Sorry for long post..

Harold c

Newbie
Messages
3
Greetings all. It’s my first post on this wonderful forum. I stumbled upon the forum while browsing though RH related searches on a random morning I was feeling ******. Knowing there are others who have this condition certainly makes me feel less alone.

I’ve been diagnosed with RH via a GTT test. Fasting insulin levels were not high so that was good news. I’ve combed though the forums and implemented most of the strategies provided. Thank you guys.

I still get night time hypos on a pretty regular basis (few days a week) that ruins half of the waking day and it’s really frustrating. I’m pretty sensitive to my levels and when I test in the mornings I feel ****** typically levels range from about 3.8-4.2.

Periodically I get hypos in the day. The symptoms are mild and easily resolved when I eat but it’s the nighttime episodes that are most difficult.

Here’s my diet plan:

Breakfast:
2 scoops protein powder (no carbs)
3 tablespoon olive oil
4 whole eggs

Lunch:
Meat or seafood
Greens

Snack:
Avocado
Berries
Nuts

Dinner:

Similar to lunch

Before bed:
2 scoops protein powder
3 tablespoon olive oil

On the 3 days that I weight train I have 4 scoops of oats before and after training. I have to incorporate that since I find that it’s really difficult to maintain muscle mass doing full keto (I’m in the fitness industry so have to look a certain way).

Supplements:
Fish oil
Vitamin D
Magnesium
Berberine (any good reviews on this?)

One thing I haven’t tried is intermittent fasting. I need to maintain my caloric intake and find it hard to stuff everything in 8 hours.

Hoping some kind souls here can help look though my plan and see if anything is missing? The biggest question is how to prevent night time hypo. Thanks a lot you guys are awesome!
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi @Harold c
Welcome to our forum.
First of all, I will try and explain why I think that you need to change a few things, just don't think that I'm not experienced because I worked in football and they do a lot of upper body workout.
So, I don't have shakes at all, and if I did it would be a vegetable shake, which @Brunneria will help.
The reason is because it is processed and it is formulated to be concentrated, also the favouring, isn't good for you in the long term. Even though it is a protein shake, like the protein bars, the amount of carbs is increased due to production sugars.
If you do have RH, you are carb intolerant, depending on a number of things, the amount of carbs recommended is gonna be low, so you have to be careful with the amount of carbs you can tolerate.
I don't have hypos. Because my diet is very low carb. So my blood sugar levels stay in normal range all the time, that stops any hypos.
What is happening to you when you hypo. Is you have carbs, for me it doesn't matter how much, the carbs push my blood sugar levels up too high, the pancreas reacts with far too much insulin, that drives your blood sugar levels down into hypo levels.
Normal range is between 3.5-6mmols. The trigger for too high is around 7.5 (ish)
So for breakfast you eat breakfast, this will start the rollercoaster ride of blood sugar levels for the rest of the day, in and out, hyper, hypo hyper, hypo and so on.
Your weight training diet of having carbs just before will result in the same reaction, and when you feel tired after a while, that is because your energy levels have dropped because of your sugar levels drop. You will get a liver dump of glucose and glycogen which will again trigger the reaction.
The fasting level insulin reading is typically RH. That is because, you body wastes insulin, for many reasons, so the initial insulin response is weak and doesn't cope with the amount of glucose derived from a typical meal with carbs.
In my experience, carbs and weight training, is something that you will have to think about. Your body is producing too much insulin and the symptoms you are getting are because of your blood sugar levels going up and down all the time.
RH is a condition that needs control to be healthy and hypo free.

Can I ask you a few questions please?

Did you have a two hour OGTT or a four to five hours OGTT?
Did you go hypo? What was your blood sugar levels at the end of the test?
Have you had any other tests?
Have you seen a specialist endocrinologist?
What dietary advice have you had?

I say this a lot but what is healthy foods for most people, they are not healthy for someone who has RH.
The next few weeks, you will need to start finding out which foods you can tolerate, keep a food diary, this will help you understand what is happening to you.

I gather from your post, that you are training to keep your fitness and wellness.
So, this will be a lifestyle choice that you need to do. Having hypos because of your fitness is dangerous, and unhealthy for us.

Any questions, please do?

Keep safe
 
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Harold c

Newbie
Messages
3
Hi @Harold c
Welcome to our forum.
First of all, I will try and explain why I think that you need to change a few things, just don't think that I'm not experienced because I worked in football and they do a lot of upper body workout.
So, I don't have shakes at all, and if I did it would be a vegetable shake, which @Brunneria will help.
The reason is because it is processed and it is formulated to be concentrated, also the favouring, isn't good for you in the long term. Even though it is a protein shake, like the protein bars, the amount of carbs is increased due to production sugars.
If you do have RH, you are carb intolerant, depending on a number of things, the amount of carbs recommended is gonna be low, so you have to be careful with the amount of carbs you can tolerate.
I don't have hypos. Because my diet is very low carb. So my blood sugar levels stay in normal range all the time, that stops any hypos.
What is happening to you when you hypo. Is you have carbs, for me it doesn't matter how much, the carbs push my blood sugar levels up too high, the pancreas reacts with far too much insulin, that drives your blood sugar levels down into hypo levels.
Normal range is between 3.5-6mmols. The trigger for too high is around 7.5 (ish)
So for breakfast you eat breakfast, this will start the rollercoaster ride of blood sugar levels for the rest of the day, in and out, hyper, hypo hyper, hypo and so on.
Your weight training diet of having carbs just before will result in the same reaction, and when you feel tired after a while, that is because your energy levels have dropped because of your sugar levels drop. You will get a liver dump of glucose and glycogen which will again trigger the reaction.
The fasting level insulin reading is typically RH. That is because, you body wastes insulin, for many reasons, so the initial insulin response is weak and doesn't cope with the amount of glucose derived from a typical meal with carbs.
In my experience, carbs and weight training, is something that you will have to think about. Your body is producing too much insulin and the symptoms you are getting are because of your blood sugar levels going up and down all the time.
RH is a condition that needs control to be healthy and hypo free.

Can I ask you a few questions please?

Did you have a two hour OGTT or a four to five hours OGTT?
Did you go hypo? What was your blood sugar levels at the end of the test?
Have you had any other tests?
Have you seen a specialist endocrinologist?
What dietary advice have you had?

I say this a lot but what is healthy foods for most people, they are not healthy for someone who has RH.
The next few weeks, you will need to start finding out which foods you can tolerate, keep a food diary, this will help you understand what is happening to you.

I gather from your post, that you are training to keep your fitness and wellness.
So, this will be a lifestyle choice that you need to do. Having hypos because of your fitness is dangerous, and unhealthy for us.

Any questions, please do?

Keep safe

Hi Lamont. Thank you for your detailed response. I choose an all natural protein powder. There’s no sweeteners, colourings or flavours. And I just checked, the carb content per serving is 1g.

Since oats taken 3x a week is my main source of carbs right now, I suppose I should do glucose tests after eating them. Weight training doesn’t seem to cause hypos for me.

Typically my days are pretty well controlled. But I’m starting to understand what you mean. Is it that since I’m able to eat throughout the day, hypos can be avoided but once this rolls over to the night and I’m sleeping, BG dips and I wake up feeling bad?

To answer your questions, I did 2 hour OGTT. I’m sorry I don’t remember the numbers but it was a positive diagnosis by my endocrinologist. He then did a fasting insulin test to make sure my baseline levels were not high. And it wasn’t. He gave me generic advice like what we can find on webmd. I noticed significant improvement after cutting almost all carbs out.

My diet is pretty consistent everyday but the morning hypo episodes come and go. Is there any specific recommendations for dealing with morning hypo?
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi Lamont. Thank you for your detailed response. I choose an all natural protein powder. There’s no sweeteners, colourings or flavours. And I just checked, the carb content per serving is 1g.

Since oats taken 3x a week is my main source of carbs right now, I suppose I should do glucose tests after eating them. Weight training doesn’t seem to cause hypos for me.

Typically my days are pretty well controlled. But I’m starting to understand what you mean. Is it that since I’m able to eat throughout the day, hypos can be avoided but once this rolls over to the night and I’m sleeping, BG dips and I wake up feeling bad?

To answer your questions, I did 2 hour OGTT. I’m sorry I don’t remember the numbers but it was a positive diagnosis by my endocrinologist. He then did a fasting insulin test to make sure my baseline levels were not high. And it wasn’t. He gave me generic advice like what we can find on webmd. I noticed significant improvement after cutting almost all carbs out.

My diet is pretty consistent everyday but the morning hypo episodes come and go. Is there any specific recommendations for dealing with morning hypo?

Hi again,

Usually a two hours OGTT is not long enough for diagnosis, the fasting insulin as I described in my last post, is typically low, and will be tempered by low carb.
As I said, only testing before and after meals will give you an idea what is happening.
Did your endo say that you went hypo before two hours and stopped because of the hypo? If so, your secondary insulin overshoot will be triggered earlier than mine.

The go to advice from doctors and dieticians is to eat every three hours, and eat carbs. This is to prevent hypos. But if you are going hypo before three hours, then you will still have the symptoms and probably eating too much. This does not work in my experience. Only very low carb and keeping your blood sugar levels in normal levels will stop the symptoms and hypos.
If you are low carb, I don't understand why you are going hypo overnight, maybe something you are drinking? If you're in control all daytime, then what is triggering the hypos overnight?
Are you going hypo before breakfast?
Because if you are going hypo, then it isn't RH.
There are other conditions, but you need to get tests done.

Can you fast without going hypo?
I have had a fasting test in hospital that lasted 80 hours and my blood levels are never came out of normal.

I now use intermittent fasting and only two meals a day, when I want to eat.
But always stop eating before 7pm, to make sure I am not going hypo before bed.

What are your symptoms, any other tests?

Keep asking we will get there.

Keep safe
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Also, is caffeine bad for RH? Anyone tried Berberine with good results?

Not for me, but I only drink water and tea, black and no sugar, stronger the better.

It can do, like everything else, too much is generally bad for your health. But finding out how much is part of the journey.
I apologise for not answering your questions about supplements.
I don't need them and was told by my GP and endo, that I didn't need to.
This is a question for your endo. Ask if you are low on any vitamins, typically with endocrine conditions, the likes of B12 and vitamins such as B and C are typically low.

Keep safe