My sincere apologies if my question is not appropriate for this board...

For many years, I've had problems with all kinds of sugars. My main symptoms are loss of appetite, feeling ill, nausea even at the thought of food, acne, and a tingling sensation in the pit of my stomach that is not stress-related or a case of "nerves" (sedatives don't have any effect on it). All my health care providers are stumped by this.

I also have hypoglycemia and lactose intolerance, but that's under control. Organic problems, diabetes, pancreatic insufficiency and yeast infection, however, have been ruled out. Other intolerances have been ruled out as well, but only on the basis of my symptoms.

The symptoms mentioned above appear with literally all kinds of sugars, even simple glucose, and often even as little as 2 teaspoons a day will cause problems (and that's all foods taken together!). I've noticed that the more quickly something is resorbed, and the more regularly I consume it, the worse my symptoms will be. To me, it feels as if my body is using up something, and when that something runs out, my symptoms start and then gradually worsen.

At the moment, I've cut all sugars from my diet, even fruit, except for very small amounts (my health care providers told me to do this). I'm chronically underweight and have to observe dietary restrictions for other health issues, too, so I'd really like to find out what this one is. Could it be some other form of carbohydrate metabolism disorder, one that is related to insulin or some other deficiency in some way? Does any of this sound familiar to anyone?

Thank you very much in advance for any info you might have! :)

This could be so many things... my first thought is have you had your Thyroid checked? Many of your symptoms could be thyroid related, especially your weight and glucose intolerance. Have you always been underweight or is it a sudden change?

Also, have you had any allergy testing done? I recommend seeing an immunologist rather that an allergist for testing - their tests are more precise. The fact that you are lactose intolerant could be related - often this is tied in with other food allergies or sensitivities. What foods do you eat? Do you keep track of the foods you eat?

How do you know that you have hypoglycemia? Was this condition diagnosed or do you just have periods where you feel symptoms of low blood sugar? I have a lot of experience with HypoG, and might be able to help you there... how are you currently controlling it?

Finally, I do recommend that you see an Endocrinologist to rule out any number of other Endocrine disorders.

jdimassimo, thanks a lot for your reply! :) Let's see if I can answer your questions.

My thyroid is usually the first thing my doctors check when they see how underweight I am, but so far, all tests have come back negative. I've always been this thin, so no sudden changes there, either.

Yes, I have multiple food allergies and sensitivities, and I've been told that the most accurate and reliable way to get to the bottom of those was to keep track of what I eat, so that's what I do. I was put on a special hypoallergenic elimination/provocation diet by an allergy specialist and a specialized dietician last year, but I'd had that sugar problem long before those allergies started, so my health care providers aren't sure what the connection might be, if any. I can't even tolerate simple, pure glucose, which puzzles them to no end.

I've also seen an endocrinologist, and had extensive tests done, but those came back negative, too. I've noticed, though, that my body seems to tolerate sugars better when I'm under stress, so there might be some connection there.

As for the hypoglycemia, that was basically diagnosed by a doctor that I consulted via the internet, plus I was diagnosed with sudden hypoglycemic attacks by my GP 16 years ago.

Recently, I also bought a glucometer at the advice of a local pharmacist. Then, every time I felt shaky, or irritable, I took a reading, and it was usually pretty low (63, 45, 56...). After eating something, I was usually fine again. When I told the endocrinologist about this, she said hypoglycemia was common in underweight people, and therefore nothing special.

My diet consists mainly of complex carbs eaten together with good proteins and fats anyway, and I eat six meals a day, so that helps a lot to keep my blood glucose levels stable. I also carry glucose tablets, just in case. I still tend to have hypoglycemic attacks under physical strain, if I'm not careful (I start to shake, feel weak and dizzy, and have a sudden craving for sugar).

Hope this makes some sense to you. Thank you very much in advance for any additional info you might have! :)

Hmmm... it seems that you have covered many bases, but I think you need to explore the HypoG further. Your bg readings are quite low and you may need to work at refining your diet to increase your bg and keep it slightly higher.

Can you be more specific about your sugar intolerance... for example, when do you have reactions - immediately? 2 hours later? and what are your reactions? How do you know its the sugar causing the reactions? How often do you eat food with sugar in it? Do you have reactions to fruits and if so which ones? Have you ever completely eliminated all sugar/fructose from your diet for more than 4 days?

The one thing you wrote that struck me is that you use glucose tablets... possibly one of the worst things a reactive HypoG can do. Ubfortunately, doctors and even Endos don't really know how to properly control reactive HypoG. They will often attempt to treat it the same way as a diabetic would, but its not the same. When a diabetic has a hypoG incident its typically a reaction to injected insulin or oral meds that have overstimulated the pancreas, so glucose tabs are a quick fix. A reactive HypoG, on the other hand, will naturally produce an excess of insulin any time your body consumes sugar of any kind, so glucose tablets, orange juice, or other highly concentrated sugars may offer an immediate fix to the lows, but will also likely cause your pancreas to overproduce insulin again several hours later. You end up in a vicious cycle of contant low bs attacks.

The key to controlling HypoG is to first break that cycle, and then to slowly introduce modest amounts of natural sugars and carbs back into your diet, but only those you know you can tolerate. This process can take many months or even years. Many recommended diets for HypoG are quite vague and leave too many choices and much room for error. I have seen some diets that are spelled out to a "T" for someone who is having a great deal of difficulty controlling this condition. There are very specific foods (complex carbs, like beans) that can contribute to HypoG and should be avoided. I will try to find more info for you. Other factors include increasing meals - you may need to eat every hour or 2 for the first few months to stabilize your body... also vitamin supplements will help - take Chromium and Vitamin B (all the B's) either separately or as part of a multi.

Asside from HypoG, you may want to have some adrenal testing done. Adrenal disorders can be connected to HypoG - the body can overproduce cortisol in response to uncontrolled HypoG and that can lead to weight loss, stress, anxiety, and many other unexplained symptoms.

Okay, I found some of the info I wanted to share with you... Do a google search on: "A Diet for living with hypoglycemia" +HAI

There is an article that offers wonderful info on HypoG. The artical is quite long but I think you will find it interesting as it addresses some things you are experiencing. The diet suggested is more thorough than most, and is aimed at controlling a difficult hypoG scenario - much more precise than the vague diets that say to eat every 3 hours and avoid sugar and starch. Here is an example of foods to avoid:

..All sugars and honey, molasses, jelly, syrup, maltose, dextrose, fructose,
and artificial sweeteners.
..Potatoes, rice, noodles, macaroni, spaghetti.
..Wheat and wheat product (wheat germ, wheat germ oil).
..Corn and corn products (corn oil, corn oil margarine, grits, hominy,
carmel coloring, and fritos.
..Cereals usually contain wheat or corn and are high in starch. Check
before using. Oatmeal may be used occasionally -- see Non-recommended
list.
..Regular bread, crackers, matzos, potato chips, & pretzels.
.. Cakes, pastries, pie candies, chewing gum, cashews, chocolate, and jello.
..Dried peas and beans (except two or three in the soup)
.. Dates, raisins, figs, and other dried fruits.
..Coffee, strong tea, postum, ovaltine, cocoa, prine, and grape juices.
..Caffeinated drinks, and other sweet soft drinks.
..All alcoholic beverages, narcotics, drugs which act as stimulators or
depressants, and tobacco products.
..MSG (monosodium glutamate).

As you can see, many of the foods on this list may be classified as complex carbs, but still have been found to contribute to HypoG.

jdimassimo, thanks a lot for the info!! :) I'll have a closer look at the material you mentioned later today.

I've cut out all sugars and fruit from my diet for months now, but I still eat plenty of the complex carbs you mentioned. The trouble is, I've had to cut out so many other foods that there wouldn't be anything substantial left if I were to cut out all the things you mentioned as well (especially since I'm trying to gain weight). :(

As for my symptoms, let me give you an example. Last year, a dietician recommended using pure maltodextrin to add some extra calories to my meals. He told me it was easily digested and had a neutral taste, so that I could use a fairly large amount each day. I started slow, using one tablespoonful once a day, and at first I felt fine. However, over the next couple of days, I gradually lost my entire appetite, I had this tingling sensation in my belly, and I started getting acne on my face and neck. The more I increased the dosage, the worse it got. I lost all desire to eat, was revolted at the mere thought of eating, and just felt lousy. I did continue to eat my usual meals, however, and kept everything down, too.

After 14 days, it slowly dawned on me that the maltodextrin might be to blame, so I stopped taking it, and hey presto! within two days, my appetite was back, and my skin cleared up almost completely. A similar thing happens with any kind of sugar I eat, be it refined fructose, glucose, fruits, honey, saccharose, or whatever. The reaction is slow, gradual, and accumulative. Since I stopped eating sugars and fruits, I've been fine. None of my health care providers have been able to explain this phenomenon yet.

This is different from my low blood sugar episodes, though. They still happen sometimes, e.g. after exercising, skipping a meal, or eating rice wafers on an empty stomach.

BTW, when I use those glucose tablets, I don't use them on their own, but always follow them up with a more substantial meal (e.g. a cooked lunch or dinner, or at least a large wholemeal bread sandwich, followed by lunch or dinner an hour or two later).

I've had adrenal testing done, and my endo said everything was fine, but I'm not entirely convinced yet...

Anyway, thanks again very, very much for your help, and all the best! :)

It is possible that hypoG is causing ALL of your symptoms, not just the classic, recognizable "low bs" symptoms.

I know that being on a food allergy rotation diet is extremely difficult - been there, done that. But have you actually identified foods you are allergic to or have an intolerance to? If not, you may want to consider ditching the rotation diet for 1 month and trying the HypoG diet posted in the article. They claim, and I believe it to be true, that overweight people lose, and underweight people gain. Because its not a diet to lose weight, its a diet to restore health and balance. So while you may be restricting certain foods, you can be free with others.

Also, some other things to keep in mind... I know you have cut out all fruits and sugars (but for the glucose tablets) - they actually do not recommend that. In fact, they recommend that you eat a very small portion of low GI fruit immediately upon awakening each morning and then follow with a full meal 20 minutes later. There is something about how the body responds to the natural fructose immediately after rest - the metabolism is different, and the follow-up with a meal shortly after interferes with the typical hypoglycemic response.

How much food do you eat? How many calories and how often? I really think you might benefit from increasing the number of times you eat throughout the day. It does not have to be a lot, but the goal is more than just avoiding the low bs response, the goal is to stabilize your bs levels at a very specific level. For example, if you feel best when your bs is 90, then the goal should be to keep yourself there all day - and you may need a small snack every hour to accomplish that.

About the reaction you had to the maltodextrin - if you are allergic to corn (which many people are) that would explain it. Maltodextrine is made from pure corn starch - and its also one of big DONTs on a hypoG diet. It is metabolically equivalent to pure dextrose, so could likely cause HypoG symptoms. It does not surprise me that you had trouble with it.

As I mentioned earlier, the adrenal function is very closely tied in with metabolism and insulin production. HypoGs typically have an imbalance in there adrenal function but not enough to necessarily show up on a test. The fact that you can better tolerate sugars when you are under stress is a sign that this is a factor for you. When the body detects an overproduction of insulin it attempts to produce adrenaline/cortisol to counterbalance it. Its very common for a severe HypoG to first overproduce insulin and then later overproduce adrenaline.

Let me know what you think after you read more...

jdimassimo, thanks again for the info -- I really appreciate it!! :)

I've got an appointment with my dietician next week to get some professional help with switching to a different diet. The one I'm on now is not a rotational diet, actually, just a special plan to find out what I'm allergic to, so maybe it won't be too difficult to incorporate the HypoG diet into it.

About maltodextrin being made from corn, that's a good point. However, I don't think I'm allergic to corn, actually, because I can eat sweetcorn or corn on the cob as a vegetable without problems, if it's as part of a full meal. I think the maltodextrin problem probably has more to do with my blood glucose than with my allergies, especially since my symptoms are the same no matter what kind of sugar I use.

What you said about the connection between insulin, blood glucose and the adrenals is also very interesting, and I think you're definitely onto something there. I've read a lot of stuff on the internet, and it seems to fit at least with some of my symptoms (the acne, for example). I'm planning to do a bit more research and then take it from there.

Thanks again very, very much, and all the best!! :)