Frequent episodes of Hypoglycemia

[Beach19]

Male. >40yo

Current protocol:

150mg Test Cyp p.w.

1100 iu’s HCG p.w.

4iu’s of GH every night before bed

5mg Reta once weekly

Peptides: GHK-Cu 2mg daily

KPV 1mg daily





For the last two weeks I’ve been a wearing Freestyle Libre 3 CGM. During this time I’ve watched my blood glucose drop to the low 50’s on multiple occasions everyday. My average glucose is 92mg/dL. My upper levels have not exceeded 140mg/mL at its peak and it’s short lived.

What I’m seeing is a relatively normal looking spike in glucose after eating and a significant drop quickly following the peak. That insulin response often pulls me into the 60 and 50’s range. It’s a quick peak and sharp decline.

Lots of peaks and valleys throughout the day, which I don’t know if that’s normal. Meals are balanced and not carb heavy, but it also seems independent of what I eat.

It seems to me that my insulin is over-responding.

Am I experiencing “reactive hypoglycemia”? Is this early insulin resistance? Should I change my protocol?

I need bloodwork: CMP, TSH and Free T4, IGF-1 and cortisol. Anything else?



My last bloodwork showed very low ferritin and really skewed Iron panel (high binding capacity and low saturation). Low iron.



Any insight would be greatly appreciated.

 

[Ghoul]

Male. >40yo

Current protocol:

150mg Test Cyp p.w.

1100 iu’s HCG p.w.

4iu’s of GH every night before bed

5mg Reta once weekly

Peptides: GHK-Cu 2mg daily

KPV 1mg daily





For the last two weeks I’ve been a wearing Freestyle Libre 3 CGM. During this time I’ve watched my blood glucose drop to the low 50’s on multiple occasions everyday. My average glucose is 92mg/dL. My upper levels have not exceeded 140mg/mL at its peak and it’s short lived.

What I’m seeing is a relatively normal looking spike in glucose after eating and a significant drop quickly following the peak. That insulin response often pulls me into the 60 and 50’s range. It’s a quick peak and sharp decline.

Lots of peaks and valleys throughout the day, which I don’t know if that’s normal. Meals are balanced and not carb heavy, but it also seems independent of what I eat.

It seems to me that my insulin is over-responding.

Am I experiencing “reactive hypoglycemia”? Is this early insulin resistance? Should I change my protocol?

I need bloodwork: CMP, TSH and Free T4, IGF-1 and cortisol. Anything else?



My last bloodwork showed very low ferritin and really skewed Iron panel (high binding capacity and low saturation). Low iron.



Any insight would be greatly appreciated.

Post a screenshot of a daily graph.

 

[Photon]

Male. >40yo

Current protocol:

150mg Test Cyp p.w.

1100 iu’s HCG p.w.

4iu’s of GH every night before bed

5mg Reta once weekly

Peptides: GHK-Cu 2mg daily

KPV 1mg daily





For the last two weeks I’ve been a wearing Freestyle Libre 3 CGM. During this time I’ve watched my blood glucose drop to the low 50’s on multiple occasions everyday. My average glucose is 92mg/dL. My upper levels have not exceeded 140mg/mL at its peak and it’s short lived.

What I’m seeing is a relatively normal looking spike in glucose after eating and a significant drop quickly following the peak. That insulin response often pulls me into the 60 and 50’s range. It’s a quick peak and sharp decline.

Lots of peaks and valleys throughout the day, which I don’t know if that’s normal. Meals are balanced and not carb heavy, but it also seems independent of what I eat.

It seems to me that my insulin is over-responding.

Am I experiencing “reactive hypoglycemia”? Is this early insulin resistance? Should I change my protocol?

I need bloodwork: CMP, TSH and Free T4, IGF-1 and cortisol. Anything else?



My last bloodwork showed very low ferritin and really skewed Iron panel (high binding capacity and low saturation). Low iron.



Any insight would be greatly appreciated.

Pull labs.
Add hscrp.
Look for signs of inflammation and infection which may affect iron. If none, supplement iron. What's your hgb, can you do an infusion?

Get a skin prick for bg, next time it tanks check your bg with the prick.

 

[Beach19]

Some of today.

 

[Beach19]

Last night. However I recently read that sleeping on the Libre 3 will give artificially low results. That may have played a part here.

 

[Photon]

How long have you been at that reta dose?

 

[Beach19]

Pull labs.
Add hscrp.
Look for signs of inflammation and infection which may affect iron. If none, supplement iron. What's your hgb, can you do an infusion?

Get a skin prick for bg, next time it tanks check your bg with the prick.

HGB as in Hemoglobin? Thats 14.1g/dL
A1C is 5.3

I haven’t inquired about an infusion, might need to see a specialist like a Gastroenterologist.

Skin pricks are more accurate than a CGM? This is all new to me.

I also take Wellbutrin and read a comment that suggested it may affect BG. That true?

 

[Beach19]

How long have you been at that reta dose?

About 4 weeks.

 

[Photon]

HGB as in Hemoglobin? Thats 14.1g/dL
A1C is 5.3

I haven’t inquired about an infusion, might need to see a specialist like a Gastroenterologist.

Skin pricks are more accurate than a CGM? This is all new to me.

I also take Wellbutrin and read a comment that suggested it may affect BG. That true?

Based off that hgb your iron is fine. Just check for inflammation and supplement iron.

Skin pricks are the most accurate. Cgm lags 15 mins and gives false positives depending on where u place it.

 

[AlexDavis43]

Am I experiencing “reactive hypoglycemia”? Is this early insulin resistance? Should I change my protocol?

Are all these drugs DIY or are you under a doctor's care ?

If the former, lay off the GH and reta for a bit, since you're monitoring with CGM now

Might be important to know if this is something that's not drug-induced

 

[Ghoul]

Last night. However I recently read that sleeping on the Libre 3 will give artificially low results. That may have played a part here.

Correct. "Compression artifacts". Use the other arm next time you place a sensor.

The daytime dips look like very mild reactive hypo, but if it's not symptomatic at all, it's nothing to be concerned about and not uncommon for people with tight glucose control using GLPs.

 

[Beach19]

Are all these drugs DIY or are you under a doctor's care ?

If the former, lay off the GH and reta for a bit, since you're monitoring with CGM now

Might be important to know if this is something that's not drug-induced

Test/HCG and CGM prescribed by Dr.
Peptides are DIY.
I’ll continue to monitor but likely back off both as you suggest.

 

[Beach19]

Correct. "Compression artifacts". Use the other arm next time you place a sensor.

The daytime dips look like very mild reactive hypo, but if it's not symptomatic at all, it's nothing to be concerned about and not uncommon for people with tight glucose control using GLPs.

Thank you Ghoul.
I do think I may be experiencing symptoms. They include muscle soreness and weakness, at times intense headaches and overall lethargy. Although, I’ve had these symptoms for a while and have become use to it. I’ll follow up with bloodwork asap.

 

[bigforyouben]

I stopped using the Libre because none of the low glucose events was confirmed by finger prick tests. I tried it with four sensors in different places on my arms. Some have said it's an issue with low body fat, so I might try again on my thighs. But I really hate the unstoppable low glucose alarms in the middle of the night.

 

[Beach19]

I stopped using the Libre because none of the low glucose events was confirmed by finger prick tests. I tried it with four sensors in different places on my arms. Some have said it's an issue with low body fat, so I might try again on my thighs. But I really hate the unstoppable low glucose alarms in the middle of the night.

Yes. It’s very alarming (no pun intended) when it goes off throughout the night. Can’t turn that setting off. I’ll get some finger prick tests to see if these events correlate.

 

[AlexDavis43]

Test/HCG and CGM prescribed by Dr.
Peptides are DIY.
I’ll continue to monitor but likely back off both as you suggest.

I wouldn't be concerned with your daytime dips bc they are nothing compared to your nighttime dips, which look more just like plain hypo, not "dips"

Also, you wouldn't really experience many symptoms bc sleeping

There's a thing called hypoglycemia unawareness: the more frequently you go hypo, the less symptoms you get, but your brain is still being deprived of glucose ("neuroglycopenia") during those times (no bueno)

Best case scenario, discontinuing reta stops the bouts of hypoglycemia ("best case" unless you stocked up or have GLP1 FOMO)

 

[Photon]

I stopped using the Libre because none of the low glucose events was confirmed by finger prick tests. I tried it with four sensors in different places on my arms. Some have said it's an issue with low body fat, so I might try again on my thighs. But I really hate the unstoppable low glucose alarms in the middle of the night.

Yes. It’s very alarming (no pun intended) when it goes off throughout the night. Can’t turn that setting off. I’ll get some finger prick tests to see if these events correlate.

Just disable the libre app before going to sleep.
Stops it from even running.

 

[AlexDavis43]

Just disable the libre app before going to sleep.
Stops it from even running.

The majority of Beach19's hypoglycemia is overnight

 

[Photon]

The majority of Beach19's hypoglycemia is overnight

Yea he can turn it off, go to sleep and it stops beeping and waking him up.
Ofc, check those with a finger prick first.

 

[Avies48]

Yes. It’s very alarming (no pun intended) when it goes off throughout the night. Can’t turn that setting off. I’ll get some finger prick tests to see if these events correlate.

Do u check it at night? With the finger prick method?

I have reactive hypo and ive had it go south quickly at night… started drinking a protein drink and sometimes adding in oats to that same drink has kept me somewhat steady thru the night

Also magnesium at every meal has shown to help keep reactice hyp at bay and actually help it not occur as often and sometimes at all

(google is ur friend here ^^^^)



I also have the libre 3 +… ima try the stelo one next…

Urs could be a combo of the glp-1 and the gh… id drop the gh and see how the glp-1 is treating u because it may be causing the low glucose…

Do u need the glp-1 or are u following the forums and adding it because if what it does?

Not everyone will or can benefit from using a glp-1 … in some it may actually cause issues from what ive seen…

Being a reactive hypoglycemic myself… it may help me… or it may throw my glucose into the dumpster even further…