Adrenergic Hormone Postprandial Syndrome = Hypoglycemia?
 

I have been doing a lot of research lately on hypoglycemia. I get moderately severe "attacks" which are exactly like a hypoglycemic attack - brain fog, loss of coordination, extreme irritability, extreme intolerance to noise, etc.

But I have tested my blood-glucose when in the midst of such an "attack" - and it was normal! That just did not make sense, but there it was.

So several years later, I have started to suspect there is something malfunctioning with my epinephrine, adrenaline etc. That my attacks, had to do with that, rather than low blood sugar.

Then I came across an article entitled "Adrenergic Hormone Postprandial Syndrome." Here's a quote form it.

"Closely related to reactive hypoglycemia, Pierre Lefebvre first proposed the term of “Adrenergic Hormone Postprandial Syndrome” in 1991 to describe the anxiety, palpitations, sweating, irritability, and tremors that patients experienced after meals that were not accompanied by low glucose levels. APS is caused by a similar process as reactive hypoglycemia, although the body avoids the hypoglycemia by stabilizing the blood sugar through a biochemical process called gluco (or sugar) homestasis. Unfortunately, due to the lack of hypoglycemia accompanying the symptoms, APS is sometimes referred to by some medical professionals as “pseudohypoglycemia” or “non-hypoglycemia.”

Anyone know more about this?

It makes sense instead.
Most dramatic symptoms of hypoglycemia do not coincide with a low glucose nadir. When being testing with an OGTT people feel their symptoms delayed compared to when their blood sugar is at their lowest. Not only indeed the dropping blood sugar causing neuroglycopenia would also cause a delayed ability to even experience the symptoms (i.e. you should experience confusion, but you're so confused that you can't even feel confused) but another cause is that most of the symptoms you described are not symptoms of low blood sugar but of high adrenalin which is being dumped in your blood to raise your blood sugar. Irritability or anger or anxiety are not symptoms of low blood sugar, they're symptoms of high adrenalin. Low blood sugar symptoms are limited to focus, coordination and energy.

Hence the worse symptoms will begins when your blood sugar is raising or already back to normal. The release of insulin besides prevents the soothing effects of endorphines that are instead released when your blood sugar is dropping. It's the same for fatigue.

Not many people feel fatigue when their body is fatigue (as seen by cardiofrequency) but when they sit down and rest. Certain people have a delayed fatigues response where they feel extremely exhausted 5 hours after the action that caused the exhaustion. There's also a condition known a athlete heart where you mightbe putting your heart to serious lethal danger without feeling any sort of symptoms, only later.

Combine all of this together and you have a situation where people tend to feel the effect of low blood sugar and high adrenalin combined several time after their blood sugar has reached the lowest point. That's why endocrinologists nowadays diagnose reactive hypoglycemia if there are symptoms during an OGTT which resulted in true hypoglycemia levels or even a quick and big lowering even if it doesn't go below normal levels (i.e going from 160 to 70 in a matter of minutes) regardless of when the symptoms occurred and if they coincide with the moment the blood sugar was low.

Dr. Keith W. Berkowitz (who is a low carb advocate) said to have met nonetheless in his clinical practice (as a renowed endocrinologist who treats less known blood sugar problems) a lot of people who had hypoglycemia even if they were low carbing or even who developed hypoglycemia from their low carbing. I don't know the details but for example I know that without carbs my liver dumps a lot more triggering glucose than what I would obtain from a serving of carbohydrates.

Makes sense





Yep - I never have an "attack" while active.



I did NOT get hese attacks UNTIL I started low-carbing for fat loss. It's like it made me carb-intolerant at times.

Caffeine is also heavily involved in my attacks. Makes me have bad reactions to carbs. Or if I drink a diet coke on an empty stomach, I will almost always get an attack.

I am gradually and steadily reducing intake of caffeine, and will be off it within a week or so.

This is what I wrote few days ago:

Also the less carb you eat the less carb you need to create not only cravings but also blood sugar instability. It's like as if decreasing a food to very low levels makes your body even more intolerant to that thing. When I was eating 10 grams of carbs from veggies, whatever kind of more concentrated carb including greek yogurt was sending my blood sugar through the roof and triggering abnormal cravings from starches and sweets.
But when I switched to 30 grams of carbs my cravings alarm and my blood sugar metabolism had already adapted to more concentrated carbs. At 50 grams of carb even more kind of carbs were tolerated by my blood glucose and didn't cause any craving. When I tried Life Without Bread with 72 grams of carbs, I could eat a lot of more carbs and an higher variety without ill effects in my cravings and blood sugar. I could even cheat without developing cravings or sending my bg to the hyperspace. That was absolutely impossible at lower carb intakes !

Jeff, I know this is antithesis to low carb philosophy, but if you have bad lows you can feel immediately better by eating 5 smarties Ce De Candy discs. They contain 2-3 grams of glucose which is all you need to stop an hypo episode. Many people are opposed to using sugar to treat hypo because they remember feeling better at the beginning and then having a worse attack an hour later. So they think that sugar creates a vicious cycle. This is true as long as when you have an hypo you run to the kitchen to gorge on biscuits, puddings and eating jam and honey by the spoon. You're indeed making your hypo worse by trying to make it better with gorging on sugar. But 2-3 grams of glucose is nothing, it will make you feel better instantly and you won't have a glycemic rebound effect. Also, if you feel immediately better after eating the 5 candy discs, you will know for sure you're suffering from reactive low blood glucose.

Insulin resistance comes in so many forms...some are just not yet associated with this because the truth of carbohydrate overload, as being poisonous, keeps getting swept under the rug. For example Alzheimers Syndrome is now called diabetes type 3. What took so long to come to this conclusion? I would wager that some intelligent researchers-doctors, nurses and even dieticians speculated this decades ago but it got swept under the rug until the ignorance could no longer be sustained.

Irritability, anxiety and anger are also symptoms of low vitamin D levels and/or gluten related problmes. Always have those checked out before moving on to anything else.

Your group of symptoms sound like a chemical sensitivity to some food, food additive, or environmental chemicals. I get all those symptoms in the presence of diesel fumes, perfumes, or pesticides. And the symptoms are worse when I eat grains, dairy or soy, or when pollen counts are high.

You may want to check out Theron Randolph's book: An Alternative Approach to Allergies - the new field of clinical ecology unravels environmental causes of mental & physical ills.

Hi Coachjeff,

I guess I'm suffering from a similar syndrome: idiopathic postprandial syndrome. Did you find anything that helped your symptoms? Maybe it would help for me, too. Thanks

Jeff:

I have had that as well. In fact I went through a period where, when I would suddenly feel the things you described, I would grab my blood glucose monitor, only to discover there was nothing unusual about my blood sugar.

Then again, I separately discovered that a) my BG tends to not rise very high, but falls very hard and very low -- is often too low even fasting, and tracked over a day of fasting will look like mountain peaks on a chart as it drives up and down without my doing anything -- and b) lowcarbing and weight loss brought on reactive hypoglycemia for me even with close to zero carb meals, which I had never had before.

I think the idea that maybe the BG is actually coming up fast and so the BG measure once extreme irritability-etc. hits might be adrenalin is a good point. I hadn't thought of that.

Dorian's comments on carbs have so far seemed to be true for me. I keep trying to stay out of ketosis and eat more carbs, and I do much better with carb intake the more regular and higher (by higher I mean < 100 usually < 70) it is. The lower my carb intake, the more I react even to protein which is hard for me to understand, but it was actually protein meals (e.g. 3 eggs and a bit of sausage) that first tipped me off to the serious RH episodes.

PJ

Are you sure, It's not true (reactive) hypoglycemia? Indicate numbers pls.


It's normal that protein intake lowers blood sugar levels. That's because protein intake causes rise in both insulin and glucagon. Insulin lowers BS. Lookup "Insulin Index" for more information.

If it isn't caused by low blood glucose then this isn't going to help, right?

I had reactive hypoglycaemia, many years ago and the first symptom for me was severe mood swings - I'd start acting completely irrationally - but I didn't know I was irrational. My boyfriend would stick a glass of orange juice in my hand and within 20 minutes I'd be feeling really embarrased about my earlier behaviour. My BG would get as low as 34, though it was only measured when I was at work.

When I started low carbing, I had a milder reaction, in that every time I ate my BG would fall, so by the end of the day I'd be feeling weird and shaky, but my BG would be something like 72.

Metformin helped, now my BG for the day are a very slight downward slope - but still no peaks at all after I eat, but at least no drops.

Lee

coachjeff, I am so glad you posted this. Do you have a link to the article? I have very similar attacks. I'm discovering they are much more related to stress and caffeine than sugar or carbs. I've had to give up my beloved iced tea.

Like others who posted, I can't go very low carb - it's too hard on my adrenals. I am better when I supplement with adrenal support. Also, Emerg C really helps when I'm in the midst of an attack.

It's nice to hear about others who understand irrational anger, and over reactive irritability.

One symptom I didn't see anyone else mention is sleeplessness. Whenever I don't take care of my adrenal health I experience the worse insomnia. Nothing is more frustrating than being dog tired but unable to fall asleep.

Maybe it's overconsumption of coffee. How much ya drinking?

If it's a large quantity, it'll be hard to self diagnose before you are drinking a more 'normal' quantity.

He refers to this article:



You won't be able to access to the full text online, I already tried. But you can find more information in this article, which is available online for free:



Greetz,

Cayron

As much as I love it, I don't drink coffee. Even a half a cup can turn me into a raving loon. :lol:

Cayron - Thank you for the links!