Very depressed over reactive hypo

Metformin basically does a few things, curbs your appetite and withholds the uptake of some of glucose into the blood stream from the food you eat...the science behind it is beyond me.....

Ultimately keeping levels down, so I don't know if that will do you any good.....but am no expert....

maybe the normal glucose absorption from your meals is what's causing the reaction and the metformin will make that process less dramatic and so may help...

has there been any pattern or link to certain foods or carb amounts that have resulted in these hypos....?

Razper said:

Hello,
I just found that forum. I'm 26 year old male not quite diagnoses with reactive hypo, but I know I have it. Very often my blood sugar is around and below 3.9 mmol/l.

I try ti eat more frequently but I start to gain weight. My doctor told me to start on Metformin but I read it's for high blood sugar and I don't know how it works or if it will make things worse.

When I'm at work sometimes I experience drop in blood sugar - lose concentration, get really really agitated and angry for no serious reason. So I started eating more and I gain weight. That condition is starting to make me very depressed because I was good looking and now I'm not so much.

I'm scared that I might have a drop in the sugar during business meeting or something important.

Please give me advice, should I take the Metormin how does it work and what can I do about that hypo, because I really do feel very bad mentally mostly of the fact that I will have to take care of that condition as long as I live, and that I won't be able to have my previous regime.

I would appreciate any guidance. God bless!

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What is your HbA1c ? Why does your GP want you on metformin ?

I'll tag in our two resident RH experts for you
@Brunneria @Lamont D
They may be better able to assist

Razper said:

No, just if I go long enough - let's say 4 hours without eating I get around 4 mmol/l or 3.9, 3.8. The interesting thing is that when I go to bed, in the morning after 9 hours of sleep I have pretty normal levels around 4.5.

In the morning I eat 3 toasts or sandwiches that's around 8 am. Then I just can't go until 1pm without a meal in between, which I usually take around 11:30am. I try to eat smaller portions with at least 15g carbs. Should I take let's say something sweet or it's better to be something with protein? Before dinner I eat one more time at 3:30 to 4pm.

I manage it somehow, but when I try to to longer periods without food (breakfast straight to lunch) it drops and I feel bad. Is it possible to have the sugar stabilized without gaining weight?

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What happens of you don't get something to eat.....?

I would assume your liver kicks in and top you up but it still feels unpleasant.....

how long has this been happening.....?

as your not medicated [I think] you shouldn't ever go dangerously low and so it may be a case of letting your body acclimatise....

From everything that you have said here, and with the OGTT result (Where you have been given a concentrated High Glucose Drink to Test how you react) it looks very much like Sandard Reactive Hypoglycemia where your pancreas over compensates for the excess glucose in your bloodstream and pulls your blood/glucose level down so rapidily that it dips below the safe thresholds.
Having a means of self testing (your B/G meter) will show you where you are in terms of B/G levels at that moment in time and 3.9 mmol/L is down below a safe level. at this level you are fortunately noticing the changes and can take remidial actions, but I know of some indivifuals who simply don't realise that their B/G has dropp so low and that they may be becomming confused, unstable in their body movement or even highly aggressive.
I would suggest that you do a few things to help yourself. Firstly always carry with you sugar tablets that are readily available from the local chemist and can be taken to rapidly boost your B/G levels up. The alternative to this is some pure sugar sweets such as 'Jelly Babies'
You can also conduct a few simple tests and from these test results establish what types of food and/or drink are causing your problem. Always remember that Alcohol will interfere with Glucose metabolism, blocking or inhibitating Glucose absorbtion.
Also the effect of various foods can dramatically effect B/G levels. We frequently talk on this site of the LCHF diet. Foods containing carbohydrate are all absorbed by the body at differing rates, some slowly and others rapidily, which can under certain circumstances result in over reaction and the Reactive Hypoglycaemic effect.
Have a closer look at Gi and GL levels for common foods and avoid foods that have HIGH GL levels and where they cannot be avoided easily, the portion size should ideally be reduced or combined with a LOW GL food so as to make in effect a MEDIUM GL average level.
Sorry it's such a lengthy reply, but I hope it helps you.

Razper said:

Hello,
I just found that forum. I'm 26 year old male not quite diagnoses with reactive hypo, but I know I have it. Very often my blood sugar is around and below 3.9 mmol/l.

I try ti eat more frequently but I start to gain weight. My doctor told me to start on Metformin but I read it's for high blood sugar and I don't know how it works or if it will make things worse.

When I'm at work sometimes I experience drop in blood sugar - lose concentration, get really really agitated and angry for no serious reason. So I started eating more and I gain weight. That condition is starting to make me very depressed because I was good looking and now I'm not so much.

I'm scared that I might have a drop in the sugar during business meeting or something important.

Please give me advice, should I take the Metormin how does it work and what can I do about that hypo, because I really do feel very bad mentally mostly of the fact that I will have to take care of that condition as long as I live, and that I won't be able to have my previous regime.

I would appreciate any guidance. God bless!

Click to expand...

Hi Rasper,
I stopped RH dead in its tracks three years ago by cutting out all refine carbs! Potatoes , bread, rice, pasta and going on a low carb, good high fat and clean protein diet. I had already cut out sugar.
One thing now is I eat as much as I like and never feel hungry and no longer get hypos and used to get one in a morning and one in an afternoon.
eg breakfast: Three eggs lightly fried in loads of olive oil with the oil soaked up with flaked almonds.
regards
Derek

I found that as I reversed my diabetes I was getting a rapid drop in energy and BG in the late afternoon - I was eating lunch and dinner. I used to get the same thing in my mid 20s long before diagnosis.
After some testing I found that eating first thing and then late sorted it out, but I do not touch heavy dense carbs as that is what triggers the release of insulin - my insulin resistance was changing, reducing through the day, so mid afternoon all the insulin I had produced took effect at once, crash dive for BG levels.
I'd not advise using low GI foods - you just never know when the carbs they have are going to take effect.
These days I eat first thing and have 10 to 20 gm of carb, but from low carb foods - and with protein and fat. My BG levels stay steady right through the day now.
I suggest that rather than trying to treat low BG by eating carbs, you take the opposite angle and try to stay away from carbs so that you do not release an over abundance of insulin in response which will eventually come back to bite you later on in the day.

An extended OGTT is likely necessary for a clinical diagnosis...and to rule out more serious causes, eg insulinoma.

But I personally believe that reactive hypoglycemia is much more common than we are prepared to accept.

This is the basic mechanics

This is especially when we have built up significant insulin resistance and tends to respond with 2-3x the usual amount of insulin per carb... as indicated by Dr Joseph Kraft's study/classifications of insulin response.



The most obvious solution is to identify the meals that triggers such responses and switch to a carbs lite, fats friendly, insulin lowering lifestyle...

Reactive Hypoglycemia


vs Carbs lite, fats friendly.

The last piece of the puzzle for RH is to recognize that ketones is neuro protective and provides a stable source of fuel for our brain. But we need time to ramp up ketones production...even if we fast completely...Once we are in full ketosis, we don't really need external source of ketones like bulletproof coffee/MCT to tide us thru the low glucose state...

Hi and welcome @Razper

Can I just clarify? Your profile says that you have RH. Do you have type 2 diabetes too?
The reason I ask is that some RHers go on to develop T2 over time, so it is possible to just have RH, or to have both at the same time.

Just a couple things that you may find useful.

As @lindisfel says, several of us RHers on the forum have been able to stop our RH episodes dead, with dietary control. But for most of us it takes going very low carb. Quite possibly lower carb than T2s need to, for their condition.

You mentioned that you have to keep eating regular meals, and snacking, and having carbs at breakfast and so on.
That is standard medical advice, and if I had followed it, I would have felt just like you do - always hovvering on the edge of needing food to keep going. Feeling contantly grotty. Etc. etc. I found that a miserable and stressful way of living.

For me, it is far better for me to avoid carbs. No bread, rice, potato, pasta, sweet fruit, and so on.
Because without those carbs, you don't get the blood glucose rise that triggers the drop that leads to the hypo that makes you feel awful. You just step off the merry go round.

Why not try it tomorrow?

Instead of having carbs for your breakfast, and then feeling grotty all day.
Just have a protein breakfast. Eggs, bacon, low carb sausages, heck, even leftover low carb curry from the night before. Just don't have any cereal, toast, rice, potato or anything with it. Hopefully you will feel comfortable all through the morning, and arrive at lunchtime without any signs of RH.

Try it and see.

You asked if you will get enough blood glucose if you don't eat carbs.
Yes! 100% YES.
Your body is clever enough to take the food you put in, and turn vegetables, meat, fish, eggs, cheese, etc into what your body needs. Some of that will be used to regulate your blood glucose. But it will be much kinder on the your RH than dumping quick release carbs in, as you have been doing with bread and snacks.

Razper said:

Thank you so much for your answers, they really shine a light.

If I get low GI food or no GI food will my blood sugar raise? Let's say if I'm at 3.9mmol/l and I wanna bring it up a bit but I eat only protein and fat, or some low GI carbs, will that raise the blood sugar without a drop afterwards? Is it possible to raise blood surar without carbs if you are not in KETO?

And if someone has it, how little food is ok to eat to bring the levels back up, without eating too many calories? I wanna cut out on carbs because I really take more than needed, because I fear if they are not enough I might get low on BG (and I get in vicious cycle).

Sometimes I start my day with 2 eggs with cheese with one or two toasts. But again as the day progresses I have a crash before noon even if I eat just 2 slices of bread. If I eat only eggs and cheese will that raise the morning blood sugar and also prevrdent a crash?

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Hi Razper,
As Brunneria says try it!
If you dont eat eat all that bread etc your blood glucose will stabilize eat more eggs, fat, meat, nuts.
Bread is just sugar in disguise, so are potatoes and all the other refined carbs!
regards
Derek

I think you may be making assumptions about ketosis that are not quite accurate.

You don’t need to be in ketosis to get nourishment from fats and protein. Both can be digested normally and will give your body energy.

I expect you have been reading about keto flu, yes? That is when your body learns to switch from fuelling your body from glucose, to switching to running on fat. But you won’t fall straight into keto flu if you get up tomorrow and make yourself a nice big breakfast of bacon and scrambled eggs, with a coffee and cream alongside. Your body will still have a nice store of glucose in your liver and large muscles, so if your blood glucose dips at all that glucose will be drip fed to top up your blood glucose, while the egg and bacon digest to provide you with plenty of energy.

In short, keto flu won’t kick in until those glucose stores in the liver and muscles run out - which usually takes several days.
And some people don’t experience keto flu at all.