low blood sugar and B12 diffancy

I need some help i have been having some low blood sugar issues. Even went to the Er basically got turned away just told to eat when it happens. I'm almost 7 yrs out I lost 142 lbs put on about 25 over time and about 2 monthes ago I started clean eating and exercising 5 days a week. Since than I ve lost 16 which is great but these attacks are awful having to monitor blood every couple hours and eat small every 2. Now its affecting my job. I was also told my b12 was around 400 and is wondering if I should suggust the shot seeing how I cant tolerate the pill. I feel sick pretty much everyday now and I'm desperate for some health we are military so my original Dr is far away so I only see who is avaliable on base and not sure if they fully understand my situation. Any help or suggestions are greatly appriceated. Thanks you all.

B12.  

That is critical: The sublinguals did nothing for me.  At the end I was taking 5,000 mcg once or 2 x a day and my B12 was barely 500. I switched to injections.  Most people do OK on once a month -1000mcg. That wa snot enough for me..  My B12 was still low for me.. (700)  Only when I started doing weekly injection - My b12 got to 1000.  Now - I can do that every 10 days. 

Initially when my doc heard how much I was doing - he objected to that - until he saw my blood work..  on weekly injections my B12 was 750... (after a week from injections) . My current test show B12 at 1100... That was 10 days after a shot..  My doc are OK with me taking that much and now I even know myself when I need extra... 

Remember - too low is not good - but way too high - is not good either. I like my B12 to be 1000-1500.  Less than that I can feel it , more than that - would not be good either. 

 

As for hypoglycemia rather Reactive hypoglycemia (RH)- it is very typical post op RNY. I had to adjust my diet very drastically. I had to eliminate starches and gluten.  Even most fruits are on the "off" list. 

 

here is some old post ... http://www.obesityhelp.com/forums/wls_grads/3453812/Reactive -Hypoglycemia-my-trial-error-research/

also check Melting mama blog and Pam.. 

A few bloggers that helped me understand the condition...

http://www.meltingmama.net/wls/hyper_hypoglycemia/

http://pamtremble.blogspot.com/2010/10/reactive- hypoglycemia-after-bariatric.html

 

also: 

"By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr

 

What is known as the hypoglycemic diet should really be called the “Natural Diet”. This is the diet that humans have consumed over the millions of years to which our digestive system has adapted. The “Natural Diet” is natural to the individual only and may be different from one person to another. Nordic European people who have consumed milk as part of their diet in their ancestry may have better tolerance to cow’s milk, than those people whose ancestry was not exposed to that kind of milk as in Asia or Africa. Southern European with a long history of alcohol consumption are more tolerant of alcohol than people for whom alcohol was never part in the hereditary diet, such as Australian aborigines....(>>"

http://www.hypoglycemia.asn.au/2011/the-hypoglycemic-diet/

 

Published

New Data on Weight Gain Following Bariatric Surgery

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

 

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

 

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

 

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss,” said Dr. Roslin.

 

http://www.lenoxhillhospital.org/press_releases.aspx? id=2106

Thank you so much for your reply and the information. I had a doctors appointment today and almost passed out twice. Had to take for sugar pills and have had a pretty bad day. I live on a military base and military doctors don't seem to understand what is going on with me with a hyperglycemic attacks. Bariatric doctor that station on-base it's not my original one says that he can't help me with this I need to go to my primary care and this is really affecting my job and my life. I've been eating really healthy and I don't understand why all of a sudden being almost 7 years out this is happening but I know I need to get control on it. But thank you so much for all the information.

You are welcome. Healthy does not mean good for RH.
You can PM me or post here what thou eat and I cash tell you if I would get reaction tho that.
There is a lot of "healthy " things that may cause RH for me. Unfortunately I had to eliminate that from my diet. Most grains, bread, milk, pasta, potatoes etc are on my 'can't east that even with proteins' list.
There may be 3 ( or more) things happening:
- you body makes too much insulin all the time and that's why you crash
- you body produces too much insulin in response to your diet
- you body does not make enough cortisone (adrenal insufficient - of any type.

It can be something else. It can be a combination of the 3 above.

After a lot of tests my doc found out that not only my body makes too much insulin in response to food - but I also have adrenal insufficiency and need to supplement for that.

I still have to control my eating... But I no longer get really low BS . I can exercise again (but have to remember I need extra hormone - hydrocortisone) and so on.

I  had Gastric  By pass  in  2004  and  ovver  the  last  2  years  have  had  to  battle  low sugars , My  A1C blood  work  was  always  in  the  good  range  5.5  ...  So  they  never  connected  my episodes as  they  called  them  to  sugar  ...  I  had  BS  was  dropping  in  the  20's  and  I  would  black they  said  it  was  some  form of  a  siezure ... Finally  my  primary  Dr  said  she had  done  some  research on BY pass and  complications  and  decided  to  put  me  through  Fast  and also  to  put  me  into a  Hypoglycemic episode and  blood  was  drawn...  I  know  am  seeing  a  special  Endocrinology team down  in  the  city  and  they  have  been  working  with  my  diet  and  some  medication  ..  I  am now  one the  second  medication and  with different  Protein  drink  and  limiting  my   carbs  to  10  a  day  I  have  had  3 successful  days  blood  sure  is  stable at  70-86 .. Will  be  intersting  to  see  how  long  this  will  work  for  me  .. 

No  matter  what  I  have  no  regrets  of  my  choice  of  my  Bypass  surgery  would  do  it  in  a  heart  all  over ..  I  lost  207  lbs  in 2004 and  have  kept  it  off  ...  Have  stayed  with  in a  5 lb  range since  reaching my  goal ....  I  just  want  encourage  you  to  keep  searching and  reading  online and  sharing  what  you  find  in  the  research  with  your  Dr's ..  There  has  to  be  a  way  to  mange  and  live  a  life  healthy  and   balanced .. Message  me  if  you  ever  need  to  talk  ..  I  will  be  more  than  happy to   share  what  my  Dr's  do  for  me ..  I  am  encouraged  finally..  Just  remember  Low  Blood  sugars  is  very  serious  if  it  is  really low ... 

Thanks for your response Im now eating every two hours protein and a complex carb. Issue is when I eat I get sick and have dihera so it is scary seen Bariatric today going to have some more test done. Ive been testing myself and find about a hour after I eat is when i have a episode. I have not passed out yet but Im so scared if i do I wont wake up. So when I get super light headed i eat peanut butter or if its real severe have to take sugar pills. Been to Er twice this week all test coming back good but im sick all day either icky stomach times 10 and diheria or light head  during certain times. Im going to have some test done with my baratrici dr and see if anything else comes up. I told him its so werid to have sugar dips when I dont eat anything bad. Feeling really discouraged though so thanks again.

I  am  so  grateful  I   found  this  thread ..  It  is  a wealth  of  information ... I  am 8  years  out  and  havelost  207 lbs   severe low  blood  sugars ..Over  the  last  4  months  I  have  missed  at  least  one  day a  week  at  work  ... To  much  activity  brings  on my low sugars  plus  my  diet . Have  been  so  so  many  Dr's they  put  me  on a  new  medication this  week  called Acarbose I  take  this  before  eating  any of  my  meals ..  With  all  the  information  on  this  thread  I  have  my  hope  restored  I  am  going  to  tweak  my  diet  even  more .. I  also  started a  new  Protein drink  ISOPURE  zero  carb  ..  Yesterday  was  my  1st  normal  day  I  have  had  in  month  then  to  find  this  thread  I  dont  feel  alone ..  I  am  truly  encouraged !  :-) Let's  keep  this  topic  alive  so  others  can be  helped  also !! Thanks  to  all  that  have  posted  !!  

Thanks ladies do either of you get the upset stomach and diherea after u eat? I get it most times? I don't know if this is a symptom of this or not and how often do you guys ck your blood sugar I get so scared probably doing to much.

Misty  I  do  have  a lot  of  trouble  with  the  nausea  feeling  ..  This new  medication  that  Endocrinologist me  on  seems  to  be helping  a lot  and  the very  low  carb  restriction diet ...  

Yeah all I eat is meat and a veggie. Eggs for breakfast and my snacks are string cheese and almonds still symptoms are not getting any better I'm losing a pound a day even with eating every 2 hours and this morning felt like I was going to pass out ck my blood and it was at 100 I'm not sure what is going on?