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Sunday, April 24, 2011

Reactive Hypoglycemia

Reactive hypoglycemia is commonly diagnosed after Roux-en-Y gastric bypass surgery. It is far more common than many deficiencies are post op so it is very important that you read about, learn about it and watch for signs of it as you progress through your journey. For most symptoms will develop after the first year, going into the second year post op. Some people do not get diagnosed though until later. Recognizing symptoms is key.

Serious/severe cases of reactive hypoglycemia can requires removal of parts of our pancreas. For most of us however, the symptoms are not that severe and we can just monitor our diet, make simple changes and monitor times when we may be high. It took me some time before I pieced together my own symptoms.

The first symptoms I noticed were at work, after I had a carb heavy lunch. I would feel "all floopy" (a quote from FRIENDS. LOL!), get a little lightheaded and VERY chatty. I really didn't think much of it to be honest.

At these times as well, I'd get a little shakiness of my hands and I felt a 'little out of it'. It wasn't until watching television one night that I really clued into what was happening. I was watching Friends and was getting a little annoyed because the people on the show seem to have lost their chins. I kid you not. It seemed as though all the charactes had these long and pointy chins. I was crabby too. I realized at that point that something weird was going on asked hubby to get his blood sugar monitor (he's diabetic). He took my reading and said "Wait! That cannot be right. It says 1.1". (In Canada we have our own system for blood sugar - that would be around 18 I believe in the American system).

He scratched his head. He did the test again. Yes, I was THAT low. This is low enough that I could have had a seizure or passed out. He immediately called his Mother who was a nurse and asked what to do. He gave me 1/4 cup of juice. Within 15 minutes, my sugar came up.

This is the scary part of hypoglycemia. If you get too low you could pass out (doing almost any task or have a seizure).

Reactive hypoglycemia - also known as Postprandial hypoglycemia (low blood glucose after meals), is a medical term describing recurrent episodes of symptomatic hypoglycemia occurring 2–4 hours after a high carb meal. Symptoms may include:

Mild Hypoglycemia:

* Increased or sudden hunger ( I don't get this one)
* Feeling shaky, dizzy or nervous (YES)
* Pounding heartbeat (NO)
* Drowsiness, feeling tired (SOMETIMES)
* Sweating (cold and clammy) (YES)
* Numbness or tingling around the mouth (YES)
* Headache or stomachache (NO)

Moderate Hypoglycemia

* Symptoms above plus:
* Headache
* Irritability
* Confusion
* Slurred or slow speech
* Coordination difficulties

Severe Hypoglycemia

* Any of the above mild or moderate symptoms, plus:
* Loss of consciousness
* Seizures and/or convulsions
* Death (not common but possible)

Most doctors will want to do a "Glucose Tolerance Test" on you to find out if you officially have reactive hypoglycemia or not. If you can avoid that, do so. My doctor really wasn't in the know and she suggested it. Dummy me agreed. Well I passed out about 5 minutes after taking the orange drink. Not so much fun. If your doctor insists that you take it, take someone with you. Prepare to dump possibly too. What you can do instead is log your foods, and your blood sugars after them. Note the carbs/sugar in each product, write down your blood sugars at the 1 hour after and 1.5 hour after and 2 hours past eating. Look for trends. You'll need to find out YOUR triggers are, and what foods work best to bring you back from a crash. You'll find what you should be carrying in your purse to bring you up from a crash whether its crackers & peanut butter, glucose tablets, juice etc. The key is to learn when you feel like you are going to crash and to deal with it then BEFORE you actually have a crash. Write down everything. My blood sugar monitor went through a huge workout until I could figure out what works for me.

Also be sure to:

*Eat according to the "rules" - protein first, moderate complex carbs and healthy fats.
*Never eat a carb without a protein or fat.
*look for lower GI breads.
*Avoid simple processed sugar products.
*If you have something high in sugar, be sure to eat something else at the 1 hour mark to avoid a crash.
*When symptoms start, take your blood sugar. Be proactive.
*Write down everything!
*Eat according to a schedule.
*Swap white bread for whole grains
*Eat before you exercise.



  1. This has been helpful and informative. I always do eat protein when I feel this way. I cannot tolerate anything with refined sugar. Now I understand what is happening physiologically.

  2. Thank you so much for the Dawn!! It's really helped me.

  3. see my second part