Struggling With Low Blood Sugar

[tonymacavoy]

Hello Folks,

Hope you are all well.

I have suffered with Reactive Hypoglycemia for over 10 years and have constantly been configuring my diet. My diet is the best it can be, i am having more protein, i have low carbohydrate bread and try having alot of no carbohydrate meals. I generally have reduced alot of my Reactive Hypoglycemia episodes, originally my blood sugar was dropping as low as 3.3mmol on a UK blood glucose reading.

I still have alot of tiredness sometimes after eating and i have had a few minor Reactive Hypoglycemia episodes. My doctor says i should try Acarbose, this slows down the absorption of food, which leads to a lower response in insulin from the pancreas. However this medication can cause alot of side effects such as gas and stomach ache that can be unpleasant.

I was kindly wondering if anyone knows of any vitamins & minerals, herbs or certain super foods, that could help with my pancreas and the over production of insulin. Even anything to help stop my blood sugar fluctuations to some extent, any help would be appreciated. There is not much more i can do, i have tried exercising more and my only other option is the Acarbose, but i do not want to try this just yet. Thank you so much for your time and for reading my post, i am grateful.

Thank you very much.

Tony

 

[Brunneria]

Hi and welcome!

I’ve tried quite a few things, but there isn’t any herb or supplement that I have found to make a noticeable difference.

In fact, for me, it has always come back to diet. Going strictly gluten free was the biggie, but I still need to low carb, and have recently settled comfortably at a level that is v low indeed. I just keep feeling better the fewer and fewer carbs I eat.

So, unfortunately, my suggestion to you, is eliminate things until you find a better balance.

 

[kokhongw]

My doctor says i should try Acarbose, this slows down the absorption of food, which leads to a lower response in insulin from the pancreas. However this medication can cause alot of side effects such as gas and stomach ache that can be unpleasant.

Eating food that leads to lower insulin response...can mean healthy dose of fats...

This graph from VirtaHealth shows the typical glucose and by proxy...insulin response...

Just wonder if you had any test done to determine your insulin levels or do you measure your ketone levels.

Since we can use both glucose or ketones as energy source...a low carb fats friendly, ketogenic type of diet should help to provide adequate energy and address the post meal lethargy.

 

[Lamont D]

Hello Folks,

Hope you are all well.

I have suffered with Reactive Hypoglycemia for over 10 years and have constantly been configuring my diet. My diet is the best it can be, i am having more protein, i have low carbohydrate bread and try having alot of no carbohydrate meals. I generally have reduced alot of my Reactive Hypoglycemia episodes, originally my blood sugar was dropping as low as 3.3mmol on a UK blood glucose reading.

I still have alot of tiredness sometimes after eating and i have had a few minor Reactive Hypoglycemia episodes. My doctor says i should try Acarbose, this slows down the absorption of food, which leads to a lower response in insulin from the pancreas. However this medication can cause alot of side effects such as gas and stomach ache that can be unpleasant.

I was kindly wondering if anyone knows of any vitamins & minerals, herbs or certain super foods, that could help with my pancreas and the over production of insulin. Even anything to help stop my blood sugar fluctuations to some extent, any help would be appreciated. There is not much more i can do, i have tried exercising more and my only other option is the Acarbose, but i do not want to try this just yet. Thank you so much for your time and for reading my post, i am grateful.

Thank you very much.

Tony

Hi @tonymacavoy and welcome to our forum.

I was diagnosed back in 2013/14, since my last eOGTT, I have not had a hypo.
I would still hypo if I did not have the control and balance of protein and fats, avoiding as many carbs as possible.
The trick is not to trigger the insulin response to food. I did this by going very low carb lifestyle. Regardless of what the doctors, dieticians have suggested, and I have had all the tests and tested every food that I enjoy and a lot I don't. It is getting the balance right for you to be healthy.
By avoiding the foods that trigger the insulin response.
For that you have to test with your glucometer and record everything to see how if they spike you. If they spike you higher than normal blood glucose levels, then that will trigger the insulin response.
No spikes, no hypo, that is how it is, unfortunately!
Do you know how high the low carb bread goes too, after half an hour, an hour, two hours? Then after that you will go hypo!

I have heard of a couple of RH ers being prescribed acerbose, this is a med that is old school, to be used for other conditions. I believe in my honest opinion, that it will not benefit the digestion at all. If anything lead to more insulin being produced.

Ask your GP to search for a diabetic drug (Gliptin) that there has been some success with increasing initial insulin response, to avoid spikes!
My endocrinologist has done extensive research and testing into the drug, sitagliptin.
I have seen on YouTube about similar studies in the states.

There is no supplements or such that will help unless your blood panel results show you are lacking in the vitamins. I have not read of any RH er who has had success with supplements, it is about what you put in your mouth!

Do read our forum, the threads can be very enlightening and there is some great information and knowledge about RH from our members.

Keep asking, keep learning, keep posting, would like to read about your experience and the battle to get diagnosed.

Best wishes

 

[McWattm]

Hello Folks,

Hope you are all well.

I have suffered with Reactive Hypoglycemia for over 10 years and have constantly been configuring my diet. My diet is the best it can be, i am having more protein, i have low carbohydrate bread and try having alot of no carbohydrate meals. I generally have reduced alot of my Reactive Hypoglycemia episodes, originally my blood sugar was dropping as low as 3.3mmol on a UK blood glucose reading.

I still have alot of tiredness sometimes after eating and i have had a few minor Reactive Hypoglycemia episodes. My doctor says i should try Acarbose, this slows down the absorption of food, which leads to a lower response in insulin from the pancreas. However this medication can cause alot of side effects such as gas and stomach ache that can be unpleasant.

I was kindly wondering if anyone knows of any vitamins & minerals, herbs or certain super foods, that could help with my pancreas and the over production of insulin. Even anything to help stop my blood sugar fluctuations to some extent, any help would be appreciated. There is not much more i can do, i have tried exercising more and my only other option is the Acarbose, but i do not want to try this just yet. Thank you so much for your time and for reading my post, i am grateful.

Thank you very much.

Tony

 

[McWattm]

Hi Tony,
I too have RH but only just diagnosed. I saw my endocrinologist last week who said if the new diet doesn't work he will consider Arcabose, I see a dietician soon.
Let me know if you start it and how it goes.
Mandy

 

[Lamont D]

Hi Tony,
I too have RH but only just diagnosed. I saw my endocrinologist last week who said if the new diet doesn't work he will consider Arcabose, I see a dietician soon.
Let me know if you start it and how it goes.
Mandy

Hi Mandy, welcome to the forum.
As I replied to the above post about acerbose, it is not a drug in my opinion will help with your initial insulin response. Slowing down digestion is not the answer.

If like me, the initial insulin response is too weak to cope with the amount of glucose.
The second response because of the high glucose will trigger an overshoot of insulin which leads to a hypo.

To avoid the spikes is the key, by avoiding food that spikes you.
No spike, no hypo!

Would like to know how you got your diagnosis.

Best wishes

 

[McWattm]

Hi, I have been having low blood sugar levels for years, mostly in the morning at about 10am. It was driving me crazy and became a problem when I started my current job which is more tasking than sitting in an office nibbling at nibbles as and when I could in my old job.
I was establishing a pattern. I ate at 7.45am 3 weetabix and then by 09.00 I was feeling hungry like I hadn't eaten for days, also vision problems and shaking.
I started to get anxious and carrying chocolate with me constantly.
This has been going on far too long so saw my doctor who was a locum and he said it could be dumping syndrome or reactive hypoglycemia and sent me for tests.
I had the fasting test and had to drink that vile glucose drink. My results showed it was indeed RH. This was 2 weeks ago and I am now waiting for a dietician appointment.

 

[Lamont D]

Thanks.
It is quite obvious that the low sugar levels was caused by your breakfast.
The cereal and indeed anything that has wheat, oats, grains would cause those atypical symptoms of a spike followed by a hypo.
Dumping syndrome is similar to RH, because of the symptoms and causes.
The carbs, and it really doesn't matter how many grams of carbs, it still creates the reactive part of the condition, carbs and sugars, anything with ose at the end of the word will have your pancreas misbehave.
Do have a read of the low carb forum or the forum on Keto diet.
That is how I control the condition, by not going out of what is termed, normal blood glucose levels range. Between 3.7-6.00mmols.
Use your glucometer to find out which foods are doing this to you.

You do need to find a way to stop the up and down blood sugar levels. This is causing the symptoms. Treating the hypo with something like chocolate is not recommended, I would have a plain biscuit., with a black cup of tea.

If you're not sure, do ask, you may have an intolerance to other foods, typically a dairy intolerance, like me.
You need to start eating fresh food, such as meat, portein, vegetables. Full fat dairy. Good fats.
You need to avoid low fat food, probably, vegetable oils. Starchy vegetables like potatoes. They are the worst for me!
I cook with animal fats or coconut oil.
And doing simple exercise, swimming or walking, after eating for fifteen minutes, you would be surprised how good that is for your blood sugar levels.
Do not overdo the exercise as this will exacerbate the blood fluctuations.
If you need to snack and eventually if you do follow a low carb diet you won't have to, just a small couple of bites of some fruit, probably an Apple or some berries. Unless of course fruit is bad for you.
You don't have to follow the usual ritual of eating meals at set times, eat every two to three hours, small meals, this will help get that control, and of course very low carb.

Hope that helps.

 

[McWattm]

Thank you so much for all the info, I am

Thanks.
It is quite obvious that the low sugar levels was caused by your breakfast.
The cereal and indeed anything that has wheat, oats, grains would cause those atypical symptoms of a spike followed by a hypo.
Dumping syndrome is similar to RH, because of the symptoms and causes.
The carbs, and it really doesn't matter how many grams of carbs, it still creates the reactive part of the condition, carbs and sugars, anything with ose at the end of the word will have your pancreas misbehave.
Do have a read of the low carb forum or the forum on Keto diet.
That is how I control the condition, by not going out of what is termed, normal blood glucose levels range. Between 3.7-6.00mmols.
Use your glucometer to find out which foods are doing this to you.

You do need to find a way to stop the up and down blood sugar levels. This is causing the symptoms. Treating the hypo with something like chocolate is not recommended, I would have a plain biscuit., with a black cup of tea.

If you're not sure, do ask, you may have an intolerance to other foods, typically a dairy intolerance, like me.
You need to start eating fresh food, such as meat, portein, vegetables. Full fat dairy. Good fats.
You need to avoid low fat food, probably, vegetable oils. Starchy vegetables like potatoes. They are the worst for me!
I cook with animal fats or coconut oil.
And doing simple exercise, swimming or walking, after eating for fifteen minutes, you would be surprised how good that is for your blood sugar levels.
Do not overdo the exercise as this will exacerbate the blood fluctuations.
If you need to snack and eventually if you do follow a low carb diet you won't have to, just a small couple of bites of some fruit, probably an Apple or some berries. Unless of course fruit is bad for you.
You don't have to follow the usual ritual of eating meals at set times, eat every two to three hours, small meals, this will help get that control, and of course very low carb.

Hope that helps.

Thanks.
It is quite obvious that the low sugar levels was caused by your breakfast.
The cereal and indeed anything that has wheat, oats, grains would cause those atypical symptoms of a spike followed by a hypo.
Dumping syndrome is similar to RH, because of the symptoms and causes.
The carbs, and it really doesn't matter how many grams of carbs, it still creates the reactive part of the condition, carbs and sugars, anything with ose at the end of the word will have your pancreas misbehave.
Do have a read of the low carb forum or the forum on Keto diet.
That is how I control the condition, by not going out of what is termed, normal blood glucose levels range. Between 3.7-6.00mmols.
Use your glucometer to find out which foods are doing this to you.

You do need to find a way to stop the up and down blood sugar levels. This is causing the symptoms. Treating the hypo with something like chocolate is not recommended, I would have a plain biscuit., with a black cup of tea.

If you're not sure, do ask, you may have an intolerance to other foods, typically a dairy intolerance, like me.
You need to start eating fresh food, such as meat, portein, vegetables. Full fat dairy. Good fats.
You need to avoid low fat food, probably, vegetable oils. Starchy vegetables like potatoes. They are the worst for me!
I cook with animal fats or coconut oil.
And doing simple exercise, swimming or walking, after eating for fifteen minutes, you would be surprised how good that is for your blood sugar levels.
Do not overdo the exercise as this will exacerbate the blood fluctuations.
If you need to snack and eventually if you do follow a low carb diet you won't have to, just a small couple of bites of some fruit, probably an Apple or some berries. Unless of course fruit is bad for you.
You don't have to follow the usual ritual of eating meals at set times, eat every two to three hours, small meals, this will help get that control, and of course very low carb.

Hope that helps.

 

[McWattm]

Thank you so much for all the info, I am

I'm having problems with this e mail sorry if it comes up twice!

Thank you so much for all the information, it's a crazy unpredictable but also predictable condition to have and I am really struggling with it. Hopefully once I get my diet sorted out it will get better.
Can I get a blood sugar monitor on the NHS do you know?

Mandy

 

[Lamont D]

Hi, again.
The control you need will take a few weeks of really being cruel to yourself.
Everything you have learned about healthy eating will not be healthy for you.
It is a rare diagnosed condition, there is not that many of us out there.
So I have declared it a weird condition because our pancreas does not react normally to digestion.
Our imbalance of hormones namely insulin is the reason for the large number of symptoms and why we have to treat it differently to other endocrine conditions.
So, we have to eat to what doesn't create the excess insulin.
You probably have too much circulating insulin along with normal background insulin, you probably have insulin resistance, and also possibly hyperinsulinaemia.
When you do start to get the control necessary, you will get real hunger pangs and other symptoms of trying to get your blood glucose levels into normal range. And then keeping them there. It will not be easy, Try and be strong, but be kind to yourself because your body will not want to change, it will miss the carbs.
Once you have the control, and start feeling better, you will realise how much, the diet change is good for you. It's important to get your balance of protein and fats right.

I had to threaten my GP, at the time, with my endocrinologist writing to him about supplying me with enough strips to use to experiment and keep track of my food diary. I already had a glucometer, mine is about fifteen years old.
It was back in them days when you got one off your GP, if you were (mis) diagnosed with T2!!!
You will need a lot of strips initially, to start, because there are certain things that you need to do and find out. Such as when you spike, when you first try certain foods for the first time, before, a half hour after, an hour, two hours. After the initial period, you can cut it down to before and two hours after.
It's important to be a bit obsessive about collecting the data you get. It will surprise you how different your readings may alter from the initial readings, because as you progress the amount of insulin will fall, your insulin resistance and blood glucose levels will become more stable. I still take readings for different reasons, especially if I feel a bit rough or trying new foods.

It will be a rollercoaster ride if you are anything like me.

Keep asking.

Let us know how you get on with your dietician. Especially if she doesn't recommend a very low carb diet! (Unless you are really lucky!!)

Best wishes

 

[McWattm]

Thank you for your support. My symptoms are always worse up until about 1pm then I seem to balance out, not sure why that is?.
Now I have found this forum I am not letting go you will be sick of me...lol.
Can I ask....when you talk about 'Spiking' how high do you mean?
I have never taken my glucose levels after eating as I always feel ok initially....until it all starts again, the RH that is.

 

[Lamont D]

If you average out the time between meals it is usually between three to four hours.
Probably if I read it right, your breakfast will give you a bad start to the day, you feel awful just before lunch, as you then decide to have lunch, you then eat something that doesn't produce as much insulin, I believe that you have unbeknownst to you have a lot less carbs for that meal, which in turn doesn't give you the symptoms.
The symptoms are the drop in blood sugar levels towards a possible hypo.

Thank you for your support. My symptoms are always worse up until about 1pm then I seem to balance out, not sure why that is?.
Now I have found this forum I am not letting go you will be sick of me...lol.
Can I ask....when you talk about 'Spiking' how high do you mean?
I have never taken my glucose levels after eating as I always feel ok initially....until it all starts again, the RH that is.

A spike is the high point of glucose produced by a meal.
When I was still eating the wrong foods, I would spike from normal levels to double figures in the teens. The worst was potatoes, then wheat, oats in porridge, rice and so on, I don't have problems with small pieces of fruit, which I snack on. I have a dairy intolerance because of lactose, but I'm ok with full fat yoghurt. Sugar is really bad for you. But dark chocolate, 85% and above is ok. A couple of pieces with a couple of strawberries and a few spoonfuls of yoghurt is my usual supper. This seems to allow me to have a good sleep. Which is a blessing from a few years ago before diagnosis.
I call a spike which is clinically called a hyperglycaemia episode, anything above normal sugar levels, because that triggers the insulin response. But can be any number where you will feel a bit wobbly, it can be similar to the symptoms of a hypo.

The timing of the spike is important, my spike is usually around forty minutes after eating. I hypo between three to four hours depending on how many carbs I ate.
You will be different but the timing of the meals you eat depends on how satiated your meals are. At this early stage after diagnosis, little and often will be good advice.
Eating smaller portions every three hours will always stop the hypo, of course, unless you go low very quickly, you must find out all this by testing and experimentation.

Keep asking

Best wishes

 

[kokhongw]

when you talk about 'Spiking' how high do you mean?

Here is an actual example...a 6-7 mmol rise and fall within 3 hrs...after a plate of Nasi Lemak(rice cooked in coconut milk)...with Crispy Chicken wings...not Rendang

 

[tonymacavoy]

Some great posts from everyone, thank you for all the information everyone has shared.

I did a sample blood glucose test when eating some low carbohydrate bread, with peanut butter and marmite. This was the results, which was quite unusual.

8:00am - Before eating 3.7mmol
8:30am - Had low carbohydrate bread, with peanut butter and marmite
9:00am - 30 minutes after eating 5.0mmol
9.30am - 1 hour after eating 4.0mmol

It did not seem to spike the blood sugar too high peaking at 5.0mmol but it came down quickly to 4.0mmol, would this suggest that maybe even this food is not really helping me to some extent. I always have trouble finding something to eat at breakfast.

I kindly wondered if anyone knows of any consultants in the UK specialising in Reactive Hypoglycemia, as i have been attempting to find a good consultant to help and guide me. My consultant is more specialising in Diabetes and tries to treat the condition with drugs for Diabetes, which i really want to try and avoid.

I am also considering starting a website and doing fundraising activies and support groups for Reactive Hypoglycemia sufferers with it being such a rare condition. Does anyone please know if there is a UK charity specifically registered to help understand more about Reactive Hypoglycemia?

Thanks again to all the brilliant posters here, without you, alot of us including myself would be totally lost and struggling very badly with our condition. You are all wonderful here a credit to the community.

 

[Lamont D]

Some great posts from everyone, thank you for all the information everyone has shared.

I did a sample blood glucose test when eating some low carbohydrate bread, with peanut butter and marmite. This was the results, which was quite unusual.

8:00am - Before eating 3.7mmol
8:30am - Had low carbohydrate bread, with peanut butter and marmite
9:00am - 30 minutes after eating 5.0mmol
9.30am - 1 hour after eating 4.0mmol

It did not seem to spike the blood sugar too high peaking at 5.0mmol but it came down quickly to 4.0mmol, would this suggest that maybe even this food is not really helping me to some extent. I always have trouble finding something to eat at breakfast.

I kindly wondered if anyone knows of any consultants in the UK specialising in Reactive Hypoglycemia, as i have been attempting to find a good consultant to help and guide me. My consultant is more specialising in Diabetes and tries to treat the condition with drugs for Diabetes, which i really want to try and avoid.

I am also considering starting a website and doing fundraising activies and support groups for Reactive Hypoglycemia sufferers with it being such a rare condition. Does anyone please know if there is a UK charity specifically registered to help understand more about Reactive Hypoglycemia?

Thanks again to all the brilliant posters here, without you, alot of us including myself would be totally lost and struggling very badly with our condition. You are all wonderful here a credit to the community.

I believe that the reason you didn't spike was because you had enough fat in the food to slow the digestion down, there is no insulin response, so you don't hyper. I believe that you had enough background insulin to cope with the meal.
That seems to be fine for your breakfast but I would test again when you have it again.

I will pm with my endocrinologist, but you need to ask your GP to refer you.

I have trailed the internet looking for such a group, I don't know of one, this is why a few members persuaded the hierarchy on this site to give us our own forum.
There is always Facebook, but I'm not a member nor a fan.
There is no charity either!

This is why, the low number of diagnosed RH ers is so low, the discussion from many members reckon there is so many out there unaware of hypoglycaemia, simply because our GPs just don't get the training or can recognise the symptoms or have the necessary availability of tests to diagnose RH.

Keep asking.

Best wishes

 

[tonymacavoy]

I agree Lamont i believe alot of people may have Reactive Hypoglycemia who are not aware of it, due to GPs not getting the training to understand it or diagnose it. I was referred to Cardiologists, Neurologists and three Endocrinologists, it was only the third Endocrinologist who stated i had Reactive Hypoglycemia then again he was not very knowledgeable about the condition.

I did another test with the low carbohydrate bread two slices with peanut butter and marmite, the results were as follows:

8:00am - before eating 3.8mmol
8.30am - low carbohydrate bread two slices with marmite and peanut butter
9.00am - 30 minutes after eating 5.0mmol
9.30am - 1 hour after eating 5.8mmol
10.00am 1 hour and 30 minutes after eating 3.9mmol

It seemed to drop fairly quickly, but i note after the 3.9mmol reading it gradually rose again and i did not have any symptoms for around 4 hours after eating this meal which was great for me. I had a slight episode of feeling anxious and weak at 3.9mmol at 10.00am but this went after 15 minutes. Not had this before but it does seem to be a good meal, do you think this is the insulin causing this to drop fairly suddenly, but then after it stays stable.

I am just experimenting with breakfast as this is usually the hardest meal for me. Thanks again for messaging me your Endocrinologist his secretary is arranging an appointment, i will update you after my visit with him. Thanks for your support without this forum i would be on a blood sugar roller coaster feeling very unwell, so thanks again.

 

[Lamont D]

I agree Lamont i believe alot of people may have Reactive Hypoglycemia who are not aware of it, due to GPs not getting the training to understand it or diagnose it. I was referred to Cardiologists, Neurologists and three Endocrinologists, it was only the third Endocrinologist who stated i had Reactive Hypoglycemia then again he was not very knowledgeable about the condition.

I did another test with the low carbohydrate bread two slices with peanut butter and marmite, the results were as follows:

8:00am - before eating 3.8mmol
8.30am - low carbohydrate bread two slices with marmite and peanut butter
9.00am - 30 minutes after eating 5.0mmol
9.30am - 1 hour after eating 5.8mmol
10.00am 1 hour and 30 minutes after eating 3.9mmol

It seemed to drop fairly quickly, but i note after the 3.9mmol reading it gradually rose again and i did not have any symptoms for around 4 hours after eating this meal which was great for me. I had a slight episode of feeling anxious and weak at 3.9mmol at 10.00am but this went after 15 minutes. Not had this before but it does seem to be a good meal, do you think this is the insulin causing this to drop fairly suddenly, but then after it stays stable.

I am just experimenting with breakfast as this is usually the hardest meal for me. Thanks again for messaging me your Endocrinologist his secretary is arranging an appointment, i will update you after my visit with him. Thanks for your support without this forum i would be on a blood sugar roller coaster feeling very unwell, so thanks again.

I am pleased to help, I have been where you are now, confusion and anxiety, feeling really s....! No idea what was going to happen next!
I must say the readings you show are in normal range and a low carb meal seems to agree with you, blood sugar wise. I would be pleased with those readings.
I don't believe it is excessive insulin, just normal insulin for that meal, you have to remember that because you didn't go high enough, you did not go high enough to trigger the secondary insulin response, I believe. But then I could always be wrong.
Breakfast is really hard because you probably like me have been brainwashed into thinking that starting the day with a substantial meal is the best way to get through the day, whereas I have found that skipping meals or not keeping to strict regimen of meal times is better. I do fast from time to time and I don't eat a lot now anyhow!
So if I start the day not eating, and I don't feel hungry and my energy levels are good then why do I need to eat. It sounds daft but it works for me.
You will probably be different, but experimenting is the only way you can go forward to find the best foods for you.
I have just enjoyed my supper of full fat Greek yoghurt, with a few strawberries and two pieces of dark chocolate, 85%!
Because I was working today, I didn't eat this morning, had a small apple at about 2pm. Then a ham salad for tea at 5pm.
So you see, a healthy diet for me!
Because of taste, your fondness for different food, your daily intake would be different. Your balance of protein and fats, a very low carb diet does work.

I hope you get your appointment soon.

Best wishes, stay well.