Keto induction vs hypoglycemia

[ghost_whistler]

How to survive drastically cutting carbs and putting the body into ketosis while hypoglycemic? One article on keto eating said that it made things worse.

http://www.ketogenic-diet-resource.com/reactive-hypoglycemia.html

 

[Resurgam]

I had what must have been false hypos when I switched to low carb, which I treated with a few grapes, then a sit down for a few minutes until the feeling passed. I think that if I had allowed myself to become anxious and consumed a lot of carbs I'd have been bouncing around like a ping pong ball. The relief did not last all that long, but I was at home so it was not all that dangerous - though I did get lost on my way to bed - I turn out all the lights and walk from the landing to bed in almost total darkness, but we have lived here for decades so it was quite a strange feeling to become disoriented. After a day or so the feeling passed and I went into ketosis, but I did have to persist. I could have dropped the carb count more slowly to allow time for my body to adapt - but I have never been afraid of low carb, and still aren't despite the hypo feeling.

 

[Lamont D]

Hi @ghost_whistler.

The article you have just posted is written by people who haven't got a clue about the symptoms and how RH happens, it is a supposition that everyone has reactive hypoglycaemic and it is normal for those who have episodes of RH is normal.
That is just not so!
The condition they are describing is post prandial symptoms that are not hypos, there is a condition that is not RH but has the exact symptoms but don't hypo.

My condition is real, my symptoms are real, I have a high intolerance to carbs and sugars. I have been in ketosis for well over two years, it is symptom free and since going into ketosis I have not had an episode of Hypoglycaemia.
I know I still have the condition because of my last eOGTT (extended or prolonged oral glucose test) and I still went into hypo.
Don't be swayed into thinking it is for normal people, it's not, many diabetics and from the response we have had from fellow RH ers, they seem to be healthier on a ketogenic lifestyle.

I would further add, that either carb flu or wild fluctuating blood glucose levels are known to be symptomatic of Hypoglycaemia. As well as other conditions that are metabolic or endocrine conditions.

If you followed their advice, I believe you would still get really severe symptoms of hypoglycaemia.

Best wishes.

 

[Brunneria]

Thanks for posting that link, @ghostwhistler I think I understand more where you are coming from now.

I am guessing that article is American, yes? Because I have noticed that American discussions on forums often don't distinguish between what we here call False Hypos and Reactive Hypoglycaemia - and it is a fundamental difference.

The beginning of that article mentions two different situations.

The first is what we call a False Hypo. It is where your blood glucose is at all times above 4mmol/l. However, the body produces hypo feelings and symptoms. This may be because it is used to having much higher blood glucose and is uncomfortable at the new, lower reading. Or it may be because the blood glucose is dropping rapidly, which feels alarming. But in False Hypos, the blood glucose does not drop into the hypo range, so these are not hypos at all. They feel very real! But blood glucose does not get too low.

The second situation described in the article is true Reactive Hypoglycaemia. This is caused by the individual eating more carbs than their body can handle. Blood glucose rises, then drops and it drops lower than it was before the food, and it drops below 4mmol/l and into a hypo. This is not a False anything. This is a very real hypo and needs treatment, by eating a few quick release carbs, and then by not re-creating the situation again (by avoiding eating too many carbs and causing the high-low RH swing).

We can only tell the difference between these two different situations by using a meter, so anyone who claims a hypo is only 'a false one' without actually using a meter is talking rubbish and their advice is bad. (I feel very strongly about this since various medical professionals have tried to fob me off with 'it is all in your head'. I don't put up with that any more, because now I am armed with my meter )

The rest of that article makes a better job of it. But the beginning of it has rather messed up the overall message.

Basically: If you have true Reactive Hypoglycaemia, then don't eat the carbs that send you high. That way, there won't be a reactive drop afterwards, and you won't have a hypo.

 

[ghost_whistler]

Hi @ghost_whistler.

The article you have just posted is written by people who haven't got a clue about the symptoms and how RH happens, it is a supposition that everyone has reactive hypoglycaemic and it is normal for those who have episodes of RH is normal.
That is just not so!
The condition they are describing is post prandial symptoms that are not hypos, there is a condition that is not RH but has the exact symptoms but don't hypo.

My condition is real, my symptoms are real, I have a high intolerance to carbs and sugars. I have been in ketosis for well over two years, it is symptom free and since going into ketosis I have not had an episode of Hypoglycaemia.
I know I still have the condition because of my last eOGTT (extended or prolonged oral glucose test) and I still went into hypo.
Don't be swayed into thinking it is for normal people, it's not, many diabetics and from the response we have had from fellow RH ers, they seem to be healthier on a ketogenic lifestyle.

I would further add, that either carb flu or wild fluctuating blood glucose levels are known to be symptomatic of Hypoglycaemia. As well as other conditions that are metabolic or endocrine conditions.

If you followed their advice, I believe you would still get really severe symptoms of hypoglycaemia.

Best wishes.

Thanks. I've no idea of the veracity of the article, but it seemed to come from a source that understood keto. I thought post prandial and reactive were the same thing, one just being the medical term.

What is the condition that has the same symptoms but without the actual hypo crash?

Sorry I'm a bit lost: if I followed who's advice? The article doesn't give any advice, that was part of my reason for raising it and starting this thread. The thought of induction is something i find absolutely terrifying - as well as the struggle to get enough fat nutrients. I like the idea of a more gentle approach than carb cold turkey, but I'm not seeing anything that supports an alternative to that approach.

I've also never heard of carb flu, though it's entirely possible, i guess, that i'm just not 'carb-compatible'.

And forgive me for asking, if it's not too intrusive, but if you're doing well in ketosis why test blood sugar/hypo? I thought ketosis bypassed all that?

 

[ghost_whistler]

Thanks for posting that link, @ghostwhistler I think I understand more where you are coming from now.

I am guessing that article is American, yes? Because I have noticed that American discussions on forums often don't distinguish between what we here call False Hypos and Reactive Hypoglycaemia - and it is a fundamental difference.

The beginning of that article mentions two different situations.

The first is what we call a False Hypo. It is where your blood glucose is at all times above 4mmol/l. However, the body produces hypo feelings and symptoms. This may be because it is used to having much higher blood glucose and is uncomfortable at the new, lower reading. Or it may be because the blood glucose is dropping rapidly, which feels alarming. But in False Hypos, the blood glucose does not drop into the hypo range, so these are not hypos at all. They feel very real! But blood glucose does not get too low.

The second situation described in the article is true Reactive Hypoglycaemia. This is caused by the individual eating more carbs than their body can handle. Blood glucose rises, then drops and it drops lower than it was before the food, and it drops below 4mmol/l and into a hypo. This is not a False anything. This is a very real hypo and needs treatment, by eating a few quick release carbs, and then by not re-creating the situation again (by avoiding eating too many carbs and causing the high-low RH swing).

We can only tell the difference between these two different situations by using a meter, so anyone who claims a hypo is only 'a false one' without actually using a meter is talking rubbish and their advice is bad. (I feel very strongly about this since various medical professionals have tried to fob me off with 'it is all in your head'. I don't put up with that any more, because now I am armed with my meter )

The rest of that article makes a better job of it. But the beginning of it has rather messed up the overall message.

Basically: If you have true Reactive Hypoglycaemia, then don't eat the carbs that send you high. That way, there won't be a reactive drop afterwards, and you won't have a hypo.

YW.

I assume it's an american article, though i don't know for sure.

How does one treat a false hypo? I'm not sure my readings confirm that as 3.3 and 3.6 (the two readings i have that are in the hypo range, according to the meter) are low.

The whole thing is honestly incredibly tiring and depressing.

 

[Brunneria]

YW.

I assume it's an american article, though i don't know for sure.

How does one treat a false hypo? I'm not sure my readings confirm that as 3.3 and 3.6 (the two readings i have that are in the hypo range, according to the meter) are low.

The whole thing is honestly incredibly tiring and depressing.

I would say that false hypos come from bad eating (too many quick release carbs, causing a rapid drop when the insulin release happens). They can be avoided by eating better choice foods. Some diabetics who have had uncontrolled high blood glucose for some time, find they get false hypos when they get their blood glucose under control. After all, if their body is used to running on blood glucose up in the 15-18mmol/l range, and they bring it down to the 5-7mmol/l range, it takes a while to adjust. People can feel seriously wobbly during the transition.

The standard rule (as discussed on this forum) is that anything below 4mmol/l counts as a hypo and should be treated as such.

So yes, you had two real hypos recorded by your meter. And your symptoms confirm it.
I would say that your previous hypo of 1.6mmol/l in the night was also a hypo. A severe one.

In my experience of prick testing with my meter, if the strip has been inserted wrongly, or I haven't used a big enough blood drop, then the meter tells me there is an error. So I don't think you should assume that the 1.6 was a error just because you haven't had it repeated. Also, remember how dreadful you felt? For days? That is classic hypo after-feeling.

Treating your hypos requires both short term action (eat a few carbs), and long term action (avoid triggering a hypo in the first place). So identify what causes them and avoid it in future.

If you do have RH, then as far as I have seen and researched and experienced, diet is the best and most effective treatment.
And for me, that means I eat very low carb (keto) to prevent triggering the high-low blood glucose bungee jump.
Not everyone has to go so low. We have had some posters with RH find that they do OK on low to moderate carbs. The main thing is that they have found something that works for them.

 

[ghost_whistler]

I'm confused about keto/vs lower carb.

Surely if you simply lower your carb intake, as I have done today, but not enough to get into ketosis you're just going to starve yourself?

 

[Lamont D]

Thanks. I've no idea of the veracity of the article, but it seemed to come from a source that understood keto. I thought post prandial and reactive were the same thing, one just being the medical term.

What is the condition that has the same symptoms but without the actual hypo crash?

Sorry I'm a bit lost: if I followed who's advice? The article doesn't give any advice, that was part of my reason for raising it and starting this thread. The thought of induction is something i find absolutely terrifying - as well as the struggle to get enough fat nutrients. I like the idea of a more gentle approach than carb cold turkey, but I'm not seeing anything that supports an alternative to that approach.

I've also never heard of carb flu, though it's entirely possible, i guess, that i'm just not 'carb-compatible'.

And forgive me for asking, if it's not too intrusive, but if you're doing well in ketosis why test blood sugar/hypo? I thought ketosis bypassed all that?

Post prandial means after eating!
Reactive means in digestion terms, your blood glucose levels react differently to normal!
My condition was called idiopathic late post prandial hypoglycaemia!
Then because they believed that the reason for it was the overshoot caused by the secondary insulin response was discovered and that the idiopathic could be dropped because it means undefined. Then post prandial was used in terms of how digestion works for everyone, that was changed to reactive hypoglycaemia. The late is because I hypo late in the digestive process.

The condition that has the same symptoms but not the hypoglycaemia is called post prandial syndrome!

You have every right to question the advice given here and it maybe remiss of us to tell you that it is right for you. We cannot diagnose you. We can only give advice about our experiences, this forum was set up because of the totally questionable advice given to diabetics about diet.
The medical industry is rife with that we need good or complex or healthy carbs!
But if you read all the way through this forum, it is totally illogical to have the amount of carbs they recommend!
We have the condition and have successfully implemented a complete lifestyle change to go very low carb because of its success in controlling the condition.
No hypos in well over two years! That is no symptoms and healthy as I can be at my age, all my health problems have gone, perfect life signs, BP etc.
But it's been a long time getting here!

It is no wonder you have depression and are fed up, they are also symptoms!
I had really terrible anxiety, that has gone, almost, it catches me out now and again, I think! On second thoughts, yes! It does! (Joke!)

The reason to test in ketosis, is because anything can catch you out and it is a safety valve if you are not sure. It helps with finding out if a cold or flu is kicking you out of ketosis or if you have too much protein or not enough full fat!
It can also help you to see if you want to (I don't!) To try a few carbs, to see how your intolerance is getting better or worse.
But the main reason is to check every now and then to see if your fasting levels are getting higher because it could be accompanied with T2, as @Brunneria has.

To give you a layman's term, without the science.
RH is a carb intolerant condition, you are insulin intolerant, your blood glucose levels are rocketing up and crashing if you eat carbs. To prevent this you don't eat them!
Simples!

Alas no!

Best wishes

 

[Lamont D]

I'm confused about keto/vs lower carb.

Surely if you simply lower your carb intake, as I have done today, but not enough to get into ketosis you're just going to starve yourself?

It doesn't mean that, I eat quite healthy, today for example.

Greek full fat yoghurt and a few bits of fruit for breakfast!
Ham salad for lunch!
Pork steaks for tea.
Not sure for supper!

Once you start low carb, the hunger pangs stop, you don't feel hungry and when you get it right, it is so rewarding. Keto is not starving yourself because your body will adapt and help become more healthy, it will stop the symptoms.

I do fast, and it's brilliant and if in your terms, I do starve myself because that's where my body and brain likes me to be. It is not unhealthy for me to fast even for days.
I had a four days stay in hospital, to do a fasting test for 72 hours, which lasted for 80 hours in total, my mind was so lucid and I began to really feel my health improve.
The fast was good, the hospital not so much!

Walking always helps as does swimming, but I can't do hard strenuous exercise like running because my liver kicks me out of ketosis and gives me a spike. Which I don't want.

Do you suffer with sleeping?

 

[Brunneria]

Low carb is eating fewer carbs than most people (say 50-130 g of carbs) and eating more of other stuff to replace them (meat, fish, eggs, low carb vegetables, salad, berries, cheese, eggs and butter, olive oil, etc) no need to ever go hungry.

Ketogenic eating is just eating fewer carbs (approx 50g carbs a day, or less) and more of the other stuff.

We can all test our blood glucose, try different foods, and see how low carb we need to go to feel well.

 

[andersl]

Are you advising keto diet for reactive hypoglycaemia? I'm going to go very low carbs from tomorrow. I drastically changed my diet after a hypo went all the way to seizure. But I need to be more consistent. Sometimes I'll have an 'all day breakfast ' with brown bread then pay for it by crashing out on the sofa for 3 hours! I've got to get better at refusing the carbs. I know it will be hard at first as my body will be relying on the carbs for energy but thought I'd use nuts to help. I agree with the fasting. I'd become scared of fasting after being told to eat every 2 to 3 hours but fasting doesn't seem to give me symptoms, it's sugar and carbs that does that .

 

[Brunneria]

Are you advising keto diet for reactive hypoglycaemia? .

I feel best when i am keto. Without a doubt. But, in my case, now that i have gone gluten free my carb tolerance has increased, so i feel better than i ever expected, on more carbs than i ever expected.

I don't think keto suits everyone, and i think everyone needs to find their own level - which may be quite a few more carbs than is needed for keto. However, if someone wants to find out whether their RH is going to respond to getting their carbs low enough, then cutting carbs down to keto levels would be the quickest way to find out. So long as they don't give up until they have gone through any keto flu. It is important to wait and see how you feel after any keto flu symptoms have passed.

Sorry to hear about your seizure! Are you aware of the circumstances that led to it? And do you feel you can avoid them in future?

 

[andersl]

I feel best when i am keto. Without a doubt. But, in my case, now that i have gone gluten free my carb tolerance has increased, so i feel better than i ever expected, on more carbs than i ever expected.

I don't think keto suits everyone, and i think everyone needs to find their own level - which may be quite a few more carbs than is needed for keto. However, if someone wants to find out whether their RH is going to respond to getting their carbs low enough, then cutting carbs down to keto levels would be the quickest way to find out. So long as they don't give up until they have gone through any keto flu. It is important to wait and see how you feel after any keto flu symptoms have passed.

Sorry to hear about your seizure! Are you aware of the circumstances that led to it? And do you feel you can avoid them in future?

 

[andersl]

The seizure was due to rapid blood glucose drop. Coming off sugar, having low carbs and eating regularly has helped. Though I still have sleeping crashes when I eat carbs hence thinking about going on keto diet. However I may try gluten free first to see if that makes a difference. It shouldn't take long to find our. What do you mean by keto flu?

 

[Brunneria]

The seizure was due to rapid blood glucose drop. Coming off sugar, having low carbs and eating regularly has helped. Though I still have sleeping crashes when I eat carbs hence thinking about going on keto diet. However I may try gluten free first to see if that makes a difference. It shouldn't take long to find our. What do you mean by keto flu?

In your situation I think I would try the keto first. In my experience it is easier to get my head around.

It is actually surprisingly challenging to eliminate all gluten from the diet - in many ways more challenging than going to keto eating. Takes quite a lot of research and preparation, and a heck of a lot of food label reading. As an example, if eating keto, you could probably have a sausage in a cafe in your cooked breakfast, but on gluten free (GF) you would have to ask the waiter if this was a GF sausage? and then trust them when they looked at you blankly and nodded. Plus, and this is the really bad news, I didn't see the full benefits of going GF for months. The effect was very slow and cumulative, and a single little error (there was that battered onion ring...) and you could set yourself back for weeks.

Besides, just because gluten affects me, doesn't mean that it is affecting you - you might have a completely different intolerance, or none at all. @Lamont D doesn't have problems with gluten, but he does have big problems with potato... unfortunately we all differ wildly.

 

[Resurgam]

Whilst eating a low carb diet and reducing BG levels nicely I started to have my energy drop to nothing in mid afternoon, just as I experienced when in my teens and twenties.
After a few experiments I found that I was eating my first meal too late in the day, but that I needed to have only a few carbs with it. No carbs was not the answer, but fewer than 10 gms were required.
Now I have it sorted out I don't get slumps, though the problem might have gone away by now I am sticking to the routine as it is no problem at all.

 

[Brunneria]

Hi again,

I just remembered that you asked about keto flu - it is basically your body learning to adapt to the new way of eating.
This link explains it much better than I can

https://www.dietdoctor.com/low-carb/side-effects