Confused by symptoms, blood lab resutls? Can you help?

[mm77]

Hi,
I went for an annual checkup in January and my glucose came out high (although I did not fast before this test...) and since I have a family history of type II diabetes, the doctor suggested I lose weight and put me on the 'south beach diet' which completely eliminates carbohydrates for the first two weeks of the diet. I began the diet and had to stop four/five days into it because of extreme light-headedness, mild headaches, fatigue, and inability to concentrate. Since then, I've continued to have these symptoms even though I am no longer on the diet. I'll sometimes be fine in the morning, then I'll eat breakfast, and feel terrible for hours. The feeling I get now (sometimes until I eat, other times just after having eaten) is a tingly sensation and slight pressure in my head. I also feel extreme fatigue also associated with when I eat. I went to the doctor and had more tests run and the results were that everything was normal except I have: high glucose again (this time I had fasted) and high triglycerides (>300), high VLDL, low HDL (~28), elevated ALT (49), AST (23), elevated albumin (5.1), and a slightly high white blood cell count, all for the first time. The doctor told me I am probably suffering from some sort of virus, but I'm not sure how that would explain the weird sensations I feel in my head. I am sure that these feelings are completely dependent on my food intake, but cannot discern any particular food item/circumstance as the direct cause of this. I'm especially concerned because this all seems to have been triggered by the diet and has not gone away (it's been over six weeks!).
Could it be some sort of connection with diabetes, would that explain the elevated triglycerides and neurological symptoms, etc.?
What other tests should be done and by whom, a gastroenterologist or a neurologist?
Is it possible that a strict diet can really trigger such severe and long-lasting symptoms? Please let me know if I should be worried and what next steps I should take.
Thank you very much in advance for your help with this.
M.

[Kevin Pho, MD]

The combination of an elevated blood sugar, low HDL and elevated triglycerides is known as the "metabolic syndrome", or insulin resistance syndrome.  Individuals with the metabolic syndrome or even insulin resistance alone have an increased risk of coronary artery disease.  The metabolic syndrome also has been associated with abnormal liver pathology in severely obese patients including steatosis, fibrosis, and cirrhosis.

If your fasting glucose is greater than 126 on 2 seperate occasions, then you have diabetes.  Increasing exercise and weight loss will improve the increased triglycerides and decreased HDL levels.  Markedly increased sugar levels can cause some of the neurologic symptoms you describe.  

If you have diabetes, then appropriate treatment needs to be instituted.  Your PCP should be able to do this.  If you continue to have neurological symptoms, then a neurologist can be considered.

If these symptoms occured after the diet, you may want to consider changing back to a more conventional diet.  If the symptoms continue, then further evaluation should be considered.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Kaplan.  The metabolic syndrome (insulin resistance syndrome or syndrome X).  UptoDate, 2004.

[mm77]

Update of previous message...Just wanted you to know I am a 27 year old male. Thanks.