Hypoglycemia and Chronic Fatigue Syndrome

Considering the complex nature of the disease, a federal advisory committee has recommended to change the name of chronic fatigue syndrome to myalgic encephalomyelitis (ME) or myalgic encephalopathy chronic fatigue syndrome (ME-CFS).

Chronic fatigue syndrome (CFS) is perhaps one of the most misunderstood and controversial diseases or syndromes. Earlier, it was not even recognized as a real disease by some medical professionals. But in the last few decades, the scenario has somewhat changed, and CFS has gained recognition as a real condition.

CFS is actually not a single condition, but a group of debilitating medical conditions characterized by persistent fatigue and a few other symptoms.

But researchers have not been able to pinpoint the exact cause of CFS. Many are of the opinion that CFS is not caused by a single factor, but by the interplay of multiple factors. Another fact about CFS that has come to light is that many CFS sufferers have hypoglycemia or low blood sugar levels.

In fact, hypoglycemia is suspected to be associated with chronic and persistent fatigue, the kind of fatigue experienced by CFS sufferers. So, let's find out more about hypoglycemia, and how it can cause chronic fatigue.

» Hypoglycemia is the condition characterized by low blood sugar levels. This condition is more common in diabetic patients, as they take blood sugar-lowering medications, and an accidental overdose of these medications can lower the level of blood sugar below the normal range.

Insufficient intake of food while taking these medications can also cause hypoglycemia. However, hypoglycemia can be experienced without diabetes as well.

» When we eat a meal, the blood sugar level increases. The beta cells of the pancreas release a hormone called insulin. Insulin facilitates the absorption of glucose from the bloodstream by the body cells and tissues, and thus, brings back the level of glucose to the normal range. So, the level of blood sugar can drop below the normal range, if there is an overproduction of insulin by the pancreas.

» Another hormone that regulates the level of blood glucose is glucagon. Glucagon signals the liver to convert glycogen to glucose, if the level of blood glucose is too low. When we do not eat for several hours, the liver breaks down the stored glycogen to keep the level of blood glucose within the normal range.

The adrenal glands also help raise the sugar level by secreting catecholamines that facilitate the conversion of glycogen to glucose. So, any disorder of the adrenal glands or liver can cause hypoglycemia. Other possible causes of hypoglycemia are, excessive alcohol consumption, eating disorders, and disorders of the pituitary gland.

» The mitochondria need glucose for producing ATP, which is the source of energy for various vital biochemical processes taking place inside the body. So, when the level of blood sugar drops, the cells do not get enough glucose to produce energy.

This can adversely affect the process of energy production. The result is low energy production and the consequent fatigue. Apart from fatigue, a significant drop in blood glucose level can cause headaches, dizziness, blurred vision, fainting, and irritability.

» Patients of CFS and hypoglycemia are often advised to avoid extreme physical exertion. Strenuous physical activity has been observed to aggravate the symptoms of CFS, and lower the blood sugar level significantly, as glucose is burned up rapidly to provide energy to the body to perform the exercise.

The liver does convert glycogen to glucose, but in a hypoglycemic person, the glucose produced from glycogen stimulates the pancreas to secrete more insulin. This again lowers the level of blood sugar.

So, strenuous exercises can aggravate both hypoglycemia and CFS, which again points to the supposition that there might be a relation between these two conditions.

» A certain degree of tiredness or fatigue is experienced by everyone due to physical exertion, which can be alleviated by taking sufficient rest. But if you experience extreme and persistent fatigue that is not relieved by rest or sleep, it may be a symptom of CFS. The symptoms of CFS are not alleviated by rest, and can be worsened by physical activity. The official symptoms of CFS, which help diagnose this condition are:

• Persistent fatigue not relieved by rest
• Unrefreshing sleep
• Poor memory or concentration
• A sore throat
• Enlarged lymph nodes (in the neck and armpit)
• Myalgia or muscle pain
• Joint stiffness and pain without swelling and redness
• Extreme exhaustion that lasts for more than 24 hours following a mental or physical exercise

» One should have at least 4 of the aforementioned symptoms, along with unexplained and persistent fatigue for six months or more, to meet the diagnostic criteria for CFS. If you do not meet these criteria, your fatigue may be related to some other health conditions, or it can be idiopathic in nature.

» Other than hypoglycemia, CFS is suspected to be associated with immune system problems, nutritional deficiencies, excessive use of antibiotics and certain other medications, stress and emotional trauma, adrenal gland dysfunction, alcoholism, hormonal imbalance, an imbalance of gut flora (especially an overgrowth of candida albicans), and viral infections caused by Epstein-Barr virus and human herpesvirus 6. CFS is more prevalent in women.

Hypoglycemia has been observed in a large of number of CFS sufferers. In the absence of any other condition that can cause chronic fatigue, physicians often look for hypoglycemia as a possible explanation. However, fatigue and CFS cannot be said to be caused only by a single factor, and not all CFS sufferers have low blood sugar levels.

Disclaimer: This story is for informative purposes only, and should not be treated as a substitute for professional medical advice.