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Resource Reccomendations

Discussion in 'Reactive Hypoglycemia' started by standardissue, Jun 20, 2021.

  1. standardissue

    standardissue · Newbie

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    Hi all, I've only just found this forum, for years I've been told by medical professionals RH is incredibly rare and my symptoms are almost "unheard of". Thankfully I'm now reading there's plenty of others out these just like me!

    The question I have is, does anyone who has a grip on their RH have suggested resources; online, books, apps etc?

    I've been through 8years of trial and error, when I get any consistency, something in my life changes (excersise, sleep, weight) and everything goes out of the window, I then find myself on the daily rollercoaster of just stuffing my face with carbs every few hours!

    I've been LCHF for 2 months and haven't crashed once, but can't find the energy to sustain excersise (cycling) so desperate to re-intriduce carbs in a measured way.

    Any help greatly appreciated.
     
  2. Antje77

    Antje77 LADA · Moderator
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    Hi @standardissue , and welcome!

    Are you eating enough, calorie-wise?
     
  3. standardissue

    standardissue · Newbie

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    I'm not sure, I don't really know what enough would be, the meals I make from online resources suggest they'd be part of a 2000 calorie/day diet.

    To be honest, I've gone from eating none stop to feeling like I can't face eating more than I have been (a totally new feeling for me)
     
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  4. Antje77

    Antje77 LADA · Moderator
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    I asked because many people do well exercising on a low carb diet. But exercise needs fuel, so I wondered if a simple lack of fuel could be the problem. Especially because many people forget to add more calories from other food groups when they cut out the carbs, leaving them hungry and lacking energy.

    I'm really out of my depth here, being a T1 diabetic without RH, and not even following a very low carb diet. Hopefully others will have more ideas!
    Tagging @Goonergal , who doesn't have RH but does eat low carb and is also way more active than I am, so she knows much more about exercise on low carb than I do :)
     
  5. Goonergal

    Goonergal Type 2 · Moderator
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    Thanks for the tag @Antje77 and hi @standardissue

    I don’t have RH but do eat very low carb - as close to zero as I can get it most days. I don’t find that I need carbs to exercise - I do long distance walking (15-20+ miles), usually in a water fasted state and similarly do weights at the gym before eating for the day.

    The trick is to ensure that you’re eating low enough carb to be burning fat for fuel instead of carbs, and to ensure that you eat enough, stay well hydrated and keep electrolytes up.

    As I understand it, the key with RH is avoiding foods that could trigger a low and that’s why low carb/keto works well to control it. Adding carbs into the mix to ‘fuel’ exercise may well set the cycle of highs and lows in motion.

    You might want to look up the work of Dr Tim Noakes (type 2), Dr Ian Lake (type 1) and Phinney/Volek on this issue.

    I’ll also tag @Mbaker who is type 2 and a prodigious exerciser.

    Editing to add some links:
    https://180nutrition.com.au/exercise/prof-tim-noakes-the-exercise-carbohydrate-myth/

    https://nutrition-network.org/what-should-i-be-eating-during-prolonged-exercise-prof-noakes-answers/


     
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    #5 Goonergal, Jun 20, 2021 at 6:02 PM
    Last edited: Jun 20, 2021
  6. Goonergal

    Goonergal Type 2 · Moderator
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  7. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I have 'Late Reactive Hypoglycaemia'
    I have been more or less very low carb since diagnosis and my health is better in and around normal levels continually.
    As mentioned above you have to avoid the trigger.
    If you eat carbs, your insulin response is poor due to various reasons, that creates the trigger to produce a secondary insulin response, which is called an overshoot, this is the reason you go hypo.
    The trick is being in control in normal levels. No carbs means no surge up in blood glucose levels, so no spike, no trigger, no overshoot, no hypo.
    If you do want your health back, go Keto.

    But, isn't there always? I have found that exercise is dependent on how much you can do without triggering a liver dump of glucose. This is your body's natural reaction to get glucose to continue exercise. But the last thing you need is going hypo after extensive exercise. I have found walking, swimming and a normal work day is enough for me, I fast till the afternoon and eat a Keto meal and finish before seven p.m. because I make sure that my levels are good going to bed.

    I am on a drug called Januvia, or sitagliptin, it has been used to have an effect on the first insulin response, which lowers the risk of Hypoglycaemia because if your balance of dietary intake is low enough, then there is less risk of developing the problems you are having, but it is not a cure. I have been a guinea pig in using the drug to get better control. The test was an eOGTT and even though the high spike wasn't there, I still went hypo.

    I can imagine your day starts with porridge or cereal, toast, coffee and tea with semi skimmed milk, and of course this is the recommended NHS guidelines, this healthy food is fine for someone who hasn't got a rare condition such as RH.
    With RH, the healthy dietary advice is avoid those so called healthy foods because they are not healthy for me and others who have the condition.
    Carbs, any carbs will make you ill.

    Please, read some of the threads, most doctors and some endocrinologists, don't understand the condition and don't understand the significance of avoiding carbs..
    RH is a dietary driven condition, and if it was something like an allergy, the doctors would tell you to not eat what you are allergic to.

    Keep safe, keep asking and welcome to the forum.
     
  8. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    I think you are not completely fat adapted. In my heavier cardio phase I would run out of energy about 3 miles into a 5 mile walk. The walk was at near maximum intensity, so my heart rate was anywhere between 135 and around 150 bpm, really going for it and faster than some joggers. I would literally have to pace down and amble back to my originating point. At home I would have some Seabass to feel better (I wish I kept better records, but I know this was less than 6 months into my starting my reversal).

    Something changed over time, I believe a metabolic switch, which enabled me to complete the walk and not eat later. This makes sense, for almost half a century I was driven by carbs, why would it not take several weeks / months to get fully fat adapted. This hypothesis is backed by the results of the faster study by Volek and Phinney, which showed elite athletes being able to eventually perform at least as good as carb burners over time, some improving fat oxidation months later, even in those who were already well tuned. The way to get fat adapted is to ensure quality fats are high enough in your diet to build the fat burning pathways fully (this can be pulled back, once performance improves).

    I have switched things up to be more muscle centric now, as I like the idea that it helps burn calories at rest, can help sponge in glucose independently of insulin and is associated with longevity independent of dietary pattern.

    Also there is the mental elephant in the room that you are having to deal with - the carb draw, this is worth a watch as it helps to explain "our" conditioning:
     
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  9. standardissue

    standardissue · Newbie

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    Thank you all for your responses, it's all great and much appreciated advice.

    Is there a way to know I'm fat adapted or is it just trial and error?

    I've been near zero carbs for 2 months and day to day feeling like a "normal" person.

    The issue came on a routine 50km ride, usually would take approx 1hr 20min (ish), on Friday on keto took 3hrs and I just couldn't spin my legs, my heart rate stayed low, I never felt like I thouched my cardio ability, never felt tired, just couldn't go!

    I was using the ketone pee sticks (I know not the best read) these were suggesting high ketone levels.

    Do I just need to keep trying?
     
  10. Goonergal

    Goonergal Type 2 · Moderator
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    Hi again. Normally, not being hungry between meals, high energy levels are all signs. It’s usually said the pee sticks are not the best indicator - if you’re peeing the ketones out, then your body isn’t using them, so that would suggest your body is still adapting. The blood test strips might be a better indicator but it’s not necessarily true that higher ketones mean ‘better’ adaptation.

    Editing to add this link, which explains things better: http://www.tuitnutrition.com/2016/01/dont-be-a-ketard1.html

    That’s a good sign that the way of eating suits you.

    Could it just be that you were a bit ‘under the weather’ without any big symptoms? I’d keep trying!
     
    #10 Goonergal, Jun 22, 2021 at 6:49 AM
    Last edited: Jun 22, 2021
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