Insomnia / Waking Up From Hypoglycemia?

[chris1983]

hi! my name is chris and I live in germany.

some data about me:
- male, 37 years old
- 70kg weight, athletic, exercise regularly (mainly calisthenics and some light barbell stuff)
- bodyfat around 20% (estimate)
- i suffer from hashimoto since 3 years but haven't had sleep issues until now. I take thyroid hormones, 100mcg T4 and 22mcg T3 (split over 3 times, 1/3 before bed).
- my daytime temperature used to be 36,8C (98,24F) in the past, now it is higher at 37C (98,6F). in the morning when I get up it is usually 36,2C (97,16F).
- recently I was also measuring my blood sugar. seems OK. around 100 when I get up and 145 after a meal with protein, fat, starch, sugar.

since 4 months or so, I have problems with sleep / insomnia / waking up. my reseach on the sleep issues led me here. it started when I had a lot of psychological stress due to relationship related issues. at first, I have barely slept at all due to racing thoughts. I could feel how I was mainly running on cortisol on the next day at that time. this lasted for a couple of weeks. it got a little bit better when I started to use progesterone for sleep (100 mg before bed). now I can fall asleep easily but after 4-4,5 hours I often wake up in sweat, breathing heavily, very hungry. after that, I am often not able to fall asleep again until I have to get up at 6 a.m.

i tried to cope with this by nutritional adjustment, eating more "peaty" as you would say, but it seems to make it worse somehow. before that, my nutrion was more "normal", with a lot of protein (>120g) and starches, very little sugar and fruit, no PUFAs. it seems that eating a lot of carbs as lunch make it worse, too. i also tried to drink a lot of OJ in the evening, but it is not helping. sometimes, when I eat very protein and fat heavy for lunch, I can sleep 6 hours before waking up. but that is not always the case.

sometimes it is better, then I just wake up with no sweat around 3 a.m., but when I wake up at 4 a.m. I am usually completely soaked.

yesterday I tried cypro. 1mg before bed. made me really sleepy, yes, but I found it too heavy, got a little anxious as well. woke up at 4am in sweat. after a little milk / OJ / coconut oil, got back to bed and could sleep again, thanks to the cypro, but I don't think I want to try it again.

I also take the following supps:
- D3 with K2
- low dose multivitamin
- selenium
- zinc
- magnesium
- DHEA 25mg occasionally

I tried the following supps but it did not change much:
- GABA
- glycin
- gelatine

I am now wondering in which direction i should further investitage?
- liver health? Is my metabolism burning glycogen too fast? because my daytime temp has risen. should I try taurine?
- endotoxin issues? therefore I wanted to try cypro. my digestion is really good and regular, though. sometimes some winds, but no loose bowels at all.
- adrenal health? I don't think my cortisol is very high now, otherwise i would not wake up in sweat!? but then... shouldn't the progesterone I take convert to cortisol?
- insulin/blood sugar issues? seems fine to me, though. nevertheless it is somehow reactive hypoglycemia?

thanks in advance.

 

[yerrag]

It seems like you do well on fats. Try taking butter before you sleep to see if that helps with your sleep.

Your blood sugar values don't look good. I see 80ish as optimal. But if your fasting blood sugar (waking up) is at 100 and you still feel hungry at night, your blood sugar isn't being absorbed and metabolized well enough.

It could be your insulin production isn't sufficient. With low insulin production, there is not enough insulin to inhibit glycogenolysis and lipolysis. If your glycogenolysis isn't being inhibited, chances are your glycogen store is low and so you can run out of sugar easily in between meals. But this is immaterial at this point because your fasting blood sugar is already high as is. But more significant is that with low insulin puts you in a state of uninhibited lipolysis, and this gives you a supply of fatty acids which you rely on for energy metabolism.

Taking butter before bed is only a stopgap solution, but it could at least help in restoring sleep for you.

Because you likely aren't burning sugar much, you're low on CO2. This has many implications. When you have to burn sugar (as the brain needs it) you're likely using little oxygen (due to low CO2) and you're producing lactic acid from being stuck at glycolysis. When you sleep, you may be mouth breathing to expel acidity by exhaling CO2 (You're acidic because of keto and lactic acids from the metabolic processes you're relying on) . This keeps you low on CO2.

I don't understand why you sweat a lot during sleep though. Why is the body choosing to excrete fluids through the skin than through urine? It could be that you're very acidic and your kidneys are unable to muster enough ammonium, and you're low on electrolyte cations to effect acid-base balancing through the kidneys. Are you low on the minerals magnesium, potassium, calcium, and sodium?

I suggest you get some urine pH test strips to check urine pH.Urine pH range 6.4 - 6.8 would map out to a blood pH of 7.4 which is optimal. Get a strip with range 5.5-8.

Why I suspect low insulin is because your blood sugar is staying high. If your blood sugar is high, it's not for having enough insulin.

I'm experiencing sleep problems like you are, and I'm figuring things out. I'm working it out. I suspect it's roots are bacterial. But it's a long story. It could cause low insulin as well as high serotonin, and. both will disturb your sleep. Being low on CO2 could also keep your lungs from excreting serotonin (this I'm not quite certain of though).

 

[Tarmander]

I had this same problem to a certain extent and Mutaflor, which is easily available in your country, fixed it for me.

Check out the mutaflor thread: Mutaflor

 

[boris]

Progesterone raises your metabolism so taking it right before bed sounds like you burn through your reserves while you sleep. Classic Peat advice is eat before bed something sweet like ice cream/sugared or honey milk for energy during sleep and something salty to keep aldosterone in check. And keep something by the bed in case you wake up, so you can eat/drink and fall right back to sleep, just like you mentionend you did.

 

[chris1983]

thx to all for your thoughts so far.

@yerrag
makes sense what you are saying. but when i am low on insulin, shouldn‘t fructose help then to fuel the glycogen stores?

what about the temp? is that serotonin excess then, when it is not burning sugar?

the night sweat is adrenaline i would say. therefore i thought about reactive hypoglycemia...

 

[chris1983]

I had this same problem to a certain extent and Mutaflor, which is easily available in your country, fixed it for me.

Check out the mutaflor thread: Mutaflor

sounds promising! will start today with mutaflor. thank you!

 

[chris1983]

Progesterone raises your metabolism so taking it right before bed sounds like you burn through your reserves while you sleep. Classic Peat advice is eat before bed something sweet like ice cream/sugared or honey milk for energy during sleep and something salty to keep aldosterone in check. And keep something by the bed in case you wake up, so you can eat/drink and fall right back to sleep, just like you mentionend you did.

yeah, I know that prog is a metabolic booster. my doc prescribed it to me for better sleep. and it works!

anyway, I had the same issues when I was not taking any prog at all. some nights I would sleep more or less good (6h), and some I would wake up after 4 hours.

started with prog just 6 weeks ago.

I try to prepare snacks for the night, but sometimes I am just too awake after the feeding to find back to sleep, especially on weekdays when I know that my day at work will be screwed again...

 

[yerrag]

makes sense what you are saying. but when i am low on insulin, shouldn‘t fructose help then to fuel the glycogen stores?

Being low on insulin has the effect of not inhibiting the conversion of glycogen to glucose. It causes glycogen stores to be used instead of accumulating.

what about the temp? is that serotonin excess then, when it is not burning sugar?

Low temps have a lot to do with poor metabolism, and poor blood sugar regulation leads to low metabolism. Low energy production = low temperature.

the night sweat is adrenaline i would say. therefore i thought about reactive hypoglycemia...

You wouldn't have reactive hypoglycemia though if you're waking up to 100 blood sugar though.

 

[chris1983]

Being low on insulin has the effect of not inhibiting the conversion of glycogen to glucose. It causes glycogen stores to be used instead of accumulating.


Low temps have a lot to do with poor metabolism, and poor blood sugar regulation leads to low metabolism. Low energy production = low temperature.

You wouldn't have reactive hypoglycemia though if you're waking up to 100 blood sugar though.

hmmm.

but I thought my temp was fine, isnt it?

anyway. just started with mutaflor. and I will consult my doc about the insulin/blood sugar issues. anyway... I still have an insulinogenic reaction when my blood sugar drops from 145 after a meal to 110 after 2 hours. what do you think about that?

 

[yerrag]

Adrenaline, yes, but since you have no glycogen, this would lead to cortisol to trigger proteolysis - to make sugar from amino acids. But I don't know much about proteolysis. Is the reaction producing water? Now, if the sugar produced isn't being used efficiently because tissue oxygenation is low (due to low CO2), the body would keep on producing sugar by proteolysis. This may lead to a lot of water being produced. And if you're producing a lot of lactic acid from glycolysis, the acidity has to be removed somehow. If the kidneys can't do it because it can't reduce the acidity going through the kidneys due to low availability of electrolytes, it will have to eliminate it through the skin. And that's why you're sweating it out.

When asleep, lipolysis may also be downregulated, so you're not getting enough fatty acids to metabolize and provide energy. And this forces your body to produce sugar proteolysis, even if the blood sugar isn't really being consumed fast enough. This could explain why your waking up blood sugar is high.

But if you were to provide your body with butter, then it wouldn't have to go to the trouble of producing sugar by proteolysis, as triggered by cortisol.

I'm just thinking out loud here, so I could be wrong.

 

[yerrag]

but I thought my temp was fine, isnt it?

It's fine, yes. I wasn't sure why you brought that up. If you're asking if serotonin is helping bring it up, I don't think so. Running on adrenaline would though, as far as I know.

I still have an insulinogenic reaction when my blood sugar drops from 145 after a meal to 110 after 2 hours. what do you think about that?

It doesn't make sense. Normally, it's when blood sugar goes up and breaches a threshold that you would get an insulin reaction. Why would blood sugar going down to that? How do you know it's an insulin reaction? Were you able to test your insulin when that happened?

 

[chris1983]

It's fine, yes. I wasn't sure why you brought that up. If you're asking if serotonin is helping bring it up, I don't think so. Running on adrenaline would though, as far as I know.
It doesn't make sense. Normally, it's when blood sugar goes up and breaches a threshold that you would get an insulin reaction. Why would blood sugar going down to that? How do you know it's an insulin reaction? Were you able to test your insulin when that happened?

no. I was just measuring blood sugar. but how else should it go down, if not from insulin?

 

[Tarmander]

sounds promising! will start today with mutaflor. thank you!

awesome. I do it in the morning, tends to mess my sleep up if it is directly before bed

 

[yerrag]

no. I was just measuring blood sugar. but how else should it go down, if not from insulin?

Ray Peat has said that potassium has an insulin-like effect, but in the sense that that it lowers blood sugar. But it does so by increasing sugar absorption into tissues. So, it's not only thru insulin that blood sugar is lowered.

 

[chris1983]

Ray Peat has said that potassium has an insulin-like effect, but in the sense that that it lowers blood sugar. But it does so by increasing sugar absorption into tissues. So, it's not only thru insulin that blood sugar is lowered.

i think it is a stress induced process: what if I have high cortisol -> high blood sugar -> high insulin peaks -> blood sugar too low -> adrenaline to bring it up again.

 

[yerrag]

Do a 5hr OGTT and feel to find out more about the nature of your problem. you may be right. buy a glucose meter.

instead of being strict about having to take 70g of glucose at the start, just have lunch. before lunch take a reading. then right after lunch. then every hr thereafter.

 

[yerrag]

But I doubt you're willing to experiment. You haven't even tried taking a dollop of butter.

Maybe after you process your thoughts as some new ideas needed to go thru the grinder.

 

[chris1983]

OK. Some news on this: my doc assumes that it is candida overgrowth, though I don't have the typical symptoms like diarrhea. But you can see a thin white yeast covering parts my tongue. Started with nystatin and another probiotic a few days ago.

The night sweating is a little bit less intense now, but happens practically every night. Could be some kind of herxheimer reaction, I guess.

The sugar cravings though have already completely stopped and I also stopped eating the "peaty" stuff like fruits and sugar in excess.

@yerrag: have tried the butter but it did not help. Now it becomes clear, that hypoglycemia was maybe just a symptom of candida.

 

[yerrag]

Thanks for trying the butter.

I hope your doc is right about the candida. Still, I personally think a 5hr OGTT would be helpful but it's your call. Doing a 5hr OGTT was the best thing I did for my health, but that's just me. All the best with you and your doctor in troubleshooting your condition.

 

[chris1983]

once more an update on this.

after candida treatment for 3 weeks with max dose of nystatin my problems got a little bit better, but I was not happy, neither with my sleep nor my hunger control over the day.

I had my stool tested: no candida found, but too much e.coli. that was 2 weeks after I stopped taking mutaflor.

so now I tried something else: upping the carb intake about 30%, reducing protein and fat just a little bit, and eating more frequently over the day. I tried to avoid this at first because I was afraid of becoming insulin resistant. in fact I think I am insulin resistant to a certain extent at the moment due to cortisol excess in the past months. at the moment I can control my hunger only for 4-5 hours after eating a meal, no matter how much it was or how many carbs it contained. or else, if it is not insulin/blood sugar, there is something wrong with leptin. i dont really know.

but eating more often helps with my problems, eating more carbs in total helps even better. I've never eaten that much carbohydrates before. my bodyweight did not increase so far. I eat every kind of carbs that comes along: bread, rice, noodles, potatoes, sugar, fruit... you name it!

before bed, I consume the following: thyroid, progesterone and a thick slice of organic whole grain bread with butter and strawberry jam. this combination lets me fall asleep easily and in the past 2 weeks, I could sleep for 6-8 hours each night. but it is also a little strange that when I wake up after 4-5 hours for the first time, I am not hungry at all.