Brief Answer:
Low sugars, need to rule out some possibilities

Detailed Answer:
Hello XXXXXXX Thanks for coming to HealthCareMagic.

I'm sorry to hear about your bouts with low blood sugar. for a 33 year old, having bouts of low sugars is not normal at all. So we need to establish the cause of the symptoms and then we can formulate a plan of action.

I see that in XXXXXXX you discussed similar issues with Dr. Thakker, you mentioned you had sweating and shivering as well and that your BP and ECG had been checked. Are the symptoms you mention now, the same as you had mentioned before? What was the result of the ECG that had been done?

Let me ask you a few basic questions so we can be systematic in managing this and not miss basic issues.

1) How do you know that your issues stem from Low Blood sugar? Have your blood sugars been checked? How and when were they checked? Were you fasting when they were checked or had you eaten recently?

2) Beyond the BP and ECG checking, has any other physical examination been carried out? Have you noticed any other physical signs? Any muscle aches or weakness?

3) Have you had ANY bloodwork done in the recent past? If so, it would be very helpful to me if you were to upload the scans of those test results to this platform so I could go over them with you.

4) Can you describe your typical diet over the last few months? I see that you have to carry chocolates to keep your sugars from getting low. What do you normally eat for your regular meals and what timings do you keep.

5) Have you noticed ANY other symptoms beyond the shivering, dizziness and drowsiness? For example, have you noticed any change in weight?

6) How much sleep do you get on a daily basis? Is this enough, have you noticed any change in your sleep patterns?

7) Do you take any regular medications? Any pain killers?

8) Do you drink alcohol? If so, how much and how often?

9) Do you smoke? If so, how much and how often?

10) Do you have any history of medical problems like Diabetes or Thyroid issues in your family? (Mother, father, Aunts Uncles, etc)

At your age, the possibilities for this kind of symptomatology are too many to describe. There could be hormonal issues, there may be stress related issues, both may be contributing. So we need to narrow down the possibilities before we can formulate a plan.

Finally, if you have not gotten any blood work done in the last 6 months, I would strongly suggest that you get the following bloodwork done at the earliest.

Go to a lab in the morning on an empty stomach and get the following blood work done

1) Fasting Blood Sugar
2) Thyroid Function Test (TSH, T3, T4)
3) Comprehensive Blood Count (CBC)
4) Comprehensive Metabolic Panel (CMP)
6) Lipid Profile
7) Vitamin D level

After giving this blood work in the morning, I want you to have a healthy breakfast and then go back 1.5 hours later and get the following blood work done.

1) Post Prandial Blood sugar.

These tests will help immensely in getting to the bottom of your issues and should not inconvenience you too much.

I look forward to your reply,

Vinay

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Brief Answer:
OK, 84 is a bit low, circumstances?

Detailed Answer:
Hey XXXXXXX Thanks for all that info. I will await the bloodwork. Just wanted to ask you a bit of follow-up on this fainting episode.

Now a random blood sugar of 84 is borderline, no doubt. But the circumstances surrounding the episode are important. Had you eaten? How long had it been since you had eaten? Had you been doing anything physically stressful? Exercise etc?

If you had been fasting that day and your sugars were 84, that would be considered normal, but if you had eaten in the last 3-4 hours and the sugars were 84 that would definitely be abnormal.

I will await your answer here as well as the blood work results.

Vinay

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