Hyperinsulinemic Hypoglycemia and anemia--feel AWFUL

I had my RNY in July, 2008 and other than dumping syndrome, I didn't have any problems.  It was almost too easy.  Now, suddenly, I am extremely anemic.  I'm taking massive doses of iron every day and I still can barely hold my head up.  I could easily sleep 16 hours a day or more!  I'm also being told that I have something called hyperinsulinemic hypoglycemia which is a condition that tends to develop several years after RNY.  I had been trying to lose a few pounds I put on due to my anemic tiredness.  I went shopping with my mother and was sitting at a restaurant with friends and I went into a horrible blood sugar spiral.  My friends said it was like watching Julia Roberts losing it in the beautician's chair in Steel Magnolias.  My boyfriend recognized the symptoms and tried to get me to eat but I got really mad at him and even kicked him.  I got home and slept for 13 hours.  When I woke I was shaking so hard all I could do was crawl to the kitchen and eat a couple of pieces of lunch meat until I got into a better state.  I didn't even remember my behavior from the night before.  I'm very careful to eat at regular intervals and have learned to keep beef jerky in my purse so I have something if I can't get a better choice quickly.

I'm just wondering if anyone else has these problems and what, if any, treatment has helped.  I have an appointment with my bariatric surgeon but not the 24th so I'm trying to hold myself together until then. 

I think you need to see a really good nutritionist for a few months to develop strategies

Have you discussed iron infusions with your surgeon?  You may want to ask for a referral to a hematologist if your insurance requires a referral.  I didn't need a referral and made my own appt.  I've dealt with some anemia also, it's fairly common for post-ops to experience anemia; for some it's preventable and manageable with iron supplements other require periodic infusions.  Infusions made a world of difference in how I felt.

On the hypoglycemia, this is something that some (not all) RNYers deal with.  Again, it's manageable for most with a good eating plan.  High protein, complex carbs, some fats and eating 3 meals and 3 snacks per day.  There are a few post-ops that require medicines to control the hypoglycemia.  Going for long periods of times without eating and/or eating lots of white carbs/sugars will possibly cause your sugar to rise and then drop significantly which causes the hypoglycemic episode. 

For me I know the few times I was there because I had gestational diabetes and had to control/manage my sugar levels.  I usually keep peanut butter crackers on me so when I feel the episode coming on I can eat something quickly.  Definitely heed the warning when your sugar drops, you don't want it to drop too low and cause seizures or possibly go into a coma.

Welcome to the Reactive Hypoglycemia Club. It not uncommon for post-ops to develop it. Most people can handle it by diet although some, like me, have a bad time with it so much that I have to take medicine before I eat to slow the digestion of carbs. What you want to do is prevent you blood sugar from going too high, that is what starts the over production of insulin.

Do you have a blood sugar test kit? If you don't you need to get one. A Dr needs to write you a prescription for the strips.

If you want, I have a file that I can email you that I got at Joslin Diabetes Center by a Dr that has studied RH in the post gastric bypass patient. If your doctor wants you to do a glucose tolerance test DON'T DO IT!!!!

You can email me if you have questions as I have been dealing with it for years now.

Martha

Should have talked to you long before now.   Had that glucose tolerance test a couple years ago and it was the sickest I think I've ever been in my life.  The diagnosis back then was reactive hypoglycemia and I have dealt with it very successfully and haven't had very many episodes.  The ones I had were on very rare occasions when I ate too much fruit.   This condition seems far more severe and I have problems with it even when I eat what I should. I was under the impression it was something different.  Was I wrong?  Thanks Martha!

Hyperinsulinemic hypoglycemia describes the condition and effects of low blood glucose caused by excessive insulin. Hypoglycemia due to excess insulin is the most common type of serious hypoglycemia.

Obviously I am not a Dr!! But this is a quick definition that I found by a Google search.

Is it different? I don't know. What Dr sent you for the glucose tolerance test? My opinion would be that hr/she doesn't know too much about this condition. I went to an endocrinologist that my bariatric center referred me to. He wanted me to go to the lab and have blood drawn and then eat something to cause a crash and have them take blood again. I said to him "So, IF I do that, what would be your plan of action?" He replied "I don't know, I'll have to read up on it." I didn't go to the lab and didn't go back to him either. 

It was at that point that I went to Joslin. I had read on this forum about a doctor who had actually studied on just this problem. I was like Hala, I couldn't eat anything except solid protein. I can eat a well balanced diet now, I don't, however, ever have anything with sugar (not including natural sugars found in dairy products).

Martha 

I am dealing with now right now. The anemia - I end up with iron infusions. That really worked for me. Make sure they also check your copper - some of us get deficient and enough copper is needed fro blood.

As for hypoglycemia - it took me over 6 months to find out what works for me.  That does not mean it will work for everybody. Now i can go for hours with no food and still have OK BS. And I can exercise and maintain my BS.

I had to eliminate most starches, simple sugars and even fruits.  I don't eat potatoes, pasta, bread, wraps, etc. no beans (except green beans) and no milk. I may get some plain Greek yogurt - but not more than 1/2 cup and at least 2% fat - Full fat is best. And I always add proteins to it. 

I also had to eliminate most protein bars and even meets with sugar (like jerky).

What really helped me was to add fat to my diet. All natural fats - butter, coconut oil, flax meal, full fat cheese, coconut milk (unsweet) and nuts and nut butters.  A coffee with milk 0- may make me crash - but same coffee with coconut milk - will not. adding just 1/2 cup of coconut milk to my protein shake makes it good for my body.  Before I started adding fat - I used to get low BS even after lean protein meal. i.e. protein shake - water based. The "adding carbs to every meal" approach did not work for me - I keep gaining weight and every time I tried to eat less - I would crash. I had to eat every 2 hrs.  But limiting carbs to the ones from veggies and nuts, I am able to keep my BS very stable for now.

And if I do something stupid - it may take 2-4 days for my body to go back to balance - almost as if once my body makes too much insulin - it needs time to stop and process what it has. I hope you find what it going to work for you.

Anemia should have been my middle name - dealing now and it is not easy.  Very hard for me to correct with Diet and supplements only.  I have no recommendations at this point, but I am going to try a new supplement as soon as it arrives via mail order.  Will post if I have good results.  I will watch for posts and thanks for sharing.

Does anyone have a good meal plan or diet plan for getting iron back up ?  I know there are lists of things to eat out there, but wondering if anyone has good actual meal plans and recipes.   Will check more on line

I need to learn more about this too.  Tacking this memo here in order to get a e-mail when someone replies.