Reactive Hypoglycaemia

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Hello everyone,

I am new here. I have been having some postprandial symptoms that seem hypoglycemia-like. I am going through this with GP and specialists, but it has taken nearly a year to finally get to an endocrinologist.

So while the medical investigation proceeds at a glacial pace, I was thinking of trying a low-carbohydrate diet off my own bat.

Here's the problem: I am vegetarian, cannot eat eggs (except in small amounts), and cannot eat high-fibre foods (e.g. lentils, chickpeas, hardcore salad stuff).

(The egg and fibre thing relate to bowel surgery that I had many years ago.)

Is it possible to eat a low-carbohydrate diet with these restrictions? I have tried and failed several times as I am stumped at what to eat and I live in a small town so no suitable take-away or restaurant options. I just got overwhelmed trying to prepare meals from scratch.

Breakfast in particular is a problem - no fruit, no toast, no porridge, no eggs. What to eat? Plus I always feel a bit queasy so there's no way I could chomp down on a plate of stirfry first thing!

I guess I am prepared to go non-veg to see if the change in diet helps.

I would really appreciate your advice. Have tried one dietitian but she wasn't any help. A, gradually reading through thread and learning a lot.

Cheers,
Sarah

hi and welcome! :)

I can see how very low carbing as a low fibre vegetarian will have its own set of difficulties!
And a lot of that will depend on how low fibre and how low carb...

are chia seeds too fibre-y for you? Only chia seed puddings are great, if made low carb.
how about tofu scrambles or yoghurt for breakfast? Or avocado and mozzarella?
Golden milk? Coffee with cream or coconut oil?

My best breakfasts don’t happen at all.
By that I mean that if I skip breakfast completely (just a hot drink with a smidge of cream in it), my blood glucose stays beautifully steady until I do eat - which was 3pm yesterday.
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi, and welcome to our forum.
Having read your post, I have come to the conclusion that you are completely different to me. Because everything you can't eat, I do and vice versa. My daily intake is mostly meat, protein, eggs, and salad vegetables, with a few added tomatoes, small portions of fruit, mushrooms, onions.
Most of my meals are cooked fresh, some batched and frozen, like soup, curries and of course all very low carb.
However, as is pointed out, that most of my food intake is late afternoon, early evening. I use intermittent fasting, because my body tells me that if I want a good day and plenty of energy, then not eating is the simplest, easiest way to start the day.
If you don't mind, what is your fasting blood glucose reading before breakfast?
What tests have you had?

RH is a condition that is caused by food or drink that is too quick to turn to glucose.
Hypos are the result of eating those foods.
We are all different, we do need to find our own dietary needs.
Have a read of the low carb forum, there are some great ideas and recipes.

Do read the threads on the forum, any questions, we will try and help.

Best wishes
 

SarahTee

Active Member
Messages
35
Hi, and welcome to our forum.
Having read your post, I have come to the conclusion that you are completely different to me. Because everything you can't eat, I do and vice versa. My daily intake is mostly meat, protein, eggs, and salad vegetables, with a few added tomatoes, small portions of fruit, mushrooms, onions.
Most of my meals are cooked fresh, some batched and frozen, like soup, curries and of course all very low carb.
However, as is pointed out, that most of my food intake is late afternoon, early evening. I use intermittent fasting, because my body tells me that if I want a good day and plenty of energy, then not eating is the simplest, easiest way to start the day.
If you don't mind, what is your fasting blood glucose reading before breakfast?
What tests have you had?

RH is a condition that is caused by food or drink that is too quick to turn to glucose.
Hypos are the result of eating those foods.
We are all different, we do need to find our own dietary needs.
Have a read of the low carb forum, there are some great ideas and recipes.

Do read the threads on the forum, any questions, we will try and help.

Best wishes

Thanks, Lamont D. We are opposites! I can drop the vegetarianism if necessary, but the restrictions from my bowel op are non-negotiable unfortunately, and that does make things hard.

I don't usually feel hungry at breakfast time so I might try ditching breakfast next week and see how that goes.

I will check out that forum thread for ideas. Thank you for taking the time to write such a helpful and detailed reply – much appreciated.

Cheers,
Sarah
 

SarahTee

Active Member
Messages
35
hi and welcome! :)

I can see how very low carbing as a low fibre vegetarian will have its own set of difficulties!
And a lot of that will depend on how low fibre and how low carb...

are chia seeds too fibre-y for you? Only chia seed puddings are great, if made low carb.
how about tofu scrambles or yoghurt for breakfast? Or avocado and mozzarella?
Golden milk? Coffee with cream or coconut oil?

My best breakfasts don’t happen at all.
By that I mean that if I skip breakfast completely (just a hot drink with a smidge of cream in it), my blood glucose stays beautifully steady until I do eat - which was 3pm yesterday.

Hello Brunneria,
Thanks very much for your reply. I had forgotten about tofu scramble and I will definitely give that a try this week. If that doesn't help I will try no breakfast, as I don't usually feel hungry first thing.
Cheers,
Sarah
 

SarahTee

Active Member
Messages
35
I forgot to ask – how long is a reasonable trial period to see whether lowering carbohydrate helps? Would 2 weeks be long enough to see a difference?


(Sorry I haven't gone into detail about which tests/investigations I've had or my symptoms. It's all a bit complicated at the moment and I don't have all the test info to hand. Plus a few things are pending because everyone is on holiday now in Australia. I just thought trying a different diet is something I can do myself in the meantime.)
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
I think the timescales vary from person to person, and there are a number of things in play.

if someone drops their carbs from high to low sharply, and ‘goes keto’ then they may experience a few symptoms called ‘keto flu’ while their body adapts. Nothing to worry about, and easily dealt with. Others breeze right through with no such symptoms.

So RH symptoms may ease quickly (in my case, as short as a couple of days), but there could be other things going on during the transition. My body certainly had to adjust to steady bg levels after so long with wildly swinging ones. Hunger at weird times, headaches, carb cravings, and so on.

most transitional symptoms can be dealt with easily with a big glass of water or a hot drink. A bit of salt on your food, and eating good, unprocessed food with enough protein and fat to keep the hunger at bay and drip feed steady blood glucose levels.

good luck, and let us know how things go? :)

Ed for a typo
 
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SarahTee

Active Member
Messages
35
Th
I think the timescales vary from person to person, and there are a number of things in play.

if someone drops their carbs from high to low sharply, and ‘goes keto’ then they may experience a few symptoms called ‘keto flu’ while their body adapts. Nothing to worry about, and easily dealt with. Others breeze RH through with no such symptoms.

So RH symptoms may ease quickly (in my case, as short as a couple of days), but there could be other things going on during the transition. My body certainly had to adjust to steady bg levels after so long with wildly swinging ones. Hunger at weird times, headaches, carb cravings, and so on.

most transitional symptoms can be dealt with easily with a big glass of water or a hot drink. A bit of salt on your food, and eating good, unprocessed food with enough protein and fat to keep the hunger at bay and drip feed steady blood glucose levels.

good luck, and let us know how things go? :)

Thank you, that's very helpful. I think I'll do it in stages. I only get the postprandial symptoms after breakfast and lunch, so I'll change those meals first. Then once I've got used to that and worked out a few recipes I'll change the rest.
 

LouisSunny

Member
Messages
11
Type of diabetes
Type 2
If you wish to ask questions or are interested in asking anything pertaining to hypoglycaemia, diabetic or non diabetic. Ask here.


Hi, I haven’t been on here for ages as I’m quite settled. I am just type 2 with RH. Hello to you all.
I had my first Covid jab on Sunday and my levels have been really strange? I usually go weird at 4.5 downwards but I’m going weird towards hypo at 6.7?? All the same symptoms but I haven’t changed any of my boring food? Have you had any other people ask?
Many Thanks Donna
 
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Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi, I haven’t been on here for ages as I’m quite settled. I am just type 2 with RH. Hello to you all.
I had my first Covid jab on Sunday and my levels have been really strange? I usually go weird at 4.5 downwards but I’m going weird towards hypo at 6.7?? All the same symptoms but I haven’t changed any of my boring food? Have you had any other people ask?
Many Thanks Donna
Hi @LouisSunny welcome back.
I myself had a little rise for a couple of days and felt a little bit off but it was similar to the flu jab I get every year.
Be patient, I have heard about many people have lost their control for a few days even those without a endocrine condition.
Both my daughter and daughter in law have been to hospital, after the jab, my daughter had bronchitis and my daughter in law wasn't aware she was pregnant. They are ok now.
I'm glad you are coping with the RH and really enjoying the healthy boring diet (for you!)
Have you looked at dietdoctor.co.uk, this is @Brunneria preferred go to low carb/Keto dietary advice.

Hope this helps.

Keep safe
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Hi, I haven’t been on here for ages as I’m quite settled. I am just type 2 with RH. Hello to you all.
I had my first Covid jab on Sunday and my levels have been really strange? I usually go weird at 4.5 downwards but I’m going weird towards hypo at 6.7?? All the same symptoms but I haven’t changed any of my boring food? Have you had any other people ask?
Many Thanks Donna

Hi and welcome!

I had my first jab today, so no symptoms or bg changes yet, but I have put a Libre sensor on specially to track any blips. :D
 
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basten60

Member
Messages
14
Type of diabetes
Prediabetes
Treatment type
Diet only
If you wish to ask questions or are interested in asking anything pertaining to hypoglycaemia, diabetic or non diabetic. Ask here.
I was pre in November..i am in pain when eat anything..cant explain too complicated. If i eat anything with fat which stays in m tummy long time my sugars waking are 7.4 to 7.9. If i eat which i did some high sugar stollan cake xmas i suddenly cant stay awake. If i eat just chickin sprouts 1 carrot i am still in awful pain all in back. Had mrcp said all ok. Wake and sugars 3.1. Or 3.4. Ate bit of choc at 1pm fine then 6.30 sugars 5.4 so hingry at bit bread by 10.pm in pain all in back sugars 13.. now yesterday all i ate was 3 bread as im not well and pain all inside awful but this morning 4.1 no food get up at 10 by 11m30 sugars 5.5. Ive can barely eat due to pain eating after off 2 bad drugs. Will tell gp again hopefully tomorrowm i was worried re pancreas. I dont know how to find my replies to my posts on here
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Can non diabetic have hypoglycemia?
Hi @bisalimo ,
Yes, is the simple answer.
Hypoglycaemia had many causes, which are more likely to be non diabetic!
Hypoglycaemia in T1 is common.
Hypoglycaemia in T2 occurs through meds or over dose of insulin injected.
hypoglycaemia in other types of diabetes can be as above.

if you are referring to RH, it is a non diabetic condition, because of too much insulin after carbs!

hope that helps.

do ask if you have more questions.
 

Keatsy1987

Member
Messages
9
I have a question!

It's more about the feeling of reactive hypoglycemia, or postprandial adrenergic syndrome.

I know insulin dumps basically are the cause of the crummy feelings. However! What is actually happening that makes it feel so bad? Like my blood sugar is in the normal range, not actually hypo, so why do I feel dizzy, weak, like I might die? What's the science behind this even with normal blood sugar levels?
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I have a question!

It's more about the feeling of reactive hypoglycemia, or postprandial adrenergic syndrome.

I know insulin dumps basically are the cause of the crummy feelings. However! What is actually happening that makes it feel so bad? Like my blood sugar is in the normal range, not actually hypo, so why do I feel dizzy, weak, like I might die? What's the science behind this even with normal blood sugar levels?

The insulin dumps are known as overshoots and with RH, the insulin drives down your blood glucose levels down and the quicker it happens the worse the symptoms. The lower your BG gets, the symptoms get worse.
The reason you feel awful in normal levels is similar to a sugar crash. Your brain is probably used to being in relatively higher than normal levels due to carbs and sugars, it wants to stay there, just in case there is too much insulin or too high a spike, so the brain reacts by issuing signals to stop the spike or wanting more glucose, when your brain gets a signal that your BG is plummeting down, it tries to defend itself, send more signals, more symptoms.
Your brain, when out of normal levels, lacks vital hormones including glucose, cortisol and so on. The high levels of insulin, means that the lack of glucose, your brain is sending signals to your body to correct it, but it can't because of the need for food to process into glucose is not there, unless you are in ketosis and using ketones.
Because you are not yet in control or in ketosis, the imbalance of insulin, glucose and other hormones have symptoms connected to it. There is insulin resistance, high levels of circulating insulin mean your energy levels are down, the brain fug, lethargy but much worse, because there is nothing your body can use to correct it, glucogenisis from your liver is very poor because of insulin resistance, hence this is why even though I was eating very little, I was steadily gaining weight. Symptoms are the brain's way of telling you something ain't right! Unused insulin turns into unwanted visceral fat around your organs.
You feel awful because of the signals not doing what your brain wants it too!
Your nervous system is connected to all your organs and glands. Your nervous system is why your symptoms include anxiety.
Without using scientific jafgon, I think that about sums it up!
Keep asking!
 

Keatsy1987

Member
Messages
9
The insulin dumps are known as overshoots and with RH, the insulin drives down your blood glucose levels down and the quicker it happens the worse the symptoms. The lower your BG gets, the symptoms get worse.
The reason you feel awful in normal levels is similar to a sugar crash. Your brain is probably used to being in relatively higher than normal levels due to carbs and sugars, it wants to stay there, just in case there is too much insulin or too high a spike, so the brain reacts by issuing signals to stop the spike or wanting more glucose, when your brain gets a signal that your BG is plummeting down, it tries to defend itself, send more signals, more symptoms.
Your brain, when out of normal levels, lacks vital hormones including glucose, cortisol and so on. The high levels of insulin, means that the lack of glucose, your brain is sending signals to your body to correct it, but it can't because of the need for food to process into glucose is not there, unless you are in ketosis and using ketones.
Because you are not yet in control or in ketosis, the imbalance of insulin, glucose and other hormones have symptoms connected to it. There is insulin resistance, high levels of circulating insulin mean your energy levels are down, the brain fug, lethargy but much worse, because there is nothing your body can use to correct it, glucogenisis from your liver is very poor because of insulin resistance, hence this is why even though I was eating very little, I was steadily gaining weight. Symptoms are the brain's way of telling you something ain't right! Unused insulin turns into unwanted visceral fat around your organs.
You feel awful because of the signals not doing what your brain wants it too!
Your nervous system is connected to all your organs and glands. Your nervous system is why your symptoms include anxiety.
Without using scientific jafgon, I think that about sums it up!
Keep asking!

So with postprandial issues, or when there isn't actually low blood glucose, is there an actual danger or is it like your brain sending out false signals of sorts?
 

Keatsy1987

Member
Messages
9
The insulin dumps are known as overshoots and with RH, the insulin drives down your blood glucose levels down and the quicker it happens the worse the symptoms. The lower your BG gets, the symptoms get worse.

Without using scientific jafgon, I think that about sums it up!
Keep asking!

Sorry, one more question.
Besides going to keto, is there other ways to manage this? Is low carb diets in itself beneficial? Does the body ever adjust itself from being "used to high blood sugars"?
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
So with postprandial issues, or when there isn't actually low blood glucose, is there an actual danger or is it like your brain sending out false signals of sorts?

I can tell you as a fact that your brain lies to you constantly.
But that is why we can use some body signals or technology to help us control.
With a consistent control, you become aware of difference between normal and either going high or low!
My hypo awareness is so good.
Yes, lack of glucose or to much insulin is really bad for you.
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Sorry, one more question.
Besides going to keto, is there other ways to manage this? Is low carb diets in itself beneficial? Does the body ever adjust itself from being "used to high blood sugars"?

Yes to both questions, even though keto is better being just above normal without triggering an overshoot can be beneficial. Not all of us to keto, as some can do above very low of low.
If you have read the quote often seen in describing RH, it is a carb laden meal that triggers a reaction. For me it is any amount of carbs that trigger it. But you may be able some low carbs, that is why we need to experiment.

during my fasting test in hospital, the lightbulb moment was that not eating was good for me, made me realise that all of a sudden, I felt better, I lost weight and the symptoms lessened. No more brain fug.
my serious health problems, began to be healthy again, doing all this and getting a diagnosis from my specialist endocrinologist saved my life. I am now an active pensioner, other than wear and tear, I am physically for for a man of my age! But I have terrible mental issues. But as always I'm fighting them and hopefully come out of it soon.

Keep asking

Best wishes
 

Keatsy1987

Member
Messages
9
I can tell you as a fact that your brain lies to you constantly.
But that is why we can use some body signals or technology to help us control.
With a consistent control, you become aware of difference between normal and either going high or low!
My hypo awareness is so good.
Yes, lack of glucose or to much insulin is really bad for you.

Hi! Thanks, sorry one more question:

With postprandial, though, there isn't actually a lack of glucose or too much insulin right? It's like an over-reaction?