Reactive Hypoglycemia Questions

 I have a few questions for those of you who have experience with reactive hypoglycemia. Let me give a little background information first. I have been trying to figure out whats wrong with me for a few months now. I was cleared of a stricture, an ulcer, any vitamin defficiancies, and gallstones. I've been through so much testing because my symptoms were sporatic at first, and have evolved over time. Currently, I get sypotoms every time I eat. After eating, I get really tired, my heart races which makes me short of breath and sometimes causes some mild pain, at times I will get nauseated, and headaches. Each morning I wake up with a headache and feel very ill. I have started reading information and am getting to eat lean proteins, complex carbs, and whole grains. As I am getting the hang of this, I am starting to feel better, but I still get sick at times from eating the wrong things. 

Is there a website or book that you like to use as a good resource guide? I would love to read anything I can that will help me to understand better what to do. I keep reading conflicting things, even though I really make sure the word reactive is there. I have gotten to understand that there is a differance between hypoglycemia and reactive hypoglycemia. I would especially love to read anything written just for rny patients, but I can't find anything.


I have been seeing my PCP for this just because at the moment, I am having trouble finding the time to get to my surgeons office (about 45 minutes away). I plan to call my surgeons office tomorrow and ask to speak witht he nurse practicioner. Usually if I have an issue, I speak with her and she will let me know if I need to get lab work, see my surgeon, or anything else. I will see what she recomends. I want to make an appointment with the NUT to make sure I am eating correctly.

This is a big question I have: What do you keep in your purse/car/briefcase to eat in an emergency? The only thing I can think of is apples, but since surgery, apples and I don't get along. I think they are just too fiberous for me. I was thinking kashi granolla bars, but I know they do have a decent amount of sugar and I have no idea if it is added sugar or natural. 

How often to you eat? Right now, I eat about every two hours. Sometimes a little less and sometimes a little longer. It all depends on how I feel.

One situation that I am finding difficult is I will eat and get sick and then I just don't have enough room to eat something else or even drink some milk.  I think this happens because I am still trying to figure out what I can and can't eat. (The other day I ate canned peaches and didn't notice until after I ate that they were in light syrup. I like to find them in pear juice with no added sugar.)

I am 10 1/2 months out of surgery. Any information would help me greatly!

You mention you get tired, heart races, short of breath, etc. after eating.  How soon after?  Is it possible dumping and not reactive hypoglycemia?  Dumping happens rather quickly after eating, RH happens after a longer interval.

I have only had a few episodes of sugar dropping and keep peanut butter crackers in my car, purse, at work.  They seem to help me quickly raise my sugar but not so much I end up crashing again.

 I guess thet ime frame would be important here. Sometimes, it happens quickly, but for the most part, it occurs anywhere from 1 1/2 hours to 4 hours after eating. While, its possible that its dumping, I generally don't think it is. Just due to the fact that things I could eat at around 6 months out, I cannot eat now. An example would be a slice of white bread or a flour tortilla for a sandwhich or wrap. 

I agree it would probably not be dumping and more along the lines of RH.  The bread and tortilla might be too many carbs with your meal especially if you are also eating other carbs with it.

Definitely be sure to eat frequently to keep your sugar levels from dropping.  RH seems to hit those over a year out more times than as a new post-op.  Eating a fat/protein/carb combo helps many, that is why I find the peanut butter crackers to work well for me.

I also have reactive hypoglycemia, but my symptoms are not the same as what you've described.  I think you're very wise to do more research on this, and to talk to your doctor.

With a little practice, RH is easy to monitor and work with.  I have a small blood sugar monitor (very inexpensive) that I keep in my purse.  When I first suspected that I was having blood sugar problems I started checking regularly to get my baseline numbers, and now I just check with I get the symptoms, or after a hard workout or race.

I've taught myself to identify the early symptoms so I know when I need to eat something to raise my sugar level.  When I'm low, I get a sluggish, zoned-out, and/or dizzy feeling.  I can usually catch it when I hit about 70, so I eat something.  For me - it's the combination of sugar and protein that's important.  If I just drink a little OJ for the sugar, I'll have a problem a few minutes later.  I eat the peanut-butter crackers because there are enough carbs and protein that it brings me up without crashing or dumping. 

I'm 3-1/2 years post op and I started having RH about a year ago, so you may be dealing with other issues. 

Hang in there!!     

As long as I stay away from sugar a high carb processed foods I am okay.  Reactive Hypoglycemia can occure 20 minutes to 2 hours after eating - give or take a few minutes.  Mine amost always happens closer to the 2 hour mark.  I also start sweating.  I have not had many episodes, but my endocrinologist was concerned enough that she prescribed a blood glucose meter for me.  You can buy them over the counter.  I was eating a spoon or two of peanut butter when it happened, but she said to add crackers to help.  She is treating several RNY patients for this.  She said if it is severe, there is a medication that can be prescribed.  She told me I have to stay on plan and stay away from sugar and the wrong carbs and to eat small meals throughout the day to keep my blood sugar stabilized.  I generally will reach for peanut butter and crackers.  I've read on here some people carry glucose tablets.  Some drink orange milk.  The other night I had an episode.  My sugar dropped to 43, and I ate a peanut butter granola bar.  I had never eaten that during an episode.  I still felt odd when normally I begin feeling better after the pb and crackers.  I took my blood sugar again, and it was 150.  That was the first time I had experienced a swing that large.  I think the granola bar had too much sugar.

Do a search on here for reactive hypoglycemia.  There as some excellent posts by really informed veterans.  That is where I got a lot of my tips.  For me the bottom line is this.  I never have problems as long as I stay on my plan.  When I don't and eat sugar or chips or stuff like that, I have problems.

It would be helpful if you would list daily food intake with some totals for calories and carbs.  I'm wondering if you arent getting too many simple carbs and sugars?

I would avoid white flour, white sugar, white rice, white potatoes, pasta, fast food & junk food.  They all make your sugar elevate quickly ( as well as hav.junk food and fast food have "hidden" sugar, fat and salt and higher calories with preservatives, chemicals, horomones, etc.)

My "rule" is no food with more than 9 gm sugar per serving - as well as avoiding the above simple carbs.  My carbs come from protein products, vegetables, raw fruit and whole grains.  My blood sugars (use a glucometer to check your blood sugar) remain pretty steady on this regime.

I do have planned snacks -always protein first with veggie/fruit or whole grain.  Never any carbs alone - without protein.

I don't do sandwiches - too many carbs.  When my blood sugar is low - I can't think straight, "foggy", weak, shaky and sweaty.  I usually have peanut butter (you can get in packets or individual servings) and whole wheat crackers.

Don't eat things high is sugar as your blood sugar will shoot up and then drop again.  Additionally it may make you crave more carbs and weight gain may result.

Don't skip meals - eat protein balanced with complex carbs.  Maybe eat every 3-4 hours.  Stay within your quantity level - for me 1 cup (4 oz protein and 4 oz veg/fruit or whole grain.)

Best wishes.

 I don't usually total calories. I just ad up my protein throughout the day and try to stay away from foods too high in calories, fat, and sugar. I have always tended to look for things with sugars less than 10 grams or so. I really try to do natural sugars if possible, but I don't always do that.

I think my main problem was with "white" foods, or even whole wheat. I found that eating whole wheat bread wasn't good enough. My father told me to stick with whole grains. That seems to be working better.

I'm a pasta and bread girl. Always have been. So I think that's where my problem has been. I don't eat nearly as many as I used to, but I still have them. So I'm venturing out to find  beter stuff without anything "simple" in it. 

We have a wegmans opeing up soon, so I think it will be much easier to find stuff I can have there. Its just pricey. That seems to be a big issue. I have a very limited budget and everything good for me is terribly expensive. 

Thanks so much for your advice. I really appriciate anything everyone has had to offer. I really don't want to get sick like I have been. Its scary at times and I feel like I'm losing my mind because I get so out of touch with reality.