What Causes Diabetes Fatigue?

<h1>What Causes Diabetes Fatigue?</h1>

What Causes Diabetes Fatigue?

Amen to your comments. I couldn’t agree more.
Best wishes and good luck working your diabetes. Glenn
I have a weight-loss endocrinologist and a GP. Which doctor is best to review the fatigue issue? Type 2 diabetic, experiencing fatigue and depression. David Spero RN
Glenn,
Self-management approaches are probably the most important. But between the docs, I would choose the GP. Others might disagree. ronald
I have had very low testosterone levels for the past month and manage my diabetes through oral medications. Previously even with diabetes I had high testosterone levels. How can I raise my testosterone level so that I am interested in my girlfriend? Rod Roddy
Having my testosterone checked helped me in the exhaustion department. Low T was a major contributor to my exhaustion. Hormone Replacement Therapy is helping. I’m sure it’s not the answer for everyone but it may help some. james lujack
I have depression,diabetes(somewhat controlled with medication),and end up taking medication that causes tiredness.I am 61 years old which probably means I have plunging testosterone and am overweight. No wondewr why I steel away to the bedroom and sleep. I do not have top hear wife saying’you in bed again?’ Thanks for the article explaining these thingas to me.At least I know I am not crazier than I think I am….. leopold steiner
What I find exhausting is taking a bolus of rapidly acting insulin to treat hyperglycemia. I quickly become so tired I can hardly move, and I often fall straight to sleep, even if I wasn’t tired prior to the bolus. Interestingly, this never happened when I was using the older, animal-source insulins, so no doubt this effect has to do with the unnaturalness of the new insulin types. The idiots who designed them decided to omit everything which did not directly have to do with reducing blood sugar levels, so the entire biochemical complex of the insulin molecule, designed by a million years of evolution, was trashed for its few ‘required features.’ This no doubt unbalanced the wisdom of nature’s subtlety, so now we patients suffer. Al
I have hi blood sugar and feel fatigued. Would Atos contribute to my fatigue Rob Baldwin
This is a concern for me about my mother, she is 63 diagnosed with diabetes (not on insulin shots) with medication, she is overweight, depressed (though she does not see a psychiatrist her primary care doctor gives her anti depressants) she has a self mutilation habit (she has sores on her legs that last year required hospitalization and they are back to almost the same again). She works 20 hours a week, and is awake beyond that for maybe another 25 hours a week, she sleeps constantly, either in her lounge chair in front of the t.v. or in her bed. She complains about her hips and back hurting as to why she can not do much as far as movement. I am concerned, what is causing this much fatigue, her mother died at the age of 68 due to diabetes, and I am worried she may not even make 68. I have to assume its a combination of her habits, including diabetes, her infections in her legs, her lack of movement, and her poor diet (she eats all the time just little amounts but she has to have something to eat all the time) she has lost 8 pounds since the beginning of the year, but i think that has more to do with her sleeping more and more than an actual diet.
Thanks for advice, David Spero RN
Hi Rob,
You are right that your mother is in a bad situation. It sounds like her diabetes may be out of control, plus she’s depressed. IF she wants to continue living (a big if), it would help to see a psychotherapist (not a psychiatrist.) She needs more support and more reasons to live.
Is she self-monitoring her blood glucose levels at all? Does she at least get a regular A1C test? Can’t be sure, but I’m really not confident in her PCP’s ability to handle either her diabetes or depression. She might need different meds or fewer meds.
She can turn this around with self-management, but it will take some effort. See any of our articles on reversing Type 2 diabetes, or on depression, for ideas. Krista
I am 42 and newly diagnosed lada. I just started Victoza lowest dose and am having extreme fatigue. I can hardly keep my eyes open and feel like I have to get back in bed to rest or sleep. I checked my bg today and it was 83. So not low or high, just perfect. I do not understand the fatigue. Could it be the victoza? I am so new to this and trying to figure all this out. Thanks for any ideas. David Spero RN
Hi Krista,
It’s almost certain the Victoza is causing your fatigue, since you weren’t having it before you started the med. Fatigue is one of the main listed side effects. It might wear off with time, or it might not. It’s good about your blood glucose, though. Ask you doctor what to do. He needs to know. Chris Edmonds
I found i was type 1 diabetic 1 week before i left to work abroad, so i haven’t had a lot of diabetic education, on a trip back home my diabetic diet advisor suggested less or no meat, fish and mainly vegetables, this was to lose weight. since this time i find that after my evening meal all i want to do is sleep. your article on diabetes and fatigue has really helped, has i am working in a third world country with no diabetic advise on hand, thanks for your article. Kim
I have a friend that has type 2 dietetes and is ever fatigue and his levels are up and down his is not sleeping very well and very upset all the time I just need to know what to do to help him with this he works outside as a pipe fitter and is in heat alday can’t eat that good at work because of the work hours. I think he needs to change his diet but he want eat much at work and then wen his at home off work for a day or two he still won’t eat because he said he’s not working and all the food does is make his levels go up and then his not felling good so what do I do to help him with this. Jason
I find I suffer constantly with fatigue. It truly is a vicious cycle – I don’t sleep well at night due to stress from work and depression. I wake up feeling “drugged” as someone else has said – even if my blood’s not high (I have rather good control right now). I constantly yawn at my desk at work which embarreses me, which causes more stress which causes me to loose sleep etc… I keep having to go to the toilet – again, even when my bloods are perfect – which causes me stress and embarresment at work (who wants to pee every 30minutes?!). People don’t realise how much of a burden Diabetes can be to people living with it. I mean, I am constantly tired. I constantly want to sleep. My girlfriend gets annoyed at me for it, and even THAT stresses me out. And as we all know, stress can cause high bloods which makes me even more tired and then more stress etc… Horrible, horrible illness. And, on top of all this, I am now being investigated for suspected Psychosis. Life is failing me right now.
I’ve been diabetic all my life (diagnosed in 1990 at 9months) so it’s all I’ve known. Perhaps I’ve just been used to how it makes me feel, but it’s only in recent months that I’ve been told people are worried about me and that the constant degree of lethargy and fatigue isn’t normal. I can barely focus at work, and I can barely do my job.
Does anyone else have this? I mean, I’ve been Diabetic for almost 23 years now… I can’t be alone, right? David Spero RN
Hi Jason,
I’m sorry that you are going through a hard time. It will get better.
If your control is good, this can’t all be diabetes’ fault. Not sleeping could cause the fatigue, the depression, and a lot of other things. Please get help. Investigate why you are urinating so often. Get some therapy and/or join a support group. debbie scott
My 59 yr old husband is 135lbs and 6ft tall. He has diabetes contolled with oral meds…half of ea pill 2X a day as he eats so little and whole pills caused his sugar to plumet. He has a low sex drive andhas always slept long periods of time….before and after diabetes diagnosis. Now hw sleeps almost round the clock and is eating even less saying nothing sounds good. What is going on? Thinking early trip to dr best idea here. David Spero RN
HI Debbie,
Yes, get him checked out ASAP. I doubt Type 2 diabetes by itself could account for such severe fatigue and loss of appetite. I also doubt that he is Type 2. Quite possibly, he needs insulin. At least get thyroid, blood count, and testosterone checked. Vimi Gisby
I have type 2 diabetes but just lately I have been feeling very tired. I normally am up around 06.30 hrs and go for a 45 minute walk, but in the last 10 days its a great effort to do the walk and have missed a few. How can I get back to a normal active life without feeling tired? Ingrid McAdoo
I was diagnosed with type 2 diabetes in 2011. I am still trying to deal with it. It was the harsh fatigue that led me to know that something was wrong-I was driving and had to pull over. The feeling is so intense I have to lay down at times. There are fatigue related problems such as delay in daily activities and others. I am 50 years of age and take an oral Med for diabetes, I take a 30 minute walk in the mornings and upon return I’m tired-not that exertion type, but fatigue-my eyes get heavy and I have to lay down. I have the endomorhic build and am obese-trying to loose weight. I need advise on what to eat before I go walking/exercise, afterwards. Someone once suggested yogurt. However,I became fatigued and nauseated walking. I would appreciate your expertise. Tamera Scheer
Ingrid, try protein. Protein and high fibre diets are a must for diabetes. I suffer from fatique all the time….but protein gives me energy, makes me full and levels my blood sure. BEfore you go for a walk have some eggs or cottage cheese, a few nuts and an orange. When you come back, you’ll feel like a million bucks. Oh and drink lots of water!
Everyone on this page needs to up their protein intake balance it with high fibre and green vegies. YOu’ll feel the difference right away.
All the best. Susan
I was diagnosed with type 2 in September this year my medication is Glucophage SR 500mg once daily. I am bad tempered and have flare ups of temper and am constantly tired I could sleep all day and then feel guilty that I have wasted my day when there are things I should be doing. I am going in to hospital on January 14th 2014 to have surgery on my cervical spine for a prolapsed disc I am worried how I will cope when I come home with this lethargy. David Spero RN
Susan,
I hope you can use some of the ideas in the article and the follow-up pieces to get your energy back. Getting your glucose levels down might be a good place to start. Timm
I have to eat at certain times to take my medication. However after I eat I find myself at my job nodding and very sluggish even after drinking coffee! I’ve tried going to bed earlier but it doens’t have anything to do with a lack of sleep but it is always after I eat something. Does this have anything to do with the insulin spike that comes after a meal? I eat healthy and light and do train with weights. gwen
every time I begin to eat healthy I get so tired. I am following my diabetic diet when trying to eat healthy but I always feel like someone sapped all the energy out of me. my dietitian set up my eating plan for me. if I can make it a full month then I feel better but that makes it really hard to eat right Dana McCutchen
I was diagnosed with type 2 diabetes in Feb. 2014. My numbers are all over the place stilll. I was extremely tired yesterday, but I thought it was my Fibromyalgia. After lying down for about an hour, I woke up feeling shaky. I checked my blood sugar and it had dropped to 60. I drank half a cup of root beer to get the sugar in me. I felt much better. Is it the sugar or the carbs that I need? My Rhematoid Arthritis makes me tired too, which makes it hard to discern what the problem is. Bunnieb
I think i am beyond help.I was diagnosed with type2 in 2007 after being diabetic for at least 2years before.I am a 57 year old woman and fatigue is the understatement of the year.I sleep 10 hours a day,and spend about 7 hours more in bed reading.I am definately overweight and have suffered from severe depression since 1996. I have mild sleeping tablet and also 30mg or more in tranquilizers a day.Here is why. My husband had Cancer in 1993,my beloved Mum and Dad died after long illnesses around the same time and my husband has been physically and mentally disabled since.Worse,3 years ago he became paranoid and until a psycotic breakdown a year ago swore and mentally abused me daily.Since his breakdown he now has early Alzheimers and i literally have to do everything.i am on a very low dose of tablets daily as my glucose crashes again and again.My worst problem started about 2 weeks ago, getting my glucose levels up and keeping them there is now a daily nightmare.Coca Cola always worked in the past but now it is like i have not drank it. As soon as my levels are good again, 15 minutes of work and another glucose crash.My husband does not have the capability to understand. I am stressed out all the time i am awake. Should i be on insulin. This thought terrifies me as i get so confused.Above is my future which can only get worse. HELP PLEASE.THANKYOU. David Spero RN
Hi Bunnie,
Things are really hard for you. It would be great to get some help with your husband, up to and including finding a place for him to be cared for.
About your sugar crashes, what does your doctor say? This is a fairly unusual symptom of diabetes, and I think your medicines might need to be changed.
Please get some help and let us know how it goes. Pam
I started feeling very lethargic, not sleepy, over 3 years ago, about the same time as I had a thyroid cyst (which went away by itself). I got lazy about meals, started eating lots of chocolate. 6 months later I was diagnosed as Type 2 diabetic, diet controlled. Now although my blood sugar is good and thyroid levels ok, I am still very lethargic and am just about managing my life. My Doctors have no answers. Any suggestions? carolina
hey, this might be a really unexpected comment, but i have an assignment for university (i´m studying medicine) which is about the mechanisms of fatigue in diabetes. i´m having difficulty finding information about this topic but your article has helped guide me a bit. i was wondering if you could let me know where i could find good and especially reliable information on this topic. thank you so much. Kerri Potvin
I am type 2 diabetic, low thyroid, anemic, depressed. All are treated with medication. I want to start working out, but am so tired and weak, I simply can’t motivate myself to get out of my chair. Should I not feel better with the medications? tahira shaheen
all information is very useful and informtive tahira shaheen
i am diabetic and i feel very much tiredness and feels lethargy by your information i change my diet habbits for the improvement of condition. Timothy J. Martinez
60 year old male I have had diabetes for approximately 15 to 20 years now I take metformin twice a day, R-Regular & N-Novolin Insulin 3 times per day. I take other medications for complications due to my diabetes such as heart medication, enlarged heart, high blood pressure, tachycardia,tendinitis especially my shoulders, diabetic neuropathy, pretty acute lots of pain, arthritis, degenerative disc disease L-5 problem area, Sleep apnea now on CPAP at night to restore breathing & sleep patterns, pain medication such as Gabapentin, a few others to manage acute pain. I also struggle with panic attacks and acute anxiety. Regularly I feel so tired simple tasks cause me to sweat and feel tired after 5 to 10 minutes of light work, often I sweat profusely, I just had my yearly with labs at the VA Dom or Veteran’s Domiciliary, Veteran’s Health clinic in my home town and all checked out fine. However, at 60 years my dad was a cattle foreman riding horse, working hard he did not have health issues though, my Mother had many of my illnesses and seemed to get more done than I do. I’m 5’9 260 pounds so I know when I was 180 pounds I felt better, losing weight is really hard for me. I have decided to do my tasks until I tire rest a few minutes and try again, often though I feel walking uphill or fishing on my boat too much for me! Any advice is MUCH appreciated! Thanks, Tim David Spero RN
Hi Tim,
You have a lot of issues here and I can’t sort them out. Perhaps your doctor can help. Getting your glucose down might help — you could try vinegar or bitter melon for that and/or a low-carb diet .
In managing your fatigue, you should rest BEFORE you tire. You know when you’re going to get tired, if you pay attention. So rest before that, then start again. You will find you can get much more done with less fatigue.
Also, taking so many medicines could contribute to fatigue. Next time you see your doctor, ask if any of these meds could be making you tired, and see if any changes can be made. Tammy Garcia
I am a 51 year ol woman who was diagnosed with type 2 diabetes in 2008. I have lost 47 pounds since then. My AC1 are always about 5.9 and my blood sugars range between 76 and 140. I have multiple problems that might be causing my fatigue including my thyroid, and Neuropathy. I have had the Neuropathy since 2001. I went to the Mayo Clinic and for 3 days they poked, prodded, and stuck me with various instruments, only to come out with the diagnosis as Idiopathic Neuropathy. I am a teacher so I keep pretty busy. I would not say I am too stressed because I am not in a hurry, depressed, anxious, or frazzled. I do have terrible fatigue though. The doctor put me on Amphetimine salts to keep me awake but then i don’t sleep well at night because of the pain so I take pain killers. They cross each other out so I am in a stuck elevator. Not moving up nor down. I read a lot of information about Diabetes and how to keep my sugars down. I will say this, with all the problems I have you would think I was depressed but I am not. I love life and enjoy doing things with my family. Some days are fine but others are bad don’t want to get off the couch because I am so tired. it has even caused me to forget things that happen in the day. Can you Help? Am I missing something? linda
I Was diagnosed with type 2abot 4 years ago have blood pressure and high colestral on tablets for all .I song know what to do feeling absolutely rubbish depressed No energy jittery all time .told doctor think it’s tablets but just says must take them. I’m at my lowest point with this David Spero RN
Hi Tammy,
If your heart and lungs are OK and your sugars as well controlled as they seem to be, and the Mayo Clinic has checked you out, you might want to ask your doctor about Provigil (modafanil) or Nuvigil (armodafanil). Or maybe more physical movement might help — like yoga, walking, tai chi, or water exercise.
David Spero RN sherry
Hi I am a 63 year old female and have had type 1 diabetes for 30 years. I have the fatigue issues but does anyone feel sl nauseaed in the morning especially if my bs is elevated. My last HA1C was 6.4. thanks just curious ANDY
SHERRY: MY WIFE EXPERIENCED THE SAME THING NAUSEATED AFTER BREAKFAST . SHE IS LACTOSE INTOLERANT. SHE IS NOW ON ALMOND MILK AS ONE EXAMPLE EVERYTHING HAS BEEN FINE SINCE. Surly Trek
Hi, I am a 5 ft ‘4’ 13 year old female, and have started feeling very fatigued, and cannot eat. I thought the reason I was tired was lack of sleep because I noticed symptoms when I wasn’t getting enough sleep at night, but later found out even when I do get at least 8 hours of sleep I still feel fatigued i the morning.As for the eating part of my problem I have not felt hungry in a few months and it never effected my eating, I just ate when it was lunch or dinner. Just last month my symptoms got worse and haven’t been able to consume a normal portion in about a month, and it keeps getting worse with time.I can’t even look at food, it makes me sick.I am trying to eat, but I feel to tired and weak to eat, and am almost to weak and tired to get out of bed. I am already a little smaller than I am supposed to be, but just last week I was 93 pounds and today I am 91. Thanks I hope you can help! Concerned mom
This is really not normal at your age. You need to see your doctor!! You seem underweight, and are beginning to experience anxiety which is coming out in being “afraid” of food. Please know you are not alone and that anxiety/depression and fatigue are all linked and easily helped with the proper diagnosis by a real doctor (maybe take an antidepressant??) Good look! Cheryl A.
Wow!…I am 54, diagnosed type 2 since 4 years ago will be 5 December 7 2009. I had a hysterectomy where they found I had diabetes was a 8 A1c, I left the hospital at 183. I lost 50 down to the lowest of 146, came back up to 150 and stayed there for 2.5 years. Was sent to a dietitian is why I lost and only in 1.5 months. my BS were always under 100, some were 71, but most 80’s. on resting. Then two hours later no more than 130’s. Long story short. quit a job, got stressed, now my sugars are anywhere from 136-403…I was off when I lost, all my blood pressure meds, and the metformin…now I feel all screwed up having been put through a lot of pill changes. I ended up back on High BP med after 5 kinds, which I still swell a lot, had a echo test done to see why, it was normal..I am on double dose of Metformin of 2000mg a day. I too am GREATLY fatigued, I drive a school bus, this is not a good thing to be so tired most the time. I am waiting to have my thyroid blood work done with extended depth of the TH’s a thoro look at it. I too am having a real tough time walking for 30 minutes let a lone 1 hour like I use to. I also have sleep problems, I don’t go to bed when I should, I have to push myself away from the computer FB world has me. But I am on a CPAP as well, and also get insomnia. I did try and do use a recipe to sleep from my dietitian it is hot milk, honey, cinnamon and ginger. It works. Like 6 oz milk, with 1/2 tsp honey, 1/4 tsp of cinnamon, 1 cube of ginger from Wal-Mart in the freezer section, by the fruit they have most stores in by the frozen fruit. But use 1 cube, heat and drink as hot as you can stand not to burn. I do get depressed not as much as I once did when younger with raising my children..but my diet is not as I once did at the best time I was at so I know what I need to do, walk at least 1 hour and good nutrition, I just need motivation. Bless everyone here, yes it is a draining disease, but one we can beat as long as we follow the right menu to succeed. Best to all here who suffer. :)Oh too, my A1c last time was a 9…that is pretty awful when my lowest was 4.9 during my 2.5 years maintaining..:( Alice
I’ve suffered from insomnia and fatigue which has led to stress for the past couple of months. I read this article which was really helpful to me, thought I’d share: http://www.vivamagonline.com/sleepless-in-canada/ eileen parker
I am type 2 diabetic, insulin and med controlled, or not as it happens, am on steroids for inflametory arthritis, low thyroid, high BP, have had a total colon removal and have a stoma, my bloods are wild, need help here pleases xx Sunny Sebastian
All the information’s in your site is worth enough. Now I have a new vision about my diabetic and how to deal with that life.
Thank you. Pat Secrest
I am a 67 year old female & have had type 1 for over 50 years. My blood sugar control has not been very good. I have had diabetic retinopathy (treated successfully) & circulation problems in my legs (now being treated with meds since the specialist does not feel that I need surgery). My heart seems to be O.K. & I have not had a heart attack or stroke. I know I am lucky & am grateful. My brother, who also had Type 1, died of a heart attack at age 28. I recently decided to try again for better control in order to have a better quality of life. My docs. insist I try for very tight blood sugar control. I have tried this before & have found that it results in more hypoglycemic episodes as well as depression & anger & this is happening now. I understand carb counting & adjusting insulin dosage but have found it does not work as well as they say. It is a frustrating process which I am prepared to deal with but I hate it that it is always my fault if everything does not go perfectly & hypoglycemic episodes do not improve my life. I would find it easier to work with doctors if they would acknowledge that this is not easy, that it is not my fault if it does not work perfectly & that hypoglycemic episodes are dangerous. Besides the obvious dangers of operating a vehicle or of hurting yourself in some other way while hypoglycemic, I recently learned that the Juvenile Diabetes Research Foundation has found that 1 in 20 Type 1 diabetics die of low blood sugar. I guess the trade off is that tight control means fewer diabetic complications & that it might be more jolly to die in your sleep from hypoglycemia than to die of a heart attack. I would find it easier to stay on track if docs. would treat me with respect & acknowledge that blood sugar control is hard. Maybe they don’t know how hard it is or perhaps they think that shaming me will motivate me to do better. It doesn’t. anonymous
You addressed MANY issues that my husband and I have dealt with. He is 68, diagnosed with Type 1 at 20. We too feel blessed. He has dealt successfully so far with retinopaty and neuropathy in feet and legs. We have learned to manage his diabetes with almost NO assistance of value from medical personal. Stay out of hospitals as they can kill you–they cannot comprehend a 65 plus year old Type 1. Control is obviously good but being incoherent at the bank is not. We have decided a glucose reading at meals and bedtime of 150 is WONDERFUL. Let those who don’t live it give it a try at 110! “Confused Arrousals” are not fun to deal with…for patient or family!! Look that up if you don’t know what it means. The other nightmare is medications which affect blood sugar levels and NO ONE (sometimes the pharmacist) believes you e.g. statins and their counterparts. They also cause muscle cramps. I have googled this topic every way I can come up with and there is NO decent info. Also medical personnel automatically assume he is type 2 because of his age, and they haave No Experience with Type 1 his age. They better get with the program…there’s a lot of type 1 kids!! Trisha
I was just wondering why no one you’ve dealt with has any experience dealing with a 65 year old Type 1. Type 1’s are diagnosed young, but you stay Type 1 for your entire life. David Spero RN
Doctors aren’t nearly as knowledgeable as we wish they were. The worst part is when they think they know you and they really don’t. If they’ve never cared for a 65 year old with Type 1, they don’t believe they exist. If they haven’t seen the evidence for bitter melon or vinegar, they don’t believe those things do any good. It’s OK to try to educate them. Rick
Hey,
I get scared to read diabetic accounts online. I respect everyone, of course, I just find that hearing about everyone’s complications brings me down. If you’re like me, those horror stories don’t have to be you.
I’m 34 years old, have been T1 for 22 years. I’m healthy and fit. But over the past 10 years I’ve been fighting fatigue, along with its associated brain fog. I recently discovered that my vegetarian diet may have been partly responsible, and I’ve since begun to take a closer look at my nutrition. I’m taking a few supplements and multivitamins now (mainly Omega 3’s) that appear to have turned the trick. It turns out my body was starving for some vitamins, almost because my vegetarian, low-fat, diabetic diet was TOO healthy- can’t say that didn’t surprise me. I’m not “as good as new” yet, but the brain fog is clearing up and the fatigue is more controllable than ever. I’ve also added salmon to my diet, along with daily antioxidants (blueberries, kiwi, red-skinned grapes) and I feel a lot more awake and in tune with the world. So it turns out that malady wasn’t entirely diabetes-related for me.
I do still get some fatigue tied to low and high blood sugars, though. I discovered this by going ape on my glucometer for a few weeks to get a full 24 hour picture of my sugars, at which point I realized that a lot of my fatigue was indeed blood sugar related- it just so happened to occur at a time of day when I had never really tested before (immediately after meals, for example). Specifically, I realized that my fatigue after eating was often due to an incredibly LOW blood sugar (I’m talking 1.6 – 2.5 mmol/L, or 30-45), and that my insulin was working faster than my body was processing the food- effectively knocking me out, which I had always assumed was a harmless “power nap” due to my stomach digesting the meal. It turns out these “naps” (usually lasting 10-15 mins) were very dangerous and in some ways I’m lucky to be alive today to write about them. Needless to say, it scared the crap out of me when I first realized it. I’d never seen readings that low on my meter before, and then thought about all the times when I might have cheated death in the past. Who knows, I’m lucky one of these power naps didn’t leave me “dead in bed.” Yikes. My body was simply metabolizing the insulin a lot faster than anyone had ever warned me, although my endo maintains I’m the exception to the rule. Either way, it’s almost come to the point where I need to eat BEFORE I take my insulin depending on my glucose level… it’s absolutely nuts. If there’s anything to take from this, it’s that YOUR body may be a little different than what your doctors, handlers tell you to expect, and that optimizing your control may require a set of tweaks that are unique to you.
So in summary, I strongly advise you to check your blood sugar every time you’re feeling tired. It may be that simple. If you’re like me, you may need some juice and it’ll wake you right up lol- it’s kinda comical. Ever since I discovered this, I adjusted my fast-acting insulin dosage accordingly and now keep some sweets nearby in case I need them. I always thought low blood sugars were obvious, but have since learned that your symptoms are a lot different when your stomach is full. And in general, I’ve found that keeping my sugars between 5.0-12.0 mmol/L (90 – 200) keeps my mind clear and focused on a consistent basis. Outside of that range is a gamble, not just physically but “cerebrally” also.
As an aside, I’ve found that regular exercise is the only way to beat this sucker and live a normal life. You don’t have to go all-out all the time, but you should keep your body active. 30 minutes every day doing something- anything! – is so important for us. You can do it, I promise, you’ll feel better for it and your system will be stronger. Anything you can do is 1 times better than nothing. That’s simply the boat that we’re in and we all need to keep rowing. Kay
Hi, I am 63 years old, had a hip replacement in July 2014. In the last few months i have notice when i do something strenuous i have to keep sitting down, my legs go weak and my heart races, i feel faint. This is so not like me. I have had blood tests for anemia and diabetes, have to wait for results. Have trouble focusing and overheat quickly. Its weird . I eat cereal for breakfast, have a yoghurt,protein, berry drink for lunch and a small main meal. Thats it plus i am gaining weight Any thoughts, oh i don,t est much red meat. Have taken a real dislike for the taste of it dscottv
Try eating low carb and walk 30 minutes per day. Imoigele Longe
I am 42 and male.I live in Lagos, Nigeria. I have been dealing with infrequent fatigue for over 2 years. I was diagnosed of diabetes just this week and I was placed on medication to manage it. All of a sudden I experience frequent fatigue often dropping off to sleep while at my desk trying to get some work done.
I retire to bed on the average about 10.30 pm and I am up at 4 am to help my wife with getting the children ready for school daily. We are all out of the house at 5.30 am heading to school and work. I often have to battle to keep awake while driving and when I get to work and sit at my desk I just dose off. This happens intermittently while at work. In fact once this happens I feel totally useless and cannot get very much done.
I resorted to drinking coffee but it only helps for a short period. When I drink more than 2 cups of coffee a day I become breathless and on the edge. Hence, I have decided to drink a cup of coffee only when necessary.
When I found out about diabetes I realised why I had been battling with fatigue. I am willing to overcome and live healthy. I know that it is not a death sentence as diabetes runs in my family. For example my father is 81 this year and he has been dealing with the disease. I have begun to read more information about it and I am now aware of how to manage it effectively. Emmanuel A.J
And what did you find out Imo? Damola
Can we hook up. I am 31 and dealing with diabetes for 6years now. Will be great to have someone to discuss and sort diabetes with. michael spencer
I’m 23, male, and have dealt with borderline hypoglycemia since I was 6. On occasion, my blood sugar drops around 50, but most of the time hovers around 80-90. Fatigue over the last few years have made it difficult to stay active, and on a daily basis if I push myself I can feel the crash, and it makes me want to lay down and pass out, and my heart rate drops to a resting rate like I’m about to fall asleep. I just came home, and had difficulty getting out of my car and going inside. But when I checked my blood sugar, it was 89. Sometimes when it’s in the 70’s and I’ve been exerting myself, I feel just fine. I take vitamins, I eat healthy, what else could be causing me to feel so faint out of nowhere? Mary Williams
I’m 32, female, and have had Type 1 diabetes since I was 10 years old (22 years). I’m also being treated for hypothyroidism, but at my last Dr’s visit my levels were back to normal since I started taking meds to treat it. However, I’m still feel very fatigued. I work a normal 8-5 job, but it’s always a struggle to get up in the morning even though I’ve had 8 hours of sleep. On the weekends, I will usually sleep 10-12 hours before I feel rested enough to get out of bed. One thing I have been experiencing lately is sudden onset of pain in my legs, arms, back, feet, pretty much everywhere. The pain can be a burning sensation or a pain that feels almost as if it’s deep in my bones. Sometimes certain areas, like near my elbows or my knees, are very sensitive to touch or experience the most pain. I have another appointment scheduled with my doctor soon and will be going over the possibility of fibromyalgia being the suspected cause. I just want to feel normal again and want this tired feeling to go away. Shawna
I suffer from horrible chronic fatigue because I have recently been dx with Polymyositis which is an autoimmune disease that causes my immune system to attack my muscles and causes them to deteriorate. I was also positive for the marker that shows I have more than one autoimmune disease but I haven’t found out exactly which other autoimmune diseases I have except that they are connective tissue autoimmune diseases. I will know more once I get in to see a Rheumatologist. The biggest problem I have is this time lapses I have where I have lost up to four hours before. The time I lost 4 hours I was sitting on my couch with my laptop on my coffee table and my notebook right beside it as I wrote down information. The last thing I remember before the black out or whatever you want to call it was looking at the clock and seeing it was 1:59am And then I continued taking notes of the info I was reading online. I don’t recall falling asleep and I don’t recall waking up the next thing I know I am standing in my kitchen getting a sprite out of the fridge and looking at the clock and seeing it is 6:12am. During the 4 hours I don’t remember I apparently continued taking notes except it was just scribbles and when I got to the end of the paper I started over at the top of the same sheet and continued scribbling like I was writing down information. I also smoked a half a pack of cigs and drank a 12 ounce sprite. I don’t remember any of this. I only know it happened because when I checked the time at 2am I was putting out a cig and remember that when I lit that cig I noticed I had about a half a pack left and I had just opened a sprite. When I came to I was out of cigs and had drank the entire sprite I had just opened before I blacked out. I have no idea if anything else happened during in that time because there was no other evidence. The other times it happens I only lost like 15 minutes or so Except for this last time in which I lost around an hour. I had just got out of the tub and was sitting on my bed getting dressed. The last thing I remember then is that I had on my panties, bra, and started putting on my socks. I had one of my socks over my toes and the next thing I remember I am fully dressed and I’m brushing my hair and my brother is yelling my name like he’s trying to get my attention and he looks terrified. After I came to he told me the look in my eyes was like that of someone that is in a coma or something but I was sitting there brushing my hair. He also said that as he was yelling my name I didn’t even flinch until I came out of whatever it was it was like I couldn’t hear him at all. I know I lost over an hour because when I sat down to put my socks on I had 30mins to finish getting ready before I had to leave to take my daughter to her Dr’s appt. When. I came to it was past time for my daughters appt that is 30mins from the house. I have no idea how I got dressed or even went and got the brush I was sitting there brushing my hair with Or how I got my shoes on which if I was awake would be part of my routine. As soon as I get dressed I always put my shoes on. I do t go see the Rheumatologist until July. Does anyone have any idea what this could be or what could be causing it? Also I went from never needing to write down anything to remember it to having to write down every single thing as its being told to me because if I don’t within 10 minutes of it being told to me I forget it. I can’t keep up with appts or anything anymore. The fatigue is horrible and unbearable. I feel like I am useless because I am now to the point I am so tired I struggle to get off the couch to go pee I just don’t have the energy. My entire body hurts so bad all the time I can barely move. I need to get in to see a Rheumatologist immediately but I can’t find one that can get me in any sooner than July. I am really hoping someone on here can give me some hope. David Spero RN
Shawna, this sounds scary and disabling. Blackouts are occasionally caused by diabetes if sugars go low. No autoimmune conditions were listed among the 38 conditions causing blackouts on RightDiagnosis.com. I would say get in to see your general practitioner or diabetes doctor. Don’t wait for the rheumatologist. Derek
My girlfriend’s sister used a fan when she slept and was suffering from fatigue because of it too. She said her husband felt her tense up every time the fan blew across her. Maybe the same thing is happening to you to. I’d try to avoid direct air flow from the fan while you sleep. Abid Mansuri
Hi I am 54 years old female and have diabetes from past 6 years. I am not sure if I have fatigue but I always like to sleep. My muscles are gone very week because I am always sleeping. I don’t like to do anything. If I walk for 2 minutes I get tired. Please if somebody can help. David Spero RN
Dear Abid, You are definitely having fatigue. As the article says, there are many causes and many treatments. Can’t tell if it’s the diabetes. You’ll have to check it out with someone. Gentle exercise might be the first place to start your management, but it would be helpful to know what’s going on. Roni
I’m a 49 year old female. I’ve had Type II for about 8 years now. My sugars are pretty much under control. I suffer from fatigue….it’s not all the time though. But when I get it, it will last for days and then I rest. I feel disgusted with myself. I’m wondering if it’s also just age creeping up on me. I certainly don’t have the energy levels that I used to. I was just wondering if anyone else go through this. Bloodyvikings
I’ve had type-1 diabetes now since 21 years (since I was 4). I just recently began feeling fatigued and I really want it to stop and go back to how it used to be. I am so tired that the long walks I used to enjoy are now more painful than ever. Being this tired is even worse than the pain I have in the shin when I’ve been walking for a short period.
I have serious issues getting out of the bed and I never remember the alarm clock going off. Seriously, I can have 20 alarms go off one after the other and I will wake up several hours late no matter what. I’ve even gone so far as to having 3 alarm clocks and one of them is my cellphone which has an alarm going off every 5 minutes.
My blood sugar can be complicated at times and it’s very hard to controll. One day I need this amount of Lantus, the next day I need twice the amount and another day I only need half. This may sound normal to you, but trust me it’s really illogical. Not even my diabetes team understand why and they’re not bad at their job, I trust them as much as I trust myself with this disease – it’s complicated and never is the same.
Though, it’s not my blood sugar that is making me tired because I always feel tired, even those days I’m lucky and the blood sugar’s stable for a couple of days.
Your fatigue may not be due to diabetes at all. Have you had it checked out? Several other causes are listed in the article. joe andrews
Well, here is where i find myself. I am a 35 year old male, maybe 20-25 lbs overweight, that is currently sleeping between 13-16 hours a day, every day. My sex drive has dropped through the floor several years ago, like seriously dropped, find myself in need maybe once a year, maybe. My house is a disaster and i cant hold down a stable job because of my need for sleep. I feel fatigued and exhausted constantly, like sleep just isnt doing anything. Friends of mine say depression, but i dont feel depressed, like, at all. These symptoms have been getting worse as the years go on. What could be possible causes? Luigi
I feel exactly the same bud. I’m 34, been diagnosed with Type 1 since the age of 30. It really has been 4 yrs of hell. I have always been healthy and no one in my family has diabetes. I eat healthy too yet feel drained. I eat only what I work through with the dietician yet its not helping. If my sugars aren’t high they are low. I’ll go to bed with a mmol/l of 14 and wakeup with a low of 2.9. Ive tried everything in these 4 yrs same foodstuff’s/ same exercise routine nada. It really feels as if I’m half dead. I would also like to know what advice a good physician can give us/me which I haven’t heard all before? David Spero RN
Luigi, it sounds like your diabetes is not being well managed. 2.9 is dangerously low and 14 is dangerously high. Your insulin doses might be way off, or there could be some other problem. I hope you can talk with your doctor about this and insist on some answers. You are an unusual case. Luigi
Hi David, my internist which happens to be the best in our city can’t give me answers. I reckon it is my work and stress related. I use Apidra after meals and Lantus at night. I do the whole carb counting routine. Last night in probably 2 months my reading after supper was 7.5(usually in the vicinity of 12) I woke up at six this morning and was at 3.3. So yes, if its not high its low. Guess its back to the dietitian and dosage changes. David Spero RN
Joe, consider bringing this article to your doctor and telling her what you just told us. Many things could be causing your fatigue. If it’s diabetes’ fault, there are many things you could do to improve your control. You don’t mention exercise. That might be the best place to start. Tariq nawaz
Hi My father is 76 year old and he has diabetic from 30 years…one moth before he can easily walk and use washroom but all of sudden he parrlised on bed ..I have checked this to doctor he give him different medicine but after taking medicine he lost his recogisation sense…know I stop medicine ..know he cannt walk and he take out vomiting whatever he take.. Doctors also give Mecabolamine injection for weakness but all of vain.. Please suggest me so that my father can walk and take food easily. If any information regarding this I can provide u with detail reports. Adam
Im a 45yr old male, I have Type 2, High blood pressure, High cholesterol, anemia, severe sleep apnea, severe depression, social anxiety, sciatica, degenerative disc disease, herniated, bulging discs and arthritis in my whole back and neck. Shooting pains, nerve impingement and damage, over 20+ injections of epidural steroids/medial branch block/Emg, in my lower back and neck, anterior discectomy with fusion on my neck(C5-6) with many other back and neck issues. I’m taking metformin, Lisinopril, ferris sulfate, have a Cpap, taking Cialopram/celexa, Wellbutrin, klonipin, gabapentin and tZanadine. I’m an alcoholic but celebrated 2 yrs of sobriety on July 14th, and quit smoking 10 months ago. I’m in pain from the moment I wake up till I go to bed. I played sports, drank alcohol and smoked heavily from my early 20’s till 42. Then my body started to fall apart. I’ve seen 3 doctors in the last 5yrs. I worked 20yrs for one company before taking a severance package last year. Now I have gone through 3 jobs in the last 8 months and I can’t physically work long periods without pain or fatigue. It’s miserable. I’ve unsuccessfully tried to commit suicide 5 times in the last few years. I’m at my wits end. David Spero RN
Adam, you are on a hard road and have been for a long time. Please don’t forget you have strengths as well as symptoms. This may sound crazy, but I would suggest volunteering or finding a way to help somebody else. Maybe just visiting people in a long-term care facility or taking in a cat or dog, or whatever sounds good to you. Amanda Bradshaw
Omg. Dont let go. I too struggle with this… youre not alone. Rita
Yea I hate it and feel sick I have no control at all I hate poking my self and taking medicine but I have to I feel like not doing nothing I cannot concentrate on what I need to buy or cook I feel harable darn if I eat right and darn if I don’t I work it’s hard for me to get a good bite in the mornings and for lunch grab what good when I know when it’s not . LeAnn Lipps Robertson
I need advice. I’m not “tired” per se. I’m freaking sleepy. I sit down to work and cannot keep my eyes open. So much so that I have actually closed my door and taken a nap during my conference period. I am literally fighting to keep my eyes open while I’m typing this.
LeAnn, your fatigue sounds unusual. I hope you can get checked out for it. There are medications including Provigil (modanifil) and nuvigil that help people with your symptoms, but they might not be right for you. Zuhad Munawar
Hi LeAnn I am type diabetic since 15 years and this usually happens when you’re blood sugar is way too low. It used to happen to me when i was in school and was not aware of it. Always keep a glucometer with you whenever you feel like this just do a quick check. It should be low. Act as soon as you can. Keep some sugar or sweets with you at all times Zuhad Munawar
Hi LeAnn I am type diabetic since 15 years and this usually happens when you’re blood sugar is way too low. It used to happen to me when i was in school and was not aware of it. It felt like my eyes were forcefully closing themselves. Always keep a glucometer with you whenever you feel like this just do a quick check. It should be low. Act as soon as you can. Keep some sugar or sweets with you at all times dublinireland
Sleep apnea? That’s one of the things that happens to people when they have severe sleep apnea. Check with your doctor. Zuhad Munawar
I know its late but please dont talk like that. You are stronger and smarter than this. Just take you’re life a little easy. Take less stress, go out with friends or family which ever makes you feel better. Loosen up have fun and just watch the diet. Pain in you’re feet is because of high blood sugar. Try and talk to doctor about it, you need to control it. It gets better trust me. Hope you feel better soon Aurelia Hoogerzeil
You’ve hit it right on the head! I’m 69, Type 2, and get real sleepy right after I eat something. Thing to do is get the heck up, walk around or do some task. Literally, just “shake it off”. Or just enjoy the nap. LOL dublinireland
I have cared for both a diabetic cat and a diabetic schnauzer, giving the proper diets and daily insulin shots. Keeping the doggy on a walking regimen helped her a lot. Exercise is good for man and beast. Aurelia Hoogerzeil
Stop complaining, everyone! Do what #dublinireland said to do. I’m 69, Type 2, and get real sleepy right after I eat something. Thing to do is get the heck up, walk around or do some task. Literally, just “shake it off”. When it comes to your body, 99% of the time it’s mind over matter. (My Opinion) Or just enjoy the nap. LOL alan
I have that problem too, I get very sleepy and it’s very hard for me to stay awake, on top of that I go to school so it’s really hard for me to focus. HEAVEN
HELLO 2 U !!!! THIS IS MY 1ST TIME ON THE SITE AND I NOTICED UR PROFILE. I READ WHAT U SAID AND MY HEART CRIES OUT FOR YOU. I AM FAIRLY NEW WITH THE DOCTR ADVISING ME OF MY SITUTATION AND IT IS HARD ON ME. BECAUSE I DONT EAT MUCH AND IT SEEMS LIKE I CAN’T DETERMINE WHEN I AM JUST GOING TO FALL ASLEEP FROM A SMALL MEAL.. BUT , I KEEP RESEARCHING – I KNOW YOU HAVE BEEN DEALING WITH SOME PAINS IN YOUR LIFE. AND I WILL BE PRAYING FOR YOU I PROMISE. I HAVE EXPERIENCED SO MANY DARK DAYS . BUT, I SOMEHOW REACH 4 HOPE.
PLEASE IF YOU HAVE A LOCAL CHRUCH GO OR CALL. ALLOW THEM TO PRAY FOR YOU. I ONLY BEAT SEVERE DEPRESSION AND NOT WANTING TO FACE THIS WORLD THROUGH CHRUCH AND SPEAKING TO SOMEONE. I WANT YOU TO KNOW THAT I CARE THAT YOU DON’T EVER GIVE UP. WE DONT KNOW WHAT THE FUTURE MY HOLD AND I DO KNOW IT WILL AND CAN GET BETTER 4 U. GIVE CHRIST A TRY HE HAS TRULY BLESSED MY LIFE TO WERE I FINALLY GOT FROM A DARKNESS INSIDE- TO FEELING I WANTED TO LIVE.
WE CAN BEAT THIS – I HAVE STARTED TAKING APPLE CIDER VINEGAR (BRAGGS) AND READ UP ON IT ALSO . PEOPLE WERE ABLE TO COME OFF SOME OFF THEIR MEDS JUST BY USING THIS IT DOES WONDERS FOR GLUCOSE LEVLES. IF, YOU NEED SOMEONE I CAN BE THAT SOMEONE YOU CAN TALK WITH I AM GOING TO BE CHECKING BACK- IN HOPES THAT YOU HAVE THIS MESSAGE. AND, WE CAN SOMEHOW EXCHANGE INFO.
BECAUSE I TRULY KNOW HOW DARK THINGS CAN FEEL. BUT, IT WILL GET BETTER ONCE WE SET IT IN OUR MINDS. BE ENCOURAGED AND KNOW THERE IS SOMEONE ON THIS EARTH WHO CARES ABOUT YOU. LET’S HAVE HOPE TOGETHER- WE WILL BEAT THIS SICKNESS AND IT WILL NOT RUIN UR LIFE ANYMORE. IN, CHRIST PRECIOUS NAME I PRAY – HEAVEN
thx for the encouraging wisdom u have provided Adam
Bob, (can I call you that?), don’t give up. I have had some success with vitamins/minerals – something you might consider trying since nothing else seems to be working. Chromium polynicotinate and vanadyl sulfate are two important parts of it for me. Chromium soaks up insulin/helps your blood sugar normalize, and vanadyl sulfate can mimic insulin. I’ve also been taking B-100 complex vitamins every two hours, large doses of vitamin c (talking like 16 grams a day for me), niacin, magnesium, calcium, vitamin e, and coq 10. I seem to have had some success, so maybe look into it. You can Google “Doctor Yourself,” if you’re interested. Andrew Saul, the guy who runs the site, is a nutritionist and advocates using vitamin/mineral supplements to improve your health, and has several plans for multiple health conditions. So far it’s helped me a lot. I also just wanna say that I’ve been there, too. My childhood wasn’t very happy (I come from a very broken home), and all in all, I can’t look back and say my life has always been awesome and happy. But there’s always time to make new memories – happy ones. God Bless! Gabriela J
I’m 18 and have T2 . I’m so depressed . I hate this stonecold
I am t1, 43 years old with chronic fatigue. I am also an elementary school teacher. I cannot work fulltime. Since becoming diabetic 7 years ago, I am also tired and more so since starting antidepressants 4 years ago. The only time I generally have bursts of energy is when I gulp down another cup of coffee. And of course that causes fatigue later on. I have a hyperactive autistic 5 year old and I simply can’t keep up. It’s awful. I feel like I am walking though cement every day when I wake up. Rant over. For now… 🙂 Jeannine Dawn Arteta
I’m 48. I have lupus, and still new to the diabetes. Never have had sugar issues. Tests were all perfect… Then last year,bam. Urine test was over 500. A1 was over 10. Last summer, I stopped taking the metformen ; I thought it was making me feel worse. Saw my doc in November. I’d lost almost 50 pounds out of nowhere. Blood glucose was 317. Creatinine high, and sodium low. Back on metformen lol. Saw the doc again this week. A1 was 9. I deal with severe fatigue because of the lupus. I’ve lost a lot of muscle mass along with the weight. Was on prednisone for a year. Stopped last spring. Started back on this week. I have fungal and bacterial infections, so on systemic meds for that Also have nasty arthritis issues…
It’s difficult to understand what is causing what, for me. I’ve been falling asleep before bed, lately. Some days I can’t stay awake or move because of the constant lupus flares. It just never ends. Did my first home glucose test today. Both times were well over 300. But I haven’t eaten today. Just not hungry. I know that’s bad. Drinking lots of water because I’m very dehydrated, n doc says more because the prednisone will contribute.
Yeah. I’m fed up. Lol David Spero RN
Jeannine, I’m sorry you are going through more health problems than any one person should have to deal with. Lupus and diabetes often go together. I wonder if you’d be willing to try a low-carb (“Paleo”) diet. It might help both conditions, although there are no guarantees. Sending you healing thoughts. Jeannine Dawn Arteta
I don’t believe in diets. I think a person needs common sense. I appreciate your thoughtfulness, though. I sometimes eat red meat, but stick mostly to boneless skinless chicken breasts. Veggies… I alternate protein by using beans. I do love ice cream, but only Ben and Jerry’s ice cream. That’s my treat. Lol I’m on prednisone again, so it messes with my levels. Started self testing this week, so looking for a trigger. It’s so unstable. Can be ideal numbers, then shoot to over 300. Then back down again. But again, I’m in a bad flare and have current infections. I have a problem with not eating. I know what I’m supposed to do. I’m either not hungry or I forget to eat. I know that sounds dumb lol. I get dehydrated really fast, so I’m always drinking water. Sodium was low, too. I rarely eat potatoes. I like wild rices in salads, or with chicken or salmon. On metformen. And lupus meds. Rare fast food. I hardly leave my apartment lol Jan Levine
I rec this book, Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars He is 85 and has had Type l DM since a young boy. https://www.youtube.com/watch?v=WFNGdKSXx64 , Session 1. Introduction.- Dr. Bernstein’s Diabetes University https://www.youtube.com/watch?v=mAwgdX5VxGc , How to Reverse Type 2 Diabetes Naturally, dr jason fung, nephrologist. his blog, https://intensivedietarymanagement.com/ Dawn Jones
Hi It is so difficult to get under control with other illnesses that interfere with the hormones. I have Addison’s and have to take steroids to live as my adrenals don’t produce the necessary required. Trouble is getting it fine tuned to replace mine and not affect my blood sugars is nigh on impossible so far. I believe my diabetes may be steroid induced but I have to stay on them and also take the steroid inhaler for my asthma. It is like a roller coaster. God bless Arreee
Hi Jeannine, I’ve been a type 1 diabetic for 40 years (I’m 41) and I’ve been through so many related issues its ridiculous. Currently my sugars are well under control, with A1C in the low 6s, but I am also morbidly obese with severe obstructive sleep apnea. Lets just say I’m experienced with both diabetic symptoms and fatigue. High blood sugars mean your cells are not getting the food and water they need to survive, IE that’s why your sugars are high (the sugar is not getting absorbed so its still floating around in your bloodstream) and why you’re constantly dehydrated (insulin is what allows food and water to enter the cells of your body and satiate their needs. your cells don’t get the water they need so they tell your body to be thirsty so you’ll drink something). Work with your doctor to get your sugars under control. You cannot address anything else as a diabetic until your sugars are consistently under control, because no matter what else is going on, high blood sugars will consistently be the primary and/or secondary causes to symptoms you’re feeling.
Please do whatever it takes to get your blood sugars under control. Becky Jasinski
I think you are receiving treatment as a Type 2 diabetic when you are really Type 1. I think you need to be on insulin. Many Doctors are not fully aware that their patients can develop Type 1 diabetes as adults. You have an existing autoimmue disorder (Lupus). Commonly, if you have one autoimmune disorder – over time you will develop others.
Your weight loss is very very suspect. I am fairly positive you are type 1 from what you have explained. You can feel more functional with insulin. Talk to your Dr about Type 1 Diabetes (Adult Onset). Type 1 is basically autoimmune destruction of pancreas cells that produce insulin – the C-Reactive protein and islet anti-body tests are diagnostic tests that can help determine if you are Type 1.
I struggled under a Type 2 diagnosis – and declined declined declined – before finally asking for insulin and pursuing an endocrinologst and getting more testing. I was at a point where I could not work, or drive, or read… could barely lift anything… Glucose is your body’s energy source – but it needs insulin to get into the cells (insulin works like a key). With insufficient insulin, your energy will be low and your cells will be starving for glucose. Over time, with the cells perceiving “starvation”, the body is triggered to rapidly break down fat and muscle (the body consuming itself) to send more glucose into the system. (This is the cause of blood sugars increasing without eating a morsel!). Weight loss – muscle mass loss…. get on insulin and get a little of your life back… Good luck to you! Jeannine Dawn Arteta
Yes, type 2. Just popped up outta nowhere. But, like you said, it came from the lupus. When from great blood levels all of my life to BAM! I’ve had almost constant lupus flares since September…or,worsening of, I should say. So far, minimal kidney involvement, but a lot of soft tissue inflammation, and bone problems. I couldn’t figure out the rapid weight loss. Figured it was from the lupus, because that one of the signs. It is, but also the loss of muscle has been rapid, too. Scary fast. I’m on metformen right now, but we’re figuring something else out, I think. Steroids caused a lot of the insulin probs. Levels got some better awhile after the last session. I appreciate you input on this! Thank you. =)
I tend to agree with Becky above. Whether they call you Type 1 or 2, you would probably benefit from insulin and feel much better. An option is bitter melon, if insulin is a no-go for you. Jeannine Dawn Arteta
I’m not sure if insulin will be a no go, yet. I’ve heard about that. And a few others being researched. Of course, being cured is optimal lol. But, that’s not going to happen. So, continue to deal with what I can. Thank you. Jerry
It could also be the Prednisone that has raised your blood sugar. It is known to cause diabetes and to make blood sugar control even harder in those who are already diabetic. Clay Bauer
I have type 2 diabetes which is now FINALLY getting under control. I too love junk food and have a sweet tooth. Take metphormin and farxiga but since doing a Ketogenic/Paleo diet I have dropped 5lbs which doesn’t sound like much but it helps. I have more energy since doing this high protein, high fat and low carb eating. My A1c was at a 6.3 when I had my check up 3 months ago and when I went back recently after only eating this way for 3 weeks, my A1c had dropped to a 6.1. When I go back in Feb I plan to be a 5.9 or better, that’s my goal anyway. Can’t promise it will help any of you but myself and several others it has worked miracles. They are all off all medication now and feel GREAT. May be worth looking into. brad_8898
Sometimes I get worn out by the simplest things. Today I vacuumed the stairwell in my home and it wore me out so much that I haven’t had any energy for the rest of the evening. I have checked my bood sugar when I have felt this way before and it was a normal high 90s. Not sure what it might be. I have read about endocrine levels and I think that might be what I have. Not really sure. Joshua Hood
I am 15 years old and I am a Type 1 Diabetic, I’ve had it for almost ten years and I can’t stay active. I feel that whatever my condition is, is tearing me away from my family. I try to tell them but I’m afraid, I say things that only I understand to what their actual meaning is, I want to do right, but I can’t stop doing wrong, this is also greatly affecting my grades and my everyday life. David Spero RN
Joshua, some of what you are going through may be related to diabetes, but some sounds like being 15 years old. Find someone other than your parents to talk with. Maybe someone at school or a social club or a church or neighbor. Or online. If your blood sugar numbers are way off, see a doctor. Otherwise it’s probably not about your diabetes. You’re at a tough time in life; it will get better. Joshua Hood David Spero RN
Hi Tracy, like the article says, there are many causes of fatigue. If your glucose levels are OK now, and if you can afford to be checked for anemia, thyroid, and other causes, do that. See the other articles we have on fatigue for other ideas. Tracy Hardy
Thank you nikki h
I was diagnosed type 2 diabetic about 2 years ago and hadn’t noticed any major difference with my sleep until about 2/3 months ago but I am SO TIRED AND SLEEPY ALL THE TIME I literally can sleep all day n night on the weekends David Spero RN
Nikki, Type 2 can cause that kind of fatigue if your sugars are way off. If your glucose is not too high, it could be something else. You probably need to see a doctor to get some idea why you’re so tired. You may need a medication change, more exercise, or alternative approaches such as vinegar, bitter melon, a low-carb diet, or nutritional supplements. Dawn Jones
I was sleeping for days and only waking for the occasional nibble of food then couldn’t keep awake, I was severely hypothyroid. Please get a thyroid function test. Melissa Jobe
I was diagnosed with lada 1 diabetes when I was 26 / 10 years ago and have just experienced my third dka in four years. I do try hard to keep my sugar levels under control, eat healthy and seen many endo professionals. How possible is it to end up with dka from stress and pms? Each time I have been hospitalised it has been that time of month.. Also it was about a week a go now but I still have zero energy as well as feel dizzy and muddled which did not happen the other two times which is very worrying. Can you please advise me as to what is going on and recommend any advice or information as I cannot keep living like this and I certainly do not ever want to experience dka.. Aka living nightmare.. Again. Thanks, Melissa
Melissa, can you get checked out more for this? Your glucose control might need work, like a medication change. GB
Hi Melissa I am a type 1 now for 50 years. Can’t speak to your pms but I can tell you I am fatigued all the time. Ruled out thyroid, anemia etc. My blood sugar is under reasonable control now that I am on a pump. The best I have found for energy is some exercise so I hop on the treadmill or go for a walk for a mile a day. Still don’t feel fully energized but then again many of the meds I am on are known to sap energy. Good luck, keep the faith.
Mike, it sounds like something else may be going on besides diabetes. Do you have a personal physician you can talk to? ER is usually not the best place to deal with problems like yours. boss lady cofield
Im 32 and I have type 2 dibieties, I feel so yuck right now I just started my cycle and I need to know if this is making me feel the way I do I feel weak I’m sleeping alot my body hurt I have jittery feeling I feel yuck please help
Dear Lady Cofield, Are your sugars running high? If so, that could be causing your fatigue. If not, please get those symptoms checked out medically if you can. This can’t be diagnosed by Internet. Ravi Janu
eat super foods, eat multi-vitamins+multi-minerals, use low carb diet (eliminate all flour +rice based product no bread, no sugar, no carb no rice just fresh vegetables and fruits, exercise, diabetes medicine and hopefully u will feel better after ur body adjust to low carb after few days.. i am in the same boat and feel better till i control my carb and sweets. as soon as start eating bread, rice, bakery flour based food, rice etc my sugar spike up and i get so tired, sleeping, yukky all the time. Frances Ayers
I am 55,have type two Diabetes and am on Prandin,Kombiglyze,Levothyroxine,Lisinipril/HCTZ,and was recently diagnosed with a heart problem called Dyastolic Dysfunction.I am extremely tired most days and have been taking vitamin supplements.I just switched to another primary care doctor,hoping to get some answers.My a1c dropped to 7 from 11,but am still tired. David Spero RN
HI Frances, I hope your new doctor can help; your situation is complicated. Diastolic dysfunction is a mild form of heart failure. Your heart is pumping well, but it’s not relaxing enough to let new blood in. That would account for your fatigue. You are taking supplements, and, if your doctor agrees it’s a good idea, you might want to add coenzyme Q-10. Don’t give up. Relaxation, meditation, and prayer might help.
Thanks,David.I will certainly try the Q-10. Mike
I’ve had type 1 diabetes since I was 2. At 26 years old I’ve become exhausted through out the day and will take a nap to rectify the situation but it messes with my sleep cycle because I fall asleep late at night and wake up early for work and am so fatigued. If I don’t take a nap, I’m just grouchy through out the day and almost can’t think and just waiting to get off work. Once I finally do it’s almost as if I’m too anxious to sleep. I started taking an extended release of adderrol so that I could stay vigilant during the day but am so exhausted at night, it’s depriving me of any social activity after work and I feel like I’m not getting a deep sleep. I’ve been off it for a month now and use coffee as an alternative but it still isn’t the same. I end up needed copious amounts. My numbers for the most part are under control but I can’t help but think my diabetes is to blame. I have hypothyroidism but on right dosage of levoxyl. I feel like I have an exceedingly long list of things I have to be cognizant about to ensure my day or else I’m depressed and that itself is exhausting. It feels as though I have to go not just the extra mile but flight! Has anyone else taken adderrol just to stay alert and awake? I’m considering taking it again. I hate feeling like I’m not reaching my full potential. Cory David Zapatka
Hey Mike — 26 year old, here, too. Dx’d when I was 15. Dealing with energy issues, as well, and unsure if it’s mental or physical (or both?). I can get through the day, but it can sometimes be a struggle. I’m starting a CGM regiment next week –most likely Enlite to work with my MiniMed — looking to see if I’m having any overnight lows or highs that could be affecting my sleep cycle. I have more hypoglycemic events than I’d like to admit (almost daily, due to an over-aggressive carb:insulin ratio), so I’m trying to get to the root of the problem by tightening up my control. Giving up coffee and excessive alcohol during this time, too, just to rule out any outside factors. I’d be more than happy to talk if you need some support. Jason Dixon
Cory, I can relate to exactly what you have described. I am feeling fatigued almost every single day and I just turned 33. I was diagnosed with type 1 diabetes when I was 22 and my blood sugar was recorded at over 1500. The doctor was amazed I walked into triage on my own two feet. I also was in diabetic ketoacidosis at the time of diagnosis. Diabetes has ruined by aspects of my life and even taken away many of the freedoms we are given. At the time of my diagnosis, I had a BAC of 0.16 due to alcohol being manufactured within my body. Over the last decade, I have been arrested and charged with DUI twice due to my diabetes being out of control and have been incarcerated because of it. I also hate feeling that I am not taking my full potential and forcing myself to complete tasks that were easy in the past. I am willing to do whatever it takes to get my energy levels back to what they used to be prior to my onset and so desperate to do so that I am willing to give up whatever I have to just to feel normal again. I am tired of feeling like my life is wasting away because of the way I feel due to this horrible disease. I am open to anything and anyone’s suggestions to improve my quality of life. My family is paying for my disease and it is heartbreaking to see that I cannot provide the quality time I once was able to. I look forward to beating the disease with you all and sharing with the rest of the world how I got my life back. Thank you! David Spero RN
Hi Jason, Cory, Mike, Thank you all for sharing your stories of struggle. Fatigue can take you away from life, can’t it? You need more support than a website can give you, so I hope you can find doctors and/or diabetes educators you can work with. It sounds like you would benefit from a book such as Dr. Bernstein’s Diabetes Solution. Dr. B was in your situation for years — suffering with Type 1, until he found he could manage with much lower doses of insulin by eating almost no carbohydrates. Now he’s like 78 and still practicing medicine and lifting weights. His book is complete — what to do about exercise, supplements, rest, medications, and everything, not just food. Laura
Understand completely. I’m 46. Been type1 for 35 years. I’m mostly tired all of the time. I’m diligent on glucose checking. No joke 12 times daily. I can’t tell anymore if I’m high or low. I’m tired of being tired. Exercise is crazy. I’ve had 2 frozen shoulders 1 on each side which I’m told is common with type 1. Now have a frozen hip. Uncommon for anyone. Lucky me. I have an awesome husband. Recently stopped being a nurse in the er because I couldn’t physically handle the hours and no breaks. Not sure what the answer is. Just know, I feel your exhaustion. Wish I could help. Michele L Knowles
I would suggest taking a nap in your car on breaks and/or lunchtime. Lilhaus
Adrenal Fatigue. Its prevalent and most no one ever thinks about it! Your adrenals are shot. And then you feel like your OK for a bit, and go and blow all that energy on stuff like…life. So your glands never get to recuperate! I was helped by a website Dr Lam has on Adrenal Fatigue…BIG TIME! But look up any AF site to get info. It seriously helped me!! I’m Type 2, was depressed, fatigued, the whole enchilada. Once I treated the adrenals, all is well!! Dawn Jones
I have Hashimoto’s, Addison’s and diabetes, at least 2 of those are AI and if the diabetes is LADA then they all are. I hear that if you have one AI disease you are at risk of others 🙁 Don’t know the why though,, that would be very useful to know. x happyfeet64
Not sure when you were diagnosed with DM but consider you may actually have LADA. I was dx around the age of 37, started out with oral meds but within a few years was put on insulin. Reason? My levels were/are whacked. Lowest A1c I’ve ever had was 9 and that was 13 years ago. 3-4 shots of Novolog a day now with Lantus and my last A1c was 14. Just got dx of LADA today. Danny Gaskins
Doctors suck, stories I can tell. No one tells you the truth about diabetes, too much money being made by the industry of “diabetes”. Having type 2, trying to figure out what works best for me. Everyone is different, so you have to figure out what works for you. Energy is a problem for me. In a normal person, you ideally would have 50% of your calories come from carbs. Balanced with proteins and fats, you would be healthy and have plenty of energy. As a diabetic, you are told how bad carbs are, limiting them to about 10% of your calories. THIS is why diabetics have problems with energy, loss of carbs which is your bodies BEST source of energy. Everything else to do with fatigue is secondary. Protein is not a good source of energy. Now I have to figure out the rest of the puzzle, can’t rely on the professionals. David Spero RN
Danny, I don’t think what you’re saying about carbs as the only good source of energy is true. Fat can be a good source of energy when your body gets used to using it. At least, that’s what all the Paleo and low-carb diet sites and books say. Artio Nope
I feel the same way. Fruits and carbs for energy. But carbs from whole grains. People fail to realize that sugar is not the enemy that created their diabetes. Animal fat and oils is the culprit. I eat fruits, salads, and all kinds of bean soups. No oils or overt fats at all. Ms. Lynna Math
Not true. So-called “whole grains” are still carbs and ALL grains and ALL carbs are BAD for diabetics. We are CARB INTOLERANT! There is NO such thing as “healthy grains” for us. We are being lied to because diabetes is a multi-billion dollar business. Also, we should not have any fruits whatsoever. Fruit is terrible for us. And wrong again: fats and proteins are great for us. You should be eating nothing but wild fish, sardines, greens, nuts, seeds, avocados, butter, eggs. And if you have to have something sweet, only dark chocolate. Jojo
That does not work for me,i run 3 miles a day, when my carbs get above a certain point I am in bed most of the next day,you need no more carbs than you can burn off,the rest is just fat I don’t need. Danny Gaskins
Jay Cutler plays professional football and is successful. How can he play at that level with Type 1 diabetes? Doesn’t make sense that so many people can’t function with basic tasks and this other guy plays a sport at such a high level. Something is not adding up, doctors have been trained to think a certain way about diabetes, that doesn’t work for most people. Drew
I can’t find a single reference to what I experience. Perhaps I’m not looking in the right places, or maybe I’m not using the right words, but, it’s very very strange. I know this happens in certain types of animals, and those effects are well known to most people with those animals.
For example, if you tuck a chicken’s head under it’s wing, it will go to sleep. If you flip a shark on it’s back, it goes to sleep. With me, it’s just like that.
f I look to the left, right, up or down too long, or have my head tilted or turned slightly for too long, with my eyes turned in the same manner, I become extremely drowsy, and can even induce sleep if I let it continue.
What is this? Could it be a strange form of Narcolepsy? Some blood sugar thing, or … I don’t know. I don’t have a doctor I can consult. It’s not really a big problem, but.. weird. Wish I knew more about it. Has anyone else experienced this phenomena? I can’t be the only one. Robert
Sounds like Vasovagal syncope. It’s not super common, but common enough that most doctors know it well. It’s easily treated. I have a friend who has this and he can likewise tilt his head a certain way and, boom, he’s out.
http://www.mayoclinic.org/diseases-conditions/vasovagal-syncope/diagnosis-treatment/treatment/txc-20184861 “toniliberty777” L.
I have almost no energy at all. I was told I was prediabetic in 2002, didn’t take it seriously. Then again in 2009, lost 14 pounds that same month, felt better, and stopped with change. Fast forward 2015 was told “You’re diabetic!” Highest A1c was 8.9 came down to 7.3 2015 and now 7.0 but my doctor says because the numbers are not changing I need to take the meds. I feel sick and nausea all the time and tired too. Glad I found this site to know I am not alone. Wishing everyone the best. Jane
Just want to share my experience. I have had type 1 diabetes for nearly 40 years, now, and generally just feel tired. I decided, recently, to take a vitamin d supplement, and beforehand did a little research, and I read about magnesium, and it’s interactions with vitamin d, and vitamin d uses magnesium, and a low level can cause insomnia, when taken with vitamin d.
I started taking the vitamin d alone, and then just recently had three nights of not sleeping, and remembered about the magnesium issue. So started doing a little more research and learned that people with type 1 diabetes will lose magnesium from their body when they have a high blood sugar, at about 2.4 times the rate other people do, and that people with diabetes who have eye and nerve problems have low magnesium. I also learnt that people with type 1 diabetes tend to have low magnesium levels, generally.
I have always had quite a good intake of magnesium, in food, and don’t have eye or nerve problems, fortunately. But I have decided to take a small magnesium supplement, and stabilise my dietary intake at a high level. So I have a daily intake of about 700 mg,consistently every day, so that high blood sugars don’t cause serious depletion.
The symptoms of magnesium deficiency include insulin resistance, insomnia, fatigue and it turns out it is an incredibly important mineral for our bodies, and is present in every cell in the body, it plays a part in controlling hormones, and pretty much everything.
I.m pleased I know this now, but I feel like I’ve been denied this incredibly important information which would have been extremely useful to me. Why aren’t we told this? David Spero RN
Hi Jane, Glad you figured this out for yourself. I wrote here about “Magnesium: The Forgotten Healer,” but that was four years ago. You’re right. We should cover it more often. It’s one of the most important and least talked about nutrients. Deborah R
I have Celiac (probably all my life but they just did the test), Neuropathy (15 years) not Diabetic related, low Vitamin D, B12 and now Diabetes Type 2! But the most scary part is I drive and hour each way to work and all of a sudden I can’t keep my eyes open I have fallen to sleep driving, at my desk working and once when I went to use the bathroom. Super tired all the time now! I imagine if I went riding on my horse I would fall to sleep on him as well! I also just recently started having leg cramps in one leg three or four times a night! At this rate I doubt I will make 55 much less 65 so I can retire. David Spero RN
Deborah, you need to get checked out for this fatigue ASAP. Before you crash your car. It could be the diabetes, or it could be something else. High blood sugar can cause fatigue, but you have a lot of other issues. Please see a health professional who can do some tests. Diane Wickham
Having a problem with elevated am sugars. Haven’t change my diet, ta king my meds, getting some exerciserious plus gardening. It is super hot here ( I drink fluids). Could the weather play a part in this? My last A1C was 6.5 Danial
I just got diagnosed with type 2 diabetes. Am 20 years old. Have high high blood pressure since i was 14 years old. Dont know what the cause is. My doctor also says that i have what they call a metabollic syndrome and so i have to accept the reality that i have to take medications for life. Few months back ive always felt so tired, like when i reach home, i can literally dose off there and then. Also, i drive to school, so i was wondering why i was so tired. I know smth was wrong with me. As for now im just basically tired everyday. Every single hour. I feel depressed. I have no motivation to do anything. Once i slept for 10 hours and still could not wake up in the morning. School assignments are tough, once i get home i get very tired. I will on my comp and then fall asleep right there. As you can see its affecting my daily activities. Used to play the guitar everyday, now i cant even find the fun in playing it. Havent met friends for a few months due to my internship. Even on weekends when my friends meet, i would back out. Well staying home, i usually play my console but recently, i CAN EVEN DOZE OFF WHEN THE GAME IS LOADING. Used to go to the gym alot too, always lifting heavy weights. However, i felt healthier back then, i felt better and have more energy compared to how i am now. Furthermore, now i cant do much physical activity due to my torn ACL and medial meniscus. Some of you might think why not go for surgery. The thing is i want to but my diabetes and high blood blood pressure are preventing me from going for it. Going for a surgery whilst my condtion are not being controlled can cause serious complications so i need to control them first. Im really in need of help because no understands me, im just graually tired and sleepy all day. HBA1C was 7.7. So please can someone help me? Or can someone with the same age share some exprerience? It sucks that i have all these health issues when im only 20. I hate life. David Spero RN
Hi Danial, I’m sorry to hear you are going through such a hard time. I’m not your age, but I know that having metabolic syndrome and depression is hard combination. With your sleepiness, I strongly suspect you may have sleep apnea, and I want you to get checked for that. Once you start getting a decent night’s sleep, other things may start to fall into place. Rahiman Shaik
Feel sorry about you, need to look into different medications like unani, Ayurvedic, homeopathi, Yoga and try Black seed oil twice a day 2.5ml Mrs. Rosario
i feel very tired and very sleepy and my sugar is HB… is 10.2 Also suffering from high blood pressures and asthama problem plz advise David Spero RN
Hi, Mrs. Rosario. With an HbA1c over 10 and high blood pressure and asthma, it’s normal to have low energy. Your medications may also be making you tired. If you are ready to make some changes, learn about low-carb diets and natural treatments such as vinegar and bitter melon. Start walking regularly, even if it’s just very short distances at first. Take time to relax without TV and just focus on breathing. Get help. Can you see a diabetes educator or go to a diabetes support group? You might find people there in a similar situation to you. Kelsey
Can someone please help me? I gained around 60,pounds while pregnant and ever since I have been so sick. I already had problems with low blood sugar but it got even worse. Diabetes and low blood sugar , both run in my family. Every morning I wake up and my blood sugar is so low I feel so sick until I eat. The top of my stomach kills so bad it happens all day no natter what I eat, nothing ever sounds good to me and I have to force myself to eat or I won’t feel good….it seems every couple hours my stomach will start to hurt again and I have to eat or I get bad pains at the top of my stomach. I feel sick all day even after eating, no matter what i eat, I constantly feel sick. Now sometimes in the morning I’ve thrown up and right after felt completely better. I can barely go on every day my stomach hurts so bad I’m always hungry but nothing ever sounds good to eat. When i eat I feel sick fast or full fast then a little while later I’ll be hungry again. Someone please help
Kelsey, please see a doctor — you need help with those stomach and intestine problems. Diabetes and low blood sugar doesn’t seem to be the issue — something is going on in your digestive tract. Phil
Have you ever had your gall bladder checked? tinatype1
this definitely sounds like a stomach problem not a diabetic one. I have a hiatus hernia and used to vomit randomly until diagnosed, Diabetics also get slow digestion called gastroparesis. all these things need referral to a gastroenterologist. Good luck don’t ignore it. Concerned Citizen
I am sorry to hear you are so severely depressed. I have been there and I promise, it will get better. I was so depressed that I hardly left my bed and enjoyed nothing in my life. I would suggest you talk with your doctor about starting on an anti-depressant, in fact I think I would request to be sent to a specialist, psychiatrist, as they are much more knowledgeable of antidepressant treatments and dosage amount. Often times, primary care doctors prescribe doses which are way too low to do much good. Hang in there and don’t give up. Things will get better. Jerry
I don’t know how much this will help, but I still eat regular foods. I just do It in controlled portions and I use fast acting Insulin to keep my blood sugars normal. I used to get 180 blood sugar from a sandwich. Now I use 5 units of fast acting insulin, and that same sandwich will not even raise my blood sugar over 100. I know a lot of people are afraid of Insulin, but it has worked well for me this past year. Some days, when I eat very low carb, I do not use the insulin. My blood sugar remains normal in between meals, and when I’m not eating as long as I take my Metformin. If I do not take my Metformin (2000 mgs a day) my fasting sugars will go back into the 130 range no matter how low carb I eat. I just need some extra help for my post mealtime blood sugar spikes. Limiting the post meal blood sugar spikes has really helped with my daytime sleepiness. My A1C went from 7.3 to 5.4 in three months with just the addition of Novolin fast acting insulin. Sometimes I eat a nice piece of cake, I just take insulin to cover the carbs.
I even eat pizza a few times a month too, in moderation though. But the fast acting Insulin allows me to enjoy some of these foods in moderation. I do not eat sweets mostly, I do not snack in between meals, and I swapped out sugar drinks for Splenda. I cannot live without sweet iced tea and Koolaid sweetened with Splenda. I consume a couple of tablespoons of Splenda per day, and it does not raise my blood sugar at all. I hate the taste of plain water, so the iced tea and Koolaid are my main source of hydration. I know a lot of you are against artificial sweeteners, but they do help me control my blood sugar. I can make a chocolate cake with Splenda, cocoa, and almond flour that is only 5 net grams of carbs. It will satisfy your sweet tooth, and it will not spike your blood sugar one bit. Almond flour can be quite expensive, but it is a good flour substitute. It is also good for the gluten free folks. There is a paleo bread out there that is made with pure almond flour, and it is good, and it will not raise your blood sugar. I can’t stand the thought of never having a pizza or pasta again. I use my insulin and eat the good foods every now and again. Sarah
I have been feeling weird for the past couple days. I took my blood sugar this morning at 9:34 am and it was 109 and then at 2:00 it was 95. I am dizzy and feel sick to my stomach. Have dirrehia also. Should I go to the er and get checked out. Help! Does anyone have any suggestions. Dianne
If you take metformin, that may be a cause of the diarrhea. I had been taking it for 30 years and finally I had to go off it because of the diarrhea. Within 3 days things were almost back to normal and with 2 weeks I was doing good. Also, your dose may be too high. Make sure that your diet has enough protein and healthy fats (coconut oil is good) Ask your Dr for a referral to a Diabetic Educator. Good Luck. Dianne bob
Janument gives me GI distress but metforim itself does not. Of course everyone is different. Tinatype1
hi I am 43 and have had Type 1 diabetes since I was 24 and a very active student, although always out doing stuff have never been a gym exercise fanatic. I also have had long term fatigue, but after studying nutrition I would recommend that you start taking Magnesium, which 80% of women are deficient in. Although it may take time to see the difference, it may be your diet rather than diabetes causing your tiredness. I cut back on carbs last year and the change in my energy levels is amazing, I rarely eat chips, potatoes or pastas now, and just that minor change made a big difference. hope that helps, also you may be anemic.

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Glucocorticoid

Glucocorticoids are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor,[1] that is present in almost every vertebrate animal cell. The name “glucocorticoid” is a portmanteau (glucose + cortex + steroid) and is composed from its role in regulation of glucose metabolism, synthesis in the adrenal cortex, and its steroidal structure (see structure to the right). A less common synonym is glucocorticosteroid.

Glucocorticoids are part of the feedback mechanism in the immune system which reduces certain aspects of immune function, such as inflammation. They are therefore used in medicine to treat diseases caused by an overactive immune system, such as allergies, asthma, autoimmune diseases, and sepsis. Glucocorticoids have many diverse (pleiotropic) effects, including potentially harmful side effects, and as a result are rarely sold over the counter.[2] They also interfere with some of the abnormal mechanisms in cancer cells, so they are used in high doses to treat cancer. This includes inhibitory effects on lymphocyte proliferation, as in the treatment of lymphomas and leukemias, and the mitigation of side effects of anticancer drugs.

Glucocorticoids affect cells by binding to the glucocorticoid receptor. The activated glucocorticoid receptor-glucocorticoid complex up-regulates the expression of anti-inflammatory proteins in the nucleus (a process known as transactivation) and represses the expression of proinflammatory proteins in the cytosol by preventing the translocation of other transcription factors from the cytosol into the nucleus (transrepression).[2]

Glucocorticoids are distinguished from mineralocorticoids and sex steroids by their specific receptors, target cells, and effects. In technical terms, “corticosteroid” refers to both glucocorticoids and mineralocorticoids (as both are mimics of hormones produced by the adrenal cortex), but is often used as a synonym for “glucocorticoid.” Glucocorticoids are chiefly produced in the zona fasciculata of the adrenal cortex, whereas mineralocorticoids are synthesized in the zona glomerulosa.

Cortisol (or hydrocortisone) is the most important human glucocorticoid. It is essential for life, and it regulates or supports a variety of important cardiovascular, metabolic, immunologic, and homeostatic functions. Various synthetic glucocorticoids are available; these are widely utilized in general medical practice and numerous specialties either as replacement therapy in glucocorticoid deficiency or to suppress the immune system.

Contents

  • 1 Effects
    • 1.1 Immune
    • 1.2 Metabolic
    • 1.3 Developmental
    • 1.4 Arousal and cognition
    • 1.5 Body fluid homeostasis
  • 2 Mechanism of action
    • 2.1 Transactivation
    • 2.2 Transrepression
    • 2.3 Nongenomic effects
  • 3 Pharmacology
  • 4 Therapeutic use
    • 4.1 Physiological replacement
    • 4.2 Therapeutic immunosuppression
    • 4.3 Anti-inflammatory
    • 4.4 Hyperaldosteronism
    • 4.5 Resistance
    • 4.6 Heart failure
  • 5 Side effects
    • 5.1 Immunodeficiency
    • 5.2 Withdrawal
  • 6 See also
  • 7 References
  • 8 External links

Effects[edit]

Steroidogenesis showing glucocorticoids in green ellipse at right with the primary example being cortisol.[3] It is not a strictly bounded group, but a continuum of structures with increasing glucocorticoid effect.

Glucocorticoid effects may be broadly classified into two major categories: immunological and metabolic. In addition, glucocorticoids play important roles in fetal development and body fluid homeostasis.

Immune[edit]

As discussed in more detail below, glucocorticoids function through interaction with the glucocorticoid receptor:

  • up-regulate the expression of anti-inflammatory proteins.
  • down-regulate the expression of proinflammatory proteins.

Glucocorticoids are also shown to play a role in the development and homeostasis of T lymphocytes. This has been shown in transgenic mice with either increased or decreased sensitivity of T cell lineage to glucocorticoids.[4]

Metabolic[edit]

The name “glucocorticoid” derives from early observations that these hormones were involved in glucose metabolism. In the fasted state, cortisol stimulates several processes that collectively serve to increase and maintain normal concentrations of glucose in blood.

Metabolic effects:

  • Stimulation of gluconeogenesis, in particular, in the liver: This pathway results in the synthesis of glucose from non-hexose substrates, such as amino acids and glycerol from triglyceride breakdown, and is particularly important in carnivores and certain herbivores. Enhancing the expression of enzymes involved in gluconeogenesis is probably the best-known metabolic function of glucocorticoids.
  • Mobilization of amino acids from extrahepatic tissues: These serve as substrates for gluconeogenesis.
  • Inhibition of glucose uptake in muscle and adipose tissue: A mechanism to conserve glucose
  • Stimulation of fat breakdown in adipose tissue: The fatty acids released by lipolysis are used for production of energy in tissues like muscle, and the released glycerol provide another substrate for gluconeogenesis.

Excessive glucocorticoid levels resulting from administration as a drug or hyperadrenocorticism have effects on many systems. Some examples include inhibition of bone formation, suppression of calcium absorption (both of which can lead to osteoporosis), delayed wound healing, muscle weakness, and increased risk of infection. These observations suggest a multitude of less-dramatic physiologic roles for glucocorticoids.[4]

Developmental[edit]

Glucocorticoids have multiple effects on fetal development. An important example is their role in promoting maturation of the lung and production of the surfactant necessary for extrauterine lung function. Mice with homozygous disruptions in the corticotropin-releasing hormone gene (see below) die at birth due to pulmonary immaturity. In addition, glucocorticoids are necessary for normal brain development, by initiating terminal maturation, remodeling axons and dendrites, and affecting cell survival[5] and may also play a role in hippocampal development. Glucocorticoids stimulate the maturation of the Na+/K+/ATPase, nutrient transporters, and digestion enzymes, promoting the development of a functioning gastro-intestinal system. Glucocorticoids also support the development of the neonate’s renal system by increasing glomerular filtration.

Arousal and cognition[edit]

A graphical representation of the Yerkes-Dodson curve

Glucocorticoids act on the hippocampus, amygdala, and frontal lobes. Along with adrenaline, these enhance the formation of flashbulb memories of events associated with strong emotions, both positive and negative.[6] This has been confirmed in studies, whereby blockade of either glucocorticoids or noradrenaline activity impaired the recall of emotionally relevant information. Additional sources have shown subjects whose fear learning was accompanied by high cortisol levels had better consolidation of this memory (this effect was more important in men). The effect that glucocorticoids have on memory may be due to damage specifically to the CA1 area of the hippocampal formation. In multiple animal studies, prolonged stress (causing prolonged increases in glucocorticoid levels) have shown destruction of the neurons in this area of the brain, which has been connected to lower memory performance.[7][8][9]

Glucocorticoids have also been shown to have a significant impact on vigilance (attention deficit disorder) and cognition (memory). This appears to follow the Yerkes-Dodson curve, as studies have shown circulating levels of glucocorticoids vs. memory performance follow an upside-down U pattern, much like the Yerkes-Dodson curve. For example, long-term potentiation (LTP; the process of forming long-term memories) is optimal when glucocorticoid levels are mildly elevated, whereas significant decreases of LTP are observed after adrenalectomy (low-glucocorticoid state) or after exogenous glucocorticoid administration (high-glucocorticoid state). Elevated levels of glucocorticoids enhance memory for emotionally arousing events, but lead more often than not to poor memory for material unrelated to the source of stress/emotional arousal.[10] In contrast to the dose-dependent enhancing effects of glucocorticoids on memory consolidation, these stress hormones have been shown to inhibit the retrieval of already stored information.[11] Long-term exposure to glucocorticoid medications, such as asthma and anti-inflammatory medication, has been shown to create deficits in memory and attention both during and, to a lesser extent, after treatment,[12][13] a condition known as “steroid dementia.”[14]

Body fluid homeostasis[edit]

Glucocorticoids could act centrally, as well as peripherally, to assist in the normalization of extracellular fluid volume by regulating body’s action to atrial natriuretic peptide (ANP). Centrally, glucocorticoids could inhibit dehydration induced water intake;[15] peripherally, glucocorticoids could induce a potent diuresis.[16]

Mechanism of action[edit]

Transactivation[edit]

Glucocorticoids bind to the cytosolic glucocorticoid receptor, a type of nuclear receptor that is activated by ligand binding. After a hormone binds to the corresponding receptor, the newly formed complex translocates itself into the cell nucleus, where it binds to glucocorticoid response elements in the promoter region of the target genes resulting in the regulation of gene expression. This process is commonly referred to as transcriptional activation, or transactivation.[17][18]

The proteins encoded by these up-regulated genes have a wide range of effects, including, for example:[18]

  • anti-inflammatory – lipocortin I, p11/calpactin binding protein, secretory leukocyte protease inhibitor 1 (SLPI), and Mitogen-activated protein kinase phosphatase (MAPK phosphatase)
  • increased gluconeogenesis – glucose-6-phosphatase and tyrosine aminotransferase

Transrepression[edit]

The opposite mechanism is called transcriptional repression, or transrepression. The classical understanding of this mechanism is that activated glucocorticoid receptor binds to DNA in the same site where another transcription factor would bind, which prevents the transcription of genes that are transcribed via the activity of that factor.[17][18] While this does occur, the results are not consistent for all cell types and conditions; there is no generally accepted, general mechanism for transrepression.[18]

New mechanisms are being discovered where transcription is repressed, but the activated glucocorticoid receptor is not interacting with DNA, but rather with another transcription factor directly, thus interfering with it, or with other proteins that interfere with the function of other transcription factors. This latter mechanism appears to be the most likely way that activated glucocorticoid receptor interferes with NF-κB – namely by recruiting histone deacetylase, which deacetylate the DNA in the promoter region leading to closing of the chromatin structure where NF-κB needs to bind.[17][18]

Nongenomic effects[edit]

Activated glucocorticoid receptor has effects that have been experimentally shown to be independent of any effects on transcription and can only be due to direct binding of activated glucocorticoid receptor with other proteins or with mRNA.[17][18]

For example, Src kinase which binds to inactive glucocorticoid receptor, is released when a glucocorticoid binds to glucocorticoid receptor, and phosphorylates a protein that in turn displaces an adaptor protein from a receptor important in inflammation, epidermal growth factor, reducing its activity, which in turn results in reduced creation of arachidonic acid – a key proinflammatory molecule. This is one mechanism by which glucocorticoids have an anti-inflammatory effect.[17]

Pharmacology[edit]

Dexamethasone – a synthetic glucocorticoid binds more powerfully to the glucocorticoid receptor than cortisol does. Dexamethasone is based on the cortisol structure but differs at three positions (extra double bond in the A-ring between carbons 1 and 2 and addition of a 9-α-fluoro group and a 16-α-methyl substituent).

A variety of synthetic glucocorticoids, some far more potent than cortisol, have been created for therapeutic use. They differ in both pharmacokinetics (absorption factor, half-life, volume of distribution, clearance) and pharmacodynamics (for example the capacity of mineralocorticoid activity: retention of sodium (Na+) and water; renal physiology). Because they permeate the intestines easily, they are administered primarily per os (by mouth), but also by other methods, such as topically on skin. More than 90% of them bind different plasma proteins, though with a different binding specificity. Endogenous glucocorticoids and some synthetic corticoids have high affinity to the protein transcortin (also called corticosteroid-binding globulin), whereas all of them bind albumin. In the liver, they quickly metabolize by conjugation with a sulfate or glucuronic acid, and are secreted in the urine.

Glucocorticoid potency, duration of effect, and the overlapping mineralocorticoid potency vary. Cortisol is the standard of comparison for glucocorticoid potency. Hydrocortisone is the name used for pharmaceutical preparations of cortisol.

The data below refer to oral administration. Oral potency may be less than parenteral potency because significant amounts (up to 50% in some cases) may not reach the circulation. Fludrocortisone acetate and deoxycorticosterone acetate are, by definition, mineralocorticoids rather than glucocorticoids, but they do have minor glucocorticoid potency and are included in this table to provide perspective on mineralocorticoid potency.

Therapeutic use[edit]

Glucocorticoids may be used in low doses in adrenal insufficiency. In much higher doses, oral or inhaled glucocorticoids are used to suppress various allergic, inflammatory, and autoimmune disorders. Inhaled glucocorticoids are the second-line treatment for asthma. They are also administered as post-transplantory immunosuppressants to prevent the acute transplant rejection and the graft-versus-host disease. Nevertheless, they do not prevent an infection and also inhibit later reparative processes. Newly emerging evidence showed that glucocorticoids could be used in the treatment of heart failure to increase the renal responsiveness to diuretics and natriuretic peptides. Glucocorticoids are historically used for pain relief in inflammatory conditions.[20][21][22] However, corticosteroids show limited efficacy in pain relief and potential adverse events for their use in tendinopathies.[23]

Physiological replacement[edit]

Any glucocorticoid can be given in a dose that provides approximately the same glucocorticoid effects as normal cortisol production; this is referred to as physiologic, replacement, or maintenance dosing. This is approximately 6–12 mg/m²/day of hydrocortisone (m² refers to body surface area (BSA), and is a measure of body size; an average man’s BSA is 1.9 m²).

Therapeutic immunosuppression[edit]

See section on “Immunodeficiency” below for adverse effects

Glucocorticoids cause immunosuppression, and the therapeutic component of this effect is mainly the decreases in the function and numbers of lymphocytes, including both B cells and T cells.

The major mechanism for this immunosuppression is through inhibition of nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB). NF-κB is a critical transcription factor involved in the synthesis of many mediators (i.e., cytokines) and proteins (i.e., adhesion proteins) that promote the immune response. Inhibition of this transcription factor, therefore, blunts the capacity of the immune system to mount a response.[2]

Glucocorticoids suppress cell-mediated immunity by inhibiting genes that code for the cytokines IL-1, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8 and IFN-γ, the most important of which is IL-2. Smaller cytokine production reduces the T cell proliferation.[24]

Glucocorticoids, however, not only reduce T cell proliferation, but also lead to another well known effect – glucocorticoid-induced apoptosis. The effect is more prominent in immature T cells still inside in the thymus, but peripheral T cells are also affected. The exact mechanism regulating this glucocorticoid sensitivity lies in the Bcl-2 gene.[25]

Glucocorticoids also suppress the humoral immunity, thereby causing a humoral immune deficiency. Glucocorticoids cause B cells to express smaller amounts of IL-2 and of IL-2 receptors. This diminishes both B cell clone expansion and antibody synthesis. The diminished amounts of IL-2 also cause fewer T lymphocyte cells to be activated.

The effect of glucocorticoids on Fc receptor expression in immune cells is complicated. Dexamethasone decreases IFN-gamma simulated Fc gamma RI expression in neutrophils while conversely causing an increase in monocytes.[26] Glucocorticoids may also decrease the expression of Fc receptors in macrophages,[27] but the evidence supporting this regulation in earlier studies has been questioned.[28] The effect of Fc receptor expression in macrophages is important since it is necessary for the phagocytosis of opsonised cells. This is because Fc receptors bind antibodies attached to cells targeted for destruction by macrophages.

Anti-inflammatory[edit]

Glucocorticoids are potent anti-inflammatories, regardless of the inflammation’s cause; their primary anti-inflammatory mechanism is lipocortin-1 (annexin-1) synthesis. Lipocortin-1 both suppresses phospholipase A2, thereby blocking eicosanoid production, and inhibits various leukocyte inflammatory events (epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst, etc.). In other words, glucocorticoids not only suppress immune response, but also inhibit the two main products of inflammation, prostaglandins and leukotrienes. They inhibit prostaglandin synthesis at the level of phospholipase A2 as well as at the level of cyclooxygenase/PGE isomerase (COX-1 and COX-2),[29] the latter effect being much like that of NSAIDs, potentiating the anti-inflammatory effect.

In addition, glucocorticoids also suppress cyclooxygenase expression. [30]

Glucocorticoids marketed as anti-inflammatories are often topical formulations, such as nasal sprays for rhinitis or inhalers for asthma. These preparations have the advantage of only affecting the targeted area, thereby reducing side effects or potential interactions. In this case, the main compounds used are beclometasone, budesonide, fluticasone, mometasone and ciclesonide. In rhinitis, sprays are used. For asthma, glucocorticoids are administered as inhalants with a metered-dose or dry powder inhaler.[31]

Hyperaldosteronism[edit]

Glucocorticoids can be used in the management of familial hyperaldosteronism type 1. They are not effective, however, for use in the type 2 condition.

Resistance[edit]

Corticosteroid resistance mechanisms

Resistance to the therapeutic uses of glucocorticoids can present difficulty; for instance, 25% of cases of severe asthma may be unresponsive to steroids. This may be the result of genetic predisposition, ongoing exposure to the cause of the inflammation (such as allergens), immunological phenomena that bypass glucocorticoids, and pharmacokinetic disturbances (incomplete absorption or accelerated excretion or metabolism).[24]

Heart failure[edit]

Glucocorticoids could be used in the treatment of decompensated heart failure to potentiate renal responsiveness to diuretics, especially in heart failure patients with refractory diuretic resistance with large doses of loop diuretics.[32][33][34][35][36][37][38]

Side effects[edit]

Glucocorticoid drugs currently being used act nonselectively, so in the long run they may impair many healthy anabolic processes. To prevent this, much research has been focused recently on the elaboration of selectively acting glucocorticoid drugs. Side effects include:

  • Immunodeficiency (see section below)
  • Hyperglycemia due to increased gluconeogenesis, insulin resistance, and impaired glucose tolerance (“steroid diabetes”); caution in those with diabetes mellitus
  • Increased skin fragility, easy bruising
  • Negative calcium balance due to reduced intestinal calcium absorption[39]
  • Steroid-induced osteoporosis: reduced bone density (osteoporosis, osteonecrosis, higher fracture risk, slower fracture repair)
  • Weight gain due to increased visceral and truncal fat deposition (central obesity) and appetite stimulation
  • Hypercortisolemia with prolonged or excessive use (also known as, exogenous Cushing’s syndrome)
  • Impaired memory and attention deficits[40]
  • Adrenal insufficiency (if used for long time and stopped suddenly without a taper)
  • Muscle and tendon breakdown (proteolysis), weakness, reduced muscle mass and repair[41][23]
  • Expansion of malar fat pads and dilation of small blood vessels in skin
  • Lipomatosis within the epidural space[42]
  • Excitatory effect on central nervous system (euphoria, psychosis)
  • Anovulation, irregularity of menstrual periods
  • Growth failure, delayed puberty
  • Increased plasma amino acids, increased urea formation, negative nitrogen balance
  • Glaucoma due to increased ocular pressure
  • Cataracts
  • Topical steroid addiction

In high doses, hydrocortisone (cortisol) and those glucocorticoids with appreciable mineralocorticoid potency can exert a mineralocorticoid effect as well, although in physiologic doses this is prevented by rapid degradation of cortisol by 11β-hydroxysteroid dehydrogenase isoenzyme 2 (11β-HSD2) in mineralocorticoid target tissues. Mineralocorticoid effects can include salt and water retention, extracellular fluid volume expansion, hypertension, potassium depletion, and metabolic alkalosis.

Immunodeficiency[edit]

Glucocorticoids cause immunosuppression, decreasing the function and/or numbers of neutrophils, lymphocytes (including both B cells and T cells), monocytes, macrophages, and the anatomical barrier function of the skin.[43] This suppression, if large enough, can cause manifestations of immunodeficiency, including T cell deficiency, humoral immune deficiency and neutropenia.

Withdrawal[edit]

In addition to the effects listed above, use of high-dose steroids for more than a week begins to produce suppression of the patient’s adrenal glands because the exogenous glucocorticoids suppress hypothalamic corticotropin-releasing hormone and pituitary adrenocorticotropic hormone. With prolonged suppression, the adrenal glands atrophy (physically shrink), and can take months to recover full function after discontinuation of the exogenous glucocorticoid.

During this recovery time, the patient is vulnerable to adrenal insufficiency during times of stress, such as illness. While suppressive dose and time for adrenal recovery vary widely, clinical guidelines have been devised to estimate potential adrenal suppression and recovery, to reduce risk to the patient. The following is one example:

  • If patients have been receiving daily high doses for five days or less, they can be abruptly stopped (or reduced to physiologic replacement if patients are adrenal-deficient). Full adrenal recovery can be assumed to occur by a week afterward.
  • If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids.
  • If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days. Stop entirely when dose is less than half of replacement. Full adrenal recovery should occur within one to three months of completion of withdrawal.
  • If high doses were used more than 30 days, cut dose immediately to twice replacement, and reduce by 25% each week until replacement is reached. Then change to oral hydrocortisone or cortisone as a single morning dose, and gradually decrease by 2.5 mg each week. When the morning dose is less than replacement, the return of normal basal adrenal function may be documented by checking 0800 cortisol levels prior to the morning dose; stop drugs when 0800 cortisol is 10 μg/dl. Predicting the time to full adrenal recovery after prolonged suppressive exogenous steroids is difficult; some people may take nearly a year.
  • Flare-up of the underlying condition for which steroids are given may require a more gradual taper than outlined above.

See also[edit]

  • List of corticosteroids
  • List of corticosteroid cyclic ketals
  • List of corticosteroid esters
  • Aminoglutethimide blocks glucocorticoid secretion
  • GITR (glucocorticoid-induced TNF receptor)
  • Glucocorticoid receptor
  • Immunosuppressive drug
  • Membrane glucocorticoid receptor
  • Metyrapone blocks glucocorticoid secretion
  • Selective glucocorticoid receptor agonist
  • Topical steroid
  • Steroid atrophy
  • Topical steroid withdrawal
  • Non-steroidal anti-inflammatory drug (NSAID)

References[edit]

  • ^ Pelt AC (2011). Glucocorticoids: effects, action mechanisms, and therapeutic uses. Hauppauge, N.Y.: Nova Science. ISBN 978-1617287589. 
  • ^ a b c Rhen T, Cidlowski JA (Oct 2005). “Antiinflammatory action of glucocorticoids–new mechanisms for old drugs”. The New England Journal of Medicine. 353 (16): 1711–23. doi:10.1056/NEJMra050541. PMID 16236742. 
  • ^ Häggström, Mikael; Richfield, David (2014). “Diagram of the pathways of human steroidogenesis”. WikiJournal of Medicine. 1 (1). doi:10.15347/wjm/2014.005. ISSN 2002-4436. 
  • ^ a b Pazirandeh A, Xue Y, Prestegaard T, Jondal M, Okret S (May 2002). “Effects of altered glucocorticoid sensitivity in the T cell lineage on thymocyte and T cell homeostasis”. FASEB Journal. 16 (7): 727–9. doi:10.1096/fj.01-0891fje. PMID 11923224. 
  • ^ Lupien SJ, McEwen BS, Gunnar MR, Heim C (Jun 2009). “Effects of stress throughout the lifespan on the brain, behaviour and cognition”. Nature Reviews. Neuroscience. 10 (6): 434–45. doi:10.1038/nrn2639. PMID 19401723. 
  • ^ Cahill L, McGaugh JL (Jul 1998). “Mechanisms of emotional arousal and lasting declarative memory”. Trends in Neurosciences. 21 (7): 294–9. doi:10.1016/s0166-2236(97)01214-9. PMID 9683321. 
  • ^ Carlson NR (2010). Physiology of Behavior (11th ed.). New York: Allyn & Bacon. p. 605. ISBN 978-0-205-23939-9. 
  • ^ Belanoff JK, Gross K, Yager A, Schatzberg AF (2001). “Corticosteroids and cognition”. Journal of Psychiatric Research. 35 (3): 127–45. doi:10.1016/S0022-3956(01)00018-8. PMID 11461709. 
  • ^ Sapolsky RM (October 1994). “Glucocorticoids, stress and exacerbation of excitotoxic neuron death”. Seminars in Neuroscience. 6 (5): 323–331. doi:10.1006/smns.1994.1041. 
  • ^ Lupien SJ, Maheu F, Tu M, Fiocco A, Schramek TE (Dec 2007). “The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition”. Brain and Cognition. 65 (3): 209–37. doi:10.1016/j.bandc.2007.02.007. PMID 17466428. 
  • ^ de Quervain DJ, Roozendaal B, McGaugh JL (Aug 1998). “Stress and glucocorticoids impair retrieval of long-term spatial memory”. Nature. 394 (6695): 787–90. doi:10.1038/29542. PMID 9723618. 
  • ^ Wolkowitz OM, Lupien SJ, Bigler ED (Jun 2007). “The “steroid dementia syndrome”: a possible model of human glucocorticoid neurotoxicity”. Neurocase. 13 (3): 189–200. doi:10.1080/13554790701475468. PMID 17786779. 
  • ^ Norra C, Arndt M, Kunert HJ (Jan 2006). “Steroid dementia: an overlooked diagnosis?”. Neurology. 66 (1): 155; author reply 155. doi:10.1212/01.wnl.0000203713.04232.82. PMID 16401879. 
  • ^ Varney NR, Alexander B, MacIndoe JH (Mar 1984). “Reversible steroid dementia in patients without steroid psychosis”. The American Journal of Psychiatry. 141 (3): 369–72. doi:10.1176/ajp.141.3.369. PMID 6703100. 
  • ^ Liu C, Guan J, Kang Y, Xiu H, Chen Y, Deng B, Liu K (2010). “Inhibition of dehydration-induced water intake by glucocorticoids is associated with activation of hypothalamic natriuretic peptide receptor-A in rat”. PLoS One. 5 (12): e15607. doi:10.1371/journal.pone.0015607. PMC 3004933 . PMID 21187974. 
  • ^ Liu C, Chen Y, Kang Y, Ni Z, Xiu H, Guan J, Liu K (Oct 2011). “Glucocorticoids improve renal responsiveness to atrial natriuretic peptide by up-regulating natriuretic peptide receptor-A expression in the renal inner medullary collecting duct in decompensated heart failure”. The Journal of Pharmacology and Experimental Therapeutics. 339 (1): 203–9. doi:10.1124/jpet.111.184796. PMID 21737535. 
  • ^ a b c d e Revollo JR, Cidlowski JA (Oct 2009). “Mechanisms generating diversity in glucocorticoid receptor signaling”. Annals of the New York Academy of Sciences. 1179: 167–78. doi:10.1111/j.1749-6632.2009.04986.x. PMID 19906239. 
  • ^ a b c d e f Newton R, Holden NS (Oct 2007). “Separating transrepression and transactivation: a distressing divorce for the glucocorticoid receptor?”. Molecular Pharmacology. 72 (4): 799–809. doi:10.1124/mol.107.038794. PMID 17622575. 
  • ^ Chrousos G, Pavlaki AN, Magiakou MA (2011). “Glucocorticoid Therapy and Adrenal Suppression”. PMID 25905379. 
  • ^ Tarner IH, Englbrecht M, Schneider M, van der Heijde DM, Müller-Ladner U (2012). “The role of corticosteroids for pain relief in persistent pain of inflammatory arthritis: a systematic literature review”. The Journal of Rheumatology. Supplement. 90: 17–20. doi:10.3899/jrheum.120337. PMID 22942324. 
  • ^ Haywood A, Good P, Khan S, Leupp A, Jenkins-Marsh S, Rickett K, Hardy JR (2015). “Corticosteroids for the management of cancer-related pain in adults”. The Cochrane Database of Systematic Reviews (4): CD010756. doi:10.1002/14651858.CD010756.pub2. PMID 25908299. 
  • ^ Chowdhury R, Naaseri S, Lee J, Rajeswaran G (2014). “Imaging and management of greater trochanteric pain syndrome”. Postgraduate Medical Journal. 90 (1068): 576–81. doi:10.1136/postgradmedj-2013-131828. PMID 25187570. 
  • ^ a b Mohamadi A, Chan JJ, Claessen FM, Ring D, Chen NC (January 2017). “Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis”. Clinical Orthopaedics and Related Research. 475 (1): 232–243. doi:10.1007/s11999-016-5002-1. PMC 5174041 . PMID 27469590. 
  • ^ a b Leung DY, Bloom JW (Jan 2003). “Update on glucocorticoid action and resistance”. The Journal of Allergy and Clinical Immunology. 111 (1): 3–22; quiz 23. doi:10.1067/mai.2003.97. PMID 12532089. 
  • ^ Banuelos J, Shin S, Cao Y, Bochner BS, Morales-Nebreda L, Budinger GR, Zhou L, Li S, Xin J, Lingen MW, Dong C, Schleimer RP, Lu NZ (Jan 2016). “BCL-2 protects human and mouse Th17 cells from glucocorticoid-induced apoptosis”. Allergy. 71: 640–50. doi:10.1111/all.12840. PMID 26752231. 
  • ^ Pan LY, Mendel DB, Zurlo J, Guyre PM (1990). “Regulation of the steady state level of Fc gamma RI mRNA by IFN-gamma and dexamethasone in human monocytes, neutrophils, and U-937 cells”. Journal of Immunology. 145 (1): 267–75. PMID 2141616. 
  • ^ Ruiz P, Gomez F, King M, Lopez R, Darby C, Schreiber AD (1991). “In vivo glucocorticoid modulation of guinea pig splenic macrophage Fc gamma receptors”. The Journal of Clinical Investigation. 88 (1): 149–57. doi:10.1172/JCI115271. PMC 296015 . PMID 1829095. 
  • ^ Werb Z (1980). “Hormone receptors and normal regulation of macrophage physiological function”. In van Furth R. Mononuclear phagocytes functional aspects. The Hague: M. Nijhoff. p. 825. ISBN 978-94-009-8793-7. Glucocorticoids may also decrease the number of Fc receptors on macrophages, but this immunosuppressive function is controversial because of the lack of sensitivity in Fc receptor techniques and the high concentration of glucocorticoids used in previous experiments. 
  • ^ Goppelt-Struebe M, Wolter D, Resch K (Dec 1989). “Glucocorticoids inhibit prostaglandin synthesis not only at the level of phospholipase A2 but also at the level of cyclo-oxygenase/PGE isomerase”. British Journal of Pharmacology. 98 (4): 1287–95. doi:10.1111/j.1476-5381.1989.tb12676.x. PMC 1854794 . PMID 2514948. 
  • ^ Jun SS, Chen Z, Pace MC, Shaul PW (Feb 1999). “Glucocorticoids downregulate cyclooxygenase-1 gene expression and prostacyclin synthesis in fetal pulmonary artery endothelium”. Circulation Research. 84 (2): 193–200. doi:10.1161/01.RES.84.2.193. PMID 9933251. 
  • ^ Flower R, Rang HP, Dale MM, Ritter JM (2007). Rang & Dale’s pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-06911-5. 
  • ^ Rado JP, Blumenfeld G, Hammer S (Nov 1959). “The effect of prednisone and 6-methylprednisolone on mercurial diuresis in patients with refractory cardiac edema”. The American Journal of the Medical Sciences. 238: 542–51. PMID 14435747. 
  • ^ Riemer AD (Apr 1958). “Application of the newer corticosteroids to augment diuresis in congestive heart failure”. The American Journal of Cardiology. 1 (4): 488–96. doi:10.1016/0002-9149(58)90120-6. PMID 13520608. 
  • ^ Newman DA (Feb 1959). “Reversal of intractable cardiac edema with prednisone”. New York State Journal of Medicine. 59 (4): 625–33. PMID 13632954. 
  • ^ Zhang H, Liu C, Ji Z, Liu G, Zhao Q, Ao YG, Wang L, Deng B, Zhen Y, Tian L, Ji L, Liu K (Sep 2008). “Prednisone adding to usual care treatment for refractory decompensated congestive heart failure”. International Heart Journal. 49 (5): 587–95. doi:10.1536/ihj.49.587. PMID 18971570. 
  • ^ Liu C, Liu G, Zhou C, Ji Z, Zhen Y, Liu K (Sep 2007). “Potent diuretic effects of prednisone in heart failure patients with refractory diuretic resistance”. The Canadian Journal of Cardiology. 23 (11): 865–8. doi:10.1016/s0828-282x(07)70840-1. PMC 2651362 . PMID 17876376. 
  • ^ Liu C, Chen H, Zhou C, Ji Z, Liu G, Gao Y, Tian L, Yao L, Zheng Y, Zhao Q, Liu K (Oct 2006). “Potent potentiating diuretic effects of prednisone in congestive heart failure”. Journal of Cardiovascular Pharmacology. 48 (4): 173–6. doi:10.1097/01.fjc.0000245242.57088.5b. PMID 17086096. 
  • ^ Massari F, Mastropasqua F, Iacoviello M, Nuzzolese V, Torres D, Parrinello G (Mar 2012). “The glucocorticoid in acute decompensated heart failure: Dr Jekyll or Mr Hyde?”. The American Journal of Emergency Medicine. 30 (3): 517.e5–10. doi:10.1016/j.ajem.2011.01.023. PMID 21406321. 
  • ^ Gennari C (May 1993). “Differential effect of glucocorticoids on calcium absorption and bone mass”. British Journal of Rheumatology. 32 Suppl 2: 11–4. doi:10.1093/rheumatology/32.suppl_2.11. PMID 8495275. 
  • ^ Keenan PA, Jacobson MW, Soleymani RM, Mayes MD, Stress ME, Yaldoo DT (Dec 1996). “The effect on memory of chronic prednisone treatment in patients with systemic disease”. Neurology. 47 (6): 1396–402. doi:10.1212/WNL.47.6.1396. PMID 8960717. 
  • ^ Gelber JD (January 2017). “CORR Insights: Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis”. Clinical Orthopaedics and Related Research. 475 (1): 244–246. doi:10.1007/s11999-016-5044-4. PMC 5174046 . PMID 27572298. 
  • ^ Koch CA, Doppman JL, Patronas NJ, Nieman LK, Chrousos GP (Apr 2000). “Do glucocorticoids cause spinal epidural lipomatosis? When endocrinology and spinal surgery meet”. Trends in Endocrinology and Metabolism. 11 (3): 86–90. doi:10.1016/S1043-2760(00)00236-8. PMID 10707048. 
  • ^ a b Klein NC, Go CH, Cunha BA (Jun 2001). “Infections associated with steroid use”. Infectious Disease Clinics of North America. 15 (2): 423–32, viii. doi:10.1016/s0891-5520(05)70154-9. PMID 11447704. 
  • External links[edit]

    • Glucocorticoids at the US National Library of Medicine Medical Subject Headings (MeSH)
    • Bowen R (2006-05-26). “Glucocorticoids”. Colorado State University. Retrieved 2008-05-11. 
    • Wolkowitz OM, Burke H, Epel ES, Reus VI (Oct 2009). “Glucocorticoids. Mood, memory, and mechanisms”. Annals of the New York Academy of Sciences. 1179: 19–40. doi:10.1111/j.1749-6632.2009.04980.x. PMID 19906230. 
    • “Introduction + Classification + Pharmacological Action + Regulation of Release and Drawback of Glucocorticoids Hormone”. 

    Antiglucocorticoids

    • Antagonists: Aglepristone
    • Ketoconazole
    • Mifepristone
    • Ulipristal acetate

    Synthesis modifiers

    • Acetoxolone
    • Aminoglutethimide
    • Carbenoxolone
    • Enoxolone
    • Ketoconazole
    • Metyrapone
    • Mitotane
    • Trilostane
    • #WHO-EM
    • ‡Withdrawn from market
    • Clinical trials:
      • †Phase III
      • §Never to phase III

    See also
    Glucocorticoid receptor modulators
    Mineralocorticoids and antimineralocorticoids
    List of corticosteroids

    See also
    Receptor/signaling modulators
    Glucocorticoids and antiglucocorticoids
    Mineralocorticoid receptor modulators
    List of corticosteroids


    Last week…

    Last week…

    Last week I had a bit of a scare…
    Here’s the FB post I wrote about it.
    Here’s what happened yesterday…
    the night before I got carried away at the pool with Derek. My back was already funny, and I was lifting him in the pool….
    Note to self: Derek is 85 lbs, not 40. That night, Wed, my back started having spasms. I used my tens unit, and it kind of helped. Went to bed, and had a hard time finding a comfortable position. Woke up around 5am with really bad spasms again. I put the tens unit on my back and tried to sleep more. Around 8:40 I called my doctor and made an appointment. Used the heating pad till it was time to go. The earliest appointment was 11:15. Drove to Weirton with an icepack on my back. Was seen right away. My bp was 128/90 I am assuming due to the amount of pain I was in. My Doc had me get a steroid shot in my hip/butt area, and she prescribed prednisone and a new (to me) muscle relaxer Tizanidine aka Zanaflex. I had them filled at the in-house pharmacy.
    As soon as I got in the car I took one of the muscle relaxers. (I was in a lot of pain from the spasms.) This was around noon. I got home around 12:30, and the spasms had stopped. I packed a lunch for Derek to at in the car as we had to get to Wheeling for Jeff to work on some stuff for GOV, and I had flyers to distribute to local businesses. Before we left, I had started wheezing a little bit. I used my rescue inhaler, then we left. On the way down, I was kind of struggling. I had started coughing. It seemed like there was mucus building up in my lungs. Jeff asked me a few times if I was ok. I said yes… But by the time we got to the garage for him to gather some tools, I was not feeling fine. I called my Dr office back and they put me on the line with the triage nurse. I told her I felt like I was having a reaction to the med. By this point, I was gasping for air. She asked me if I was driving. I told her I had been. She said call an ambulance. I told her my partner was with me and I’d have him drive to the hospital. I called Jeff out of the garage and said we had to go. He came out, and I set the gps to hospital. Off we went.
    We went to Wheeling hospital. I was met at the door with a wheelchair. Told admitting what was going on. A few minutes later I was taken into triage. I told the nurse I felt like I needed Oxygen badly. She checked my O2 saturation and it was at 80%.
    Then she did a quick EKG. She told me to breathe slowly, I told her I couldn’t.
    She got an oxygen tank and took me out to the waiting area. Then she put the nasal cannula on me and turned the oxygen up to 5 liters. My o2 Saturation was not coming up so they took me right back to a room. (below 90% can cause damage) Back in the room, they switched me to a mask. I have to admit I was scared. I cried a little… Even though I didn’t have an asthma attack with the Toradol reaction, it still brought up all those memories. I later found out from Jeff that he was going through it too. (8 years ago a Dr almost killed me by giving me a drug I couldn’t have. I have aspirin sensitive asthma, and the drug had asthma. I almost died, but the hospital saved me. I had to be on dialysis for 5 weeks. no fun.) They had me put on a gown, hooked me up to all the monitors, and started an IV. Then They came to my room and did a chest x-ray. I kept asking about Jeff and Derek, and they were allowed to come back to my room after I was all set up.
    Fortunately, the tablet was fully charged. I was thankful Derek had something to occupy him. The Doctor came in and told me everything they were going to do. He was super nice and I felt pretty good about him. They gave me magnesium in my IV. I asked that what it was for, and they said it was a bronchial dilator. I swear I felt it work. Shortly after they put it in, I was able to slow down my breathing so I wasn’t gasping like a fish out of water. Next came in the respiratory therapist, and he set me up on an hour-long breathing treatment, and the nurse came in and put Benadryl in my IV. Within about 20 minutes I was totally relaxed enough to doze off. We were there for probably about 3 hours… maybe more. Everything felt so surreal for the whole rest of the day. When I was finally released, and we were walking to the car I asked Derek if it was scary… at first he said no… but then he said, “Yeah kinda.” Jeff had explained everything that was going on. I’m sure it has to be kind of scary to be 7 and see that happen with your mom. But I am so glad they were there with me. The good news is my back isn’t spasming today. 😉
    The bad is I have a new drug to add to my list of drugs I can NEVER take again. I texted my dad last night to let him know what happened, and that I was ok. Apparently, he has a sensitivity to medications too, and his body rejects sutures. He said he has an overactive immune system. and found out that a cousin of mine who has passed had asthma too. (Another case for OPEN RECORDS)
    but anyway he was glad I was ok. It was a bit of a nightmare.
    But I am ok.
    This morning I had a follow up with my regular Dr. again. I told her that was the worst asthma attack I had ever had. She said, “no, actually that was an anaphylactic reaction. That is truly some scary shit! I told her I was sitting there with the oxygen mask on crying because it was like PTSD all over again. I could’ve died… again…

    Read More…

    Confidential Info About Prednisone a Corticosteroid That Only the Pros Know Exist

    The Basics of Prednisone a Corticosteroid

    Prednisone is quite successful in RA therapy, and is frequently used temporarily during flareups. Before you take prednisone, tell your health care provider if you’re pregnant, think you could be pregnant, wish to get pregnant, or are breast-feeding. Consult your healthcare provider any questions that you might have regarding how to utilize Prednisone. If you are supposed to take prednisone more often than once per day, take it at evenly spaced intervals between the moment you awake in the morning and the time you visit the bed at night. Prednisone, also sometimes thought of as prednisolone, is in a category of drugs called glucocorticords and is a synthetic type of the hormone cortisol. It stops the function of bone-forming cells. Prednisone, a generic prescription drug, has existed since the 1950s and is created by means of a variety of drug businesses.

    Corticosteroids shouldn’t be utilised in active ocular herpes simplex. They may mask some signs of infection and may reduce resistance to new infections. They are drugs that are closely related to cortisol, hormones produced by the adrenal gland. They also cause bone breakdown directly. They hurt bones in a number of ways. The drug may also cause small euphoria and full-blown mania.

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    You are able to even have an appetizer and a dessert as a substitute for a most important meal. The very best thing to do is not get any junk food, so it’s not offered. Diet and exercise might be needed to steer clear of the gain. Your likelihood of securing affordable life insurance policy increase whenever you’re living a wholesome lifestyle. A wholesome lifestyle for RA is important. Everything from personal events, the work life there’s an entire host of things that go on in our lives every single day and all of us have various ways of coping, states Woods. If you take prednisone once per day, take the missed dose when you remember it.

    There are a lot of various ways to dispense fluoride. Consequently, information about the dosage, toxicity, and power of the treatment is quite limited. Obviously, it’s important to keep in mind that you are unable to get prednisone online with no valid medical prescription. If you’re interested in buying prednisone online, you should have the correct medical prescription in order to purchase it.

    High dosages are somewhat more likely to trigger severe psychiatric side results. Your dose might need to be adjusted or you may have to get started taking the drug again. The dose of Rayos ought to be individualized based on the seriousness of the disease and the response of the individual. Some individuals are, but it’s usually a fairly low dose. Lower doses weren’t studied, and for that reason, a no effect level couldn’t be identified. If it’s almost time for your next dose, skip the missed dose and return to your normal dosing schedule. If you skip a dose of Prednisone, take it whenever possible.

    Like the more customary treatments, the alternative treatments don’t have exactly the same effects in all who try them. Lots of the alternative treatments try to correct the underlying problem as opposed to treat the signs of the disease. ITP treatment is evolving as researchers learn more regarding the disease.

    Because elderly patients are more inclined to have decreased renal function, care needs to be taken in dose selection, and it might be beneficial to monitor renal function. Your physician also may suggest a particular diet plan and workout program tailored to helping you maintain a wholesome weight. Though most physicians convey the side results and the demand for patient-doctor communication, many men and women aren’t in close contact with their health care provider. If you get pregnant, get in touch with your health care provider.

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    As a dependable method of decreasing inflammation, many pain management centers incorporate using prednisone in their treatment plans. Try to remember, insurance businesses choose whether or not they’ll absorb risk and charge a premium for this risk. Decrease in the corticosteroid dose is a significant goal in SLE administration. So far as side effects go I don’t think that’s one that you should really worry about. The impacts of inflammation and the drugs used to control inflammation may also destroy bones, resulting in osteoporosis.

    The usage of oral corticosteroids is not wise in the treatment of optic neuritis and can cause an increase in the chance of new episodes. It excel or sheets to calculate the components of the equation and then use a formula in excel or sheets to do all the arithmetic in one step. In reality, corticosteroid use over time was linked to a growth in irreversible organ damage.

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    Typically, prednisone will be provided in one of two ways. If it is used for a longer period of time, the steroid comes with a long list of side effects that might end up giving you more problems than just a nagging cough. So you might be on prednisone for a couple of days or a couple of weeks. Prednisone mimics the consequences of cortisol by decreasing the quantity of inflammation in the TMJ joints. It may be prescribed along with other medications like analgesics and muscle relaxants depending on the severity of the disorder. There’s oral prednisone in the shape of pills, which are simple to administer but don’t get the job done as quickly as injectable prednisone. Last, there’s inhalable prednisone that’s probably the very best mix of convenience and quickness.

    In other words, Mg is vital for keeping us alive. A few of the doses of medication are determined based on the weight of the individual. Employing a decrease dosage prevents upsetting your stomach and enables you to avert the gastrointestinal side effects of Berberine. Plus many allergy medications can have side effects, so be certain to confirm the label before purchasing it. The very last thing that you want to hear is that one of the drugs you’re taking is making you get weight. My addiction to Medium is dependent on my urge to read the literary mundane. Healthy eating habits are an excellent means to support a well-balanced blood glucose level Although Berberine is considered an extremely safe dietary supplement with a minimal toxicity and few side effects, it has the capability to interact with a huge number of medications.

    Here’s What I Know About Prednisone and Diabetes

    Hand tremors can happen for many reasons and frequently affect other sections of your body also. Hand tremors can happen at any age but are more prevalent in older people. Sometimes they can be caused by your reaction to medications.

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    In case the tumor is malignant, the surgery may purchase the dog some moment, but the prognosis is not as favorable. Viral infections are an extra consideration. Testing the blood to set up Mg levels is a bad way of diagnosing Mg deficiency. After the human body’s blood pressure goes down below normal levels, the blood is unable to make it to the brain as efficiently, resulting in a feeling of dizziness and perhaps even fainting. Insulin resistance is a state that is normal in pre-diabetes and increases the chance of early-onset heart disease. By abiding By a low-glycemic diet, you might be able to reverse insulin resistance.

    Impaired kidney function has systemic impacts on the body. In addition, there are different factors to think about, including when you’re feeling ill, your appetite lessons and once the drug starts making you feel better, you’re apt to begin eating more than normal. Potential side effects differ from person to person. In some instances, nerve damage brought on by a wound reverses itself as the wound heals.

    People with a magnesium deficiency may have issues with insomnia. High potassium levels are hard to diagnose because side effects might not be felt until the levels are dangerously significant. Weigh yourself each morning and keep tabs on your weight, if you see a five-pound gain and suspect it’s the medication, call your physician and discuss the prospect of changing to a different drug. Taking steps to lower moisture in the genital area can cut the likelihood of creating a yeast infection.

    Cats are extremely clean animals. Your cat will probably require no less than a couple of days in the veterinary hospital. Dogs can itch for several of factors. Your dog requires some relief! If your dog was diagnosed with pituitary-dependent Cushing’s disease, he’ll have to take medication the remainder of his life.

    The Budwig diet is advised for use in cats and dogs, in addition to humans. A food elimination diet is wise to help determine a food allergy, as it’s the only accurate method to figure it out. Men and women that are inactive are more inclined to get weight only because they don’t burn the calories they take in from food and drinks. 1 important point to bear in mind is that the excess weight may be minimal in comparison with the benefits you’re receiving from the drug.

    For those who have diabetes and peripheral neuropathy, strict charge of your blood glucose levels can lessen your neuropathic symptoms. Insulin regulates the quantity of glucose in the blood made by the pancreas. Hormones in the body are delicately balanced by the actions of distinct glands. Steroids can cut back the immune system, which raises the possibility of infection.

    Whatever They Told You About Viagra B Board Is Dead Wrong…And Here’s Why

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    In other nations, the issue gets far more clouded and complicated. Hip problems can occur at birth. Digital currency failures previously have made investors lose substantial amounts of authentic money. It can even prevent erectile dysfunction. Erectile dysfunction happens when a man gets sexually excited, but his penis doesn’t fill with enough blood to cause an erection, or whenever the man can’t maintain an erection long enough to finish a sexual act. Before you take a very first dosage of Suboxone, you are going to have to abstain for some time from the other opiates, and you are going to have to be feeling the beginnings of withdrawal pain.

    Ultimately everything is likely to deal with itself. Long-term methadone patients will experience a decrease in basal testosterone levels with time, and ED (erectile dysfunction) or the ability to accomplish a satisfactory erection is often related to the use of the replacement opiate therapy. Your physician will counsel you on the length of time you will have to wait prior to taking a very first dosage of Suboxone.

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    Just since there is more than 1 path to the peak of a mountain, there’s more than 1 path to building wealth, improving confidence, and building muscle. Thus, the mode can help with respect to ballistic purposes, thereby assisting you to take the shot precisely. More to the point, you’ll find a distinctive mode that lets you know the precise horizontal distance of an object in the slope.

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    When a chemistry is correct, the mindset is correct, usually the ending will be right, Thomas explained. There’s very limited interaction between game elements and therefore the game remains shallow. With the assistance of light carbon fiber, optical together with electronic components are integrated with die-cast metallic housing of the gadget.

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    If you are able to continue to get better, there’s a reason to come back to a game over and over. Most individuals are extremely delighted to have a game at the place where they can learn the rules and play at a competitive level. The game is about reading your opponent and seeking to outsmart them. On the surface Poker is a fairly boring game. Well, you’re attempting to make plays and you’re attempting to win, Manning stated. Players handle pressure in their very own way. They will need to discover that card, what it does and how it works with the rest of the game.

    Peer-to-peer marketplaces like Zaarly permit you to promote your abilities and services through your own online shop. Focus on what you could learn from different men and women, on what you may teach them, on what you may leave behind, and on how you’re able to produce the world a better place. Approach every new person that you meet with the belief that they might know something which you don’t, and learn how to see in the world what most cannot see. Thus consuming milk with Jaiphal on the very first wedding night is a standard standard practice in India. An excellent teacher is someone that could discover distinctive strategies to convey exactly the same message because every individual learns differently.

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    Don’t just guess how you’re doing know how you’re doing. You’ve got to show yourself. Most of you, in case you get an excellent strength and conditioning program, know precisely what your lift numbers are. So having more of them is able to help raise your libido along with sexual stamina. It is crucial to learn to 1. Though it’s simple to use, you might need some time to become accustomed to the menu. The waiting times will fluctuate based on the drug of abuse.

    If you aren’t getting adequate rest, your body doesn’t have an opportunity to totally recharge. You don’t observe a great deal of back that try to get every inch they’re able to. If you are really courting, make 1 point of conversation your wellness and wellness. In Puerto Rico however there’s a massive difference between the initial and the second game. Then you’ve got to determine a means to provide twice as much price.

    In the self-improvement world, it’s typical that people search for an easy trick or outside remedy to their problems. You’re speaking about a guy that looks like he’s on a mission. You are obtaining a guy that could score touchdowns in three unique ways for you.

    The Most Incredibly Neglected Answer for Hepatitis C Prednisone

    So How About Hepatitis C Prednisone?

    Avoid drinking alcohol when you are taking prednisone. You should not quit using prednisone suddenly. Tell any doctor who treats you which you are using prednisone. If you’re a breast-feeding mother and are taking prednisone, it might affect your baby. Prednisone may raise your risk of damaging effects from a live vaccine. You ought not take prednisone if you’ve got a fungal infection anywhere in your physique.

    The conventional dosage employed in a lot of patients is prednisone 10-15 mg each day, either alone or with azathioprine 50 mg each day. You ought not use this medication if you’re allergic to prednisone, or when you have a fungal infection anywhere in your entire body. Prior to beginning using a medication, remember to inform your doctor of any medical conditions or allergies you might have, any medications you’re taking, whether you’re pregnant or breast-feeding, and any other vital truth about your wellbeing. If you get pregnant when taking this medication, contact your physician immediately. If this medication is stopped, the dose should be decreased gradually in accordance with your doctor’s instructions. If it has been taken for extended periods, do not stop taking it without talking with your doctor. Steroid medication can weaken your immune system, making it simpler for you to receive an infection.

    Any medical care provider who treats you ought to know that you’re employing a steroid. Treatment options vary based on which kind of hepatitis you’ve got. Using vaccines is a significant key to preventing hepatitis. Long-term use of steroids may lead to bone loss (osteoporosis), especially in the event you smoke, if you don’t exercise, if you don’t get enough vitamin D or calcium in your diet plan, or in case you own a family history of osteoporosis. Consider whether the individual has a disorder regarding the gastrointestinal and hepatobiliary system or whether the signs are the end result of a disorder from another system or other aspects like pregnancy, medications, or a psychological disorder. Your blood pressure may also need to get checked. You could also retain added fluid that might cause a rise in your blood pressure.

    Beneficial effects might not be seen for as many as 8 wk. Evidence suggests that steroid boluses used to take care of acute rejection are associated with a gain in HCV viral load and the seriousness of recurrence. The ideal evidence for long-term drug usage is the mixture of a superior history and a urine toxicology screen. If you have any questions about the drugs you’re taking, check with your physician, nurse, or pharmacist. By the moment you finish that kind of knife test you would know for sure if you’ve got a good handle or not. When using prednisone, you can need frequent blood tests at your physician’s office. If your liver function tests are abnormal, your health care provider will probably order different bloodtests to detect the source of the issue.

    The approach to treatment is dependent upon the reason for the disease. Treatment with steroids could be effective, but might exacerbate the viral infection. Such patients are not likely to respond to further medical therapy, and liver transplantation needs to be considered. Your health care provider may also feel to see whether your liver is enlarged. If you work with your doctor to create choices that minimize side effects, you can achieve vital benefits with a reduced probability of such issues. Your health care provider may occasionally change your dose to be certain you have the best outcomes. Your pharmacist might be able to counsel you on managing side effects.

    A different virus is accountable for each form of virally transmitted hepatitis. People having this type of infection are often advised to acquire adequate rest, drink enough fluids, get enough nutrients, and prevent alcohol. This short-term infection is known as acute hepatitis B. To establish whether you have an acute or chronic infection, you have to be tested for hepatitis B on a six-month period. The disease is currently called autoimmune hepatitis. It later became evident this disease wasn’t related to SLE.

    Hepatitis refers to an inflammatory state of the liver. A lot more people don’t even know they have hepatitis. Autoimmune hepatitis is contained in this classification. The vaccine is also encouraged for all healthcare and health care personnel. Vaccinations are readily available to stop the evolution of hepatitis A and B. Experts are developing vaccines against hepatitis C.

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    HCV is one of the most typical bloodborne viral infections in the usa. A wide selection of health problems may lead to elevated liver enzymes. The attractiveness of Puristat’s Liver Detoxification program is that it’s easy to use. Tell your physician if you’re breast-feeding a baby. An overdose of prednisone isn’t expected to generate life threatening symptoms. Stimulants may boost blood levels of TCAs, increasing the danger of cardiotoxicity. Certain supplements and medications may also have an effect on liver function.

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    Commonly referred to as impotence it happens for many diverse reasons. Erectile dysfunction can be a result of physiological or physical issues like anxiety, depression and stress. As it may be a sign of an underlying condition such as diabetes, high blood pressure, or heart disease, there could also be a wider benefit to public health in the long term. It can be a debilitating condition, so it’s important men feel they have fast access to quality and legitimate care, and do not feel they need to turn to counterfeit online supplies which could have potentially serious side effects. There are a number of various ways to manage erectile dysfunction depending of the causes.

    Viagra can be rather dangerous depending upon your blood pressure and state of your heart and can become addictive. Only if Viagra does not work or it’s unsafe to use the drug in the very first place will they be in a position to move the individual onto the pricier therapy choices. When you visit a pharmacy in America to get a prescription, you’ll. Prescription is a huge one, obtaining a high quality preparation at a traditional store could be impossible without a prescription, which of course implies a visit to a physician. You do not need the prescription to acquire what you need badly. Unfortunately, these medications may also have an effect on blood circulation in arteries in different components of the human body, producing serious, unwanted side effects. It’s a perfectly safe medication.

    Advice about erectile dysfunction and the possible side-effects of the medication will likewise be given by pharmacists, along with advice on whether further consultation with a GP is needed. Once you answer the questions, don’t hesitate to make any extra comments you like (try to keep on the topic generally please). Consumers who have questions regarding fertility in combination with different diagnoses.

    Utilizing rest stops on a road trip is a significant method to conserve money and time. So make sure that it is legitimate place to create orders and that they use SSL cerfiticates. Any time they you take a medication, is going to get side effects and advantages. You’re going to want to provide the ride more than 1 go. If you have problems sleeping try turning off your cell phone before getting into bed. In any case, sometimes it’s the use and abuse of particular drugs that can make sexual dysfunction. With Viagra, is not any different.

    You want a correct heart to heart in which you sit down and chat about where you go from here because in terms of fertility, time isn’t on your side and you have to discuss the implications for you both. Men can get the drug in pharmacies and online after answering a set of questions to help determine whether the item is appropriate for them. Most men report some level of penis sensitivity reduction with time.

    These days, the overwhelming majority of websites selling prescription drugs online are. These websites provide a good deal on something which would cost us a fortune otherwise. The good thing is that through the usage of private care products containing penis-specific vitamins and minerals and observing some basic suggestions, loss of penis sensation does not need to mean the conclusion of sexual enjoyment.

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    Consumers ought to be cautious when buying pet drugs online and should not allow Internet pharmacies. If only the public knew about our lifestyles and all the effort which gets put into our job, we’d find a great deal more leniency. New research indicates that exercise should incorporate a more compact hippocampus and the United States. Meanwhile, the researchers mentioned that the consequences of cocaine abuse.