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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16283
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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I was diagnosed with hypoglycemia when I was 18 years old.

Customer Question

I was diagnosed with hypoglycemia when I was 18 years old. After many years of watching my sugar levels and avoiding sugar almost completely I finally got my glycemia under control to a point where I no longer had a visible physical reaction whenever I ate sugary foods.
I have battled to lose weight my whole life and in my early 20's the only way I could manage to lose weight was to cycle for an hour a day (then weight train for an additional hour) 6 days a week to see any results. Surely this amount of excercise is not necessary? At the time I read that hypoglycemia plays a strong influence on weight gain and a difficulty to lose it...
Naturally I couldn't maintain my crazy exercise routine and over the years the weight has begun to creep slowly back on.
Last year I gave birth to a baby girl and within 3 days was back to my original weight before my pregnancy - and less. However I suffered from really bad postnatal depression and battled to feed my baby and so was put on a course of anti depressants (sulpiride/equimode) which helped with the depression and the milk supply but literally made me gain weight overnight.
That was 10 months ago and no matter how much I have dieted or exercised since then, nothing I do will bring my weight down (I can't lose a single pound) My gut tells me there is something wrong, be it my hypoglycemia or possibly an underlying thyroid problem. Could this be the case or am I going crazy here? (I am a recovering bulumic so am desperate to sort out my weight problems before the matter gets out of hand. Please help!)
Submitted: 7 years ago.
Category: Health
Expert:  A. Schuyler, NP replied 7 years ago.



Welcome to Just Answer and thanks for your question. The first step would be to see your primary provider for blood tests for thyroid and other endocrine problems. A glucose tolerance test would check for hypoglycemia. If all tests are normal, then the only way to lose weight is to reduce calories. While I know you have limited sugar consumption to avoid hypoglycemia, calories are just as important to losing weight. Weighing and measuring portions is also important, because most people eat 2-3 times as much as they think they do. I have provided some typical 1,200 calories diets in the links below. No one should ever eat less than that, because it is the minimum needed to maintain proper nutrition. Everyone needs 30-60 minutes of brisk exercise most days of the week. Cycling is an excellent choice, but so is jogging (and you can push the baby in a jogging stroller), or even a brisk walk.

Customer: replied 7 years ago.

Thank you for the advice.

Unfortunately I live in a third world country which means we are limited to what tests can be done (a blood test a few years ago indicated that my thyroid was slightly out but the matter was never taken further) I believe that thyroid problems are not always detected through a mere blood test..... It doesn't help that I do not have a medical practioner that I can trust at present as my previous practioner labelled everything I went to her for as a "virus" .


As for diet - I have been restricting my sugars but I have also been keeping my intake of carbohydrates (or rather starches) to a minimum, I am also lactose intollerant which means my calcium comes from soya rather than full cream dairy, I eat almost no bread and never touch fast food. If anything I should be eating more (bad for a hypoglycemic I know) I am also on the go all day every day with regards XXXXX XXXXX exercise.

The weight gain (as I mentioned) was a result of the tablets I took (and probably the fact that I quit smoking a few months before my daughter's birth) and NOT from over eating or bad eating habits...


Expert:  A. Schuyler, NP replied 7 years ago.

Even in a third world country, a thyroid panel is a thyroid panel. Be sure to ask for both TSH and free T4 since TSH alone isn't definitive. Any practitioner can order one, and it is done at a lab so results aren't skewed by the beliefs of the practitioner.


It's fine to limit sugars and starches, but protein and fats also contain calories and the equation for weight control is that calores in must be fewer than calories out (exercise and metabolism) for any weight loss to occur. Medications can contribute to fluid gain and improved appetite that results in increased eating, but those factors are eliminated when the tablets are stopped.


Customer: replied 7 years ago.

While I appreciate your reply, unfortunately it is the response I get from most practitioners. It's frustrating being brushed off with replies of "eat less and you will lose weight". Again I must reiterate it is NOT my diet that is the problem for my weight.

My question was more to confirm what the possibilities are that I may have a thyroid problem or if my hypoglycaemia has returned (ie if my pregnancy could have triggered one of these two) and are these two linked like articles I have read on the web seem to suggest.


Sorry if I seem ungrateful but am very frustrated and despondent

Expert:  A. Schuyler, NP replied 7 years ago.

The only way to tell if you have a thyroid problem or hypoglycemia is to have the blood tests I mentioned.


I realize you are frustrated and despondent, but you cannot ignore laws of physics. Calories are always the reason for weight gain if someone is not taking medication. That includes weight gain from deficient thyroid. By the way, underactive thyroid is responsible for only about 5% of body weight, and that is because it causes fluid retention. The answer to weight loss will always be to reduce calories, just as the sun will always rise in the East. That is frustrating, but it is true.


Customer: replied 7 years ago.

Thanks but I am more frustrated and despondent by the constant advice to "eat less" when I know there is something more...


You did not mention whether is was POSSIBLE and I understand only tests will tell but in my country, where even water is a luxury, I may not be able to get any accurate tests done. I need to know what the chances are on whether I look outside my country to have further tests done if necessary. (my midwife said my weight is "hormone related")


Can I "opt out" and see what someone else has to say? My apologies to you.

(I will be online same time tomorrow for a reply)

Expert:  A. Schuyler, NP replied 7 years ago.

I have opted out since you have no interest in hearing the most basic of science from a PhD in biochemistry. I have sent your question to an MD for further comment.


I would certainly advise endocrine testing in another country if yours cannot even perform simple blood tests.

Customer: replied 7 years ago.

While I appreciate your advice I find your manner very patronising especially given that you did not answer the question I repeatedly asked for.


One should consider it a privaledge to live in a country where the luxury of good medical care and services are taken for granted. I live in a country where 4000 people died from a cholera pandemic last year, not just because of bad sanitation but because there was no basic oral rehydrations available. I find your response to my questions and your attitude to my situation most disappointing.

Expert:  A. Schuyler, NP replied 7 years ago.

The answer, of course, is that anything is possible - the sky could fall tomorrow - but use of one medication months ago is not a cause for weight gain continuing past the half life of the medication which is only a few days after you stop taking it. Hypothyroidism, if you even have it, is responsible for only about 5% of total body weight. That amounts to only 10 pounds for someone who currently weighs 200 pounds. That you would consider the opinion of a midwife without basis in any fact or blood test and who knows what education or lack thereof over that of a PhD biochemist who is also an NP plus every other medical practitioner you have seen, is what I find baffling, and very frustrating. The only way to determine if you have an endocrine problem that is causing weight gain of any kind is to have a blood test. I've done lots of medical missions throughout the third world, and I've never seen a spot where blood tests weren't possible to obtain, even though it meant sending the blood out of the country to a laboratory.


The MD to whom I sent your question replied to me that he wasn't going to waste his time on an answer because nothing he could say would be any different from what I had already told you, and that wasn't what you wanted to hear. I'm sorry we cannot give you an excuse for your weight gain since we cannot do any testing online.


I suggest you email [email protected] and ask for a refund of your deposit since no one is going to give you any other answer than the ones you have heard ad infinitum.

Customer: replied 7 years ago.

If you didn't think there was a possibility that weight gain could be related to hypoglycemia or underactive thyroid you could have simply stated that IN THE BEGINNING. There is absolutely NO justification for your rudeness, or your demeaning and disrespectful attitude towards my midwife (who you know absolutely NOTHING about) or the UNPROFFESIONAL way in which you referred my case and responded on behalf of your collegue.


You know nothing about me, my life, or where I live in the world, so please do not even pretend you know what my world is like or what we have or don't have.


Just because you have a string of initials in front of your name does not mean you know how to really listen, nor should it be an excuse to make others feel inferior.


As a professional your rude response is undeserved and uncalled for . However I wish you the best and rest assured I will no longer be using this website.