Conversation: The conversation between human and AI assistant.
[|Human|] I am a 45 year old female and had a gastric bypass 2 years ago. I lost 70 pounds and now am at a healthy weight. i exercise 2-4 times a week. for the last month my blood sugar levels have been drastically dropping down to 46. this is happening almost daily but i have never been a diabetic. i am trying to get into see an endocronologist but this is taking a lot of time. my doctor did some blood work and says my insulin levels are very elevated. I even had to go to the ER one night and he said all the initial labs that he could do in the ER came back fine so my issue was above his level. what do i do and what could be causing this? i heard a possibility could be insulinoma?
[|AI|]  In your case, insulin is definitely a possibility. The symptoms that you have described plus the low sugar levels and high insulin levels, all point towards the possibility of insulin. It is a tumor arising from the pancreas from the cells that produce insulin in the body. The only definitive treatment is removal of the tumor surgically. For this, we have to locate the tumor first. For this, you should get a contrast enhance CT scan of the abdomen done. If it is normal, then an upper GI endoscopy with endoscopic ultrasound should help locate the tumor. Meanwhile, always keep something sweet like biscuits or sugar handy and eat it as soon as you feel the sugar going down. Don't miss any meals.