metabolism issue?

I'm a female, age 46, began having extremely low energy and lack of stamina about seven years ago. Nothing helped until a few weeks ago when I started taking an l-carnitine supplement. I felt better almost immediately.  

I've had symptoms of hypoglycemia all my life (I used to pass out in high school and was on seizure meds until I realized all I had to do was eat a candy bar), but blood glucose levels are usually normal when measured. Annual fasting test is normal. I'm about 30 lbs overweight, and it's all in my belly. My cholesterol is about 200, with an unusually high HDL.  I also have early menopause (age 44), spinal osteopenia, and osteoarthritis in hands, neck, knees, etc.

I'm assuming my carnitine miracle has something to do with fat and/or sugar metabolism, and that whatever malfunction I have is probably outside the resources of my HMO. My question is if there's any reason to follow up with a doctor to try to find out what's going on, or should I just be happy that I apparently have my life back.  Any suggestions are appreciated. Thank you.  

[Anita Ramsetty, MD]

Hello,
I am not familiar with the use of L-Carnitine for medicinal purposes so I am afraid I am not the best person to ask in this regard.

In regard to your blood sugar questions: hypoglycemia is defined by numbers so if your sugars were normal this likely is not truly what you had. You may have had what we call "relative reactive hypoglycemia" where you feel symptoms from a drop in sugars from high to lower but the number does not actually become low. This is thought to be a risk factor for future diabetes and a sign of hyperinsulinemia, so you should get tested formally using a 2-hour glucose tolerance test to make sure you are metabolizing glucose normally.

Given your early menopause and osteopenia as well, i would suggest at least one appointment with an Endocrinologist to ensure everything is on the right track.
Take care.

[beeblebrox42]

Thanks for your reply.  I did check my sugar repeatedly over a couple days a few months ago (Ouch!). Highest was 166 (after cereal) and lowest was 87.  There was one drop of 21 points in 5 minutes (from 126 to 105), and a 73 point rise in 45 minutes (from 93 to 166).  Is that abnormal?  Thanks again.

[Anita Ramsetty, MD]

Hello,

Those rises and falls seem consistent with hyperinsulinemia and possibly some early delayed insulin release which can be some very early signs prior to development of diabetes in the future. That rapid drop from a higher to lower number is likely contributing to some of your symptoms, certainly. I think you should definitely speak to your doctor about doing a 2-hour glucose tolerance test in the near future to get this formally tested.

Take care.