Orthostatic intolerance occurring together with a hypoglycemia-like state

It happened again yesterday. I did some household work and at some point I noticed that I was becoming lightheaded and weak. I picked up something from the floor, and as I stood up the body seemed to struggle to maintain adequate blood flow, and as this happened, moving my limbs also became more difficult. They felt weak, and my movements slowed. My body did not return to normal. A minute later I picked up something else and it became even more pronounced. It felt like my body was no longer able to compensate, that I needed to lie down, and I was hungry and knew from experience that eating something would make me feel better. I also know that lying down would also help. I slowly waddled back to my bed and fell asleep for about an hour. Then I was able to continue and made lunch.

It seems like I'm simultaneously experiencing orthostatic intolerance plus some low blood sugar state (but not low enough to count as proper hypoglycemia). Is this a known phenomenon with a name?

Also what should I do to investigate this further? Could this be some hormonal deficit? I know that some hormones are involved in both OI and blood sugar regulation so it seems like an obvious question to ask whether they're related to this problem. But I don't know the specifics.

 

I don't know how common this is. My daughter has had this recently, though she describes it as feeling as though you'd been hung upside down for ages ,then turn right way up quickly and all blood remains pooled in head. This is not uncommon but the hunger is. She normally never gets hungry .

March does usually see a change for her, so perhaps it's a different manifestation this year as her sleep shift over winter has not been as pronounced .

 

I get 'mild' hypos which make me feel and be very wierd, I have had the standard GP blood tests done for that and did my own finger trick testing (which showed me just about going into hypoglycemia) and now been referred to endocrinology for further investigation. The ME clinic said that this isn't uncommon as a feature of ME and POTS as it's to do with autonomic dysfunction. I read that 'splanchnic pooling' (blood pooling in stomach) after a meal is a feature of autonomic dysfunction which in turn alters hormone levels (including the ones that regulate blood sugar). My hypos are always after eating carbs (or I think more precisely - higher GI foods) and resolve much more quickly if I eat sweets, but doing that just sustains the rollercoaster so I currently eat very low carb and I get way less of 'those' episodes. I am rambling now but I think my point was that they can be linked. I suppose normal people can feel faint from not eating and we are more sensitive to insults (ie low fuel) than others.

Some of this may be relevant, I stumbled upon it recently, sorry I don't know where you would get a transcript.
[The Clinical Problem Solvers] Episode 289: Spaced Learning Series – Recurrent Presyncope #theClinicalProblemSolvers
https://podcastaddict.com/the-clinical-problem-solvers/episode/158907439 via @PodcastAddict

 

I would interpret that as plain old orthostatic intolerance, with the hunger signal you're getting probably your body's way of saying, "Give me fluids! Give me salt!" to rectify it. So more of a dehydration signal than a low blood sugar signal. Could absolutely come along with feeling hungry as you're more likely to be dehydrated if it's been a while since you ate.

I don't know that hypoglycaemia needs to come into it at all, unless you have a blood sugar testing device and it shows something unusual at those times that doesn't happen at other times?

Lie down as soon as you feel lightheaded, or you could properly faint and hit your head.

Not always possible, but I find it helpful to bend like a ballerina doing a plié when picking something up. So you bend your knees out to the sides and kind of reach your hand out semi-blindly for the thing you need to pick up, without letting your head go below your heart.

I groan if I drop something at the end of a shower, because bending down to pick something up after strenuous activity is prime time for my orthostatic hypotension. And I don't have room for ballerina antics.

 

I also do an upright squat type move to pick things up, I'm not usually around people but when I am, I get some funny looks for that!