I am a 37 year old office worker sitting in front of a computer all day. A couple of months ago at work, about 1pm, before lunch i felt dizzy with blurred vision. I stood up and almost fainted! I had tingling sensations in my arms, i thought i was having a stroke or heart attack! They called an ambulance, my blood pressure was 220/140 & they shipped me off to hospital.
They ran tests (bloods, CT+MRI+kidney+chest scans) but couldn't find anything. They sent me home with BP medication. The first few days at home were terrible, i had several episodes with severe shakes and my BP was high. I couldnt really eat much - i felt terrible.
Things slowly got better over a week. I changed my diet and started eating breakfast every day. I gave up alcohol and coffee. I went back to work. However i felt terrible most days. Tired, nausea, dizzyness and blurred vision (not as bad as that first episode). The GP switched me from Coversyl to Noten and then to Micardis which i am on now.
Episodes of dizzy spells continued.
Then it dawned on me, i sit at work for 3 to 4 hours without eating... So i bought a blood glucose monitor. Initially levels were normal however when i started feeling dizzy @ 11am the next day - i noticed glucose levels were 3.3mmol. It was only a mild dizzyness - about half as bad as the day before. So I started eating more regularly. Over several days the dizzyness stopped completely, which was amazing! However today the dizzy spells resumed (still eating regularly) and i felt bad all day. I think that first "attack" was possibly hypoglycemia? By the time we got to the hospital perhaps my blood sugar returned to normal or close to it?
My questions are:
1. I've never eaten breakfast all my working life and never suffered this before, could this be hypo and why now?
1) Hypoglycemia is among the causes that can lead to this picture. If suspected, there are a number of tests that can cement the diagnosis, including, a 72-hour fast and testing for insulin, C-peptide, and beta-hydroxybutyrate levels.
2) You have already had a thorough evaluation for dizziness. A referral to an ENT physician to determine inner ear causes can be considered. I would also consider a referral to a neurologist.
3) In addition to the aforementioned tests, you can also consider tilt-table testing done by a cardiologist, which can look for more uncommon causes of blacking out, or syncope.
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.
Kevin Pho, M.D.
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