Mestali

Iron Deficient Anemia and Hypoglycemia after RNY

4 posts in this topic

I am 8 years lost op from RNY and having an extremely difficult time. Last year (2016) after having extreme fatigue, fainting spells, racing heart beat, some tachycardic issues, whole body jitters/shakes, I was diagnosed with having Iron Deficient Anemia. Extremely low ferratin levels warranted 2 IV Injecatfer iron infusions. After 3 weeks, I felt fantastic and have felt great for over a year. Several weeks ago I started feeling all the same symptoms as before. My Hematologist did lab work but my ferratin levels were "within normal range" despite having dropped almost 40 points in 3 months. Since I was symptomatic, they approved another of iron infusion. I started to feel slight improvement of my symptoms after 5 days, but then all of those symptoms returned with a vengeance. My Hematologist is positive my symptoms are not from my IDA. I have seen every specialist to rule out other issues. Everything has been deemed ok. 

I went back to my PCP and he ordered a ton of lab work, including a 4 hour GTT. I had that done 3 days ago. It was absolutely awful. I was having uncontrollable jitters, severe cold sweats and my eyes started to dialate. The nurse on staff at the lab almost called 911. 

PCP called today to tell me that I have severe Hypoglycemia and that is what is causing all of my dizziness, lightheadedness, shakiness and fainting. He is positive changing to a low-glycemic diet will fix it. The concern I have is that those symptoms are pretty much constant 24/7. If I am lying down or sitting with neck support, i usually feel better. 

Is it possible to have hypoglycemia symptoms CONSTANTLY, or is this not a true hypoglycemia diagnosis?? I have not noticed any increase in symptoms before or after i eat. I pretty much feel lightheaded and like i am going to pass out all of the time. I am thinking maybe a copper deficiency, which results are still pending. Or is it a nasty combination of Iron Deficient Anemia, hypoglycemia and another vitamin deficiency??

I am supposed to see a Nutritionalist at the hospital this week. Would it be better to see a specialist that works with gastric bypass patients or an endocrinologist? Or is there someone else I should seek out? (I have already seen a neurologist, opthamologist, ENT, gastroenterologist, etc)

4 hour GTT results:

Fasting: 79

1 hour: 105

2 hour: 40 (lab repeated the test to verify results)

3 hour: 67

4 hour: 83

My hgbA1C was normal at 5.4

 Any thoughts would be appreciated.

Share this post


Link to post
Share on other sites

I am very sorry for what you are going through.  You should not be shy about seeking a second opinion from another physician if your physicians are not sure how best to proceed.

We are here to support you.  

Share this post


Link to post
Share on other sites

Hello Mestali - it sounds like you're going through a pretty rough time, and I'm sorry to hear that. In my readings around various WLS forums, I've run into the idea several times of GTT being a bad way to check for hypoglycemia in RNY patients due to the way we process sugar. That's where dumping syndrome comes from, of course. I don't have any research on hand, but you might look into asking your PCP to research this, or trying to find a PCP who understands these considerations. I don't know anything about this, but your question reminded me of some concerns I've run across. Worth looking into.

I hope you get this figured out soon!

Share this post


Link to post
Share on other sites

Mestali, I think this kind of hypoglycemia is thought to be due to excess insulin production after eating a meal. You were not hypoglycemic until 2 hours after the glucose challenge.  A low glycemic diet should be the first thing a person with this syndrome tries. Take a look at this article from the Joslin Clinic. 

http://blog.joslin.org/2017/03/dealing-with-post-bariatric-surgery-hypoglycemia/

Hope this helps ---

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now