How to gain weight with Reactive Hypoglycemia ?

[Anastasia Verner]

Hi everyone! I'm so glad I found this forum, and I'm new here.
I have Reactive Hypoglycemia. I think it started after I had anorexia, or after I'd Covid... At first, the symptoms were rare, but then they started to happen more and more often. Now my sugar drops every 3-4 hours if I don't eat. At night my sugar is normal (at least, that's what my measurements with a glucometer. I didn't wear CGM).

My glucose tolerance test readings:
Fasting glucose: 4.6
Fasting insulin: 5
Glucose 2 hours after glucose load: 5.7
Insulin 2 hours after glucose load: 98
I guess there's too much insulin after the load?

I don't wanna go on a keto diet, cause I've high cholesterol since childhood, also I have autoimmune thyroiditis and hypothyroidism. Now I eat every 3 hours, practically don't eat easily digestible carbohydrates, replacing them with slow ones, and I also eat more fat and protein.

At the same time, it's very difficult for me to gain weight. I am 5'3" tall, weigh 42 kg, my bones are sticking out. I've an absolutely passive lifestyle while I eat 1400 calories on average, and my weight doesn't grow by a gram.
It's hard for me to eat a lot.
A lot of fat or protein also exhausts me.
High-calorie, fast-digesting carbohydrates are not allowed if you have RH. What should I do then?
Are there any who have RH and have had difficulty gaining weight? Have you managed to gain weight?

 

[Lamont D]

Hi everyone! I'm so glad I found this forum, and I'm new here.
I have Reactive Hypoglycemia. I think it started after I had anorexia, or after I'd Covid... At first, the symptoms were rare, but then they started to happen more and more often. Now my sugar drops every 3-4 hours if I don't eat. At night my sugar is normal (at least, that's what my measurements with a glucometer. I didn't wear CGM).

My glucose tolerance test readings:
Fasting glucose: 4.6
Fasting insulin: 5
Glucose 2 hours after glucose load: 5.7
Insulin 2 hours after glucose load: 98
I guess there's too much insulin after the load?

I don't wanna go on a keto diet, cause I've high cholesterol since childhood, also I have autoimmune thyroiditis and hypothyroidism. Now I eat every 3 hours, practically don't eat easily digestible carbohydrates, replacing them with slow ones, and I also eat more fat and protein.

At the same time, it's very difficult for me to gain weight. I am 5'3" tall, weigh 42 kg, my bones are sticking out. I've an absolutely passive lifestyle while I eat 1400 calories on average, and my weight doesn't grow by a gram.
It's hard for me to eat a lot.
A lot of fat or protein also exhausts me.
High-calorie, fast-digesting carbohydrates are not allowed if you have RH. What should I do then?
Are there any who have RH and have had difficulty gaining weight? Have you managed to gain weight?

Hi and welcome to our forum.
You have a complicated metabolism.
Before I can advise you, I would like to ask a couple of q, if I may?
A two hours glucose tolerance test, yes?
Any other tests or results from them?
Has your CGM recorded a hypo with and without after food, as a post pandrial readings?
Have you an endocrinologist?

What I believe is happening irrespective of a diagnosis of RH, your other conditions, will not help in with the symptoms you are getting, or the meds that you must be on.
my daughter, had issues exactly like you, with the one thyroid being hyper and the other hypo.
And with diverticulitis and other issues.
I can help with giving you the science behind RH. Because it is important you do understand the reasons I am trying to help.
RH is a specific food related condition. The trigger is the glucose derived from carbs and sugars.
Not all related hypoglycaemi hypoglycaemic conditions are the same. But the majority of Reactive Hypoglycaemia is food or drink.
I am carb intolerant, as I am lactose intolerant.
my doctors from young told me to stay away from dairy. But like you the advice to stay away from carbs is not there.. So I experimented... And recorded and did more....... Kept a food diary. Shower my endocrinologist what was happening when I had carbs.
I had six extended oral glucose tolerance tests. I also had a mixed meal test, and a fasting test.
The fasting test was for 72 hours in hospital.
Because if you don't go hypo fasting, then it is RH, if you go hypo fasting, then it is another condition.
Which obviously you would need the tests.
I have an issue with weight gain, I have always struggled to stay slim.
I will tag @Melgar , who has weight gain issues, has similar symptoms as RH, but is not RH. Complicated like yourself.
I have found that a tailored diet to my favourite food is what works for me. It is mostly in keto. As being in keto doesn't trigger the overshoot of Insulin response to rapid high BG levels from carbs.
I tried the many small meals but it is supposed to stop the hypos, it didn't for me.
And it didn't stop the dreadful symptoms because your BG levels are still going up and down.
And it was a bit of a pain.

Keep asking, I will help as much as I can.

Best wishes

 

[Anastasia Verner]

Hi and welcome to our forum.
You have a complicated metabolism.
Before I can advise you, I would like to ask a couple of q, if I may?
A two hours glucose tolerance test, yes?
Any other tests or results from them?
Has your CGM recorded a hypo with and without after food, as a post pandrial readings?
Have you an endocrinologist?

What I believe is happening irrespective of a diagnosis of RH, your other conditions, will not help in with the symptoms you are getting, or the meds that you must be on.
my daughter, had issues exactly like you, with the one thyroid being hyper and the other hypo.
And with diverticulitis and other issues.
I can help with giving you the science behind RH. Because it is important you do understand the reasons I am trying to help.
RH is a specific food related condition. The trigger is the glucose derived from carbs and sugars.
Not all related hypoglycaemi hypoglycaemic conditions are the same. But the majority of Reactive Hypoglycaemia is food or drink.
I am carb intolerant, as I am lactose intolerant.
my doctors from young told me to stay away from dairy. But like you the advice to stay away from carbs is not there.. So I experimented... And recorded and did more....... Kept a food diary. Shower my endocrinologist what was happening when I had carbs.
I had six extended oral glucose tolerance tests. I also had a mixed meal test, and a fasting test.
The fasting test was for 72 hours in hospital.
Because if you don't go hypo fasting, then it is RH, if you go hypo fasting, then it is another condition.
Which obviously you would need the tests.
I have an issue with weight gain, I have always struggled to stay slim.
I will tag @Melgar , who has weight gain issues, has similar symptoms as RH, but is not RH. Complicated like yourself.
I have found that a tailored diet to my favourite food is what works for me. It is mostly in keto. As being in keto doesn't trigger the overshoot of Insulin response to rapid high BG levels from carbs.
I tried the many small meals but it is supposed to stop the hypos, it didn't for me.
And it didn't stop the dreadful symptoms because your BG levels are still going up and down.
And it was a bit of a pain.

Keep asking, I will help as much as I can.

Best wishes

Thank you for trying to help me, Lamont!

Yes, it was a two hours glucose tolerance test. Is my insulin considered too high after two hours?
I've had many other tests, all of them are normal, but my vitamin D, vitamin B12 and ferritin are low. I also have hypothyroidism and high cholesterol.
My glycated hemoglobin is 4.9 %

No, I don't have an endocrinologist. None of them understand this disease. It's so, so sad and scared...

I don't wear a CGM. I monitor my sugar levels with a glucometer.
I have found that my body reacts to carbohydrates in completely different ways. Glucose can be 10.9 an hour after millet porridge, and it can also be 5.7 an hour after a sweet eclair, can you imagine..? My glucose doesn't always rise too high, this happens to certain types of carbohydrates. Also, combining carbohydrates with protein and fats does't raise it too high. But even if my glucose doesn't rise above 6, it still crush 3-4 hours after eating. How do you think, why it doesn't crush at night?

I tried not eating for a three hours after waking up in the morning, but I started to feel weak and cold. My stomach hurt and wanted to eat. Sometimes glucose dropped at that moment. That way or another, I don't have strength to work on an empty stomach, I feel energy when I eat...

I just don't understand what and how much I can eat to gain weight, without making my disease worse...

 

[Africanaussie]

Yes ma’am it seems that way, but you are already doing well just by monitoring your glucose and eating balanced meals. For gaining weight with RH, it can be tricky, especially with the dietary restrictions you’ve got, but here are a few tips that might help:

Calorie-dense but slow-digesting foods: Nuts , seeds avocados and nut butters are amongst the foods that have many calories but you don’t need to consume large portions of in order to get them.
Small, frequent meals: You are already eating every 3 hours and that is perfect for RH. Perhaps considering incorporating more nutrient rich between meals bites such to include Greek yogurt, chia seeds or a little trail mix.

 

[Lamont D]

Thank you for trying to help me, Lamont!

Yes, it was a two hours glucose tolerance test. Is my insulin considered too high after two hours?
I've had many other tests, all of them are normal, but my vitamin D, vitamin B12 and ferritin are low. I also have hypothyroidism and high cholesterol.
My glycated hemoglobin is 4.9 %

No, I don't have an endocrinologist. None of them understand this disease. It's so, so sad and scared...

I don't wear a CGM. I monitor my sugar levels with a glucometer.
I have found that my body reacts to carbohydrates in completely different ways. Glucose can be 10.9 an hour after millet porridge, and it can also be 5.7 an hour after a sweet eclair, can you imagine..? My glucose doesn't always rise too high, this happens to certain types of carbohydrates. Also, combining carbohydrates with protein and fats does't raise it too high. But even if my glucose doesn't rise above 6, it still crush 3-4 hours after eating. How do you think, why it doesn't crush at night?

I tried not eating for a three hours after waking up in the morning, but I started to feel weak and cold. My stomach hurt and wanted to eat. Sometimes glucose dropped at that moment. That way or another, I don't have strength to work on an empty stomach, I feel energy when I eat...

I just don't understand what and how much I can eat to gain weight, without making my disease worse...

Hi again, good information.
If it is RH then it is highly likely that your insulin levels or should I say your circulating insulin levels not used is high. A little explanation.
Because you go high after carbs, which is too high for the insulin first phase response, your brain tells the pancreas to create more, and in most cases it over produces, and swamps the glucose. This is called an overshoot, with RH, the liver is unable to produce enough glycogen and glucogon to stop going into Hypoglycaemia.
It is the rapidity of the high levels and the (sugar) crash, is mostly where the symptoms come from.
The glycated haemoglobin is normal.

most RH patients have normal hba1c and fasting levels.

I'm surprised, that your doctor doesn't refer you to a specialist endocrinologist with all your issues, your doctor is not trained in the specialty of endocrinology or with your thyroid issues. You can find good specialists by searching the interweb.
Are you in uk?

With BG levels, it is how you individually cope with the glucose derived from carbs and of course the hormonal response as well. The best way is to use a food diary.
texting before meals and two hours after, recording the results.
If the two hours reading is more than two mmols higher than your pre meal reading, then something is causing it. It is trial and error. It is finding the right foods that you can cope or tolerate. Your intolerance to carbs will be different from mine. Take porridge, hot water no sugar. My BG levels will go into double figures from normal BG levels. And be above 4mmols higher at two hours from my pre meal reading. And porridge was my staple breakfast!!!!!!!!.
all it did was put me on a rollercoaster ride of BG levels all day, every day, so porridge no matter what type of oats, or cereal, is not recommended. They are 100% carbs.

How would you know you weren't crashing during sleep?
I know I have in the past.
But I don't eat four hours before bed, to ensure I don't.
However, saying all that, I believe I have woken up every morning in normal levels.
I do also believe, your body, uses homeostasis to help with this.

As I said previously, if you do have RH, you should be able to fast.
When changing to lower carbs, your body slowly adapts to the new diet and obviously this takes time,
So I would imagine that the struggle to adapt is a natural response to lower carbs. I recommend you keep doing so, as it will be worth it.
And eating very small low carb snacks, through the day, but do try to stretch the time between them. You do not need to have meal times, such as breakfast, elevenses, lunch, tea, dinner and supper etc. You eat when You want.

I will end with the diagnosis. Until the diagnostic tests are done, you are in limbo.
I can try and help from my experience and my way of treatment with RH. But if it isn't. I don't want to do harm.
certain things, will be good but I am loathe to try and go with the thyroid issues.

keep asking.

 

[Lamont D]

Yes ma’am it seems that way, but you are already doing well just by monitoring your glucose and eating balanced meals. For gaining weight with RH, it can be tricky, especially with the dietary restrictions you’ve got, but here are a few tips that might help:

Calorie-dense but slow-digesting foods: Nuts , seeds avocados and nut butters are amongst the foods that have many calories but you don’t need to consume large portions of in order to get them.
Small, frequent meals: You are already eating every 3 hours and that is perfect for RH. Perhaps considering incorporating more nutrient rich between meals bites such to include Greek yogurt, chia seeds or a little trail mix.

Hi, it says you have T2.
What experience of RH, have you had?
The tips and suggestions you have made are what was recommended by the three dieticians gave to me.
It is the NICE recommendations.
I found after diagnosis, that this method of treatment was not for me.
The three hours small meals, is designed to stop the hypos recurring, but it doesn't, it creates rollercoaster BG levels all day and you get those same symptoms. Very low carb, stops the trigger, the cause, the rollercoaster ride, so you can use fasting, intermittent or longer, to help homeostasis. Give your pancreas a rest, help with lowering your circulating insulin levels, that are no good for your liver and you.
keep learning, knowledge us always good.

 

[Anastasia Verner]

Hi again, good information.
If it is RH then it is highly likely that your insulin levels or should I say your circulating insulin levels not used is high. A little explanation.
Because you go high after carbs, which is too high for the insulin first phase response, your brain tells the pancreas to create more, and in most cases it over produces, and swamps the glucose. This is called an overshoot, with RH, the liver is unable to produce enough glycogen and glucogon to stop going into Hypoglycaemia.
It is the rapidity of the high levels and the (sugar) crash, is mostly where the symptoms come from.
The glycated haemoglobin is normal.

most RH patients have normal hba1c and fasting levels.

I'm surprised, that your doctor doesn't refer you to a specialist endocrinologist with all your issues, your doctor is not trained in the specialty of endocrinology or with your thyroid issues. You can find good specialists by searching the interweb.
Are you in uk?

With BG levels, it is how you individually cope with the glucose derived from carbs and of course the hormonal response as well. The best way is to use a food diary.
texting before meals and two hours after, recording the results.
If the two hours reading is more than two mmols higher than your pre meal reading, then something is causing it. It is trial and error. It is finding the right foods that you can cope or tolerate. Your intolerance to carbs will be different from mine. Take porridge, hot water no sugar. My BG levels will go into double figures from normal BG levels. And be above 4mmols higher at two hours from my pre meal reading. And porridge was my staple breakfast!!!!!!!!.
all it did was put me on a rollercoaster ride of BG levels all day, every day, so porridge no matter what type of oats, or cereal, is not recommended. They are 100% carbs.

How would you know you weren't crashing during sleep?
I know I have in the past.
But I don't eat four hours before bed, to ensure I don't.
However, saying all that, I believe I have woken up every morning in normal levels.
I do also believe, your body, uses homeostasis to help with this.

As I said previously, if you do have RH, you should be able to fast.
When changing to lower carbs, your body slowly adapts to the new diet and obviously this takes time,
So I would imagine that the struggle to adapt is a natural response to lower carbs. I recommend you keep doing so, as it will be worth it.
And eating very small low carb snacks, through the day, but do try to stretch the time between them. You do not need to have meal times, such as breakfast, elevenses, lunch, tea, dinner and supper etc. You eat when You want.

I will end with the diagnosis. Until the diagnostic tests are done, you are in limbo.
I can try and help from my experience and my way of treatment with RH. But if it isn't. I don't want to do harm.
certain things, will be good but I am loathe to try and go with the thyroid issues.

keep asking.

Hi again, Lamont.
I keep a food diary with a glucometer. I know what food my blood sugar to rise too much and what causes it to rise only a little. But no matter how much it is, my blood sugar still crush after 3-4 hours. I tried a low-carb breakfast once (2 eggs, half an avocado, a couple slices of salted trout, and some spinach). I didn't feel any energy after that. And my blood sugar still dropped later. Why?

I thought if I had hypoglycemia during sleep, would I wake up at that moment, or wake up in the morning feeling exhausted or sweaty? I've heard something like that from people with RH.
Once I set an alarm to measure my blood sugar twice a night, and it was normal.
Well, I hope someday I can afford to buy a CGM and find out for sure.

I understand why keto is good for people with RH, but I don't want to use this diet because it implies a lot of fat and protein. I already have high cholesterol and a tendency to constipation... Also, my doctor thinks keto is unsafe for people with endocrine diseases.
I'm quite comfortable eating every 3 hours. Long fasting and rare meals would complicate my task of gaining weight.
This worries me maybe even more than RH
I live in Russia now. The endocrinologists I have seen don't come to the same opinion. I suspect that in my case ther's no way to get rid of RH without harming myself...

 

[Lamont D]

Hi again, Lamont.
I keep a food diary with a glucometer. I know what food my blood sugar to rise too much and what causes it to rise only a little. But no matter how much it is, my blood sugar still crush after 3-4 hours. I tried a low-carb breakfast once (2 eggs, half an avocado, a couple slices of salted trout, and some spinach). I didn't feel any energy after that. And my blood sugar still dropped later. Why?

I thought if I had hypoglycemia during sleep, would I wake up at that moment, or wake up in the morning feeling exhausted or sweaty? I've heard something like that from people with RH.
Once I set an alarm to measure my blood sugar twice a night, and it was normal.
Well, I hope someday I can afford to buy a CGM and find out for sure.

I understand why keto is good for people with RH, but I don't want to use this diet because it implies a lot of fat and protein. I already have high cholesterol and a tendency to constipation... Also, my doctor thinks keto is unsafe for people with endocrine diseases.
I'm quite comfortable eating every 3 hours. Long fasting and rare meals would complicate my task of gaining weight.
This worries me maybe even more than RH
I live in Russia now. The endocrinologists I have seen don't come to the same opinion. I suspect that in my case ther's no way to get rid of RH without harming myself...

Hi again, again.
It is great that you use a food diary. You can gain so much information from one. Seeing trends when your dietary approach gets used to lower carbs intake, you can see how the intolerance levels of individual foods effect your BG levels.
Even tho the food you describe is low carb, it does seem a lot for one meal. I think it might be the reason you are still getting symptoms, until your system does get used to the low carb, your body hasn't adapted especially if you do have high GI carbs with some of your meals. And will still over producing too much insulin.
And you will probably still be getting a weak first phase insulin response regardless of food.

I would imagine, once again that because of the still going through the process of getting used to low carb, that it would not surprise me that you might not have noticed the lesser symptoms. It is called hypo awareness.
And the more time low carb, the more sensitive you become. One of my symptoms of being aware is dreams.
Technicolor vivid dreams. And to go with that, my wife is wary to be in the same bed, if I have one. And sweats etc.
An I'm not surprised it is normal reading, your are non diabetic if you have the condition of RH.
I know that to have the actual condition of RH is rare. meds y more have the symptoms, some are T2, some go through it in pregnancy, some have sugar crashes there is also, a child ailment. And then the other hypoglycaemic conditions. Some are non diabetic, some have it with T2, some don't have symptoms.
And similar to T1, pancreatic conditions, can be autoimmune, or can be symptomatic with hypoglycaemia as in insulinoma, or in some cancers of the pancreas.
as I said, until the tests are done, you are in limbo.
And I agree that the priority in your case should be the more severe conditions you have.
I have lived with RH for over twelve years doing keto as well, so I would disagree with your doct or, it is sustainable. There are many with metabolic conditions that have chosen a keto lifestyle, because the difference is a lot better than the medical profession assume.
If I didn't do keto, I would be very ill, overweight and suffering.
My health since diagnosis is excellent, at seventy (nearly) I am very good.
If not for my endocrinologist, I don't believe I would have survived to this age as my health was so bad at the time. Keto works for me.
Good proteins and in my experience good saturated fats are very good for me. Fresh food only.
It is the production type foods that are not, anything with production sugars, sweetners, additives, oils and vegetable oils. Some ingredients are toxic I believe. Especially to me.
And before diagnosis, keto, my cholesterol was high and bad. It is not now.
With your other conditions, I have not much experience with, so I won't , what low carb effects you, is for you to ,experience, experiment with.
Yes, as soon as you can afford one, it is a good method of testing. There may be a new gadget soon enough cheap and better, and synced to your smartphone. It can't be soon enough.

Finally, RH is a condition that at the present time has no cure, no magic pill, only controlling blood glucose.
The longer in control the better. The more time spent in or just above normal range, your health will improve and the symptoms ease.

I don't have much idea what medical assistance is like in modern Russia, but I have no doubt it is just as bad in the U.K.. So we do have to look after ourselves and use our experience.
The forum was set up for those, who with metabolic conditions, mainly diabetes, couldn't make sense of the NHS advice. And these diabetics through experience, found that reduction of carbs improved their health and reduced meds. I am only on aspirin and irbesarten for hypertension from years ago. No other meds.
And this forum helped with my realisation that it would be a healthy option for my condition.
And it has.
my best wishes.

 

[Anastasia Verner]

Hi again, again.
It is great that you use a food diary. You can gain so much information from one. Seeing trends when your dietary approach gets used to lower carbs intake, you can see how the intolerance levels of individual foods effect your BG levels.
Even tho the food you describe is low carb, it does seem a lot for one meal. I think it might be the reason you are still getting symptoms, until your system does get used to the low carb, your body hasn't adapted especially if you do have high GI carbs with some of your meals. And will still over producing too much insulin.
And you will probably still be getting a weak first phase insulin response regardless of food.

I would imagine, once again that because of the still going through the process of getting used to low carb, that it would not surprise me that you might not have noticed the lesser symptoms. It is called hypo awareness.
And the more time low carb, the more sensitive you become. One of my symptoms of being aware is dreams.
Technicolor vivid dreams. And to go with that, my wife is wary to be in the same bed, if I have one. And sweats etc.
An I'm not surprised it is normal reading, your are non diabetic if you have the condition of RH.
I know that to have the actual condition of RH is rare. meds y more have the symptoms, some are T2, some go through it in pregnancy, some have sugar crashes there is also, a child ailment. And then the other hypoglycaemic conditions. Some are non diabetic, some have it with T2, some don't have symptoms.
And similar to T1, pancreatic conditions, can be autoimmune, or can be symptomatic with hypoglycaemia as in insulinoma, or in some cancers of the pancreas.
as I said, until the tests are done, you are in limbo.
And I agree that the priority in your case should be the more severe conditions you have.
I have lived with RH for over twelve years doing keto as well, so I would disagree with your doct or, it is sustainable. There are many with metabolic conditions that have chosen a keto lifestyle, because the difference is a lot better than the medical profession assume.
If I didn't do keto, I would be very ill, overweight and suffering.
My health since diagnosis is excellent, at seventy (nearly) I am very good.
If not for my endocrinologist, I don't believe I would have survived to this age as my health was so bad at the time. Keto works for me.
Good proteins and in my experience good saturated fats are very good for me. Fresh food only.
It is the production type foods that are not, anything with production sugars, sweetners, additives, oils and vegetable oils. Some ingredients are toxic I believe. Especially to me.
And before diagnosis, keto, my cholesterol was high and bad. It is not now.
With your other conditions, I have not much experience with, so I won't , what low carb effects you, is for you to ,experience, experiment with.
Yes, as soon as you can afford one, it is a good method of testing. There may be a new gadget soon enough cheap and better, and synced to your smartphone. It can't be soon enough.

Finally, RH is a condition that at the present time has no cure, no magic pill, only controlling blood glucose.
The longer in control the better. The more time spent in or just above normal range, your health will improve and the symptoms ease.

I don't have much idea what medical assistance is like in modern Russia, but I have no doubt it is just as bad in the U.K.. So we do have to look after ourselves and use our experience.
The forum was set up for those, who with metabolic conditions, mainly diabetes, couldn't make sense of the NHS advice. And these diabetics through experience, found that reduction of carbs improved their health and reduced meds. I am only on aspirin and irbesarten for hypertension from years ago. No other meds.
And this forum helped with my realisation that it would be a healthy option for my condition.
And it has.
my best wishes.

I have already taken many tests, and none of them found the cause of my disease... There's no antibodies, no insulinoma, etc... Endocrinologists in Russia don't know about reactive hypoglycemia. They think it's insulin resistance. How is insulin resistance different from RH? Maybe can metformin Increase Insulin sensitivity in RH?
I'm wandering about the question, is it possible to gain fat and muscle while in ketosis? I need to gain weight, but I constantly see information that people on keto lose weight or have difficulty gaining muscle...

And is it true that RH will turn into diabetes if nothing is done about it?

 

[Lamont D]

I have already taken many tests, and none of them found the cause of my disease... There's no antibodies, no insulinoma, etc... Endocrinologists in Russia don't know about reactive hypoglycemia. They think it's insulin resistance. How is insulin resistance different from RH? Maybe can metformin Increase Insulin sensitivity in RH?
I'm wandering about the question, is it possible to gain fat and muscle while in ketosis? I need to gain weight, but I constantly see information that people on keto lose weight or have difficulty gaining muscle...

And is it true that RH will turn into diabetes if nothing is done about it?

I was lucky to find an endocrinologist who had already seen a woman who at the same time as me, was having the same symptoms/hypos. I had a hypo in my first appointment with him, which gave him an excuse to look into my case further, and my first extended oral glucose tolerance test, I again had a very low hypo after about 3 and a half hours. After the glucose.
Insulin resistance is not the same, of course you can have it alongside RH. But it is different.
Insulin resistance is when you produce insulin that is not used because of the inflammation of the cells and it doesn't produce the energy.
With or without insulin resistance, you will still go hypo, with carbs, with RH.
RH is a food tolerance issue, such as lactose intolerance., So don't eat dairy.
RH is carb intolerance, reducing carbs and having control of your dietary intake is essential.

As I said, I have not had that issue, but if you get your dietary balance right for you, there is no reason why you couldn't put weight on.
There are many, many athletes that do keto. They gain muscle, I'm sure there is something on line that supports this.

Yes, you are correct. The logical conclusion if nothing is done, would be T2.
The amount of Insulin resistance would increase, which is not good for your liver, your pancreas, and your but biome. Which I am certain has a lot to do with causality.
I believe that my RH was caused by a bacterial infection in the but called helicobactor pylori. But there are other causes as well.
I was taken off metformin because the drug helps with reducing glycogen and glucagon from the liver, to help with the excess high circulating insulin.

I have seen reports from other countries, which have recognised RH or hypoglycaemia as a condition.
What is lacking is the research and study.
The most obvious recent cause, is after surgery, to the upper stomach, reducing the size.
It is called, glucose dumping, because without part of the stomach, the glucose derived from food, is very rapid and the first phase insulin response is ineffective. The second phase is when insulin is over produced called an overshoot. Swamps the glucose driving the BG levels down into hypoglycaemia.
I wondering why your doctors have not heard of these issues.

Keep asking, best wishes.

 

[Anastasia Verner]

I was lucky to find an endocrinologist who had already seen a woman who at the same time as me, was having the same symptoms/hypos. I had a hypo in my first appointment with him, which gave him an excuse to look into my case further, and my first extended oral glucose tolerance test, I again had a very low hypo after about 3 and a half hours. After the glucose.
Insulin resistance is not the same, of course you can have it alongside RH. But it is different.
Insulin resistance is when you produce insulin that is not used because of the inflammation of the cells and it doesn't produce the energy.
With or without insulin resistance, you will still go hypo, with carbs, with RH.
RH is a food tolerance issue, such as lactose intolerance., So don't eat dairy.
RH is carb intolerance, reducing carbs and having control of your dietary intake is essential.

As I said, I have not had that issue, but if you get your dietary balance right for you, there is no reason why you couldn't put weight on.
There are many, many athletes that do keto. They gain muscle, I'm sure there is something on line that supports this.

Yes, you are correct. The logical conclusion if nothing is done, would be T2.
The amount of Insulin resistance would increase, which is not good for your liver, your pancreas, and your but biome. Which I am certain has a lot to do with causality.
I believe that my RH was caused by a bacterial infection in the but called helicobactor pylori. But there are other causes as well.
I was taken off metformin because the drug helps with reducing glycogen and glucagon from the liver, to help with the excess high circulating insulin.

I have seen reports from other countries, which have recognised RH or hypoglycaemia as a condition.
What is lacking is the research and study.
The most obvious recent cause, is after surgery, to the upper stomach, reducing the size.
It is called, glucose dumping, because without part of the stomach, the glucose derived from food, is very rapid and the first phase insulin response is ineffective. The second phase is when insulin is over produced called an overshoot. Swamps the glucose driving the BG levels down into hypoglycaemia.
I wondering why your doctors have not heard of these issues.

Keep asking, best wishes.

Thanks for the explanations!
I read that athletes use a keto diet or low-carb diet before a competition to burn fat and make muscles more defined. But then they go back to their normal eating style to gain mass. Maybe if I continue searching, I'll find examples of those athletes who were able to gain mass on keto... In any case, it seems very difficult to do.

Can reactive hypoglycemia be with a normal 1 and 2-hour blood sugar levels, when sugar doesn't rise above 7 mmol, but then falls?

If I'll on keto and want to go back to low-carb, will I feel bad? How do it right?

 

[Lamont D]

Thanks for the explanations!
I read that athletes use a keto diet or low-carb diet before a competition to burn fat and make muscles more defined. But then they go back to their normal eating style to gain mass. Maybe if I continue searching, I'll find examples of those athletes who were able to gain mass on keto... In any case, it seems very difficult to do.

Can reactive hypoglycemia be with a normal 1 and 2-hour blood sugar levels, when sugar doesn't rise above 7 mmol, but then falls?

If I'll on keto and want to go back to low-carb, will I feel bad? How do it right?

The problem with the example you give, is it is for those without a metabolic condition.
Athletes, especially those who are professional, will have their dietary requirements worked out for them.
With RH, carb loading before or after exercise doesn't stop the symptoms or hypos.
And even exercise has to be done with caution. As it could cause a reaction if you do too much.

It is ideal not to go above your own trigger point, and mine is around 7mmols. I try my hardest to stay under that as much as possible regardless. I have found that your health improves and you become more aware of the many symptoms if you do go high.
If it falls into normal levels, that is not a problem unless it does go lower because of other issues.
3.5 is above hypo levels. So anywhere between 3.5 and 7mmols is fine.
By the two hours reading, any reading between that should never lead to a hypo.

I would always advise lowering your carb gradually and of course using your food diary to keep an eye on How you are doing, I would lower around 20g to 50g over a week, until you find that the symptoms ease. And you are happy at that level of carbs.
going completely keto, only when you are comfortable with your progress.

do not go cold turkey.
do not just stop eating some carbs, unless you are certain.
If you do, you might feel worse, with what we call carb flu.
And it will take time, don't rush it.
I always recommend a very low carb diet, tailored to you, your tastes, your ethnicity, your budget and obviously what is available, wherever you are and most importantly affordability.

Keep asking.
Best wishes.