Reactive Hypoglycemia- help on how to control!

[Hsol]

hi guys, in may 16 I got diagnosed with RH. I managed to control it through diet. In Dec 16 I became pregnant and through the pregnancy my sugars were fine.

After my daughter was born in sept 17 the RH came back. However this time I am struggling to control it with diet. On average my sugar readings are 2.8-3.5. They may climb after I have eaten but they soon drop after.

I don’t leave the house much as I’m scared the sugars will drop.

Is there any advice on what I can do to help manage the low blood sugars. Thanks so much guys.

 

[Brunneria]

Hi and welcome!

How did you control it with diet last time? (what were you eating?)
And what are you eating now that it is uncontrolled this time?

I think we all seem to have different severities, and sometimes food intolerances can play a part (they do with me), but diet is often key in handling this. But maybe you need to eat slightly differently this time.

 

[Lamont D]

Hi, and welcome to the forum.
Can you give us an idea of what you are eating and if you are dropping low soon after eating, how long? You may have to eat more regularly say every two to three hours but very small amounts. So you can keep them at a good levels.
What I have found is that keeping stable blood levels in or near normal levels, is the best way to keep control.
Do you have an endocrinologist to get advice from?
What tests have you had?

Best wishes

 

[Hsol]

Hi brunneria,

Thank you for your message. So the diet I was eating last time is exactly what I tried tho time but I’m struggling to make it work.

For example breakfast would be porridge made with yoghurt and mulled and soaked overnight. This is high in protein but it drops my sugar after approx 45 mins of eating the porridge.

My lunch is ok which is a chicken/tuna/ham/egg salad wrap.

My dinners are normally good too. For example egg curry, roasted veg with chicken etc.

But my main concern is I’m struggling to maintain the sugar levels as they keep dropping.

I need a good breakfast which maintains the sugars and also I am struggling to find snacks which work too.

Any help is greatly appreciated.

Hi and welcome!

How did you control it with diet last time? (what were you eating?)
And what are you eating now that it is uncontrolled this time?

I think we all seem to have different severities, and sometimes food intolerances can play a part (they do with me), but diet is often key in handling this. But maybe you need to eat slightly differently this time.

 

[Hsol]

Hi Lamont,

Thank you for your reply.

My breakfast would be porridge made with yoghurt and milk and soaked overnight. This is high in protein but it drops my sugar after approx 45 mins of eating the porridge.

My lunch is ok which is a chicken/tuna/ham/egg salad wrap.

My dinners are normally good too. For example egg curry, roasted veg with chicken etc.

But my main concern is I’m struggling to maintain the sugar levels as they keep dropping.

I need a good breakfast which maintains the sugars and also I am struggling to find snacks which work too.

I do have an endocrinologist and when the RH began prior to me becoming pregnant he did some tests. I had the test where I had to fast and then drink a glucose drink and then my blood sugar was measured every 30 mins. This test concluded I have RH.

do you think it would be beneficial to contact my endocrinologist again. Would he be able to help me?

Any help is greatly appreciated.

Hi, and welcome to the forum.
Can you give us an idea of what you are eating and if you are dropping low soon after eating, how long? You may have to eat more regularly say every two to three hours but very small amounts. So you can keep them at a good levels.
What I have found is that keeping stable blood levels in or near normal levels, is the best way to keep control.
Do you have an endocrinologist to get advice from?
What tests have you had?

Best wishes

 

[Brunneria]

Hi,

Well, speaking from personal experience, the porridge, the wraps, and any rice you may have with the curry in the evening would all be too much carb for me and would trigger a hypo. Sad but true. The low glycaemic carb mantra doesn't always work for us. It certainly doesn't for me.

There was a time (seems a long time ago now) when I used to be able to tolerate carbs like that, but nowadays I need to be stricter. Over recent years I have steadily eliminated all grains, and discovered a couple of food intolerances which were causing knock on blood glucose problems. I end up changing my way of eating and running self experiments on myself quite a lot, and recently have been the lowest carb I have ever achieved - and felt the best for ages.

So I would suggest that you try having no carbs at breakfast at all for a day, and see how you feel on it. Scrambled eggs, no toast. Or 97% meat sausages, or bacon and egg. Something that is just protein and fat. They often keep us feeling comfortable til lunchtime. See how you do.

I think that with age, we often become more sensitive to carbs, and if you have a history of RH, then things can (and sadly do) often deteriorate with time. However, these can often be controlled by just switching up the way of eating a bit.

 

[Kailee56]

I’m rediscovering egg cups aka crustless quiches. They work for a meal or snack, refrigerate and freeze well, and can be warmed in the microwave. They would give the protein without carbs and be as easy as the overnight porridge.

There are also pancake and waffle recipes make with pork rinds instead of flour. They also freeze well and can be warmed up in the microwave or toaster, for the waffles. I often use the waffles instead of bread.

An easy snack to carry is nuts. At home I tend toward sausage slices with cream cheese

 

[Lamont D]

Hi Lamont,

Thank you for your reply.

My breakfast would be porridge made with yoghurt and milk and soaked overnight. This is high in protein but it drops my sugar after approx 45 mins of eating the porridge.

My lunch is ok which is a chicken/tuna/ham/egg salad wrap.

My dinners are normally good too. For example egg curry, roasted veg with chicken etc.

But my main concern is I’m struggling to maintain the sugar levels as they keep dropping.

I need a good breakfast which maintains the sugars and also I am struggling to find snacks which work too.

I do have an endocrinologist and when the RH began prior to me becoming pregnant he did some tests. I had the test where I had to fast and then drink a glucose drink and then my blood sugar was measured every 30 mins. This test concluded I have RH.

do you think it would be beneficial to contact my endocrinologist again. Would he be able to help me?

Any help is greatly appreciated.

Hi, again,
As @Brunneria has said porridge is not a good idea, that is not a good start to your day, and from there you would never gain the control to regulate your glucose levels.
I would also test the milk, and is the yoghurt low fat?

Experiment and test.
If you haven't already started a food diary, do so.
If you have rh, you don't need to eat breakfast. And if you do, no carbs at all. Eggs are great. You probably do have intolerance to some foods that you are not aware of.
Potatoes really are bad for me, as well as rice, wheat, it could be gluten!
But I do believe that the reactive part of this condition is because of intolerance.
Once you go high in the morning, it is so difficult to get back to normal levels.
Your fasting levels in the morning are probably normal.
So why upset your body with unnecessary carbs?

But in the meantime, you will have to find food that doesn't spike you, for breakfast, then eat regularly every couple of hours, very small meals, so you don't hypo. Until you get the necessary control. Then eating very low carb will become the norm, you will find that you don't have to eat so often, to offset the hypos.
Have you tried fasting?
You mentioned a eOGTT (ex extended oral glucose tolerance test) that your endo did.
Did he not give you details of that test?
Any other tests, other than blood panels?
Have you been tested for food intolerance? (Such as gluten)

For instance today, I have had a couple of eggs (boiled) at eleven.
Then some roast pork at three, I will probably eat something around seven or eight this evening and some yoghurt (full fat) before I go to bed.
Not much is it?

Your body does not let you have a normal healthy diet.
Healthy for you is different to others. We cannot eat healthy.
We have to find our own individual balance of foods.

If you are not sure about food, test!

Would I contact my endocrinologist, of course, I would, but by his diagnosis, it does seem he hasn't got the dietary information right. It is all about diet and most doctors would not realise that we are intolerant to a lot of foods.
Even my endocrinologist has been surprised at my health even though I stay away from so called healthy foods!