MEDICAL MATTERS
- Medical Matters features questions asked by Members of the ME Association on health-related topics.
- Dr Charles Shepherd and the ME Association's other advisers answer these questions by sharing their expert knowledge.
- Medical Matters is based on the popular ‘Ask the Doctor’ series in ME Essential magazine.
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Questions in the Category: Hypoglycaemia
Shakiness
I am hoping you can shed some light on two types of shakiness which I've had since a recent relapse of my ME.
Some days I start feeling shaky shortly after getting moving in the morning. It's like I've had a big dose of caffeine (which I definitely haven't) and at its worst my hands will be too shaky to do anything fiddly like sewing but resting is hard because I feel wired with it. It normally fades around the middle of the day. It's intermittent and there are no obvious triggers.
More difficult to describe is a sensation I get sometimes which is more disturbing. It's like an inner wobble, possibly centred around my abdomen. It comes and goes and tends to make me feel vaguely weak. It's possible that one trigger is doing too much but otherwise it's random and can disappear for weeks. I find it difficult because I don't know whether I should be resting more when I have this shakiness or trying to ignore it like a lot of other symptoms.
Symptoms: Low blood sugar
I sometimes have acute and short-lived episodes involving symptoms that are found with low blood sugar: feeling weak and dizzy, looking pale, sweating, increased pulse rate, blurred vision and confusion.
I’ve read on the internet that one of the symptoms of ME can be episodes of low blood sugar (hypoglycaemia). However, I cannot find hypoglycaemia being listed in any of the official diagnostic criteria for ME/CFS, or in the symptom list in the MEA purple book.
As my brother is diabetic, I’ve been checking my blood sugar levels at these times and found them to be low. My GP said he didn’t know if this could be related to ME/CFS and has arranged for me to see an endocrinologist (hormone specialist) for further assessment.
Please could you clarify if there is a link between ME/CFS and low blood sugar. If so, what is the best form of treatment? I should add that I have a healthy balanced diet with no food restrictions.
Blood sugars: Hypoglycaemia
I sometimes have acute and short lived episodes involving symptoms that are found with low blood sugar: feeling weak and dizzy, looking pale, sweating, increased pulse rate, blurred vision and confusion.
I’ve read on the internet that one of the symptoms of ME can be episodes of low blood sugar (hypoglycaemia). However, I cannot find hypoglycaemia being listed in any of the official diagnostic criteria for ME/CFS, or in the symptom list in the MEA purple book.
As my brother is diabetic, I’ve been checking my blood sugar levels at these times and found them to be low. My GP said he didn’t know if this could be related to ME/CFS and has arranged for me to see an endocrinologist (hormone specialist) for further assessment.
Please could you clarify if there is a link between ME/CFS and low blood sugar. If so, what is the best form of treatment? I should add that I have a healthy balanced diet with no food restrictions.
Symptom: Tremor
I understand that a tremor, or shaking in the hands, sometimes occurs in ME/CFS. But it could also be a sign of Parkinson’s disease. I’m in my mid fifties and have had moderate ME/CFS for about five years. It is fairly stable but the tremor, which is in both hands and tends to be more noticeable when I’m fatigued, has only been present for a few weeks. Should I see my GP?
Dr Charles Shepherd
Dr Shepherd has been Trustee and Hon. Medical Adviser to the ME Association for more than 40 years. He is integral to the charity's activities and provides information and support based on his professional knowledge, personal experience as a doctor with ME/CFS, and the understanding gained from helping many thousands of people with the condition. He was a member of the comittee responsible for the 2021 NICE Clinical Guideline and is a recognised expert on ME/CFS in the UK. His knowledge extends to Post-Viral Fatigue Syndromes (PVFS), Myalgic Encephalopathy/Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or Long Covid.
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Medical Matters is based on the popular ‘Ask the Doctor‘ series featured in the highly-regarded member’s magazine, ME Essential, and in the healthcare professional magazine, ME Medical. Both are produced by the ME Association and published as hard-copy magazines every 3 months and sent to members and healthcare professionals by post to home or business addresses.
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