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Fasting and reactive hypoglycemia

U

Ummsafia

Member
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Hi everyone I am new here.
I self diagnosed myself with reactive hypoglycemia about 2 years ago.
I have been controlling it with diet .
Last Tuesday I fasted. I woke up and ate my usual well balanced breakfast at 5:30. I then fasted from 6 am until average 7pm for religious reasons.
As soon as I broke my fast I felt dizzy and had symptoms. This whole week I have continued my diet but I feel the symptoms of low blood and feel like I have been set back. I know it will take me a while to stabilise.
We have Ramadan coming up soon, which is a month of fasting.
Can people with reactive hypoglycemia not fast ? Is it a trigger for anyone else who is feeling like the are doing well with their diet?
Please advise.
I never want to feel like I did two years ago,
Thankyou
 
Welcome @Ummsafia
As I understand reactive hypoglycemia, carbohydrates cause your body to overproduce insulin which then forces your blood sugar into hypo levels. So I would have thought that not eating wouldn't be a problem, it's all about what you do eat.
Ummsafia said:
usual well balanced breakfast
Click to expand...
As a T2 my insulin doesn't work as it should, if I eat carbs my blood sugar levels go too high. The last thing I need is a balanced diet. I need to cut carbohydrates out of my diet as much as possible and eat protein, mainly green leafy vegetables and healthy fats. You definitely wouldn't describe my diet as balanced.
Ummsafia said:
As soon as I broke my fast I felt dizzy and had symptoms
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What were your blood sugar levels when you had these symptoms, did you check with a glucose meter? I ask because low blood sugar is not the only possible cause of your symptoms.
I really do believe that your best course of action would be to visit your doctor to get a professional diagnosis.
Tagging @Lamont D
 
Thankyou for your reply .
My breakfast was a bowl of steamed vegetables with salt and olive oil, 2 eggs and 1tsp of tahini.
I don't eat any sugar, bread, rice, pasta, potato etc.
I broke my fast with a bowl of vegetable soup , chicken breast and salad.
I didn't measure my blood sugar at that moment but during the week I have had a few readings under 70.
I agree I need to go the doctor and a official diagnosis .
At the moment my readings seem stable and my symptoms are lessening but I still feel unstable. I know it takes time to stabilise.
When I feel unstable one of my symptoms are that I need to eat every 2 1/2 hours , I don't normally feel like that .
That's why I wondered if it was the fasting that triggered my blood sugar crash because my diet hasn't changed.
 
Maybe a more structured testing regime would help you understand what's going on. Test just before you eat and again at maybe hourly intervals afterwards. It would mean possibly 4 tests for each meal and I guess sore fingers but it would show what's happening with your blood sugar. If you keep a detailed food diary along with the results of the test's it could help you to figure out what is triggering your symptoms. It would also be useful information to show your Dr and maybe help him/her come to a diagnosis.
 
I should give a back story of how this started and why I think I have reactive hypoglycemia.
One evening out of the blue I started feeling really strange,
Sweating, hot flushes, crying, hole in my stomach feeling , panic, heart fluttering.
Lay down and started shaking. We had no idea what was wrong had no blood sugar moniter in the house as none of us needed it.
DH googled and gave me some honey sugar etc. Immediately started to feel bit better but still shaken.
After research I straight away changed my diet, per Dr berg recommendation.
It took me over 3 weeks to stabilise. Plenty of lows under 70 .
Since then I was very strict. Except once after about 9 months I had pizza and ice-cream , my blood sugar dropped and again it took me a while to stabilise.
Since then over a year, I have been very very strict and felt great until last Tuesday when I fasted.
 
Yes my testing regime is not very structured, and I don't write things down
 
Hi @Ummsafia

Welcome to our forum, I do hope you don't mind, how I give you some advice!
It is very difficult to diagnose Reactive Hypoglycaemia, it is only diagnosed by a series of tests, which does not in itself prove it is, but a series of elimination of other conditions, and the final test is a four days fasting test!
If you are fasting, the trigger for the reaction will not happen. It is solely carbohydrates that causes the trigger for the secondary insulin response called an overshoot.
If you do go hypo whilst fasting, then it is definitely not reactive hypoglycaemia!

So that being said, one of the first advice I had from someone who didn't understand that carbohydrates are the root cause of the hypoglycaemic episodes, the only way to stop the hypoglycaemic episodes was to eat every two to three hours! This was medical advice, this was always because of the belief that we needed carbohydrates for essential health, this was totally wrong! If we rise and break fast at 6 a.m. Then we would need to eat, at 9a.m, 12, 3, 6, 9p.m presuming your bed time is before 12 midnight! That is unsustainable for anyone! It is six meals a day! It is too much food, for many reasons.
The main one is that your blood glucose levels would be going up and down all day creating a higher than normal glycaemic level. And that would trigger an overwhelming amount of unnecessary and unhealthy amount of insulin to compensate for the higher levels of glucose!
Of course, you need to know what is going on, something like this, needs a specialist, one who can help you get the diagnostic tests.
Ramadan being a fasting religious holiday should not be a problem for me. I use intermittent fasting every day! It is my way of coping with the condition.
You have to find your balance of nutrition, depending on what is available and obviously religious observations and if you have food intolerance or allergies!

Stay safe, best wishes.
 
pre-predb said:
This might be useful which I came across recently.
Click to expand...

I was agreeing with the majority of this video until he came to tubers, having any type of starch carbohydrate filled vegetable is a total waste of having the rest of the goods he listed.
Also, the video was directed at breaking a fast, so after eating a a meal intentionally low carb and healthy, why would you if you had to eat something that according to that list was healthy for you, eat something else at other times?
 
Thankyou for your reply. That's what I needed to know , if fasting affects reactive hypoglycemia. So more likely it was the vegetable soup I had first that might have triggered me? As I said above maybe I should of eaten the protein first.
I will continue reading the posts and try and see a doctor to get a better diagnosis.
Thankyou again .
 
Having good fats with the small amount of carbs in all foods will help with control. These fats are the natural saturated fats and vegetable oils and polyunsaturated fats are really bad!
if the soup was high in carbs or a tinned variety, there are so many sugar based additives, if not, there may have been a food that you are intolerant to, but don't know about!

take care and get those tests.
 
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Hi Lamont D I have just joined this forum. I have been diagnosed with Reactive Hypoglycemia last month with no advice or support from the Doctor I have been following guidance from the NHS West Suffolk guidelines to eat less simple carbs, more protein and no more than 20g complex carbs in a snack and no more than 50g complex carbs in a meal and to eat every 2-3 hours so I eat cereal about 8pm banana with few seeds or nuts about 10:30-11, small lunch 13:00 ish, snack 16:00 ish tea about 19:30 and have to make myself go to bed before 11pm otherwise I get too hungry and need to eat again. It is now day 23 of my new regieme and most of my symptoms are much worse my tummy is so sore, I really do not know what to do with myself, here is a bit of background about me, I have no clue how to monitor with B.G. readings but I am willing to do whatever it takes...
I have lost a further 8lbs, hadn’t slept for 3 nights, stomach issues much worse, saliva or bile issues much worse getting numb in upper leg, upper arm, lower arm or hand several nights a week waking up numb, reaction to hot and cold seems more severe, crying 2-3 times a day instead of once a day, sensitivity to light much worse had to get new glasses again after getting glasses in February eyes preseciption changing very fast and Optician said my small blood vessels by my eyes are very twisted. I am concerned that I get the majority of hypo symptoms within 1.5 hours of eating a meal or and a snack, so now I feel like I am permanently eating and drinking, I thought Reactive Hypoglycemia is after 2-3 hours?. I had Bone appointment with Dr Ahmed who wants me to take one of two types of acid tablets for osteoporosis, but while I am so ill with my tummy, unable to take my current medication or calcium supplement, unable to eat fruit or any of my other supplements I am hesitant to try something else acidic?!. I need urgent help, also I am confused, I thought the point of coming to endocrine was to look into why I have become so ill and lost so much of my bone mineral density since having the COVID Pfizer Vaccine?. I thought I was going to have my hormones monitored for stress and menopause as well as Blood Glucose? So far all I have had is a 6 hour every 30 mins B.G. test and a few blood tests (not had results of blood tests yet are they available to e-mail to me please?). Reading the guidelines on Reactive Hypoglycemia it states it is often a diagnosis masking other conditions such as pancreatitis (pancreas is where my inflammation and pain is), Addisons Disease something that my old GP (Dr Afridi) suggested testing for in May?, heat exhaustion, menopause, hypo or hyperthyroidism, syncope. Don’t we need to work out why my pancreas is over producing insulin?. I am at my wits end please help.
 
Hi and welcome to our forum.
First of all, how can the doctor diagnosed you with only one extended glucose tolerance test plus blood panel test. Am I right?
Second, the advice does not solve the problem of the carb intolerance if you do have RH.
RH is a condition where if you eat carbs or sugars, your reaction will spike your blood glucose levels too high and is abnormal. This triggers the release of overshoot of insulin, which is the reaction and this drives your blood glucose levels down into Hypoglycaemia.u
The only way is if you think it through logically. If you don't eat the foods that triggers the release of insulin, then you won't get the hypoglycaemia.
I do this every day. And I don't hypo.
Eating every three hours, is not useful nor relevant. It is designed to stop Hypoglycaemia, but it doesn't if you forget to eat or eat too many carbs above your intolerance.

all in all until they do the other tests to rule out the likes of insulinoma or pancreatitis or other pancreatic conditions, they should not have diagnosed RH.

All the other symptoms, with your stomach issue s are synonymous with bacterial infection. Which one I have no idea. But you should be investigating that a biopsy of stomach, as an endoscopy would reveal.
I had helicobactor pylori about fifteen years ago and after a course of anti biotics, I have had very few stomach issued since.

A very low carb diet including intermittent fasting works for me. Please look at a keto diet. This will help with the necessity to keep eating all day. Control of your blood glucose levels is so important in not having continuous daily hypoglycaemia. No carbs, no spike, no excess insulin, no hypo.
That is how I control my RH. Nowt else comes close.

Have a read of our RH forum and the low carb forum. Also dietdoctor.com is recommended for keto diet.

If you haven't got a specialist, ask your doctors for a specialist in hypoglycaemia. They are out there.
keep asking
 

Hi Lamont, THank you for your speedy response, I tried fasting for one day and was in complete agony by tea time, so in that case it isn't reactive hyperglycemia is it?. I failed at endoscopy, I need a pill cam or capsule endoscopy my Doctor won't refer me for one. Do you know what antibiotics would work?. I am concerned as think its partly antibiotics that got me in this mess in the first place. I think its some kind of block near my pancreas or liver as my lower intestine is burgling and growling so often like its permanently empty? and I have bile or saliva coming up so much and a need to swallow all of the time, either that or issue with my saliva glands or thyroid. I thought that keto was bad for liver long term will check out your suggestions, thank you, is there any way to speak to you or any advisors on the phone? as not too good at typing and reading on screen these days, I phoned the diabeties helpline the lady that answered wasn't trained on reactive hypoglycemia
 
I understand your frustration and the need to look for answers. I'm not suggesting it is RH or not. But there is something you do need to see a specialist. I can't give you the answers, treatment, advice except about my experiences with gut problems, RH and certain symptoms.
I do know that certain anti biotics can cause some issues and I don't know the name of the ones I took, but they are only available by prescription in the U.K.
Keto has not been a problem for me after nearly ten years of having to go low carb.I
Fasting, some can, some can't. However that is why I suggested intermittent fasting, which we all do natrually, overnight as such. You could actually please yourself how long or when during the day you don't eat. Fasting is simply not eating for an extended period during a day. For example, on waking, you could maybe, not eat until mid morning or lunchtime. Or eat breakfast, then nothing till dinner! It is entirely up to you and every day can vary. Fasting is a way to rest your organs, your glands, your digestive system. And will also keep your blood glucose levels in normal levels longer and it is so beneficial. But you do have to ease yourself into it. Your body is not use to it and your brain function will keep on insisting more food because it likes it.

I am not surprised at the level of knowledge from most of the medical establishment, especially at surgery level or the likes of whatever diabetes helpline you phoned. Only a few specialists, would know the proper diagnostic tests and understand the symptoms shown.

That is why I was misdiagnosed with T2 in 2009, until I was going hypo eating healthy carbs, which wasn't healthy for me.

You need a specialist, I wish I could help you more, but I'm not a doctor. Just a layman that understands my condition. Because no one else really did and looking for answers lead me here.

my best wishes and keep asking, there are other posters who I'm sure have had but problems and issued such as you have had.
 
Thank you Lamont, you said
RH is a condition where if you eat carbs or sugars, your reaction will spike your blood glucose levels too high and is abnormal. If I test my B.G. myself what would you class as high or abnormal? and how long or before after eater?. I hear about people saying they tested their B.G. to work out foods they were intolerant too, can you explain how to do this please?. My brain function is so foggy and I am in the middle of trying to sort my divorce, sell my car, feix my heating get a new matress and its too much to even work out what I can eat let alone everything else, I would be so grateful for answers to these questions above would help me enormously
 
Ummsafia said:
Yes my testing regime is not very structured, and I don't write things down
Click to expand...
Hi Ummsafia, I am about to start testing myself every hour and before and after food, can you tell me what to look out for please? what is high and what is low, when it might be that there is possible intolerance to a food?, I have so much going on in my life I can't concentrate on the simplest of tasks, everything I look up online is just advice for people with diabeties.
 
It all depends on how intolerant you are or how much insulin response you have. I can only go on my experience. Which is typically over double figures mmols for a carb laden meal.
As suggested, a food diary is a great tool. If you use a glucometer to test and record, the meals should be the same each time, to get a reference. Such as so many grams of carbs in each meal.
Stress, anxiety and possible depression can play havoc with symptoms and your blood glucose levels.
It would be remiss of me to suggest anything dramatic or advise doing anything until your doctor suggests diagnostic tests. I would suggest a counsellor, whilst going through this stressful time. It could be the trigger of all your issues. You still have to eat, and eat healthily, to what you know is healthy for you.

You can get through this. It is your health. Take care of yourself.
Talk to someone, someone who won't judge you and not talk about it to anyone else. Someone you can be honest with. And help you get help. Your GP will do this. Please do it.

Best wishes, take care.
 
pre-predb said:
This might be useful which I came across recently.
Click to expand...
Hi. I think I have both reactive and fasting hypoglycaemia. I am not diabetic but have been tested and diagnosed as RH. In addition if I don’t eat enough or if I fast ( Eg intermittent fasting) my blood sugar crashes usually about 3.5). Real problem if I have to have an operation. Drs not interested even the endocrinologist
 
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