Hypoglycemia

Thanks for asking. I'm doing pretty good. I have been through five chemos, and will have to do at least two more -- maybe three -- depending on my blood test in two weeks to see where my CA-125 level is. They like to do two chemos under 35, which is considered in remission. My levels are at 107 -- down from 750 in January. I'm doing pretty good and I'm sure it's all the prayers. I actually feel better that this low blood sugar may be related to the WSL and not the chemo! LOL I'm keeping busy, and having fun wearing different wigs. I have one with long brown hair that freaks everyone out. Hey, if I have to wear one, why not have fun! Take care.... Joni

I think I'm going through it right now as I'm typing this. I've been having a really tough time with all food since I had stomach flu early in the week. Now if I eat more than about 4 oz or if it has much carb at all an hour after I eat I'm in pain and ready to . Also tired, lots of mucus and....feel lousy. Think I'll go to bed and sleep this off.... Pat

Hi. I'm responding to your post about Hypoglycemia without reading the other posts... I researched, well... actually all I did was spend about 4 hours googling hypoglycemia... About 3 months ago I started to feel I was hypoglycemic. I really backed off the sugar and carbs, and fed myself protein and very little carb... After consuming that kind of food for about a week, I started feeling goofy and my color in the the face and body was very pale... I was told I looked horrible and ill.... that is when I started to eat sugar. After feeling hypoglycemic I actually had some M&M's and felt immediately better, I had some apple and felt better still, then I ate some soup full of carbs and REALLY felt better by the end of the day. Mind you all of this was after I had some milk that morning... Milk contains a lot of sugar (fat free, 2% or the fully loaded whole milk) and it put me over the edge that morning...having had no sugar or carbs for about a week. Anyway, My symptoms and such weren't exactly hypoglycemic that day but I noticed many articles atributed hypoglycemic symptoms in patients who underwent RNY WLS. This doesn't seem to happen to banded or DS folks... their system is different.

It sounds like reactive hypoglycemia. You don't have to eat sweets/sugar to bring it on. Carbs can bring it on. It is a late dumping that occurs through the carbs causing an immediate spike in your blood sugar level, then your body starts making all kinds of insulin to deal with that sugar level, but there's really not enough sugar/food there to deal with all that insulin you now have floating around in your bloodstream, so the level then drops out the bottom. If you eat/drink a sugar source to bring it up, you may start the whole process again and keep rebounding back and forth between high and low. If you truly suspect this is happening, eat a protein like a spoonful of peanut butter or a couple of peanut butter crackers that have a good amount of peanut butter in them. That will bring it up and maintain it for a few hours. I had PCOS with insulin resistance prior to surgery, still have it and have been dealing with the reactive hypoglycemia since surgery last year for adhesions. I keep my carbs to below 20 a day and still have trouble with it at times. I'm extremely sensitive to carbs. I'm on Avandia for the hypoglycemia and metformin for the insulin resistance. You really should see your doctor about it. You could be driving and have it bottom out. Good luck Rachel

I have emailed you a couple articles that might be of help. I have to take in 200-300 calories every 2-3 hours in the form of protien and minimal carbs to avoid BS problems. Sandy

Here is the article about late dumping. as far as eating sugar/ peppermints every hour, this is only going to prolong the roller coaster blood sugar levels. While I cant officially disagree with anyones Dr I think if your doctor is telling you something that you would question, then you need to question - and in depth,. talk to a dietician. And if a doctor is telling a WLS pt to eat candy I'm qestioning if thyey understand WLS and I would ask them if they are familiar with alimentary hypoglycemia. (aka late dumping trnslated into medical terminolgy) also read this - http://www.emedicine.com/med/topic589.htm http://www.ajcn.org/cgi/reprint/32/10/2104 PROTEIN, PROTEIN , PROTEIN will help moiderate blood sugar levels at a steady pace. along with a small amount of complex carbs. peanut butter on whole wheat bread ( not peanut butter on white or fake cheese crackers in the little packages) a slice of meat and whole wheat bread or rolled in a whole wheat tortilla, a slice of cheese or a string cheese stick with a small piece of fruit. , a low sugar potein bar, Kashi high protein cereal, The Physiology of Dumping Syndrome Dumping syndrome is usually divided into "early" and "late" phases - the two phases have separate physiologic causes and will be described separately. In practical fact, a patient usually experiences a combination of these events and there is no clear-cut division between them. Early dumping is caused by the high osmolarity of simple carbohydrates in the bowel. The various types of sugar all have small molecules, so that a gram of (for example) sucrose has MANY more molecules than a gram of protein, creating a higher concentration (number of molecules per cc) from simple sugars than from other foods. This matters because, inside the body, fluid shifts will generally go toward the higher concentration of molecules. So, if a patient consumes a bite of milk chocolate (lots of sugar), when it gets to the Roux limb it will quickly "suck" a significant amount of fluid into the bowel. This rapid filling of the small bowel causes it to be stretched (which causes cramping pain). This also causes the activation of hormonal and nerve responses that cause the heart to race (palpitations) and cause the individual to become clammy and sweaty. Vomiting or diarrhea may follow as the intestine tries to quickly rid itself of this "irritant." Late dumping has to do with the blood sugar level. The small bowel is very effective in absorbing sugar, so that the rapid absorption of a relatively small amount of sugar can cause the glucose level in the blood to "spike" upward. The pancreas responds to this glucose challenge by "cranking up" its output of insulin. Unfortunately, the sugar that started the whole cycle was such a small amount that it does not sustain the increase in blood glucose, which tends to fall back down at about the time the insulin surge really gets going. These factors combine to produce hypoglycemia (low blood sugar) which causes the individual to feel weak, sleepy, and profoundly fatigued. Late dumping is the mechanism by which sugar intake can create low blood sugar, and it is also a way for gastric bypass patients to get into a vicious cycle of eating. If the patient takes in sugar or a food that is closely related to sugar (simple carbohydrates like rice, pasta, potatoes) they will experience some degree of hypoglycemia in the hour or two after eating. The hypoglycemia stimulates appetite, and it's easy to see where that is going.... The reason that sugar does not cause dumping in non-operated people is that the stomach, pancreas, and liver work together to prepare nutrients (or sugar) before they reach the small intestine for absorption. The stomach serves as a reservoir that releases food downstream only at a controlled rate, avoiding sudden large influxes of sugar that can occur after a Roux-en-Y. The released food is also mixed with stomach acid, bile, and pancreatic juice to control the chemical makeup of the stuff that goes downstream and avoid all the effects outlined above. Obviously, surgeons consider dumping syndrome to be a beneficial effect of gastric bypass - it seems to be important to provide quick and reliable negative feedback for intake of the "wrong" foods. In practice, most patients do NOT experience full-blown dumping more than once or twice. Most simply say that they have "lost their taste" for sweets. Of course, this is always a great topic to ask patients about directly, so you may want to ask about it at our support group in person, or in a support group online.

I can't belive i read this post today! I really thought I was going nuts! I never heard about late dumping, but I see this is exactly what I have ben experiencing. I have had a problem eating all of my proein since the begining, (WLS 2/5/05 RNY) I rely on protein drinks and bars mostly, lately I have been doing rice cakes with peanut butter, which were OK, but I guess I started to crave other carbs, so I tried low carb whole wheat bread, crakers etc. I have been feeling dizzy, tired, mentally foggy and just not myself. I exersice regularly, (I acctually work in a gym as a coach)but have not lost any weight in about 4 months (even gained 4#), after reading all these posts I may have found my answer! I have lost about 150# but still want to lose about 15 more before plastics. Thank you all for your posts! This has been a great releif and learning experience!!!!Angela