damn that link wasn't to the article I thought it was.

I have a few research articles on this, let me see if I can find them.

Here is the link again, in case anyone wants to read it.

http://annals.org/...spx?articleid=706778

---

Brian Stover USAT LII
Accelerate3 Coaching
Insta

Yep, caffeine was a huge part of the mix as well. I think it acts like a metabolizer accelerator, like pouring gas on a fire.

---

----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

n=1 here

I've had significant issues with this starting with more training load (and presumably more fitness) when I was working toward my first 1/2 IM in 2008. 20 minutes into a workout, start feeling a little lightheaded, dizzy... then it progresses quickly into seeing stars, cold sweats and on the worst episodes I've gone into a "black tunnel" and felt like I was going to pass out. Have to sit down and wait 10 minutes before I could go again, and often that was the end of my workout.

I would have episodes while not exercising but these were less frequent. I was also concerned about diabetes... I have several Type 1 in my family. Got checked out with the usual stuff, blood tests, etc and it turned up negative for any signs and my blood sugar was always in a normal range. Doctors said it wasn't a blood sugar issue and acute hypoglycemia was "extremely rare", which I'm sure it is.

It was frustrating. Hitting a wall 20 minutes into a light jog? Seriously? So I bought a glucose testing kit and carried it with me. When I had a hypoglycemic reaction I tested and sure enough I was in the low 50 mg/dL... way lower than my "normal" range around 85 - 100. I was glad to at least self-diagnose that I was indeed having a low blood glucose reaction.

Over the past several years I've really been able to bring it under control. I still have episodes but I can feel them coming and they're much more infrequent. In my experience the following things helped:

- Reduced simple sugar and processed carbs. Not a saint on this but a lot less sugar and flour, more protein especially eggs in the morning.
- Take it easier on the caffeine. No saint here either... I love coffee but try for moderation or water it down with decaf.
- This was the biggest one for me: I exercise first thing in the morning on a relatively empty stomach. I have not tried to understand this from a medical/scientific perspective but even a 30 minute run in the morning (or a spin on the trainer in the dead of winter) seems to "set me right". If I DON'T do this, I'm much more likely to have an episode, often on my bike commute to work after breakfast. I believe the timing of a meal (breakfast) followed by exercise (bike commute or a later workout) causes trouble. And hey this is a great motivator to get out of bed and train... if I don't I might pass out in a ditch. I can confirm I have NEVER had a hypoglycemic reaction in a morning workout prior to breakfast.

YMMV, but I feel your pain. Really frustrating stuff and I'm glad to hear I'm not the only one, and it's not just in my head!

It's fascinating stuff... From what I understand, eating simple sugars before your workout causes an insulin spike. That's fine. But your body should clear that pretty quickly. If you're nearing type 2 diabetes, this insulin doesn't clear very fast. Then when you exercise, the muscles burn off the glycogen and then your body also catches up with the insulin and you get a double hammer effect.

But the case can still happen with non-diabetics where your muscles are so adapted to pulling out blood sugar, that plus the normal insulin crash from eating sugary stuff (plus caffeine as somebody pointed out) can get you. And being overtrained also means probably depleted reserves of glycogen in the first place.

---

----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

That is, as best I know, fairly accurate. Even wo meds a type 2 can have exercise induced hypoglycemia, but it's much more common with medication. Is your diet and exercise fairly steady? I think an on /off nature to training would intensify the effect.

Are you simply jogging first thing in the morning without eating first?

If it is blood sugar related there are excellent tools out there to help you understand what's going on. Any decent specialist should have a continuous glucose monitor you could borrow to monitor what is happening during exercise. You may even be able to call your local dexcom rep and ask for a demo.

I happen to be Type II. Over time, I've figured out, for the most part, what works and what doesn't although I still sometimes get it wrong and suffer. I can't eat simple sugars unless I eat within a couple of hours again. For example, I've had pancakes with syrup as part of breakfast and if I don't eat within a few hours, I will go Hypoglycemic and that's if I'm doing nothing.

So, figure out what does and doesn't work while training and figure out what you body feels like as you are crashing so you can do something about it.

---

BC Don
Pain is temporary, not giving it your all lasts all Winter.

Did they ever make you do an "OGTT", Oral Glucose Tolerance Test.

Take blood sugar, drink 75g glucose, take measurement at 1hr and 2hr ?

Or was it simply fasted blood tests, one blood sample and it's done.

I believe we started with the fasted blood test and proceeded to the OGTT (both normal). But I'd have to go check records because I could be confusing my doc appointments and the super-sweet glucose drink with my wife's who was pregnant at the time.

BTW the internist moved off of blood glucose and proceeded to evaluate potential cardiac/blood pressure causes (ECG, stress test, tilt table). Nothing was coming up there. I stopped the process prior to an echo... honestly it was getting expensive and wasn't seeming to lead anywhere.

The fasted blood tests do not catch the insulin resistant cases especially at the beginning of the development of insulin resistance. For years I had problems and the fasting and Hba1c testing were not catching.

As I suggested to Brett, eat a plain white bagel, drink a glass of OJ for breakfast, test your glucose 2 hours later and you will see if you have a glucose tolerance issue. That is roughly the equivalent of 75g load they give you in an OGTT.

I can't find the research I was looking for in my files. The 3 or 4 articles were on postprandial levels and their impact of exercise performance or something along those lines

I did some research on this when I experienced this problem. Here is the thread, well let me link to what I think is the best answer in the thread.
http://forum.slowtwitch.com/...post=2691691#2691691 or it could be this response http://forum.slowtwitch.com/...post=2691810#2691810

Once I'm in shape this is never an issue but the few times I've experienced this I've always been out of shape and it's only been in the afternoon

If I find those research articles I'll post them in this thread.

---

Brian Stover USAT LII
Accelerate3 Coaching
Insta

I fought this BIG time last year.

Even bought a blood sugar kit and was pricking my fingers around meals. Thought it was carbs, meal size, low protein, iron deficiency etc.

I started getting night sweats while sleeping as well

Long story short - I cut out 100% of caffeine and replaced with water and after two weeks, it worked. I reintroduced decaf coffee and all has been good since

I actually had the same thing a few years ago. Didn't have any symptoms, but was doing a research project where they were taking blood samples during a run, and after the first ~10', my blood glucose went outrageously low, and gradually started to normalize as time continued. The researchers were shocked that I was still running perfectly happily.

Talked it over with my exercise physiology professors, and he said it's not that uncommon. High glycemic pre-exercise meal -> insulin response -> activation of insulin mediated pathways to take glucose into skeletal muscle + exercise -> activation of non-insulin dependent pathways to take glucose into skeletal muscle. With both pathways working at the same time, blood glucose drops lower than it should. Over time though, the insulin pathway is down-regulated and glucose levels will normalize with release of glucose from the liver..

Nothing to do with diabetes (if anything, you're effectively more sensitive to insulin... early type 2 diabetes is characterized by insulin resistance). I believe I read that this can be a sign of the parasympthetic form of the overtraining syndrome, but it was years ago and I'm struggling to find it again.

Is this since starting ZenDurance? maybe its due to the different diet Tawnee has you on

---

-

http://www.thetrinerd.com

yes, but is also depends on the timing of that high glycemic meal. 30-45 minutes before I agree insulin resistance may not be playing a part. If the meals is 2hrs before and I was crashing, I would not rule out some insulin resistance and I would certainly get to the bottom of it.

you eat a meal and you will get a "first phase insulin response" about 20 minutes or so later. Yes you can probably time the exercise and insulin response to cause a low.

but if you are getting these crashes twenty minutes into excercise, 2+ hours after a meal, I would double and triple check there isn't some insulin resistance going on.

That's what I was thinking. Not sure why this would be related to Type II diabetes since with that you'd get less of the insulin mediated uptake of glucose, after all that's what causes the disease.

We didn't have a bagel and orange juice last night, so instead I ate two large bowls of ice cream with chocolate syrup on top (I know, it was so hard to eat that. lol) and waited two hours. Blood sugar was 119. Do you think what I used was an equivalent?

---

----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

I think this is exactly what the cause was. Overtrained, tired... drink something sugary for some energy before going out the door. Depressed system and then "first phase" insulin response like you said and whammo... Seeing stars and having to walk. Crazy!

---

----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

119 is really good and normal. They look for under 140.

They normally do the test fasted in the morning, which does make a difference but I would certainly not be concerned in your case. I'm pretty sure that was a good load of carbs.

can u imagine us type 1's eating all that without a bolus lol?

I know. My wife is type 1 and is just laughing at me with my concerns. But the amount of sugars we eat to do this stuff is pretty intense. When crazy symptoms start popping up, it's time to figure it out.

I think caffeine is my biggest issue. It is a crutch that allows me to overtrain and also burns off blood sugar at an accelerated rate. I look back and my best years of great performances were when I went caffeine free for a while.

Thanks everybody for all the help!

---

----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

It was a spectacular load of carbs. I had trouble doing it, even. But in the name of research and science I toughed it out. :)

---

----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

oh yeh, we take on heaps of sugar. Dental nightmare!
interesting symptoms you get though, definite lows for a non-diabetic is interesting.

I wish I could bolus :-)

I am a T2 and it's a pain in the ....I am not saying I'd want to be T1 but at least you guys have some control over things.

My only control is timing the exercise and carbs. I can eat that if I run an easy half marathon before. But then again I guess God put carbs in beer so they would be consumed after running