Managing reactive hypoglycemia

[Anonymous]

Anyone else have an issue with this? Dr hasn’t been able to figure out why it happens, though it occasionally (but not always) seems triggered by particular food combinations (e.g., whole wheat toast with avocado). I’m curious how others deal with it, what diet helps, what test - if any - your Dr has done, etc. I have a Tbs of maple syrup when it hits and usually feel ok within a handful of minutes, but it’s frustrating and a little scary at times.

[Anonymous]

Test cortisol levels (4 times/day....it's a saliva test), and did he check your potassium level?

[Anonymous]

Have you ever measured low blood glucose, or are you just going by symptoms?

[Anonymous]

Do you have diabetes?
Reactive hypoglycemia is rare outside of diabetes. My son was diagnosed with it, but only after extensive testing to rule out diabetes and rule in reactive hypoglycemia. He was 4 the first time he fainted, and was finally diagnosed around 6. He’s a teen now and eats a high protein, low sugar, frequent meals on a predictable schedule. He is usually fine, but it can get complicated during his sport season. He is tested every year or two to ensure he hasn’t developed diabetes.

If you haven’t had proper testing to get to the bottom of this, I would recommend starting there.

[Anonymous]

Anonymous wrote:Do you have diabetes?
Reactive hypoglycemia is rare outside of diabetes. My son was diagnosed with it, but only after extensive testing to rule out diabetes and rule in reactive hypoglycemia. He was 4 the first time he fainted, and was finally diagnosed around 6. He’s a teen now and eats a high protein, low sugar, frequent meals on a predictable schedule. He is usually fine, but it can get complicated during his sport season. He is tested every year or two to ensure he hasn’t developed diabetes.

If you haven’t had proper testing to get to the bottom of this, I would recommend starting there.

DP. Right.

People often self-diagnose based on symptoms and context, but if you actually check the blood glucose on them, it's normal. What they are feeling is the action of glucagon, which is keeping the blood sugar in the normal range -- side effects can be dizziness, irritability or fogginess, nausea, low blood pressure, fast heart rate, etc.

If you are GOING to run low on blood sugar, glucagon kicks in and keeps it level. However, if you are sensitive to the feeling of a glucagon response, you would probably benefit from keeping snacks around and not going too long without eating -- but it's not dangerous at all. Just annoying.

Be sure to document whether the blood sugar actually goes low. If not, nothing to work up any further.

[Anonymous]

OP here. Not diabetic. The reactive hypoglycemia was diagnosed through testing.

[Anonymous]

So you did have a blood glucose level outside the normal range? (Just making sure I understand.)

[Anonymous]

Reactive hypoglycemia can be a precursor, years before frank diabetes. Keep an eye on your a1c.

Smaller more frequent meals is the treatment. Or, if it's only an occasional problem, then carry some candy in your purse/pocket if you get low. But if you're not diabetic, or even if you are diabetic but are not taking certain medications including insulin and some others, then if you are low, if you wait, your body will correct.

[Anonymous]

One tip—always pair carbs with a protein. Carbs can cause a quick rise and fall in blood sugar, but the protein will help stabilize it. So have toast with peanut butter instead of avocado, for example.

[Anonymous]

You might want to have a session with. Registered Dietician to give advice, meal planning ideas, etc.

[Anonymous]

I used to struggle with reactive hypoglycemia. Diagnosed through a three hour glucose tolerance test.

Frequent meals/snacks. Protein with breakfast. Protein to get your blood sugar back up - no candy. That will spike your sugar and send it plummeting again.

Protein and fat will keep it stable.

Are you thin by chance? Once I gained weight (think BMI of 23 instead of 19), it pretty much went away.