Unfortunately I have a lot of mineral/vitamin deficiencies, adrenal fatigue, allergies, depression etc. so I need to take supplements. I'd be interested to know exactly why I have RH (other than an element of insulin resistance) and will push for more info next time I see the specialist.
Agreed keto is difficult to maintain, I have a histamine intolerance and dairy allergy so its even more limited for me....thats why I've been racking my brains and figuring out if this is something I can maintain long term.
I've probably been doing keto for 6 months now and have been kicked out of ketosis a handful of times...each time has been a horrible hypo reaction and taken me a few days to get back on track. Sugars are hidden in everything!
I was hoping I could maybe try the low carb diet long term but we'll see.
With exercise I've started walking and cycling again, I was swimming every day before lockdown. Occasionally do light weight training and the days I have my two toddlers are exhausting!
As far as I have researched and through my own experience, reactive hypoglycaemia is a condition where you have in layman's terms carb intolerant.
So every time carbs are eaten the lack of background insulin at first phase of initial insulin response is very low. The quick glucose derived from carbs depending on how much or high GI the carbs, the higher and faster the hyper goes, (spike) this is the trigger and your brain signals your pancreas to produce insulin, (the overshoot) problem is the amount of insulin drives your blood glucose levels down quickly and it won't stop production until you can gain control by eating or strangely a mild form of exercise.
Even just this one episode of hypoglycaemia is enough to cause severe symptoms, the symptoms persist the amount of time your blood glucose levels are fluctuating up and down and the amounts of over produced insulin is dangerous over time.
Insulin resistance and hyperinsulinaemia (high insulin levels) is not recommended and does cause further health issues especially in your organs, mainly liver function, fatty liver, kidney function to name a couple.
As in my case, a few years before diagnosis, my control (in ignorance) was really bad and because of no control my blood glucose levels were sometimes in the twenty plus mmols range, so I was diagnosed with T2. But what they didn't realise that my hba1c levels and fasting levels were in normal levels! I didn't understand why and I was following their recommendations for dietary intake, unfortunately for me, mostly carbs!
So every day, I climbed aboard the rollercoaster ride of fluctuating blood glucose levels, the constant symptoms, the unending series of feeling my health get worse and every time I went to my surgery, they deflected every query, every time I told them it was something more than T2.
It took me to have a hypoglycaemic episode in front of a GP, who recognised it for what it was, but my GP was confused, so I got a referral.
I'm still on a very low carb diet, it is sustainable and I have found a balance that suits me and my lifestyle, it is now nearly seven years doing this, I haven't had a hypoglycaemic episode in that time since my last eOGTT and my health is excellent.
It is doable and probably the only treatment that works. It does go against medical dietary advice, but because it is quite rare, not a lot of research is done, but because there is a written rule in medical dietary advice that you have to eat complex carbs to sustain the amount of glucose to sustain the brain function, so that is why they have to find an alternative treatment than being in ketosis, hence eating smaller meals every couple of hours to offset the hypoglycaemic episode, to stop hypos occurring, but it doesn't prevent the symptoms or stop the hypos when you don't keep to the number of times you have to eat. The amounts of food eaten to do this, never mind buying, preparation and time consuming doing all this is not gonna do you much for your health.
I hope I have helped try and explain the how and why of RH, getting your head around it all doesn't help, the anxiety and worry, never heard of the condition doesn't help, the doctors, dieticians trying to understand it doesn't help, and having to explain to everyone that you are not diabetic, to get your family, friends, work colleagues and bosses to understand what you are going through and how you are doing to control, so that you can have a normal working life, a battle against the normal, the weirdness of why we are different than most of the population, the realisation that so called healthy foods are really unhealthy for you and me!
And the most important thing of all, is the belief that you were ill, that you can get through this and be healthy again, despite all the barriers that go up against you through the knowledge of what is happening to you.
Keep asking, keep safe, best wishes.