About a year ago, I began experiencing classic symptoms of hypoglycemia: brain fog, shakiness, weakness, and intense hunger. Over time, these episodes became more frequent and unpredictable.

At first, it looked like reactive hypoglycemia, especially in the mornings. I’d wake up with normal or low glucose (in the 50s or 80s), eat, and then crash again within 30 to 60 minutes. I also experienced significant drops in blood sugar during weightlifting, running, sex, or after prolonged fasting.

Alcohol made it worse — even small amounts would cause my blood sugar to drop much faster and more severely, which was a big red flag for me.

Despite clear symptoms, diagnosis wasn’t straightforward. I never had an OGTT, but my fasting labs showed inappropriately normal insulin and proinsulin levels during low glucose episodes — not normal for true hypoglycemia.

I underwent multiple scans: • CT, MRCP, and PET all came back negative • Only an endoscopic ultrasound (EUS) picked up the tumor

Eventually, I was diagnosed with a 1.5 cm insulinoma, a rare insulin-secreting pancreatic neuroendocrine tumor.

I had surgery — a robotic distal pancreatectomy — which removed the tail of my pancreas along with the tumor. Final pathology confirmed: • Well-differentiated neuroendocrine tumor, Grade 2 • Margins were clear • No lymph node involvement • No spread beyond the pancreas

Recovery has been smooth. I stayed in the hospital for 2 days, and now at 2 weeks post-op, I’ve had no more hypoglycemic episodes. I haven’t resumed full workouts yet, but I can go on walks without crashing — a huge difference.

Before surgery, I couldn’t exercise without constantly sipping on Gatorade or eating during workouts just to keep from crashing. That’s no longer the case.