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How to exercise with RH please?

Discussion in 'Reactive Hypoglycemia' started by Tam123456, Feb 21, 2021.

  1. Tam123456

    Tam123456 · Member

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    Hi there, I am waiting to speak to my consultant after a 5 hour GTT but I think will be told I have RH - my glucose went from 4.5 to 9.3 and down to 2.9 after 150 minutes. Insulin went to 63 at 90 minutes and then back down to less than 2. Does that sound like RH to you as you are no doubt familiar with the results of GTT?

    This forum has really really helped - thank you! I have cut out sugar, starchy veg, most fruit and other carbs (pasta bread rice etc). Eating mainly protein and non starchy veg, nuts and seeds, full fat diary plus small amount of berries as seem to be low carb/sugar. No alcohol either. I monitor my blood glucose currently to keep track. I am slim and don't have much fat to lose which makes ketosis tricky.

    A couple of questions please?
    - is RH episodic? last week I was doing better with balanced glucose levels, then yesterday I suddenly crashed again - finding it really difficult to stay above 3.2 and going to 2.8 at night - for no apparent reason. Eating the same so what causes that? Driving me mad trying to find some logic and consistency to all of this!
    -is there a specialist in this country who is recognised as an expert in RH? It seems to be a forgotten or neglected area of medicine
    - why does exercise cause my glucose to plummet - even just a moderate walk after 20 minutes? I don't understand why it happens given that it has no relation to what I have eaten (glucose always drops with exercise regardless of whether I have recently eaten or not, what I eat etc)?
    - how do I exercise with RH? I love walking, cycling etc and feel desperate that I end up in a hypo so easily with only mild exercise. It is really upsetting me now! Any guidance would be very much appreciated.
    - does anyone recommend MCT oil, particularly as I am slim (thin)?
    Sorry for all the questions!! So hoping for some help - thank you.
     
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  2. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi and welcome to our forum.
    Your glucose is typically RH, even though I have been higher than a reading of 9mmols, the insulin is again something that I have gone through, the high figure at 90 minutes is what is your secondary response of insulin called an overshoot, this is what drives your glucose levels down into hypoglycaemia.
    Well done on realising that it is food that triggers the reaction and food (very low carb)
    Is the only treatment I would recommend for RH.
    In ketosis, if you don't want to lose weight, is eat more protein, a bit more full fat for satiety, but finding the right balance of food is important for your health, testing and experimenting will help you do this and keep a record of before and after meals.

    I don't believe it is episodic when you have good control, but am I right in thinking that you have only been doing low carb a short while, your body needs to adjust and adapt to being in ketosis. Also, you still could be eating too many carbs and triggered the reaction, but that is why I stop eating before 7pm, so I know I'm not going hypo before bed.

    There isn't a lot of research or knowledge and experience with RH and to be healthy as well, because the theology stopping hypos is not the answer, it is, the not having hypos in the place that works, no carbs, no trigger, no hyper, no overshoot, no hypo.
    Even my endocrinologist, was advising me to eat more carbs and we discussed it, he had a read of my food diary, and looked at my body and my demeanour and of course no hypos.
    My endocrinologist is based in the north, If you are close enough he does see referred patients and private.
    Exercise can be tricky, I usually have a walk in the morning, a walk after every meal and if I'm feeling a bit off as a warning, then I walk then.
    Fifteen minutes walk after fifteen minutes after meal, it really does help keep your blood glucose levels around normal range.
    If I did do too much, then I would probably get a boost from my liver, because that is the body's reaction to low glucose levels. I suspect that because of not being in ketosis long enough, you may still be adapting to having low carbs. I would suspect that cycling at an easy pace if you're used to riding should be ok, swimming is recommended, light weight training and walking, obviously Working and walking should be enough. But as always finding your personal balance of lifestyle is what makes you healthy.
    RH is a condition that is triggered by foods, mainly carbs., so not eating carbs is the only logical conclusion. It works for me. I don't suffer from hypos, and I don't really, really miss the carbs!

    Keep asking, keep safe. Let us know how you get on.
     
  3. Brunneria

    Brunneria Other · Guru
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    Hi and welcome Tam,

    Glad our posts and threads have been helpful, and well done on making dietary changes that are helping.

    the think the short answer to your questions is ‘we are all different’ so what works for you regarding exercise, and what works for someone else, may be different.

    for myself,
    - stress is a huge factor in my blood glucose stability. So with everything else being equal, stress can turn a nice stable day into a rollercoaster.
    - I do best with exercising several hours after a good meal, because the food (protein and fat, not carbs), is gently drip feeding into the bloodstream. Others may find exercising on an empty stomach is best, but that doesn’t work so well in my case.
    - MCT oil works for me in hot drinks (bulletproof coffee, tea or hot choc), but MCT is surprisingly highly processed and I prefer butter and/or cream, which also taste much better too :D

    Hope that helps.
     
  4. Tam123456

    Tam123456 · Member

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    Thanks very much again! Really grateful for your thoughts.
    What kind of carb level do you aim to keep below per day? I have seen 30g but wasn’t sure
    Best wishes
     
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  5. Tam123456

    Tam123456 · Member

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    Thank you- that does help. Stress seems to be a factor for me too.
    thanks again!
     
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  6. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi again, as you can never go completely zero carbs, so I try and go as low as possible. Literally my diet is meat, fish, eggs and salad vegetables mushrooms tomatoes, onions, I make fresh food every day. That is why I have such a short window, I've said many times that my body is happier without food. You can have fruit but stay away from tropical fruits. I make home made soup and curry, no rice of course! Stay away from low fat foods or no sugar added food. They will have too much sugar. Stay away from dressing and sauces or manufactured foods.
    Have a read of the low carb diet forum, you will get some good ideas and recipes.
    Also dietdoctor.co, as they have good keto ideas.
    For one of my two meals, I only have meat.
    One of the surprising thing is my body does not like vegetable oils or most additives.
    It doesn't sound very appetizing, but I enjoy my food, there is so many ways to prepare meat, with a bit of imagination.

    Keep asking, keep safe.
     
  7. Tam123456

    Tam123456 · Member

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    Really helpful and thanks. Will take a look at those sites.
    Best wishes
     
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  8. KStag

    KStag · Newbie

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    I've said many times that my body is happier without food - Omg I literally couldn't have written this sentance, I wish we didn't have to eat it would be so much easier!
     
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