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

strategist said:
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?
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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 go between not able to eat anything in mornings due to nauseous rough achy horrible morning feeling eventually ok and a normal brunch portion to not feeling properly full unless I have second servings of evening meal. Seems like it could well be messed up grelin and leptin but I haven’t tried to ask about that.
 
strategist said:
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?
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You're thinking of the Norwegian data that found that pwME had lower concentrations of amino acids that could be utilized in the Kreb's cycle? I get protein cravings often, and have a relatively high protein intake due tot his, though I haven't found a connection between my meals and this feeling. To me it occurs most often if I have overexerted myself, which could fit with the idea that the other sources of energy (fat and carbs) are not enough for the body when in a certain state. Being mild/moderate I might not be in that state often.

A more mundane explanation is that meals rich in meat and cooked vegetables are rich in protein and fibre, which are both very satiating. Celiac patients are a nice example of a group where "hungry all the time" occurs, when switching from a diet with gluten to one without, as many of the gluten-free substitute foods simply have a very poor nutrient quality and only provide empty calories.
 
Midnattsol said:
A more mundane explanation is that meals rich in meat and cooked vegetables are rich in protein and fibre, which are both very satiating. Celiac patients are a nice example of a group where "hungry all the time" occurs, when switching from a diet with gluten to one without, as many of the gluten-free substitute foods simply have a very poor nutrient quality and only provide empty calories.
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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.
 
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strategist said:
So you believe it's likely that in my or our case this is just a signal for needing more nutrient rich food?
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I don't know, as I said I haven't found a connection between my own intake and the feeling of starving. I eat pretty much the same every week, and this feeling only occurs sometimes and that makes me think it has to do with something going in the body, a change in metabolism that occurs at those times.

But if I had a patient telling me s/he often felt like starving despite eating normally, I would start with asking about their diet to rule it out :)

For pwCeliac I've met who report being "hungry all the time", where I've actually looked at their food intake, then yes I believe it's a signal for more nutrient dense foods. Often the diet is high in nutrient poor bread substitutes and the like, with little fibre or protein. Meals that would make anyone hungry again shortly after eating it. Since the symptoms of ME could easily make it difficult for someone to prepare and eat food (let alone shop!), I also believe some pwME will end up with nutrient poor diets since that is what is possible for them to achieve with limited energy reserves.
 
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.
 
strategist said:
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?
Click to expand...

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.
 
strategist said:
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.
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If I didn't have someone who shops for me when I'm not able my diet would probably look very different (or I would have to cut down on other things I do, like my studies and soon job). :(

I so look forward to decodeME and hopefully learning more about genes related to fat/carbs/protein metabolism and ME!

Arnie Pye said:
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.
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In Norway, the general guideline for protein intake is for healthy adults to get 10-20% of their energy intake from protein, for elderly it is 15-20%. This is to accomodate that our digestion slows down when we age. A higher protein intake is not believed to be helpful or beneficial for sick people as a group, but in some illnesses there is an increased need for protein as the body is catabolising itself. Providing enough protein slows this process down. In weight loss studies a higher protein intake is associated with less loss of muscle, and this could potentially be usefull when ill and inactive as well.
 
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.
 
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strategist said:
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.
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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/
 
Ryan31337 said:
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.
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When you say "akin to postprodinal hypoglycemia", did you have the blood sugar drop or did you get the symptoms without actual hypoglycemia? When I first started getting ME symptoms and PEM, my aunt recognized a crash as a hypoglycemic episode, and backed it up by testing my blood sugar which was well below what it should have been. I had this problem for a while, but it has since disappeared and I don't have postprandial (also called reactive) hypoglycemia now. The hunger feeling I've described above is not linked to my carb intake, unless I somehow change my reaction to carbs when I get these episodes. It doesn't disappear by eating fats or protein either when it has first manifested itself.
 
strategist said:
What is the formal name for this? Is i postprandial hypoglycaemia or some sort of carbohydrate intolerance?
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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.
 
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