Why do I get hypoglycemia during exercise, brain fog, and fatigue?

Question

Hello doctor,

I get hypoglycemia during exercise, fasting or not, brain fog, and fatigue. This has been happening daily for a month. Prior to that, I had been exercising an hour a day, five days a week, no issue. Currently still aiming for five, but symptoms will start out on my bike or on the treadmill. I had a gastric bypass 11 years ago. I rarely get hypoglycemia episodes when I eat sugar. History of insulin resistance. Glucose is always under 100. Insulin was 9 six months back. It was 6 two weeks ago, glucose was 88. Ferritin 15, d-20. Currently, I have Neurontin 800 four times a day, and Vyvanse 50 once daily.

Kindly guide.

Answer 1

Hello,

Welcome to icliniq.com.

I just read your query, and from what you have mentioned, it appears that you have hypoglycemic symptoms. First of all, I would suggest that instead of doing finger-prick testing of blood sugar, it is preferable to do a laboratory test for blood sugar. Secondly, there is an inpatient (after admission to the hospital) test to check your blood sugar after fasting for a required number of hours under observation. C-peptide and proinsulin need to be measured as well. All these are inpatient tests to rule out any cause of hypoglycemia. Also, if you exercise, it is expected that your blood sugar levels fall even though it is recent, probably because you have improved in losing stored fat, which was initially preventing this from happening. This can be improved if you eat complex carbohydrates like oatmeal, yogurt, and fibrous fruits and nuts (if not allergic) before working out.

I hope this information helps you.

Thank you.