need some help with reactive hypoglycemia

on 5/18/11 11:43 am

Hi all-
   I have had some issues with RH for several months now, and I have gotten pretty good at knowing what combinations of protein/carbs keep me stable for longer time periods.  But, for the past several days some strange stuff is going on and I am hoping that someone out there can shed some light and offer some suggestions.

   For the past two days, my blood sugar is dropping every 2 hours, regardless of what I eat or drink (protein shakes).  Typically, I can get 3.5 - 4 hours stable and lately I just cannot go that long.  So, I am eating more often and more total calories, which I am not pleased with.   It is starting to scare me because pre-op I was a horrible grazer, and I don't want to go there again.  I am not mindlessly eating, and I am careful to make choices within my plan,but I am eating MORE and with greater frequency, and I am scared.   I am about 7.5 months out and had been eating 800-900 calories a day.  Now, I am usually between 1000-1100.

   Also, and sorry if this is TMI, but last month my period was 2 weeks late and then only lasted for half a day, more like spotting.  Now, I am spotting again and having lots of PMS symptoms.  The most concerning symptom is that I "magically" gained 5 lbs in the past 48 hours.  I know that I haven't really gained that weight because I am not eating more than 1100 or so calories a day.  I know that it is related to whatever is going on with my cycle, but it is still freaky to see.

   I do have PCOS, but since my RNY my period has been as regular as clockwork, for the first time in my entire life.  So, this is definitely strange.  (Also...before anyone suggests it, I am absolutely not pregant.  Trust me....I am a single mom and not dating.  No immaculate conception going on.....)

   Does anyone else have more issues with RH related to menstrual cycle issues?   Any info appreciated!  Thanks!


HW 320/SW 280/CW 149.5 /GW 145
on 5/18/11 12:14 pm - AL
Sorry to hear that.  I don't necessarily have any suggestions or answers, just that I have not yet had surgery but do currently have hypglycemia and have worried about how I will do with it myself after surgery.  The past year I have real bad lows the week before my cycle when that was never the case before.  My PCP thinks it is early stages of hormone changes as I get older.  (I am 38)  I wish I knew how to help!  Hopefully someone else on here has experienced what you are and can shed some light. 

                  "When you know better, you do better." ~Maya Angelou~

BW 334.4 / CW: 227 / GW 180             
on 5/18/11 12:17 pm

Thanks for answering.  I am about the same age as you (I'm 37), so I wonder if that is part of what is going on, too.  Interesting that you have lows the week before  your cycle.....

Thanks!  Good luck on your journey!

HW 320/SW 280/CW 149.5 /GW 145
on 5/18/11 1:09 pm - AL
Yes and to add to that...I can tell when i am going to have an extra heavy cycle because the lows and irritability and headaches begins 3-4 days prior whereas when i am going to have more of what my norm used to be, I have lows, but not as bad and usually on 1-2 days before.  It is odd I know.  ha ha  Ever since I first started in 6th grade, I have never had cramps, never had the "PMS" symptoms, never had any major issues until this past year.  What we women endure I tell ya!! 

                  "When you know better, you do better." ~Maya Angelou~

BW 334.4 / CW: 227 / GW 180             
Lady Lithia
on 5/18/11 1:19 pm

I've started to notice a pattern to my RH that is, weirdly, related to my period. Haven't had it enough to pinpoint it, but I'm thinking that every month I have a few days where my blood sugar just won't stabilize..... but then after some super-mindful-super-frequent eating, I get back on track and the episodes disappear.

I'd start writing down everything you consume .... including artificial sweeteners.....and your blood sugar readings.... try to correlate everything

Now that my RH has stabilized I am NOT doing it, but if it starts to crash a lot again, I'll do that..... record all calories, grams of sugar, grams of complex carbs, etc. then your blood sugar an hour after, and also if/when yhou feel it dropping.

As you keep a food journal and watch trends, you might discover the truth behind what REALLY sets you off. It might be that whole grains are fine, except when they're oats, or 10 g sugar does you in but 9 doesn't. or 9 with artificial sweeteners knocks you back, and 9 without doesn't.

The more knowlege you have, the better.

For the last month I've been living on Fage Yoghurt, minuet muffins, and snack bars.

~Lady Lithia~ 200 lbs lost! 
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!
giraffesmiley.gif picture by hardyharhar_bucket

on 5/18/11 3:29 pm
RNY on 12/22/08 with

I'm wondering with your history of PCOS that the hormone changes are playing havoc with your blood sugars. Hormones can totally affect levels.
I would not stress over 1100 calories a day. You burn off enough and you are far enough out to be eating that much. You need to eat to manage this. I eat 5 times a day and it keeps it at bay.

Good luck, I hope you feel better,
Deb T.


H.A.L.A B.
on 5/18/11 11:49 pm
It may help if you can post what did you eat and what time...
I deal with a very sensitive RH.  I have issues with most carbs, even complex.  And if I do something (i.e exercise)- or eat something that will trigger a bad RH - then my body is in RH like stage for 2-3 days.  During that time - almost any amount of sugar - carbs would trigger another episode...
IF I get a really bad RH - I may need 2-4 days to calm my system down.  Then I can slowly go back to normal. (i.e. during those 2-4 days - I need to avoid most carbs - eat a lot of proteins with fat and some carbs - like in green veggies, maybe nuts, - but never any starchy carbs . I need to avoid milk and yogurt and most fruits... )
Then - after my system is back to "normal" I can slowly start introducing more carbs: some fruits, some starches, etc.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

on 5/19/11 12:25 am
That is very helpful info, Hala.  That is exactly how I I triggered something and I can't get my system to settle back down.  I am having a lot of PMS symptoms today, so I still think that my cycle is at play here, too.

Typically, if I strive for each meal or snack to be 40%/35%/25% protein, carbs, and fat, then I am good.  For the past couple days, though, it seems like ANY carbs are causing me to crash.  So, I will try to cut out as many as I can and see if I can settle things down.

I get the bulk of my carbs from veggies, dairy, and quinoa.  I don't eat much starchy carb stuff at all.  I have noticed that the dairy carbs seem to be a problem. 

Also, I think that I need to really track my sugar alchohols and see how that comes into play.  I use a significant amount of them in SF syrups because I drink LOTS of decaf intead of water.  I have a tough time with plain water since my surgery, so I either drink it flavored (more sugar alchohols) or drink decaf coffee or tea, with artificial sweeteners.

Thanks to everyone for your very helpful info!
HW 320/SW 280/CW 149.5 /GW 145
H.A.L.A B.
on 5/19/11 1:18 am
Yea... I had to eliminate most (striving for all -but nearly impossible) SA and artificial sweeteners. They were causing a lot of problems for me.
I use stevia.
I use natural (no artificial stuff ) protein powders. - there are some now that taste good (IMO) and are all natural - and sugar - carb free or very, very low carbs.
dairy: I only use half and half, or heavy whip cream ... or unsweet almond milk. Again - I add stevia. I also use Greek yogurt - but no more than 4-6 oz for serving, and always use with proteins, and or fiber. (i.e. flax meal)
I try to avoid SA and splenda.  And NutraSweet. If I need some sweetener - and do not have stevia with me - I use the saccharine based .  There is much longer study with that, and much less (IMO) risks associated with that sweetener.  But only when I am out.

Severe RH to me it feels like I aggravated my pancreas -0 and it is producing so much insulin that even a small amount of starchy carbs will trigger over production. So I give my system a break and take is supper easy. 
That also mean avoiding strenuous exercise - no more than 15-20 min of vigorous activity.
Also add more supplements that support the sugar balance: i.e. chromium, or alpha lipoic acid, or more good spices - like cinnamon - add to almost anything.  Cinnamon helps stabilize blood sugar.  I sprinkle cinnamon in my coffee...
And so on and so ....
I set up my phone allarm to remind me I need to eat every 2 hrs. Small meals. maybe 100 cal?  i.e. 12 almonds, or a 1Tbs almond butter.

Days when I try to normalize my system I ALWAYS eat fat with my meals and fiber.   Somehow - the fat helps me more that proteins - BTW: proteins can be converted to sugar into body - fat - not so much...  Nuts and nut butter are the best.   even a tsp will help.  Natural - no sugar added - no artificial stuff.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

on 5/19/11 2:19 am

Thanks again....all super useful information.  I tend to use a lot of Splenda, and also a lot of Truvia.  I will have to work on reducing that.

I also did a vigorous yoga workout last night for about 45 minutes.  So, that could absolutely be part of it.  Come to think of it, I had a bad low about 25 minutes after I finished exercising.  Hmmm...

I actually do eat a lot of cinnamon, so that is good, but I can start adding it to my coffee since I drink that throughout the day. 

I really do appreciate all of your info!

HW 320/SW 280/CW 149.5 /GW 145