Afaik you would get glucose back whenever you ate anything. Unless you were doing keto, but then your body and brain run on ketones. And if you did somehow deprive your brain of fuel, you would get symptoms in a much shorter span.
Maybe undereating, but he doesn't list weight loss, and if you're rapidly losing weight and start to notice these symptoms it would seem pretty obvious to try eating more.
> A systematic review found that stressful life events and childhood neglect were significantly more common in patients with FND than the general population, although many patients (around 70%) report no stressors. https://en.wikipedia.org/wiki/Functional_neurologic_disorder...
The OP doesn't state what diagnostic data or opinion led him to the glucose/dopamine depletion conclusion: https://twitter.com/TinkerSec/status/1388114584209350658
Regarding the post up above about a TIA (thank you for sharing this story) or the one below about the Microsoft engineer who had neck pain and then a stroke (carotid or vertebral artery dissection, often caused in younger people by car crashes or neck manipulation by a chiropractor..), I think a TIA/stroke is much less likely in this guy's case because of the recurrence of the symptoms after being able to work for a period of time. Someone who's had a TIA hitting Broca's area (motor speech) won't be able to work for a little and then have to stop, they're just not going to be able to speak/type. And unless they're very unlucky they're not going to have them repeatedly only after working for a short period of time. Maybe it is an exact match with the TIA post above with anxiety/PTSD after the initial TIA with word finding difficulty, but it doesn't seem like this guy had word finding difficulty at first because he was able to work after sleeping off his stroke.
If you want to run with glucose, he could have type I diabetes or an insulinoma if you want to go rare, but the symptoms are going to be resolved immediately after eating anything with carbs.
But what do I know, just a student in the American medical system.
In China there is even sort of a common saying for this. Generally when someone starts sort of acting stupid or in a daze its commonly related to, half jokingly, as “低血糖” or "low blood sugar"
Dangerously low blood sugar doesn't cause losing the ability to speak or to function that you can ignore and just keep working.
"As Harrington explained, "The brain is able to shunt blood [and thus energy] to particular regions that are being active at that point. But the overall energy availability in the brain is thought to be constant." So, while there might be significant spikes in energy use at localized regions of the brain when we perform difficult cognitive tasks, when it comes to the whole brain's energy budget overall, these activities don’t significantly alter it."
"Elite chess players are under intense pressure that causes stress, which can lead to an elevated heart rate, faster breathing and sweating. Combined, these effects burn calories over time."
They might've actually had something like a nervous breakdown or a TIA.
PSA: Don't self-diagnose, esp. if you're not an MD. 99% of the time, you'll be wrong.
At first I start to feel a little bit "stupid", like my brain isn't functioning properly, and is working in slow motion. Talking is more difficult. Next I start to feel a bit weak/shaky/trembly. Next I start to feel anxiety/dread. Sometimes now I can get very aggressive (which isn't in my nature at all!). Then comes an incredible desire to eat sweet things - once you start eating, it can actually be difficult to stop! Depending on how bad things got, I might feel too confused to actually just go and eat something.
Now, all being well, I did eat something, and will start to feel a lot better within 10-15 minutes.
If I didn't eat something (because there wasn't anything available, or because the "stupid" feeling had given in to confusion, and I didn't know wtf was happening), everything ramps up - the anxiety becomes full on dread, the world seems to be caving in on me, and I literally feel like I'm going to die. The weakness feels like I need to lie down (a couple of times I have, but thankfully my partner was at home and found me). The "stupid" feeling gets much worse - my speech is slurred, and finding the right words to talk is very difficult - mostly what comes out it is "umm.. err.. what?.. uhh..".
> Then comes an incredible desire to eat sweet things - once you start eating, it can actually be difficult to stop!
This sucks a lot with diabetes. The survival mechanism kicks in and tells you "eat something, anything, everything", which can subsequently cause your blood sugar to skyrocket, which you then have to correct with more insulin...it can send you on a blood sugar roller coaster than can ruin your entire day. Diabetes sucks.
My dad was using low blood sugar as an excuse and insulin as an enabler to eat crap, and gained a lot of weight.
He eventually got an insulin pump and cut down on simple carbs.
For me, a CGM was the biggest game changer, by far. Second was cutting down to eating one (larger) meal per day.
If you're not diabetic and have low blood sugar from exertion, just stop what you're doing and drink some water and rest. Your body will handle it just fine. Carbs should be reserved for real emergencies.
In my particular situation, the best way to manage things has been to go keto - any more than around 5g of carbs causes me to have a hypo, presumably because my body over-compensates and releases too much insulin. I switched to keto a few years back, and my life has been so much easier since then - I went from having a hypo multiple times a day, to very rarely. It's been several months since my last one.
If I hypo (or in the more general case when a T1 takes too much insulin by mistake and hypos), the "healthier" option is to use glucose tablets or a glucogel tube (a measured dose of glycogen, often carried by T1s).
But when you're having a hypo, you don't always think clearly - it's fine if you catch it early enough, but otherwise it really is like you're under a magical compulsion to eat as much sugar as you can; I'm not sure there is another experience I can relate it to. And once you eat some carbs, it's 10-15 minutes before you even start to feel better - believe me, you can eat an obscene amount in that time!
Nevertheless, who knows what combination of medical peculiarities might be involved, so I guess it cannot be ruled out.
My prior assumption would still be that a case of burnout/exhaustion, or micro stroke seems like a more probable explanation.
He writes
> talking to other hackers & infosec folk, they have said they've felt similar symptoms. The brain fog after working too hard & too long.
I really get the feeling that being overworked, not resting enough is the problem. I get the feeling that the work ethics and self-concept of being a hard worker makes it somewhat hard to admit that one is being overworked and thus a medical explanation for breakdown is very welcome for some individuals.
Not quite. He cites the specific diagnosis the doctor gave him and the associated DSM-5 code, but his extrapolation about dopamine and glucose is not part of that diagnosis. It’s not actually physically possible as he describes it.
This is a decent overview of the exact diagnosis he cites: https://www.mayoclinic.org/diseases-conditions/conversion-di...
In short: It’s a stress-triggered disorder that doesn’t correspond to specific physical conditions, contrary to how he describes it.
As long as you have the fat reserves, it's possible to fast for weeks with nothing more than water. As long as you have a functioning liver, your body uses glycogenesis to create enough glucose for your brain to function.
Not to mention getting warning signs and pushing through, which I'll be honest I'm guilty of doing as well (though I never got that far, and mostly it was sleep deprivation)
As other commenters have said, absent any extreme weight loss or undiagnosed metabolism disorders like diabetes, there is nearly no chance that glucose burn-out occurred in an otherwise 'healthy' person.
We may all be wrong, or missing some key information, at which point I look forward to the cuhbbyEmu video on it.