Comment on: The chronic fatigue syndrome: what do we know? [BMJ. 1993]
Editor,-In discussing the various causes of the chronic fatigue syndrome P K Thomas fails to mention one syndrome-namely, functional hypoglycaemia. We do not believe that such a syndrome exists, but in the Netherlands it has become a popular diagnosis among “alternative doctors,” who claim that chronic fatigue is caused by inappropriately increased postprandial insulin concentrations with subsequent hypoglycaemia. This disease is linked to a so called allergy to endogenous glucose.
It is clear from this description that there is no scientific basis for this syndrome, and this is confirmed in the literature. Unfortunately, doctors and dietitians who recognise this syndrome have burdened their patients with complicated diets, requiring the elimination of all simple carbohydrates. When we asked an alternative doctor why we never see hypoglycaemia in these patients we were told that we do not measure glucose concentrations at the right moment. The diagnosis should be made after a standard oral glucose tolerance test with measurement of glucose concentrations three and five hours after glucose intake. “Overproduction” of insulin is thus shown by reactive hypoglycaemia.
The use of this non-physiological test to diagnose this syndrome has no scientific basis whatsoever. Nevertheless, tens of thousands of patients are treated for this syndrome in the Netherlands.
You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1678679/pdf/bmj00039-0047a.pdf
Source: Heuft L, Bravenboer B, Ziekenhuis C. Functional hypoglycaemia postulated as cause of chronic fatigue syndrome. BMJ. 1993 Sep 18;307(6906):735. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1678679/