Hi and welcome to our forum. Reactive Hypoglycaemia, the basics! What is Hypoglycaemia? Hypoglycaemia is in response to your blood glucose levels going below a certain percentage of blood sugar. Usually depending on personal experience anything below 3.5 is a hypo and should be treated. There are differing opinions and some hypoglycaemiacs can live comfortably as low as 3.0 Reactive Hypoglycaemia is a condition, where your pancreas over produces too much Insulin for the meal you have digested. Reactive Hypoglycaemia or post prandial hypoglycaemia is a medical term describing recurrent episodes of symptomatic Hypoglycaemia occurring within four hours after a high carbohydrate meal or oral glucose load in people who do not have diabetes. It is thought to represent a consequence of excessive insulin release triggered by the carb meal but continuing past the digestion and disposal of glucose derived from the meal. So depending on what you eat, your blood glucose response and your body's ability to cope with carbs and sugars, the excess insulin and the very quick hyper (high blood sugar) within an hour. The drop to normal levels, but it continues to drop to a low blood sugar level (hypo). The condition is unique because the hormonal response to carbs and glucose. We spike quickly, we do not have a lull in our spike, in others, the spike is interrupted in its climb, RH ers don't! We use up our glucose from the meal. Hence the speed of our hyper. When we treat our hypos, we fluctuate between highs and lows, hence the excessive symptoms and why our brain is bombarded with different psychological associated symptoms. I didn't want to make this too scientific, there is a lot of science information on the internet. I did say this was basic! Symptoms Symptoms vary from Individuals hydration levels, according to Wikipedia! The sensitivity of the rate and magnitude of decline of their blood glucose concentration. They include; Blurred vision. Headaches. Frequent urination. Depression. Unclear thinking. Nervousness. Sleep disruption or insomnia. Muscle twitches. Heart palpitations or fibrillation. Irritability. Fatigue. Tremors. Dizziness. Flushing. Lightheadedness. Craving sweets. Sweating. Increased appetite. Rhinitis. Vomiting. Nausea. Panic attack. Numbness. Coldness in the extremities. Confusion. Irrational. Bad tempered. Disoriented. Anxiety. Anger. Rage. Coma. Can occur in extreme conditions in severe untreated episodes. There are others, but it shows how diverse the symptoms are! I personally did not have all the symptoms, but only missed out on a few! Types of Hypoglycaemia. Alimentary Hypoglycaemia. Or dumping syndrome. Prevalent after stomach surgery. Hormonal Hypoglycaemia. Hypothyroidism. Helicobacter Hypoglycaemia. Pylori induced gastritis. Bacteria in the gut and through digestion. Congenital enzyme deficiencies. Fructose intolerance. Late Reactive Hypoglycaemia. Used to be called idiopathic hypoglycaemia. Because they have not found any known cause and is rare! This is me! Naturally weird! Causes. As I've already said, I developed my condition naturally. But usually it is prevalent after stomach surgery. Trauma. Fructose intolerance, usually hereditary. I believe diet should be one of the causes, but there is nothing or research to back it up! Also no way has been found to create insulin overshoot. Treatment. This is open to discussion. However, a low carbohydrate intake is recommended by consensus on this forum. No sugar. Eating regularly. Depending on individual, seven to nine small meals per day. Small plate size is important because of protein and calorie intake. Exercise is important. Walking does lower blood glucose levels. Anything strenuous will temporarily increase your blood glucose levels, exercise is good for you! Just don't overdo it! In my experience of continuous hypos and hypers, one after another! I have found the best way to avoid further hypers and hypos is to eat regularly throughout the day. To treat a hypo, well, what I do is make a cuppa of tea, eat a biscuit, plain or something that is low carb, and sit and relax, this will raise your blood glucose levels slowly, then within a half hour, have a very small low carb meal. Hopefully you won't hyper, so no hypo! No fluctuating blood glucose sugar levels. Foods to avoid. We recommend a low carbohydrate lifestyle. Sugars and carbohydrates are the foods that you don't tolerate well. And you 'react' to them. Obviously you cannot not eat carbs as they are everywhere, but avoid the starchy ones and the fructose sugars in fruit. As with all blood glucose disorders, there are some foods that you can eat very small amounts of, but the only way to know is to test and experiment. Flour of all grains are to be avoided. Factory made food is full of what is known as production sugars and ingredients such as corn syrup. Tinned products such as soups. Rice. Pasta. Fast food. Even the meat is processed. Some RH ers can be tolerant to dairy products and lactose, which is a sugar. Low, reduced or no fat products! Such as yoghurt! The full fat is replaced by processed sugars. Confectionery. Some patients who have Reactive Hypoglycaemia, can also have T2 diabetes, but not the other way around. Diabetic hypoglycaemia can be caused by drugs or by not eating regularly. This does not include T1 or T2 diabetics who regularly hypo because they have to have insulin injections because of insulin resistance. Most RH ers are not diabetic. If your fasting hba1c level is normal, then you are not diabetic.There is always those who can attain normal levels through diet but are susceptible to diabetic levels. There are no medication that have yet to recognised just for RH. But there are trials and research. There is no known cure for Reactive Hypoglycaemia! As I've said, this is the basics, from a layman who has the condition. I've been through hypo hell, done the tests and experimentation and found myself fit and healthy again after a lot of years. Hope this helps, those who find themselves in need of information. Welcome to the forum.