Hello,
I have posted several times to this thread and others on this forum as for about 10 years I suffered from "reactive hypoglycemia."
I am writing this update to share what has helped go from living in the torturous food desert of extreme reactive hypoglycemia (RH) to being able to eat nearly everything now. It was a long and tough journey but I hope my notes and experience helps someone else.
If you want the short version of things that helped me get back to eating normally, here’s a list:
Berberine
Nac
Dr. Brian Walsh (zoom appointment with specialist in reactive hypoglycemia, took me years to discover him, I’m not affiliated with him in any way)
Avoided Glucose tolerance test and took food tolerance test multiple times
Extras
Prioritising my symptoms over everything else
Food intake order and balancing fat with other ingredients
Weighing external factors: how much exercise, stress, ambient temperature, hard mental thinking I had been doing since my last food intake
The Glucose goddess (instagram) and her interview here:
Adequate sleep
So here goes:
I could not tolerate sugars, not even natural ones: no veggies, fruits, simple carbs, etc. Even most seasoning set off my symptoms.
My diet was protein and protein: chicken, pork, eggs, cheese (not all kinds, some were too high in sugar content), a small amount of raw, thick-cut oatmeal, some nuts (not pistachios, not almonds), mung bean noodles (0 sugar), some 0 sugar whole grain pastas (small amounts with protein), some whole grain 0 sugar crackers (again small amounts with protein).
I always had to check both the ingredient list and the nutritional info to see how many natural sugars were in a product. In cheese, if it had more than 1.5-1.7 grams I couldn’t eat it.
The only artificial sweetener I could tolerate was monk fruit in small quantities (although my husband who suffers from the same condition found it crashed him).
At some points in my journey, for months on end, I had to eat every two hours, although for the bulk of the 10 years, I could get away with every 3 1/2-4 hours on the clock, IF I monitored my levels, my symptoms and my energy output, external circumstances and fat ratio to proteins in my food.
I used the Bitesnap app (I’m not affiliated with them and it is free), to take a picture of what I ate and then set a timer or took a screenshot of the time to make sure I didn’t overshoot my window and crash. At 3 hours, I tried to always internally check in to see if I had an early signs of a crash so that I could keep my energy, functioning and productivity stable throughout the day.
To preface, I still have hypoglycemic crashes, but I am eating almost everything, and the crashes are much less. I am not eating on a timed clock, I am no longer chained to the 4 hour circus of having to eat, I can go longer, especially after dinner. I no longer need to eat first thing in the morning or last thing before I go to bed.
Also I still cannot sit down and eat just a piece of cake, I am careful about the order in which I eat as well as the balance of proteins to fats to carbs and sugars.
I never achieved a diagnosis from a medical practitioner. One of the endocrinologists I saw refused to give me the glucose tolerance test because she said she didn’t “want to deal with a dead body.” The only thing she said she had for me was metformin which she did not recommend for my case as it didn’t fit the glove and could be an extra hypoglycaemic agent.
When my sugar levels were at 90-91, I was already shaking.
At 80-85, I was dizzy, trembling, my cognitive functioning shot, emotions frayed and my whole system had gone into panic mode.
It took me years to be able to monitor my levels effectively, because I didn’t understand that my symptoms had anything to do with food intake, as usually when a crash was coming on, I wasn’t hungry and had no desire to eat. And often the only warning sign or symptom was a mild dip in my energy levels before I hit a concrete crash and lost the rest of the day trying to recuperate.
I did acupuncture, so many supplements, magnets, ozone therapy, ivs, emotional and psychological work, etc, etc.
I also don’t know what caused my RH, but my hunch is a mix between many multiple courses of antibiotics over the years and being vegan for 11 years prior without proper supplementation.
My turning point came when I really started digging for a doctor who had experience dealing exactly with my condition. It took me days and days of weeding through internet haystacks to find Dr. Brian Walsh (@bryanpwalsh) who said he had successfully treated many people with the condition.
He had an online course to educate other doctors to reactive hypoglycaemia so that they would know how to diagnose, treat it and think critically (Rethinking Reactive Hypoglycaemia). I took it first. I think the course cost me about $100 dollars. In it, he lists about 10 different reasons that may cause RH, how to rule out and better conclude which reason is affecting the patient and what to do about it. Many of the classic reasons I had known about and ruled out (pregnancy, gastric surgery, kidney tumour), but there were a few I had never heard of.
Still I didn’t feel that my cause was in the list. So I booked an appointment with him. The appointment was 45 mins and expensive for me (about $650 out of pocket), and he was ultra specific about what tests he wanted submitted before hand.
When I went into the appointment, it was clear that he had studied my blood work and had been mulling over it. He was also honest that he didn’t know how to cure me, and that he had had only one other patient similar to me (all the rest had fit into 10 reasons that he had outlined in the course). “Did she get cured?” I asked. He said he didn’t know. She had disappeared. Not encouraging.
But as I had taken the food tolerance test classically: testing my sugar levels after eating, two hours thereafter and four hours after that, he said he couldn’t really “see” what was going on, but his hunch was that the problem was within the first two hours.
He asked me to go back and re-take the food-tolerance test but to have blood drawn every half an hour after eating up until the two hour mark (which took some educating the lab).
The second round of the food tolerance test, drawing blood every half an hour up until two hours, at first glance didn’t revealed that two hours after eating my sugar levels were normal and my insulin was in the normal range, but that my insulin levels were double what was needed for that amount of sugar. So although the levels were normal, the ratio of sugar to insulin was “excessive”, in his opinion.
He theorised this condition as hypersensitivity to insulin (within normal ranges but hypersensitivity all the same). Opposite to insulin resistance, if I understood correctly.
He did not know the cause or the cure. He said the condition basically did not exist in medical literature or studies, but that he had seen it before.
He suggested a bunch of things. On the top of the list was berberine. He explained that it was impossible to find out where the weak link in my chain of dealing insulin was, but that berberine would strengthen the entire cause and effect chains that dealt with insulin. He hoped over time, that this would lower my hyper-sensibility to insulin and that my body would be able to deal with it better.
He did warn me that berberine was a hypoglycemic agent and that it might give me more crashes, more frequently. He said to suck it up (but in a compassionate way). He also urged me to add Nac slowly.
I was really not excited to play with my stable sugar levels after fighting and struggling for years to keep them level and stay out of crashes.
My husband who also suffers from the same condition, as well as another condition which forces him to take medications which lower his blood sugar levels, has not felt excited yet to risk introducing yet another hypoglycemic agent on his collar coaster ride , and I respect his decision.
But I was tired and done with living in a stark nutritional desert, and felt my body needed to get out.
I had already add the Nac several months before based on the suggestion from my husband.
So I started taking the berberine once a day about 3 times a week.
I noticed, I had to eat more often, I could rarely make it to 4 hours. I sucked it up.
About 3 months later, I found, I could eat some veggies with my meal. I started slowly incorporating small amount of different foods to my diet, being careful to always eat protein first and to balance out whatever I was trying with copious amounts of fat, sleep, and not too much sweating or physical exertion.
The first time I added anything with natural sugars to my diet was a year and half ago: August of 2022. I now eat salads, veggies, dessert after a meal and pretty much anything I want AS LONG AS I EAT IT it an informed order and balance. (See the glucose goddess on instagram).
There are certain foods I still avoid and probably will never won’t go near: beets, swiss chard, liquorice, cinnamon, maltodextrin and maltose.
I am no way associated with Dr. Brian Walsh or the Glucose Goddess and do not benefit in anyway from recommending them. I am only speaking from my personal experiences.
I hope my commentary helps those others out there struggling. I hope you achieve nutritional richness, metabolic health, flexibility and food freedom.