Dr. Basuki Nath Bhagat
Family Physician
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Patient's Query
Hello doctor,
Just recently, around 15 days back, I went out drinking with my friends. I only drank 2 pints of beer that night at a normal rate. The next afternoon at about 12 PM, I had two slices of toast with chocolate spread and coffee for brunch. The next meal was at 4 PM (4 hours later). However, it was during this time that I began cooking, and I felt my hands shaking, my heartbeat going fast, my face flushed, and I felt like I was going to faint if I did not eat anything. I then had some oat bar and the hand trembling stopped. I searched on the internet about my symptoms and found them to be hypoglycemia. I know for a fact that I am not diabetic, so it totally caught me by surprise. So three days later, I ran an HbA1c screening to understand my blood sugar level. The result came up the same day, and it was 34.9 mmol/ml (non-diabetic). I have attached the results. Following that, a week later, I met with another group of old friends, and we ended up having quite a number of drinks. I got slightly tipsy, but I drank a lot of water in between as I was afraid of the after-effects. Ever since then, I have decided not to consume alcohol and to gain abstinence for good health. Moving forward to today, I went in for an MMR vaccine from the occupational health department as a precaution for exposure-prone procedures, as I will be starting medicine this September. So I was given the MMR booster vaccine as suggested by them. I got the shot. They advised eating something as I went on an empty stomach from an early breakfast in the morning (6 hours fast). I then had coffee and an oat bar cookie. After that, I returned home and had a shower before dinner. Again, I started to feel the hand tremors but not as significant as in the previous episode, and after eating, the hand tremors stopped. Could this be due to the vaccine, or is there something wrong with me? Please give me a good explanation.
Hello,
Welcome to icliniq.com.
You had two episodes of similar symptoms. The first episode happened after the intake of alcohol. Alcohol is one of the etiological factors that can cause hypoglycemia. In the first episode, you had symptoms of a feeling of fainting, increased heart rate, and tremors in your hand, this is called adrenergic symptoms. The Second episode happened due to a prolonged gap in the intake of food. I think the symptom of the second episode is not related to the MMR (measles-mumps-rubella) vaccine. The above symptoms are due to hypoglycemia. To confirm the diagnosis of hypoglycemia, blood should be drawn, whenever possible, before the administration of glucose or intake of food to allow documentation of low plasma glucose concentrations. Thus the ideal time to measure the plasma glucose level is during a symptomatic episode. Have you measured plasma glucose levels during the above symptoms? A normal glucose level excludes hypoglycemia as the cause of the symptoms. There are many causes of hypoglycemia, and one is alcohol, but usually, alcohol causes hypoglycemia episodes in ill or medicated individuals. To evaluate various causes of hypoglycemia, a detailed medical history would be needed, along with relevant medical investigations that have to be done based on the medical history. I sincerely request you completely prevent the intake of alcohol in any circumstances. If similar episodes happen again, try to measure plasma glucose level during the episode of hypoglycemia. Do not worry about it. I hope you find my reply helpful. Please follow up if you have any further related queries about it.
Thank you.
Patient's Query
Hello doctor,
Thanks a lot.
Hello,
Welcome back to icliniq.com.
You are welcome.
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Family Physician
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