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Comment by pmichaud | Hacker News Reader

Many of his symptoms sound just like severe hypoglycemia. My wife has similar, but much less dramatic things happen to her when her blood sugar crashes. Really interesting.

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I've occasionally dug deep enough into exercise-inducded hypoglycemia to have very, very mild hallucinations, but mostly it just forces you off the bike; if you could go on exercising at that point, you'd be at risk of doing neurological damage, like someone injecting an OD of insulin. I'm familiar with Robic from other articles, and it seems pretty clear that his craziness is sleep-deprivation induced. He wins those multi-day "ultra" events more by sleeping much less than by going faster.

90 minutes of sleep a day is enough for "normal people" to avoid hallucinations... But doing what he's doing, I'd imagine he'd need a hell of a lot more, so you're probably right.

How is it diagnosed? What are the usual measures one should take if he/she has one?

A simple finger prick blood glucose check[1] will give the current blood sugar level. A doctor's office can also check A1C level that basically gives a longer term (couple of months) look at what the blood glucose level has been.

1. http://en.wikipedia.org/wiki/Blood_glucose_monitoring

To determine if you have reactive hypoglycemia you go through something called a 5 hour GTT (Glucose Tolerance Test), which is hell if you really do have the disorder. Essentially you fast after drinking a sugary drinks, and they test your blood at intervals to see what it does. A Reactive Hypoglycemic will spike, then crash, unlike a normal person who will have a smaller rise then pretty much stay there. See, she normally has to eat ridiculously healthy food every 2 hours to stay even, otherwise she crashes.

It starts with cold sweats, then degenerates into nausea, confusion and a rotten mood. It never gets that bad with her anymore, we have a good system going now. When she is upset about something the first thing I ask is: when's the last time you ate?

If you want to know more about it, check out her site: http://www.reactivehypoglycemia.info/articles/

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