Low blood sugar

[anna-maro]

Hi! I have not been here for years, but I have an issue that I have a hard time finding usable information on. I have had reactive hypoglycemia for decades but learnt to live with it. I don't eat high sugar foods on a regular, or high carb foods especially in the morning. I generally learnt (I thought) to feel when my blood sugar is dropping, before shakiness and confusion occurs.
Just recently got a blood test done for other reasons, and my doctor told me my blood sugar level was 3.4. Now that was not a fasted state, but I don't remember what I ate. I also did not feel it, and my doctor told me probably because I had it for so long I got used to it. I do not have diabetes, I do not take any medications, I am 30, 5'9, 155lb bf% in the low 20s. I have a physically demanding job, I bike a lot, work a lot and have not been able to hit the gym as I used to, because I am too exhausted and sleep too much. Sometimes working out makes me even more sleepy or gives me head aches if i strain too much, and now I think it all has to do with my blood sugar being low the entire time. Can anyone help me with a little more detailed explanation in what is going on? How it effects me in working out, building muscle, losing fat? How to eat to benefit me in training and staying lean but not get sick?

[Heisman2]

You should absolutely see an endocrinologist. They can do a fasting challenge,where they put you in a hospital and you fast for up to 48 hours with regular glucose monitoring until your glucose dips below 50. At that point they do a bunch of bloodwork and a glucagon stimulation test, then more blood work. After they look at all he results they can come up with a diagnosis (hopefully).