possible postprandial hypoglycemia anyone? And brain fog?

[Rachel F]

Hello Amazing Members-
I am back to the board- was on many years ago when I was trying to get initially diagnosed and received so much help and support. Don't know if I could have done it without all of you! I am back with a new problem I am having trouble resolving.

My main issue- severe issues with brain fog especially after eating lunch. I have to be very careful to not eat any carbs during the day. My blood glucose has been a little low but the endocrinologist says not low enough to treat. I think around a 62 in the AM. I think I have postprandial hypoglycemia but not sure because sometimes, even when I eat right I still feel fatigued especially after eating.I went through the 5 hour blood glucose test and the endocrinologist just told me to eat small meals throughout the day. I have been doing that- not helping. If I don't eat, or after eating the wrong thing (carbs) I will also get very tired, feel a cold feeling in my mouth, have bad brain fog, and my vision becomes blurry. If I wait too long between meals I also start to feel fatigued and will start to get nauseous. I eat a bit every 2-3 hours.

Initially my rheumatologist prescribed  Wellbutrin and it actually eliminated my focus problems in the afternoon, but eventually that has stopped helping, even with increasing the dose. Which makes me wonder- why did I feel better on that? Now using Methylphenidate - up to 10 mg in the afternoon-  and it seems to help sometimes but sometimes not.

I am working with a nutritionist and my rheumatologist. The nutritionist is not sure I really have hypoglycemia because I don't get shakey between meals. My main problem is not being able to focus and even find words after eating. The methylphenidate does help me at least remember words!  If I don't eat, I will also get very tired and nauseous, feel a cold feeling in my mouth.

After initially diagnosed I took prednisone and that was wonderful but cannot be on that forever so I am off of it for now. Plaquinil made my blood glucose problem worse so that had to be discontinued. Any suggestions? I don't think my rheumatologist would prescribe the ritubimax. 

Thanks in advance. Also, anyone else have kids with POTS?

[SunshineDaydream]

Welcome back, Rachel. Have you tried an elimination diet for things other than carbs?

[Nymph]

Rachel, my first thought was that YOU have POTS. It can cause such symptoms after eating as blood moves away from the brain into the abdomen. It's a commonly-described symptom. Have you had a poor-man's tilt table? You could get your own cuff and try it after a meal. The catecholamine release with POTS has always felt like low blood sugar to me and I believe it can even induce low blood sugar. Anyway, it could be worth checking out.