Help Please. I don't know what to do, feel hopeless blood sugar issues.

Hello,

I haven't been on here in a long time.  Surgery was 11/09.  Lost 150 and was doing pretty good.  In the last 6 months I have had problems with hypoglycemia.  Saw the GP for it and she said I was "dumping" because I was eating too many carbs and then blood sugar spiked and then dropped.  So i adjusted my diet and things were pretty good. Although i seemed to be hungry and need to snack all the time and have gained about 20 pounds in 6 months.  I never was a snacker, and now I was back to wanting to eat all the time, and I was getting really bummed.  But about 6 weeks ago I started feeling very ill.  sweating all the time, tired, achy muscles  ( I also have fibro) and I went to my GP again and thought maybe I developed Lupus, or something else.  She ran the first round of labs which came back all normal except for my iron which is really low.  So i started an iron supp.  Unfortunately she now is on a long vacation and wont be bac****il mid July.  After she left shortly after my appointment I kept having the strange symptoms but i could never figure out what was going on.  I saw no real pattern, and I was also having some other sensations such as burning feelings on my neck and head, (which I later figured must have been a reaction to a supplement I started and have since stopped).  So i also saw my nuero Dr, to see what he could do.  He wanted to order an MRI of neck and brain, and more labs, for things like lupus, lyme desease, RA etc.  everything came back normal.    I have been at the end of my rope and was getting very very depressed.  I was missing work (which I only work 3 days a week) and not being able to go anywhere because I never knew when i would have an "episode".  I thought maybe it was just a bad fibro flareup or maybe i had developed CFS.  Somehow I got the idea to check my blood sugars and when i saw that they were low, sometimes around 40 even after eating protein I started googling low blood surgar and wls and ended up here!  I have been trying to keep a food journal and record my blood sugar levels too, but I have not idea where to start.  My WLS group was let go from the hospital she was at and isn't practicing WLS anymore.  So i don't have a surgeon to go to.  only my GP.  I am so upset, i have no idea what to eat or when, or when to take my BS.  Can someone help me?  does it sound like i have Reactive hypoglycemia, or something else?  I just know whatever it is is totally related to my eating.  I am at the end of my rope.  I know even if my husband brings me to the ER (like he wanted to earlier) they would just do all the same tests and tell me everything is normal.  But I am not okay.  I am so sick sometimes and then 4 hours or so later I can feel pretty good, although not healthy like I did 2 months ago.  Will  I ever feel healthy again? 

thanks so much for any help you can give

Karil

I suggest getting your GP to sort it out, maybe send you to a specialist/nutritionist to help you get your blood sugar under control. Please don't rely on strangers on the internet for medical advice.

I'm sorry I have read a lot of posts on this site and I was under the impression that "relying on strangers" for medical advice was part of its purpose. I have Dr's handling my care, as I stated in my post, what I was hoping for was hope, encouragement, and diet suggestions from people that have experienced similar situations, something I can not get from my Drs. It looks like I went to the wrong place for that 'help'

Hi, Karil.  I'm not sure how old you are, but some of the symptoms you mentioned accompanied my journey into menopause.  Just a thought.  Also, as for the hypoglycemia, check out Reactive Hypoglycemia on the web, which is a common after effect of weight loss surgery, usually several years out.  I do eat 6 times a day in order to keep my sugars controlled, but a "meal" can be a yogurt, a piece of fruit, or a protein bar.  I did find that I'd have a low blood sugar, think carbs/sugar was the answer, but then start a carb cycle.  I read about that somewhere too, and spoke to my dietician.  Not saying that following a plan closely means you'll never have a low blood sugar again, but you'll better be able to treat it.  I do keep a blood glucose monitor at home to check when I am having those kinds of symptoms -- sweating, shaking, disorientation.

I had a revision of my rny in May, and my BS issues got much worse. I saw the endo last week, and she ordered a gastric emptying study, as she believes I may be dumping after every meal. She also gave me a rx carb blocker, to limit the absorption of carbs, and keep the glucose levels more steady. I also had a bunch of bloodwork this morning, so she can see if it's a hormone issue. Hopefully I'll have the full picture in a couple of weeks.

I think it would be a good idea for you to make an appointment with an endo, so you can get the answers you need.

It is long - but it may help you...

I deal with severe RH ... plus some other issues.  But the Rh was really bad.  I had to completely change what and how much I am eating.  I also (finally) went to allergist and was diagnosed with dairy and soy allergies. Great, no?  anyway.. after crying for a day or 2 because I already had severe restrictions - I decided to act my age and changed my diet yet again .  

Add severe gut pains when eating - that is possible IBS-C (C=constipation) and more food restriction... (elimination FODMAP foods)

Anyway, right now - I eat and I no longer deal with low BS (unless I eat stuff that I know I can't-shouldn't)

Trial and error. 

here is what I do -eat: 

protein and fat at every meal - and maybe some carbs. My ideal meal has  calories: 45% fat +35% proteins +20% carbs..  And I am losing weight.  Yes. I gained weight due to RH. In the last 2 months I lost 10 lbs without being hungry or having one low BS episode.  In addition - most of the time my gut pain is very minimal (unless i do something stupid and pay for that for 3-5 days) 

Example of my daily eats: 

coffee with Miralax (followed by more coffee) 

Green tea, water (flavored)

vegan protein shake + added fat (note - the whey and soy allergy..plus plus)

some meat, or eggs or fish plus some  non starchy veggies that my body tolerates...

snack: nuts, homemade protein based cookies or bread (keto- paleo), or  meat stick, or nuts, or nut butter, or bacon - sometimes with or without veggies.. (cucumbers, NSA pickles, greens, roasted veggies, green beans,) 

Dinner - same as lunch.

LNS: just before bed I eat something that has fat and protein - mostly nuts or my own protein cookies.   I chose to have LNS so I don't wake up in a middle of the night with low BS - horrible horrible stuff...

In addition - once or 2 times a week I may have some fruits - but only berries - and never by itself -always with fat and proteins.  

I stay away from any starches.. (grains, beans, rice, potatoes, etc).  Either that stuff is going to hurt me or may make my BS to raise and then drop.  Yea - it is challenging at times - but it is what it is. 

There are a lot of web sites, with great recipes for keto style diet.  I don't feel deprived anymore. I eat burgers and steaks (only fillet - other - too tough - hurts), fish and shrimps and scallops, good sausage (no soy or wheat fillers), chicken and turkey, etc.  plus many veggies. I use coconut oil and bacon fat (no butter = dairy=allergies)

Due to IBS symptoms I also avoid (or really limit) foods from FODMAP (google that) diet. But that still leaves a lot of veggies I can eat. And the small qty of food I can eatin one time - really makes is less difficult to decide what to eat.  Traveling is *****allenging - but most places have grilled fish or chicken - add some veggies and I am set. 

Adding fat and removing carbs made my system rather stable.  Removing food I am allergic to - also helped.  

But I can't have just lean proteins - our body can and it will turn the proteins into blood sugar, so low fat - high protein diet - made me crash over and over.. I was in tears.. Changing  to proteins + fat really made a huge difference in my life.  I chose natural fats - coconut oil, avocado, nuts, olives, bacon fat (from bacon I crisp at home- yummm)  etc.

I try to make sure that even my shakes have 2:1 ratio (protein to fat) i.e. shake with 15 gr of proteins will have 5-8 gr of fat.  But too many fats and I got runs... 

That works for me. 

I still get carbs - but only from nuts, some veggies, some berries.  

I try not to use artificial sweeteners -  some people are very sensitive to them - and in some people - artificial sweeteners can cause insulin release = too much insulin = BS crash. 

I don't use SA (sugar alcohol)  - not only they give me pain - but my body sees them as pure carbs/sugar and I may crash. 

I don't use commercially available protein bars - some claims the low net carbs - do not apply to me. My body things it is all carbs.. 

I try not to use any cold cuts that have sugar added (read labels) so most jerkies are out.  and so on.. 

I do work full time and then some.. have a BF and active life.  But I cook and freeze to grab and go dishes. 

BTW: I test almost any new foods I buy - to see how my body will react to it. i.e. some very low carb egg protein shakes - caused a very rapid blood sugar spike and then RH - I had to return them.  The shake was all natural, with stevia - but with added enzymes - so my body got a shot of very predigested proteins - and even with the fat I added - the 20 gr of proteins - my body turned them into blood sugar very fast.  

I buy protein powders  because if I don't supplement - I can get close to 80-100 of proteins my body needs...And with my IBS- I can have no more that 2 max 3 meals with proteins before everything just start hurting. I was able to find a few brands of vegan protein powders  that taste good enough to drink. Some are just horrible ( so I use them to make cookies, protein muffins, etc). 

I hope that this info may help you in any way. You can PM me - or post your typical day - meals - and your reaction to them and I can tell you if that selection would cause bad reaction for me.  

I also have severe RH and eating close to the Paleo type of diet has saved me . lost 30lbs and no blood sugar spikes since January.. 

Karil, see if you can get in to see an Endocrinologist. I've only just had the surgery, but I'm a diabetic and know about low blood sugar. A good endo can hopefully diagnose you and suggest treatment. Aside from that, protein won't raise blood sugar. Can you carry some whole grain crackers with you? Or plan on eating something with a mix of protein and carbs, like a small sandwich? The carbs bring up the blood sugar and the protein helps stabilize it. Yogurt is a good option also, but it's all very personal. Your best bet right now is probably to test your blood sugars throughout the day so you can nip problems in the bud before you crash.

You could have both reactive hypoglycemia from eating too many carbs and hypoglycemia from not eating enough. 

I would start with logging your foods using myfitnesspal and learning exactly what you are taking in.

You want a diet that is around 40% protein (or more), and 25% carbs.  You don't want to ever eat protein or carbs alone.  You don't want any more than 25 carbs per meal or snack.

If you'd like information on RH please feel free to send me your email and I'll send you something.  Just message me if I can be of any help. 

Start with your diet.  Then see what effects you and why and how long.  Monitor using your glucometer.

For most, this is very manageable.