notice any difference in the pattern. Maybe try a hardboiled egg and bagel for breakfast if you don't have time to sit down for a 'real' meal. Do a snack of some cheese and an apple for a snack instead of a candy bar, etc. Maybe stash some granola in your desk or glove compartment so that it's always around.

Believe me, I am FAR from nutritionally fit, but I know there's a direct correlation between my mood, my ability to concentrate and my eating habits. I've experienced that whole woozy feeling on several occasions and I find myself in the kitchen with the shakes, looking to snarf down whatever I can, as fast as I can before I fall down. It's all pretty much the result of poor planning on my part. You know - not eating all day and then not realising it until 2 or 3 or 4pm.
posted by dancinglamb at 10:00 AM on February 9

Sugar( and other refined carbs) and caffeine help...but only temporarily and can cause a cycle of dramatic ups and downs. Lessening their consumption or removing them altogether can make a huge difference.

I have the exact same problem and that is what I have to do. I keep nuts at my desk (no, they won't make you fat, I've actually lost weight) so I don't crave vending machine junk as much. I also started drinking herbal teas instead of carbonated drinks. I still eat junk, but less of it and I limit it until nighttime hours when feeling sleepy isn't a liability.
posted by melissam at 10:03 AM on February 9

Yes. I'm a skinny guy who grew up eating only one or two meals a day (mom doesn't cook much). I've wrestled with depression and mood swings for a long time, and I know the feeling you're describing exactly. A few months ago, it got really bad, and blood tests revealed that my blood sugar was really low. So the doc said to start eating four or five small meals throughout the day to keep my blood sugar steady. I've put on a little weight since then (nobody's noticed but me), but my energy is through the roof, and the depression has lifted.

I've instituted a fruit bowl in my kitchen stocked with apples, bananas, oranges, or whatever at all times. Fruit is good for you, and they digest quickly so the sugar hits your bloodstream right away. Candy will give you a little jolt, but it's not really long lasting. Real food is the key.

Also, the great thing about having more energy from eating is that you have more energy to cook good stuff instead of eating crap from restaurants. You don't even have to try to make anything super-healthy, pretty much anything you make yourself is going to be better than fast food.

Good luck, I hope better eating helps you the way it's helped me.
posted by buriednexttoyou at 10:04 AM on February 9 [1 favorite]

Also, I 2nd ditching the diet colas. There is absolutely no point. My girlfriend is really into tea, so I drink a bit with her, but I find that I'm not as dependent on caffeine anymore.
posted by buriednexttoyou at 10:12 AM on February 9

Heh. Five years ago when I had "weight issues", I experienced the same symptoms all the time. In fact, it had been "happening for ages". Now that I eat responsibly and exercise, it never happens at all.

So yes, see your doctor, and make sure you're not totally fucked up. If your bloodwork is fine, you need to change your lifestyle. Start eating three squares a day of lean meat with vegetables and fruit (but not starchy garbage like bananas or pure sugar like oranges), and find time to exercise. Living like you're living-- with these bonks-- is living miserably. You're (probably) biologically capable of feeling and living much better than you are now.
posted by Kwantsar at 10:45 AM on February 9

Oh, even if your bloodwork is "fine", make sure you get a copy of it. If you indeed start eating better and exercising more, have the same tests done in six months, and marvel at the improvement in your insulin, glucose, and fructosamine levels.
posted by Kwantsar at 10:50 AM on February 9

There's a pretty good discussion of this in the front end of the South Beach Diet Book. You can probably pick it up in the library.

If you decide to actually use the diet, I can attest to its effectiveness when it's closely followed. I dropped 70 lb. over 6 months.
posted by Doohickie at 11:25 AM on February 9

Interesting you mention having a diet soda just before your "spell."

Perhaps you caught "Symptoms: Metabolic Syndrome Is Tied to Diet Soda" in the NYTimes or one of the other stories talking about a study published Jan. 22:

The scientists gathered dietary information on more than 9,500 men and women ages 45 to 64 and tracked their health for nine years.

Over all, a Western dietary pattern — high intakes of refined grains, fried foods and red meat — was associated with an 18 percent increased risk for metabolic syndrome, while a “prudent” diet dominated by fruits, vegetables, fish and poultry correlated with neither an increased nor a decreased risk.

But the one-third who ate the most fried food increased their risk by 25 percent compared with the one-third who ate the least, and surprisingly, the risk of developing metabolic syndrome was 34 percent higher among those who drank one can of diet soda a day compared with those who drank none.

Surely one of the functions of tasting things in the first place is to allow your body to adjust things in advance so as to integrate nutrients which are soon going to make their way into your bloodstream smoothly into your metabolic processes. In the case of a sweet taste, your pancreas might produce the insulin which would be necessary to allow the anticipated sugar to get into the cells where it's used.

But an artificial sweetener is a false signal; if your system responds to that false signal by pumping out a lot of insulin, that would cause so much of the sugar (glucose) in your bloodstream to be taken up by cells that you would experience a very abrupt blood sugar crash.

Since neurons can metabolize only glucose and do not store it for later use (as far as I know), this very low blood sugar can produce all kinds of brain-based symptoms-- such as fainting.

It seems reasonable to think your body may have learned from previous bad experience that all that sweetens is not sugar, and to stave off fainting when the anticipated sugar does not materialize by switching off parts of your brain which are not needed for the essential business of staying conscious and upright. I love "I was just 'not responding' like an app in Vista" as a description of this, by the way.

For metabolic syndrome generally (I'm not saying I think you have it) I think this same line of reasoning can be used to explain one of the central features of the syndrome: insulin resistance. Insulin resistance would also have the effect of preventing blood sugar levels from crashing by making it harder for cells to pull sugar out of the blood, thereby leaving more for essential brain functions over a period of time.

I also wonder if this could be at the root of the apparent tendency of metabolic syndrome to develop into type II diabetes over time. If the pancreas is continually producing more insulin than is warranted by the amount of blood sugar which actually eventuates (whether because of false sweetness signals from artificial sweeteners or for other reasons) the body might deal with this problem by reducing the capacity of the pancreas to produce insulin in the first place, possibly by attacking and killing some of the insulin producing cells there, somewhat like doctors do with overactive thyroids when they kill some of the cells there with radioactive iodine.
posted by jamjam at 1:55 PM on February 9 [1 favorite]

I get a similar feeling (anxious for no reason, crabby and short-tempered, vague sense of dread) if I don't eat a little something every 2 hours or so. This is usually something like a handful of unsalted nuts, or a cheese stick or yogurt cup, or a granola bar (check label to find a less-junky kind), or a banana, or 1/2 sandwich on wheat bread. I usually have a big cup of water at the same time, since I assume the feeling comes partly from caffeine. You might try the little meals plus water thing for a few days and see if it makes a difference.

Obviously, ask your doc. But also try eating healthy snacks more regularly.
posted by LobsterMitten at 2:47 PM on February 9