Reactive Hypoglycemia

I know this reply is late but thought I'd chime in. I have pretty bad RHand will go into the 30s (fun times). My endocrinologist (who I inherited after my conversion to RNY) is a fan of kind bars, they have enough sugar to clear the dog and the nuts counterbalance the sugar high with a hit of protein. I have kind bars stashed everywhere.

Does anyone know if this can occur with VSG as well?

It does, yes. It's much more likely with slider carbs. Ice cream would do it for sure, but many other things could as well.

I have something that happens that is similar in that it's miserable and it eventually passes. It happens when I eat too fast. It's happening right now. I was at a work thing, and I ate a handful of toasted almonds, mindlessly, while socializing. Now I'm at my desk, sweating, nauseated, just wanting to go lay down and hide under the covers. It will pass in about 40 minutes and I'll be fine but OMG you'd think I'd learn my lesson!

Jeez that sounds awful. Sorry!

I also deal with RH. Luckily the first time t happened I took my blood sugar. It was down to 40. I was able to remember what I have read here about eating protein and carbs to bring it back up. Identifying the problem is half the battle. Knowing the first symptoms, and of course the triggers, helps me keep it under control. But it can be very scary and dangerous. Good luck to you!

I used to deal with very severe Hypoglycemia and RH. Took me a couple of years , but eventually I found a doc who diagnosed me with adrenal insufficiency. (AI) eat need cortisone to balance BS- my body was not making enough of it.

The AI was responsible for hypoglycemia and how severe my RH was. But RH was always caused by too many (relatively too many) carbs or lean proteins. When we eat carbs or proteins - body releases insulin. Some proteins- like heavily processed proteins - whey, egg white, eggs, etc - can cause a significant insulin reaction. (Google: food insulin index)

The faster our body can absorb carbs or proteins - the more insulin at once will try to dump in our system. I.e whey isolate is predigested - heavily processed protein - and when used as a drink - is is highly bioavailable- we drink it and able to absorb it very fast. The protein in our system get raised very fast stimulating the pancreas to release a lot of insulin. The insulin is needed for our body to process the proteins. But the insulin also would cause a drop in blood sugar - very fast drop. So we crash.

When you eat things like yogurt with maple syrup - not only this get absorbed very fast - but your body dumps 2 x the amount of insulin - one for the sugar - lactose and maple, and then second dose for the milk proteins. Typical RH for that combination can be bad. Candy or cookie may result in much less dangerous RH.

How to treat it? It depends how low your BS gets and how fast that happened.

When my BS drops to low 60-or even high 50, I just get may get some proteins and fat and some carbs - i.e peanut butter.

But if the BS gets really low and my body is freaking out - when my BS is down to low 30's and keep dropping- I need to get sugar in me fast - to prevent serious damage - then stabilize it with a complex food. One gram of glucose can raise BS by 4-5 points. With my BS at 30 - that is a danger zone. I need to bring it up to at least 60 -70 fast, 70-30=40 points, 40/5 =8 gr of glucose/sugar. 2/3 glass of milk has 8 gr of sugar, 2 glucose tablets have 8 grams or sugar, etc. If you take just enough sugar to raise your BS too a safe level - it will not cause more insulin reaction. But if you drink - eat - enough of sugar to raise it too high again - that may result in "chasing the dragon"

Glass of juice has 25-_40 gr of sugar- so drinking a glass of juice would be really bad, but a few sips may help - like 1-2 oz.

Glucose tablets are relatively cheap, and they have pre-measured amount of glucose in them. I don't have to guess. I keep them all over the house, and in my purse. And in the car. Etc. For my body raising my BS to 80-90 is safe. More that that - not so much.

Good choice are also a small bite of chocolate.

After my BS is at safe level ,- I follow up with real food- nut butter (no crackers) some meat some veggies... Later in evening - only nuts or nut butters. They don't "spoil" inside me as my body process them slowly during the night.

I used to take 2 TBS of NSA nut butter just before bed to help to deal with a middle of the night hypoglycemia.

If you follow a very strict low carb diet for a while - the RH can get much much worse. Low carb diet depletes our body of stored glycogen- so when we get H or RH - there are no reserves to quickly bring the BS up. Body can make glucose from proteins- but it is a very slow process. For that reason - due to my AI - I re-carb every so often. Once a week or once every 2 weeks- I eat more carbs - nuts, berries, more cooked veggies. To slowly digest and absorb the food and recharge my glycogen stores.

I often do that when my weight gets at its very low point and I know my body glycogen and water stored with it are mostly gone. Because of glycogen stores - my body weight can fluctuate within 4-5 lbs in a 24 hour time frame.

I don't recommend that- but I sometimes re-carb eating a high quality (I am a snob in that area) dark chocolate. Eating it very slowly. I try to have rather balanced meals. Not "zero" carbs, but some carbs, some proteins, some fats.

I started at 325 lbs before my RNY in 2008, lost and got to 204, then went to 220 for a while. I have been having so much trouble with RH for years, that I can't eat much without having a spike, then crash in BS. I can't exercise without my BS dropping, I have low fasting BS. I am now at 270 because I'm scared to not be eating constantly to keep BS stable, and I'm scared to exercise. Trying to get help from doctors but it's been a struggle. I'd really like to get it under control so I can exercise and lose weight!