Feeling like I'm starving, or continuing to feel hungry despite a full stomach

Despite an apparently normal food intake, I sometimes feel like I'm starving. I can also become hungry again despite still having a full stomach from the last meal.

What could be causing this?

 

Could it have something to do with leptin resistance? I read something about this years ago.

 

I think ME screws up neurological signalling, more or less at random, so having your satiation signals messed up seems plausible to me.

 

I suffer from this too. It is hugely annoying. I am pre-diabetic and I am fairly sure that also means I am insulin resistant. Although I don't understand the connection I'm sure there must be one.

 

I have this too sometimes. I don't have any evidence but my feeling tells me it might be related to hypometabolism.

 

The best meals for preventing this seem to be rich in meat and cooked vegetables. Maybe it has something to do with needing more amino acids than normal, as suggested by research finding lower levels of anaplerotic amino acids in ME/CFS?

 

So you believe it's likely that in my or our case this is just a signal for needing more nutrient rich food?

I've been eating a little too much bread lately and neglecting meat and fruit intake (due to recovering from a muscle biopsy and simply not having the energy to cook properly). That's why I made an extra effort into eating nutrient rich foods today. My lunch was tomato salad with leftover cooked leafy greens from yesterday, two fried eggs, some whole fat yoghurt and peaches. It was not a small meal and despite this I still felt like I needed to eat more.

 

I had actually wanted to cook some meat today but there was a long queue in front of the butcher shop. As we all know standing still in the heat is not a great idea for us, so I just didn't bother. Tourist season has fully begun now and there seem to be even more than usual.

PS:

Carnitine seems to reduce this feeling of hunger somewhat.

 

I have read that older people need to eat more protein than younger people. I just googled "protein intake elderly" and found lots of links.

I wonder if higher protein intake is also required in sick people - if they can eat it without feeling worse.

 

I found some meat in the freezer and decided to have a mainly meat based dinner to see what would happen. A few boiled carrots, boiled meat, and a raw tomato. Two hours later, I have not felt any uncomfortable hunger and my digestive system feels good. Energy is holding steady.

 

I've talked about my experiences with this sort of thing before. What started off as inappropriate hunger and tummy rumbles 1-2hrs after meals eventually became more obviously akin to postprandial hypoglycaemia. Heart palps, sweats, chills, weakness and significant fatigue/somnolence would hit me and what I was missing until it was pointed out by an endocrinologist was that it was linked to carbohydrate intake. The onset was very insidious though and the link never occurred to me, especially as I ended up snacking every hour or 2x on sugary things, even through the night, which set me on quite the unpredictable rollercoaster.

Once the carbs were gone/minimised the strong reaction went too. Sounds like what you've done there too. Easy to test, have a day of eating protein & fats with a tiny amount of complex carbs, then have a day of eating jacket potatoes, cake etc. If its poor handling of carbohydrate it'll be quite clear.

 

Should add that I was tested, multiple times, for diabetes & never showed any unusual fasting blood glucose results.

The endo saw a lot of POTS/OI patients and recognised it well in that group.

There were theories on it being motility related in some patients but it seems like there is a lot of GI hormonal stuff going wrong with the wider ANS dysfunction too that likely contributes. Shibao's group is still working on that I believe, recent paper here: https://pubmed.ncbi.nlm.nih.gov/35232225/

 

What is the formal name for this? Is i postprandial hypoglycaemia or some sort of carbohydrate intolerance?

 

The symptoms match reactive hypoglycemia or postprandial hypoglycemia but if you say that to most doctors the response will be dismissive. I had a GP tell me to "eat less cake" and another, less well informed endo tell me "you're just an outlier". In the absence of a better understood driver like diabetes or gastric resection its just thought to be a self-correcting non-issue, what some people might experience after eating a big sunday dinner - you might feel a bit lethargic and that's about it.

In my case on some days when my function was especially poor I would eat a relatively normal portion of food (in terms of size and carb/protein/fat distribution) and then an hour or 2x later have those symptoms I mentioned with noticeable blurry vision, ringing in my ears and be completely unable to remain upright or process anything. I'd sleep/pass out for 20-30mins and wake up fine - it took quite a while for it to progress to that stage though and was somewhat variable, often linked with PEM (and mirroring other OI symptom severity that also got worse in PEM).

The somnolence got so bad at times I was sent for a sleep study with MSLT and ironically the crashes were at their worst on those days because I changed my diet due being in hospital for the tests. I had brought my own food because of intolerance, there was no refrigeration so I was only eating bread, jams, fruit and sugary snacks... seems obvious now but wasn't at the time and reminds me of what you said about recently changing your diet in recovery. May be something entirely different in your case, but worth a simple food trial I think.

 

There is a test for reactive hypoglycaemia, I’ve had it done before (via endocrinology). They take your blood, then give you a sugar solution, then take your blood again a couple hours later. So they can see how the glucose is affecting you. You have to start the test on an empty stomach, and it’s usually done in the early morning eg 9am.