Adrenaline question

Has anyone here ever gone through a period of increased adrenaline, sometimes seemingly in bursts, causing unexpectedly fluctuating blood sugars and ketones?

There’s a lot of unknowns at play still, although there’s lots of medical input and a lot that I’m tracking, and I’ve been waiting for weeks for an appointment with the endocrinologist who is the go-to expert at my endo’s office. Apparently I might wait another 2 or 3 months. Waiting is not my strong suit.

I’m just looking for “been there” stories that might sound like they provide clues for my case.


Hi @theNoz . You’ve probably already ruled out any medications but sometimes “innocent” topical products can affect blood sugar - maybe that applies to adrenaline as well? Maybe a new skin care product is the culprit? Just a theory. I hope you find your answer soon!

How interesting about skin care products! Eeek, I consider myself forewarned.

But there were no new ones then. I have wracked my brain for what changed early December 18th that wasn’t true yet the week(s) before, to no avail. Same general diet. I was feeling good, had gotten a bunch of exercise in the afternoon of the 17th, and finished all my shopping and pantry stocking for upcoming holidays. And we were starting the weekend, and the next Tuesday would be the Winter Solstice! Nothing but longer days for the next 6 months!

Less than an hour before the first and worst spike, at 5 AM Dec 18th, my blood sugar was about 130 and I was having such an unusually pleasant dream. No nightmare did this.

One nurse has questioned whether the symptoms have been delayed perimenopause, something I didn’t realize existed but apparently it can manifest up to 20 years after menopause. Some perimenopause symptoms are caused by progesterone causing adrenaline spikes. Oh dear holy everything. I never did experience the symptoms of perimenopause beyond the actual stopping, 15 years ago. So they’re saying it can pop its head up over a decade later, when I’m turning 65?? Every time I contemplate that I just get… royally indignant. The nerve! I want to see the clause in its contract that allows it to do that!

But rogue perimenopause is just yet one more question. Rogue something thyroid is another, and there’s always diabetes. There are a host of questions at this point, and everyone’s deferring to the endocrinologists, and my endo is deferring to her colleague the adrenal expert - with whom I can’t seem to get an appointment yet.

hello @theNoz I had a year of what felt like torture. My endo ordered a 24 hour cortisol test and some blood work to try to eliminate some tecno-diabetes related adrenal/kidney issues which are rare but something you really want to know. Anyway for me there was no issue I was suffering from anxiety attacks and it was attributed to a divorce and PTSD. Hope you can get your diagnostics in order so you know. good luck

Thanks, Joe. I can certainly see how divorce would upset all the metaphoric apple carts of your body’s systems!!

Were your symptoms anything beyond just unreliable blood sugars? What was the most torturous? I am wondering if I’ve had other symptoms that I didn’t recognize as such.

What time of day affected you the worst, or was that not predictable?

Was it worse at one end of that torturous year vs the other (did it just ease up)?

Would you have said you were not a particularly anxious person before those anxiety attacks? In my case I was anxious almost all my life, even before the age of 6 when diabetes turned me into A Problem at home. I’m a virtual pro at anxiety, but less and less so over the last 6 years to the point that I haven’t been feeling anxious. And I’m great in emergencies!, that’s when I’m at my calmest. So I can’t say that I’ve particularly ever had anxiety attacks, but if so, they were in my teens and then in the 1990s. Certainly not lately.

I think really I’m looking for symptoms that might lead me on some investigation that would indicate a yea or nay on any of the theories that have been floated so far.

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@theNoz After my life fell apart, I left that situation, and all it entailed, and got a little apartment. I had incidences of 1-off panic attacks. Now for me, I was not used to this except for near-death experiences and certain, very specific “6-flags” type amusement rides. The first one I had brought me to my knees. I though I was going to die. tight chest, pounding heart, the feeling I could not breathe in, disorientation, sweat, loss of hearing, loss of vision (not complete, more like tunnel vision), and the perception that everything was in slow motion. After I did not actually die, I figured it would not happen again. Then this little event happened again and again. after the 3rd month of regular, (2-6 times a week) excruciating experiences, randomly occurring (day, night, shower, driving, sleeping), I first talked to my brother (he is a doctor) then I went to my endo.

For me I was never anxious to the point of symptoms. Like you I am fine when sh*t goes sideways - burst pipes water hitting the ceiling, car fires, bleeding, kids drowning in a pool, natural gas leaks, nephew caught in a rip tide, electrical shorts causing fires… been there and never even broke a sweat. So these “attacks” were crazy, new, . and very unsettling.

After the physiological issues were checked off, no tumor, no irregular heartbeat, no massive problem with chemistry, no electrical problems with the heart, no faulty vagal nerve, and I even put the goofy colander on my head and all brain waves “looked ok to me” (said the specialist) , So eliminating all that stuff lead me to deal with what’s “inside” my head.

Got me a therapist and worked on general anxiety, cut alcohol and caffeine (the latter was painful) started daily exercise, and I did other self-help oriented work, largely dealing with my own thought process and how it affects me. So fast forward almost 20 years to today. Now I am “sensitive” but with a glance at my CGM I can tell the difference between a panic attack and a low, I can also check-in with my triggers and “talk myself down” if it is only in my head. I put in a SOLID 10 years of work, followed by 10 years of coasting and now I find myself feeling better when I am doing “maintenance” type work.

I recommend eliminating any and all physical potential problems. That IMO is definitely where you want to start. and good luck on your journey!

Thank you so much for sharing that, @Joe. I haven’t had quite the same list of symptoms, but I recognize disorientation, sweat, tunnel-y vision.

I’m really glad you used the word “disorientation”, it’s exactly the one I was using most in the hospital. The first really bad episode made me fall when I tried to get to the bathroom, totally lost any idea of up or down and just went straight down, got a VCF - vertical compression fracture, of my L1 vertabra. They (all of them, ambulance, ER, Critical Care, hospital, rehab staff) kept asking me if I was feeling dizzy or unsteady, and the answer is emphatically No, but they don’t seem to understand that. The disorientation was something completely different, and the vision alteration was not helping me use visual cues to stay upright. (I tried referring to the “psychedelic” films of the 1970s to give them an idea what it was like, but they were all of them too young to remember anything like that, sigh.)

I check all medication for the influence on BGs, adrenaline, nor-adrenaline, and cortisol. Working with my endo I have been able to identify (sort of) evidence in my CareLink (Medtronic SG data). Unfortunately, the only way to know for sure is with a blood test at the time the “surge” occurs. In my experience adrenaline is the first to be released due to emotional and/or physical stress and I found that it happened often if I tried to work out (intense) without enough insulin/carbs. It shows up as a moderate to a high spike in SG levels and can be counteracted fairly easily with a bolus. Nor-adrenaline is more difficult to identify but my endo said it is far more powerful than adrenaline in spiking BGs it can also reduce insulin sensitivity in certain muscle groups - this hormone is given to counteract low blood pressure at the ER for example. Cortisol will spike more slowly and significantly reduce the general sensitivity to insulin and the effect can last for days rather than hours. I’ve seen this show up after an injury at the gym or if I push my cardio to over 120 BPM for over 15-20 minutes.

The hormonal reaction to a hypo can involve all three hormones in addition to glucagon. Unfortunately, all current closed-loop systems are “challenged” by the hormonal impact on BGs and insulin sensitivity.

A little discussed factor in blood sugar control is stress. Stress releases hormones that increases blood sugar levels. As an example, I decided last year to invest money in the stock market for the first time. It was a total new experience. For days I watched as I was losing or gaining money. I ate the same and did everything the same. However, I noticed that when I was losing money in the stock market it made me very tense and stressed and it shot up my blood sugar levels a lot. It is almost similar to the change in my blood sugar levels that happen when cold/flu sets in.

Endo’s know about this. However, I don’t think they like to talk about it a lot, because there is no numbers they can crunch to figure out how much to compensate for stress. It is not like counting carbs. It is a totally personal phenomenon. All I know is that our emotional and mental well being helps our physical well being. Best of luck to you. At least now you know that stress is powerful mover of blood sugar levels, so you can be ready.

Thanks, @Samljunggren , and I certainly agree. I’m all too familiar with stress and the role it plays, since early childhood.

But I know that I was feeling anything but stress that morning. The extreme hot flash of the first episode woke me from what had been a very pleasant dream - I remember thinking, “this is a really nice dream!” in the dream. That week I had just finished all my preparations and stocking up for the holidays and was feeling rather pleased with myself, if anything. That’s part of what’s been consternating about all this.

I’m sorry your experience with endocrinologists is that they avoid acknowledging the role of stress. Maybe I’m just lucky? My current endo is a T1 herself and very willing to talk about the effects of stress, but the endo before that understood too. But both of them are female and around or older than menopausal age, and both know a thing or two about hormone imbalances.

Theoretically I’ve been postmenopausal for 14 years, and it’s been the best phase of my life.

And then I learn that perimenopause can manifest up to 20 years after menopause. If that’s what happened to me, well. I’m feeling truckloads of righteous indignation, but I guess all bets are off.