![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Entry tags:
A puzzle and a theory
These past couple of weeks, I've been having really bad problems with feeling sick and lightheaded starting about 2h after I've eaten. Looking back at my IM records, I've mentioned this intermittently since early January. Recently, though, it's been nearly continuous. (I haven't posted much because I've been feeling crummy.)
Friday afternoon I bought a cheap blood glucose meter, and spent Saturday checking once per hour. (Which is what spurred the previous post in this journal.) Leaving aside the fact that my stomach flip-flops during the process, and that one isn't supposed to cause bleeding on Shabbat, it was entirely worthwhile to discover that when I was feeling lightheaded enough that I wondered if I was going to faint, I wasn't actually in danger of doing so. My symptoms match up well with those of hypoglycemia.. but at blood sugar levels which are still in the "normal" range. (Assuming the test is accurate. It calibrates correctly, but is really designed for people whose blood glucose is high.)
While reading a paper on the biology of blood sugar regulation, I discovered that adrenaline is involved. When available glucose falls, moderate amounts of adrenaline are used to prompt the liver to start releasing stored sugars. Now, I'm taking a noreprinephrine reuptake inhibitor, the dosage and timing of which has been jerked around by my insurance's decisions about what it will pay for. (It's currently on the high side, and not split morning/evening as is the known good configuration I was using before.) The human body manufactures adrenaline from noreprinephrine, so I wondered if the increased availability might be causing an exaggerated response. Turns out, it's more direct than that. Adrenaline & noreprinephrine share a removal mechanism, so preventing uptake of one necessarily causes the other to hang around as well.
So I checked the side effects of the medicine in question, and there's good overlap with the adrenaline-modulated symptoms of hypoglycemia. The region of overlap (feeling dizzy, nauseous, shaky, cold & tired) is also a good match for the problems I'm experiencing.
Based on previous times I've needed to reschedule, I'm unlikely to be able to move my next meds check forwards to sooner than a month. Waiting that long is not an option. This is the point where I start wishing that either of my doctors had a professional e-mail address.
Friday afternoon I bought a cheap blood glucose meter, and spent Saturday checking once per hour. (Which is what spurred the previous post in this journal.) Leaving aside the fact that my stomach flip-flops during the process, and that one isn't supposed to cause bleeding on Shabbat, it was entirely worthwhile to discover that when I was feeling lightheaded enough that I wondered if I was going to faint, I wasn't actually in danger of doing so. My symptoms match up well with those of hypoglycemia.. but at blood sugar levels which are still in the "normal" range. (Assuming the test is accurate. It calibrates correctly, but is really designed for people whose blood glucose is high.)
While reading a paper on the biology of blood sugar regulation, I discovered that adrenaline is involved. When available glucose falls, moderate amounts of adrenaline are used to prompt the liver to start releasing stored sugars. Now, I'm taking a noreprinephrine reuptake inhibitor, the dosage and timing of which has been jerked around by my insurance's decisions about what it will pay for. (It's currently on the high side, and not split morning/evening as is the known good configuration I was using before.) The human body manufactures adrenaline from noreprinephrine, so I wondered if the increased availability might be causing an exaggerated response. Turns out, it's more direct than that. Adrenaline & noreprinephrine share a removal mechanism, so preventing uptake of one necessarily causes the other to hang around as well.
So I checked the side effects of the medicine in question, and there's good overlap with the adrenaline-modulated symptoms of hypoglycemia. The region of overlap (feeling dizzy, nauseous, shaky, cold & tired) is also a good match for the problems I'm experiencing.
Based on previous times I've needed to reschedule, I'm unlikely to be able to move my next meds check forwards to sooner than a month. Waiting that long is not an option. This is the point where I start wishing that either of my doctors had a professional e-mail address.