As you will notice in all the CFS books, one possible cause for fatigue is low blood sugar. This often occurs 1 hr or so after meals. So if your fatigue is worse after meals, it is helpful to check for this. The cheapest way to do this is to buy a blood sugar measurement kit at the drug store. Buy a cheap one (e.g. $35) since you will not need to use it much. Diabetics use these to measure their levels of sugar in their blood. This involves stabbing a finger with a needle. They supply a device that helps one do this. This may be frightening, yet battling CFS requires that one do such things. Look at your blood sugar 1, 2, and 3hrs after a big meal (make sure you write down the levels and place them into your notebook). If you see a value less than 70, this is a little abnormal and may indicate hypoglycemia (low blood sugar). If one's fatigue varies through the day (e.g. it is worse in the afternoons, yet gone after taking a nap after dinner), then one can take several blood sugar readings throughout the day to see if the blood sugar level corresponds to fatigue level. If fatigue levels correspond to sugar levels above 70, then one may not have classic hypoglycemia, yet sugar may very well be related to their fatigue and you may have a major finding on your hands. This would mean that you have correlated your fatigue to an internal biochemical parameter, which is a wonderful clue. Any time you find one of these, it is recommended that you note it on an index card and tape it to the wall in front of your desk -- these are important.
If you feel sugar is an issue, it is recommended that you buy some books on hypoglycemia (preferably recently published and popular), and start reading, in addition to telling your Doc about your findings. There are a number of treatment approaches, as noted in the hypoglycemia books. Also, you may find it interesting to search "hypoglycemia" at www.medscape.com, in their own database and in the medline database. Also, Dr. St Amand's comments on hypoglycemia may be helpful -- to view these, click here.
Causes Of Sugar Disregulation
One possible cause of hypoglycemia is blocked Noradrenaline receptors, in which case, one may be extremely responsive (blood sugar level could increase significantly within 20min) after popping one NA-Agonists Rx pill, as previously described. Trying this once can yield useful information. Sugar regulation is related to a number of hormones and glands. Insulin, for example, is a hormone that has a dramatic affect on sugar levels; therefore a problem with insulin could cause a problem with sugar.
Another cause is "insulinoma", which is a type of pancreatic tumor. Folks who are at high risk of this are those who smoke cigarettes, eat high-fat foods, eat high-sugar foods, and have been exposed to harmful chemicals. An elevated insulin-to-glucose ratio may suggest insulinoma. 90% of insulinoma cases are benign and can be successfully treated (it is very important to look for it). If fasting glucose levels drop below 50 mg/dl and one has an elevated insulin to glucose ratio (e.g. greater than 0.4), it may suggest insulinoma. Normal insulin levels are typically lower than 25 mU
Tracking Down the Root Cause of Sugar Disregulation
If blood sugar regulation is off, one can test the chemicals used to regulate blood sugar, in search of a root cause. Most docs will not do this however, since it is costly and laborious. If you want to do search for the root, you would need to find a Doc that will run many tests and spend much of your money (e.g several grand). Sulfur toxins (e.g. H2S hydrogen sulfide fermented in the gut), chromium/zinc deficiencies, and impaired noradrenaline communication can all cause hypoglycemia.
Getting Sugar Disregulation Healthcare
Your Doc may not be so inclined to test for hypoglycemia since it is not easy test for. They would need for you to fast overnight, have you visit their office in the am, have you drink some sugar water, and then draw your blood at 1Hr intervals for 4hrs. You would end up spending most of the day in their office, and they would need to put up with you hanging around. This may sound funny, yet Doc's hate controversy, and they know that long tests, invasive tests, expensive tests paid for by the patient are lightning rods for controversy. And therefore, they try to avoid these things. Unfortunately, it is in the patient's best interest to do what may be uncomfortable in order to maximize the probability of solving the puzzle. In summary, try not to complain too hard when the Doc suggests something that is unpleasant. And also, if you want the Doc to test aggressively, you can coach him with things like, "I don't care how invasive a test is, I want to solve this problem", or, "I don't care how much it costs to run these tests, even if I pay for it out of pocket. I want this problem solved. I want it solved now. I will do whatever is necessary to solve it. I am willing to work hard to solve it.". Your traditional Doc is not bad with things they can see, things they know about, things they can test for, and things they have experience with.
In summary, the easiest way to test for sugar regulation problems is to do it yourself with the $35 box that you buy at your local drug store. Also, once you get this box, you can test your family and friends for fun. For example, you could check everyone's blood sugar before the Thanksgiving meal, and then 2hrs after, and you might find someone at the table with a blood sugar problem, which they would probably love to hear about as you are passing the cookies and reminiscing about previous Thanksgiving celebrations.
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