Reactive Hypoglycemia--does it go away?

on 11/24/19 7:24 pm

I've just reached my 2-year anniversary. I started out in the mid-190s, currently 130. About 2 months ago, I started feeling really sick and weak after eating. I tested my blood glucose many times a day while tracking my food. It went as high as 300, as low as 51. I also saw a new bariatric surgeon (RoseMarie Jones in Indianapolis) who confirmed that I do have RH. She sees it as a great way to make sure I'm not eating junk. I'm on a very low carb diet and absolutely no sweets.

If you've had any luck getting this to go away, please share! Or, just tell me how you're doing living with it if you can't shake it.


on 11/25/19 6:43 am
RNY on 06/03/15

I have what my PCP believes is RH (I had a complete workup at one point to try to figure out what was occasionally making me feel weak and dizzy, but at that point, all tests came back normal. But when I later noticed it happening an hour or two after eating a whole piece of cake once, she figured it was most likely RH). She suggested I eat something every three hours or so. Preferably a protein - but if I ate a carb, to pair it with a protein (e.g., apple slices with peanut butter or cheese). It seems to have solved the problem as I rarely have episodes any more.

on 11/25/19 6:45 am

Hi there, good morning.

10 years out, and I can confirm that it does not go away, or at least it never has for me. There are things you can do to mitigate occurrences, but ultimately I am not aware of any cases where they go away.

I am pretty good at knowing what I can (and should/should not) eat, it doesn't always mean I am vigilant. However, having one of those episodes always help reinforce that I should keep doing good things and eating as well as I can.


Let it begin with me.

on 11/25/19 7:44 pm

Thanks, even if this wasn't what I wanted to hear. It seems like I'm getting more sensitive to carbs of any kind. Anything you've found helpful?

on 11/26/19 6:23 am

Truthfully, I stay away from simple carbs as much as possible. However, at 10 years out I am nowhere near as vigilant as I should be. So, that being said... If I have a piece of bread, I make sure it has some peanut butter on it, and I eat it slow. If I am going to have pasta, I limit it to a really small amount and make sure there's a protein and lots of veggies around.

For me, to say "I'm NEVER going to eat sugar or bread or tortillas again" would be a lie, because I am human. I have had to become okay with one bite of cake being enough. Of course I can eat a whole slice but ultimately I am going to have to pay for it for a few hours. It just isn't worth it.

I've recently switched to intermittent fasting (again, I'm 10 years out) and I find it's really helped me become hyper focused on what I am eating during the 8 hour window. It's almost like I know I can only eat a certain amount of food (due to pouch size) so I have to maximize my intake as far as nutrition and calories go.

I wish there was one right way to do everything but every single person is different. I recommend keeping a food diary, I did that early on and it helped me realize my triggers. I should note, there's some things that trigger me into RH that might not trigger someone else. That's why I found the food diary so helpful early on.

Keep posting here, talking to other people and eventually, you can take a few tips and tricks and knowledge from everyone, and help make it fit to your needs.


Let it begin with me.

The Salty Hag
on 11/25/19 7:07 am
RNY on 05/20/13

6.5 years out and it stays with you. If you're having blood sugar crashes while completely staying away from the most likely trigger foods ( white carbs and sugar ), you should probably start a dialogue with your doc about it and see where to go from here. There are a couple of people that post on the RNY menu thread that have problems with blood sugar lows despite their staying away from triggers. Maybe they'll chime in here.

I feel lucky in that if I avoid white carbs and/or sugar, I can almost always avoid RH. There have only been two or three times that it's happened regardless of the fact that I'd not had what I call crappy carbs. I was able to stop it with my normal fix-a glass of whole milk. (Cheese also works for me as a fix)

I wish you luck! It totally sucks when RH comes out of the blue.

I woke up in between a memory and a dream...

Tom Petty

on 11/25/19 8:19 am
VSG on 05/12/14

I have severe RH. My BS has dropped as low as 29. It also happens to me when I eat foods that aren't typical "trigger" foods, i.e., broccolini and poached egg (a low of 50 after that meal). It happened over the weekend where I dropped below 40 after eating soup. I can tell you that in my case, it does not, and will not, just go away. My surgeon was hoping that it would mellow with time but it really hasn't. I'm working with an endocrinologist to try and use medication to stabilize it (acarbose, proglycem, etc.)

If I were you, I would not let a doctor get away with telling you its a good thing and a way to make sure you stay on track. I know mine has gotten progressively worse to the point where I carry glucagon injections with me should i have a reaction that leaves me unresponsive and I now wear a continuous glucose monitor.

If you believe it's becoming an issue for you, I would stay away from all trigger foods, always pair a carb with a protein (doesn't help in my case) and follow up with your doctor to see if there is a treatment that may help.

on 11/25/19 7:51 pm

I'm now staying away from trigger foods, but matters are complicated by the fact that I was hospitalized in May with a small bowel blockage. My GI had me go on a low fiber diet, but now I can't do that because my blood sugar spikes and then plummets. New low last night of 45. Do you go to the hospital when you're super low?

Due to the blockage and unexplained epigastric pain, my new bariatric surgeon scheduled me for a diagnostic laparoscopy 12/6.

on 11/25/19 10:46 am - MA
RNY on 07/20/15

I am 4 years out, and I used to have bouts of RH all the time when I was in my first year--anything I ate could swing my sugars around and knock me out. I am 3.5 years out now, and now my RH is completely avoidable by avoiding sugar--specifically sugar that is in any sort of liquid form. A sugary drink or ice cream is guaranteed to give me the sweats and make me feel like I have a wicked flu for about an hour until it passes.

  • 4'11"
  • High Weight before LapBand: 200 (2008)
  • High Weight before RNY: 160 (2015)
  • Lowest post-op weight: 110 (2016)
  • Maintenance Weight: 120 (2017-2019)
  • CW: 130 and dropping... thank you Keto! (2020)

on 11/25/19 7:53 pm

Hope springs eternal! I don't mind avoiding sugar, but I ate chicken potstickers about 4 hours before my last bad episode. I'd like to think it won't always be that bad.

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