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Reactive Hypoglycemia

What is reactive hypoglycemia?  It’s low blood sugar that happens after eating…normally 2 to 4 hours after eating.  This is a different condition than “normal” hypoglycemia.  With “normal” hypoglycemia, the patient has low blood sugar when fasting.  Reactive hypoglycemia can be caused by other conditions, but mainly is a side effect of gastric bypass.  A minority of gastric bypass patients will notice RH about three years after surgery.  After gastric bypass, the body can overreact to carbohydrates, dumping more insulin into the body than is needed.

I was diagnosed with RH several years ago.  The first time my sugar dropped it was quite scary.  Suddenly I felt nervous, sweaty, shaking, and kind of “out of it”.  Thankfully I also felt an intense desire to eat, and after eating a granola bar I found shoved at the bottom of my purse, I felt better a few minutes later.  When mentioning this to my family doctor, he said it sounded like RH, to keep food with me at all times, and to eat as soon as I felt symptoms coming on.

Unfortunately, I didn’t feel the symptoms coming on a few weeks ago; I suddenly felt extremely dizzy, as though very drunk.  I tried eating, but within two minutes I had to lay down, and ended up passing out.  I saw an endocrinologist after that, who now has me checking my blood sugars regularly.  I also had a boat load of blood work run, and will find out treatment options at my follow-up.

Of course, there are some things you can do to manage it better.  The day of the “pass out” episode, we had been to the movies, and I had eaten popcorn, without any protein before hand.  That was a total fail on my part and my own fault.

Now, being more careful, I’m back to no carbs without a protein and eating 5 small meals a day.  I’ve always kept food with me, but I now make sure to have a snack in my car too.  If you think you may have RH, see an endocrinologist to figure out how to best manage it.



Hello, I'm Kate, and I'm a 10 year gastric bypass post-op. I started this blog, as well as my nutritional website, to help other bariatric surgery post-op's on their journey as well as pre-op's with their decision if bariatric surgery is right for them or not.

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