Developing reactive hypoglycemia from being sick?

[EdgyLady]

Hi guys, I'm actually from the US but this was the only place with RH. Would this be reactive hypoglycemia? I was sick with covid and flu earlier this year and after I recovered started having a weird hypo and sometimes hyper symptoms like shakiness, always being hungry, tired after meals and falling asleep, frequent urinating, and dehydration for the past 2 months. Went to two different doctors who dismissed me after my a1c showed to be in the high side of normal on the border of prediabetic and thyroid came out normal. Anemia was also ruled out. So doctors didn't want to bother seeing me again.

My fasting numbers usually are usually around 5.3-6.0. 1 hour after meals will spike 9.4-11.1 then drop to about 4.0-5.0 2 and a half to 3 hours after meal almost everyday. Prior to getting sick, I have never had this issue that I know of. I am underweight with a bmi of 15.6 and a strong family history of underweight type 2 insulin dependent or combination treatment diabetics. Both doctors have told me there's nothing wrong with me and I'm healthy since all of my blood work came back normal except for elevated cholesterol. I definitely don't feel healthy and I don't think the a1c is reflecting my constant spikes and drops.

 

[mansingh01]

Hi guys, I'm actually from the US but this was the only place with RH. Would this be reactive hypoglycemia? I was sick with covid and flu earlier this year and after I recovered started having a weird hypo and sometimes hyper symptoms like shakiness, always being hungry, tired after meals and falling asleep, frequent urinating, and dehydration for the past 2 months. Went to two different doctors who dismissed me after my a1c showed to be in the high side of normal on the border of prediabetic and thyroid came out normal. Anemia was also ruled out. So doctors didn't want to bother seeing me again.

My fasting numbers usually are usually around 5.3-6.0. 1 hour after meals will spike 9.4-11.1 then drop to about 4.0-5.0 2 and a half to 3 hours after meal almost everyday. Prior to getting sick, I have never had this issue that I know of. I am underweight with a bmi of 15.6 and a strong family history of underweight type 2 insulin dependent or combination treatment diabetics. Both doctors have told me there's nothing wrong with me and I'm healthy since all of my blood work came back normal except for elevated cholesterol. I definitely don't feel healthy and I don't think the a1c is reflecting my constant spikes and drops.

If your going hyper then reduce yr insulin

 

[lovinglife]

If your going hyper then reduce yr insulin

The OP isn’t on insulin but even if they were your advice is totally wrong and could be dangerous- if someone is using insulin then if they are going hyper they need to increase their dose not reduce it! If you are going Hypo is when you reduce your insulin.

2 very similar words with very different meanings HYPER = High, HYPO = low

 

[EdgyLady]

The OP isn’t on insulin but even if they were your advice is totally wrong and could be dangerous- if someone is using insulin then if they are going hyper they need to increase their dose not reduce it! If you are going Hypo is when you reduce your insulin.

2 very similar words with very different meanings HYPER = High, HYPO = low

This is true, I am not on insulin. I'm just a person who is thinking they probably have reactive hypoglycemia which didn't happen until after I was sick with 2 viral infections. I don't know if viral infections can trigger RH and would it be temporary or not since I get dismissed by doctors on the grounds of A1C being still in the normal range even if it's on the high side and not being overweight.

 

[lovinglife]

This is true, I am not on insulin. I'm just a person who is thinking they probably have reactive hypoglycemia which didn't happen until after I was sick with 2 viral infections. I don't know if viral infections can trigger RH and would it be temporary or not since I get dismissed by doctors on the grounds of A1C being still in the normal range even if it's on the high side and not being overweight.

Welcome to the forum sorry I have no knowledge of reactive hypoglycaemia, hopefully some of our forum members who do will be along to help you with your questions

 

[EBe66]

Just out of curiosity, why do you think you have reactive hypoglycemia?
According to your description, you eat and your BG rises to higher than you might want levels and then falls back to perfectly normal values.
As far as I know, reactive hypoglycemia means that after eating you get a hypo i.e. your BG goes below 4.0. To me what you describe sounds like, the onset of, "normal" diabetes.

 

[EdgyLady]

Just out of curiosity, why do you think you have reactive hypoglycemia?
According to your description, you eat and your BG rises to higher than you might want levels and then falls back to perfectly normal values.
As far as I know, reactive hypoglycemia means that after eating you get a hypo i.e. your BG goes below 4.0. To me what you describe sounds like, the onset of, "normal" diabetes.

Because I spike pretty quickly after meals then drop a lot at the two hour mark even though it's not a true hypo, I definitely do feel the hypos. I hear different things where it has to be below a certain point and the other is basically reacting to carbs and dropping a lot. It was just something a few people brought up to me. Diabetes did cross my mind but I was thinking you would stay high longer instead of an immediate drop and my blood sugar problem just seem to hit out of nowhere instead of a gradual thing if that makes sense.

 

[Lamont D]

Hi, @EdgyLady and welcome to our forum.
First of all, I do agree that based on your posts, you have the symptoms of hypoglycaemia, without actually (?) going hypo. For a non diabetic BG levels are usually at 3.5mmols to be described as a hypo, but there are those that have false hypos symptoms and have the hypo symptoms that have been diagnosed with a related condition to RH or another type of hypoglycaemia.
I hope that is an explanation. If not I will clear it up a bit more.

I think your next step is to ask your doctor for an extended oral glucose tolerance test, which should be as long as five hours, unless you do go hypo before the end.
When I had mine, other tests were done which included c-peptide, GAD, insulin levels by levels taken every fifteen minutes. This would track the BG levels, spikes, insulin first and second phase and of course to see if you do go hypo. A specialist will see any abnormalities in the range of BG , during the test.

RH can only be diagnosed after a series of tests which eliminates other conditions.

Just thinking have you considered long covid?

Keep asking, keep testing.

Best wishes

 

[EdgyLady]

Hi, @EdgyLady and welcome to our forum.
First of all, I do agree that based on your posts, you have the symptoms of hypoglycaemia, without actually (?) going hypo. For a non diabetic BG levels are usually at 3.5mmols to be described as a hypo, but there are those that have false hypos symptoms and have the hypo symptoms that have been diagnosed with a related condition to RH or another type of hypoglycaemia.
I hope that is an explanation. If not I will clear it up a bit more.

I think your next step is to ask your doctor for an extended oral glucose tolerance test, which should be as long as five hours, unless you do go hypo before the end.
When I had mine, other tests were done which included c-peptide, GAD, insulin levels by levels taken every fifteen minutes. This would track the BG levels, spikes, insulin first and second phase and of course to see if you do go hypo. A specialist will see any abnormalities in the range of BG , during the test.

RH can only be diagnosed after a series of tests which eliminates other conditions.

Just thinking have you considered long covid?

Keep asking, keep testing.

Best wishes

Thank you very much! I will be honest, I have never tested beyond 3 hours since I do not fast(unless overnight of course) and have to eat something at least every 3 hours or I risk passing out(this has always been a thing even as a kid and had 3 incidents of this and don't want a repeat). My boss who is also a manager in healthcare suggested I get a cgm to monitor my blood sugar to show my doctor to push for further testing since both have refused and do not see much reason to go beyond what has already been done with basic bloodwork. Most other doctors in my location are not accepting any new patients at this time so it's a bit of a predicament. Both are too focused on raising my low bmi which I have stressed multiple times that it runs in my family.

I have thought about long covid. But was just not sure if it also causes my weird symptoms. Either way, it does not feel great. I just took a guess it was blood sugar related because of the symptoms + family history of diabetes and thyroid issues so I bought a glucometer.

 

[MattInUSA]

Since you're in the USA and are being given the same runaround that I was, you may consider some of your own tests at ultalabtests, you then get the draw from a Quest location. It would be better to have the tests covered by insurance (via a script from your GP), but if you have the money then it may be worthwhile to pursue. OGTT with insulin and glucose would be most telling for your situation.

 

[Lamont D]

Thank you very much! I will be honest, I have never tested beyond 3 hours since I do not fast(unless overnight of course) and have to eat something at least every 3 hours or I risk passing out(this has always been a thing even as a kid and had 3 incidents of this and don't want a repeat). My boss who is also a manager in healthcare suggested I get a cgm to monitor my blood sugar to show my doctor to push for further testing since both have refused and do not see much reason to go beyond what has already been done with basic bloodwork. Most other doctors in my location are not accepting any new patients at this time so it's a bit of a predicament. Both are too focused on raising my low bmi which I have stressed multiple times that it runs in my family.

I have thought about long covid. But was just not sure if it also causes my weird symptoms. Either way, it does not feel great. I just took a guess it was blood sugar related because of the symptoms + family history of diabetes and thyroid issues so I bought a glucometer.

During my first couple of months after diagnosis, my glucometer was my best friend, along with a food diary, no cgm then, testing just before eating and during the next few hours. To see what actually happens.
Eating every three hours is a common misconception to prevent hypoglycaemia. However discovering the carbs and sugars that actually do send you low, even if you don't go hypo is a great way of gaining the knowledge of how intolerant you are. And not having any hypos or symptoms.
Having hypoglycaemic issues young and not really getting a true diagnosis, along with tests is a major failing of health care.
The cgm is a great source of information. And I would recommend it. Of course there is issues but just to see the spikes and lows because of what you eat is enlightening. As for me, as a RH er, it is about what food I have!

Next time you see your doctor, ask about your insulin levels because even if you are getting the lows without hypos or if you are, then over time, you may have developed high insulin levels (hyperinsulinimia), then again, it is never usually tested. With the excess insulin over time cannot be healthy!

There is a condition called idiopathic postprandial syndrome.
Which after all the tests, the symptoms are exactly the same as RH, the blood glucose spikes are similar but no hypos! This condition is also non diabetic. There are many other rare conditions, which are non diabetic and have similar symptoms. For example, flat line hypoglycaemia. And more! The underlying problem is no two patients have exactly the same symptoms, outcomes, which does cause issues with diagnostics.
But the treatment with this type of conditions, is avoidance of the foods that spike you too high which triggers the reaction. Carbs!

Then, as always, I could be talking garbage and it's hay fever! Who knows?

keep testing, start recording, and if you can, use a cgm!

Best wishes

 

[EdgyLady]

Since you're in the USA and are being given the same runaround that I was, you may consider some of your own tests at ultalabtests, you then get the draw from a Quest location. It would be better to have the tests covered by insurance (via a script from your GP), but if you have the money then it may be worthwhile to pursue. OGTT with insulin and glucose would be most telling for your situation.

Starting to feel like it's not RH. Started taking readings again throughout the week but a bit more frequently to see when I start going down. Can't find much of a pattern anymore. It's all over the place. Used to be able to take readings approximately the same time almost everytime I eat. Which is an hour after and my steep drop will be at 2 hours. Now, I can eat the same thing and spike over 11 one day or don't go up much at all on others. Can eat a small carb meal then spike a lot or eat a lot of carbs then don't spike much. For 2 days I spiked above 8 and stay there for about 3 hours before going down. Then again, I recently got another flare up of stomach bug this time. There's an enterovirus wave going around at work. Don't know if that's what affecting the consistency of my readings this time.

 

[Lamont D]

Starting to feel like it's not RH. Started taking readings again throughout the week but a bit more frequently to see when I start going down. Can't find much of a pattern anymore. It's all over the place. Used to be able to take readings approximately the same time almost everytime I eat. Which is an hour after and my steep drop will be at 2 hours. Now, I can eat the same thing and spike over 11 one day or don't go up much at all on others. Can eat a small carb meal then spike a lot or eat a lot of carbs then don't spike much. For 2 days I spiked above 8 and stay there for about 3 hours before going down. Then again, I recently got another flare up of stomach bug this time. There's an enterovirus wave going around at work. Don't know if that's what affecting the consistency of my readings this time.

The reason is probably that the spikes you are getting are the cause.
until blood glucose levels are around normal levels consistently, you may not get relevant controlled readings.
my first couple of weeks, my readings were inconsistent until I was actually nearing ketosis, losing weight and being aware of what food was healthy for me.

Your gut is so important to how your body copes with certain foods.

You need to discover what is happening to you.

Best wishes.

 

[MattInUSA]

Starting to feel like it's not RH. Started taking readings again throughout the week but a bit more frequently to see when I start going down. Can't find much of a pattern anymore. It's all over the place. Used to be able to take readings approximately the same time almost everytime I eat. Which is an hour after and my steep drop will be at 2 hours. Now, I can eat the same thing and spike over 11 one day or don't go up much at all on others. Can eat a small carb meal then spike a lot or eat a lot of carbs then don't spike much. For 2 days I spiked above 8 and stay there for about 3 hours before going down. Then again, I recently got another flare up of stomach bug this time. There's an enterovirus wave going around at work. Don't know if that's what affecting the consistency of my readings this time.

I go through something similar. I feel like it's a late response from the pancreas (no first phase insulin response), that or the liver doesn't always respond to the insulin and continues creating glucose. So sometimes everything works as it should and there's no big spike, and other times there's a very big spike and probably an overreaction from the pancreas as a result which turns into hypoglycemia. That said, a viral infection can definitely throw a wrench into things.

my first couple of weeks, my readings were inconsistent until I was actually nearing ketosis

Can confirm that when in ketosis the readings are much more consistent, as is energy.

 

[Lamont D]

I go through something similar. I feel like it's a late response from the pancreas (no first phase insulin response), that or the liver doesn't always respond to the insulin and continues creating glucose. So sometimes everything works as it should and there's no big spike, and other times there's a very big spike and probably an overreaction from the pancreas as a result which turns into hypoglycemia. That said, a viral infection can definitely throw a wrench into things.


Can confirm that when in ketosis the readings are much more consistent, as is energy.

During my many eOGTTs, my first phase insulin was very poor, hence the high spikes, however once my brain realised the imbalance of glucose/insulin, told my pancreas to respond, what is known as an overshoot, occurs.
For some reason, scientifically complicated, the next response which should be my liver responding to the rapid drop in BG levels, is either, limited or non existent (My endocrinologist has not seen and signs of it at all, not on any graphs, nor have I seen it on a CGM) And I go hypo!

Through research and reading various similar medical papers pertaining to hypoglycaemia, the diversity of why, how, causes and impact vary so much, but have similar symptoms and similar outcomes. Every individual case of metabolic syndrome conditions can be so individual.


Knowing how to successfully control the condition, to your health needs, to improve the symptoms and overall better quality of health.

Best wishes.

 

[EdgyLady]

The reason is probably that the spikes you are getting are the cause.
until blood glucose levels are around normal levels consistently, you may not get relevant controlled readings.
my first couple of weeks, my readings were inconsistent until I was actually nearing ketosis, losing weight and being aware of what food was healthy for me.

Your gut is so important to how your body copes with certain foods.

You need to discover what is happening to you.

Best wishes.

I don't know if all of US is like this for healthcare but the area I live at is awful. Looking back I've always had issues with blood sugar regulations but it gets passed off as me being low weight. I stopped gaining any weight and growing since I was 12. Went to the eye doctor for the first time at and was concerned at 13 with "sugar in eyes" which they didn't explain much except to stop eating junk food and soda(I rarely ate junk food or soda during this time). I was 13 and it wasn't explained to me what that meant so kind of brushed it off. When I say I cannot go too long without eating, I've had severe reactions of this. Have passed out a few times in the past with the most recent being 5 years ago. One of the scariest experiences was fainting from skipping breakfast because I wanted to make it to a concert on time. Woke up in the hospital where they took my blood pressure which was too low to register. Body felt like it was shutting down. Checked for blood count which was normal and just put dehydration as a possible cause when I was discharged a few hours later. Had an incident last week where my bs went from 9 to 2.5 within an hour which was the lowest ever dipped and retested to make sure but I had some cough meds prior. Stopped taking the meds and never had that low of a dip again so may be a fluke effect from the med. Won't count it.

 

[EdgyLady]

I go through something similar. I feel like it's a late response from the pancreas (no first phase insulin response), that or the liver doesn't always respond to the insulin and continues creating glucose. So sometimes everything works as it should and there's no big spike, and other times there's a very big spike and probably an overreaction from the pancreas as a result which turns into hypoglycemia. That said, a viral infection can definitely throw a wrench into things.


Can confirm that when in ketosis the readings are much more consistent, as is energy.

Never had actual hypo numbers until last week but I brushed it off to the cough meds since I never had that low of a dip again so I consider it a fluke incident. Could be wrong but always had hypo blood sugar here and there in the past but didn't start getting hyper numbers until after I got sick. Since my thyroid and reproductive panel came back normal, my possible concern is probably starting onset of diabetes since my 2 hour numbers are starting to creep up on me. Average 2 hour range from March 95-115 compared to now 130-145 on average 2 hour mark. Never checked my one hour mark back then. My current 1 hour mark I just know is always consistently over 170. 3 hour mark is when I have the steepest drop into double digits still but I don't hit actual hypo numbers. The lowest ever recorded was 70(without the one 40s I recorded when on cough meds).

 

[Bessie23]

Hi guys, I'm actually from the US but this was the only place with RH. Would this be reactive hypoglycemia? I was sick with covid and flu earlier this year and after I recovered started having a weird hypo and sometimes hyper symptoms like shakiness, always being hungry, tired after meals and falling asleep, frequent urinating, and dehydration for the past 2 months. Went to two different doctors who dismissed me after my a1c showed to be in the high side of normal on the border of prediabetic and thyroid came out normal. Anemia was also ruled out. So doctors didn't want to bother seeing me again.

My fasting numbers usually are usually around 5.3-6.0. 1 hour after meals will spike 9.4-11.1 then drop to about 4.0-5.0 2 and a half to 3 hours after meal almost everyday. Prior to getting sick, I have never had this issue that I know of. I am underweight with a bmi of 15.6 and a strong family history of underweight type 2 insulin dependent or combination treatment diabetics. Both doctors have told me there's nothing wrong with me and I'm healthy since all of my blood work came back normal except for elevated cholesterol. I definitely don't feel healthy and I don't think the a1c is reflecting my constant spikes and drops.

If your BG spikes and then falls quickly, perhaps you might consider a low carb diet? This can help smooth out your BG. You also sound very underweight, so you might want to look at your overall nutrition and calorific intake, including protein and fats? I personally am on the carnivore diet which has not only resolved my T2, but also a number of other autoimmune problems. Being tired all the time can also be due to low B vitamins, which may also be related to diet. Good luck.

 

[EdgyLady]

If your BG spikes and then falls quickly, perhaps you might consider a low carb diet? This can help smooth out your BG. You also sound very underweight, so you might want to look at your overall nutrition and calorific intake, including protein and fats? I personally am on the carnivore diet which has not only resolved my T2, but also a number of other autoimmune problems. Being tired all the time can also be due to low B vitamins, which may also be related to diet. Good luck.

Low carb diet is what I've been doing lately but I have the issue where I will spike at 140-150s instead of the usually 170-200s then actually drop into hypo numbers at 50s. I eat a lot including fats and proteins. It's the case of me being unable to keep weight on. Many people have seen the amount I eat and are surprised I am the size that I am.

 

[Lamont D]

Low carb diet is what I've been doing lately but I have the issue where I will spike at 140-150s instead of the usually 170-200s then actually drop into hypo numbers at 50s. I eat a lot including fats and proteins. It's the case of me being unable to keep weight on. Many people have seen the amount I eat and are surprised I am the size that I am.

what you are describing about the higher than normal spikes is typically RH.
that is your first phase insulin response. Mine is wesk, not enough insulin, the imbalance causes the spike, and any carbs will do it! If you are happier snacking little bites all day, that is how you control the spikes and hypoglycaemia. If you can't fast, what else is there? Though you naturally fast overnight. It is so hard!

You have to be careful with drugs and how they effect you. Meds contain ingredients that you may be susceptible to. Containing sugars, to make you feel better (sure!) That will make is RH ers worse.
You will really have to make sure, what you eat and drink is not going to cause a spike or a hypo.

Take care.