Anyone else have reactive hypoglycemia?

Kristen

New member
The nutritionist at CF clinic told me I have reactive hypoglycemia - Every morning, I wake up feeling fine, sometimes hungry, and eat breakfast at around 7:30. Around 10:00, my blood sugar crashes - I feel ravenous, spacey, shaky, and sometimes sweaty. I eat a snack with protein and carbs, which helps for a little while, but in an hour it will happen again and will still feel like crap until I eat lunch. By lunchtime I am so hungry that I feel like I could eat a thanksgiving dinner (and I usually pig out). Then I am fine for the rest of the day.<br>The nutritionist told me to tweak my morning diet to include more fiber and protein, which I have done, and it still happens. (My breakfast is usually that Kashi Go Lean cereal that has added protein, and piece of turkey bacon, coffee, and some fruit). Has anyone found a snack that works well for you? I have been doing protein bars, because I'm usually out and about mid morning, so it's very convenient. I'm wondering if I need to add some fat, or simply just eat more food.<br>My other question is, has anyone noticed they feel more junky when their blood sugar crashes. My cough is always the worst at the same time - I wake up fine, and then, around 10:00, I start getting a junky cough and I cough until after lunch, and then I am fine for the rest of the day. I mentioned this at clinic too and they were just like, "That's weird." I'm just wondering if they could be related, or if late morning is the time when CFers cough the most.
 

rubyroselee

New member
Hi,

I have had problems with late morning reactive hypoglycemia for years. Apparently it's quite common in CF because of our pancreas issues. I was once told that it could be a sign of pre-CFRD, although I have had this reactive hypoglycemia for 10+ years and still no CFRD (knock on wood).

Anyhow, my nutritionist told me to eat a high-protein, low-sugar breakfast...and then make sure I eat a snack approximately 2 hours later. This has helped me overcome the reactive hypoglycemia. I am really bad about eating a good breakfast, so I always make sure that I have a snack with me for the late morning hours. Usually I choose to snack on nuts. And as a general rule, I just make sure I eat every 2-3 hours...so I have a snack between lunch and dinner, and then again before bed...because I had even experienced hypoglycemia around dinner time as well.

I have never experienced an increased cough with low sugars. But my cough is usually the most productive in the morning hours, so maybe that's what you're noticing...??? I wouldn't think the coughing would have anything to do with your sugars.

Well, good luck! And also, make sure you ALWAYS carry glucose tabs or gel with you. I have found that I do use them quite a bit and I wouldn't be without them!
 
B

boone06

Guest
The doc told me i have reactive hypoglycemia. It's never consistent, some days it affects me others it doesnt. The problem is i work full time so when i crash im usually at work and become dizzy, lightheaded, shaky, and extremely lethargic. I can eat a snack, put my head down and usually after about 15 minutes i am fine again for the rest of the day. The weird thing about it is it usually only happens in the morning, i drink energy drinks occasionally and never have the issue after drinking them even on an empty or semi empty stomach. Just wish i knew what i could do to stop it from happening period.
 
B

bethylove

Guest
I notice my blood sugars get funky when I start harboring an infection. (Even if it's just a cold or a relatively bad 'junky' day).

My most recent endo. told me that women *regardless of Cf or not* are more susceptible to morning reactive hypoglycemia i.e you eat a bowl of cereal and an hour later you feel like you're going to pass out... She said its relatively normal occurrence in women and said basically what everyone else is saying. Eat a high protein breakfast, have frequent snacks or 2-3 small meals. And don't eat high sugar high carb breakfasts.
 
K

Keepercjr

Guest
I sent a PM to Kristen but I will post the gist of what I said to her.

I too have/had reactive hypoglycemia. I have totally resolved it by doing 3 things to my diet - severely restricting grain (I only have grains maybe once a week - my goal is total elimination but that has not happened yet) and eating more fats (especially animal saturated fats like butter) and more protein. I have no more crashes AT ALL.

Pretty much all of the conventional dietary advice from our nutritionists and doctors is wrong. I know that I'm going to get flamed for saying that but it is true. We need little to no grain in our diets (even whole grains) and MORE fat and protein. But the fat needs to be either from avocado, palm, coconut, olives or animals (meat, butter, lard, tallow, etc). Some think that nuts in modest amounts are ok too.

My morning weekday breakfast is usually some greek yogurt (tons of protein) mixed with some honey. And because I can't find full fat greek yogurt I usually try to get some fat via butter or coconut oil (or some slices of cheese). Weekends we cook up lots of uncured bacon and some sausage. I don't eat eggs (personal gag) but I have chickens and I fry up some eggs in butter or I hard boil them for the rest of my family. Pretty soon I will have access to lots of raw milk and plan to start making my own full fat greek yogurt. My other meals consist of protein and veggies and or sweet potatoes for carbohydrates. I occasionally have some white rice as well. I have also found that my daily bloating has disappeared but I will write a post on that in a little bit.
 
A

alegris

Guest
Hi,
I also have reactive hypoglycemia. I eat breakfast around 7am and lunch around 11:30am. The ONLY breakfast food that can get me through to lunch without my blood sugar dropping is oatmeal. I have two packs of the instant oatmeal every morning and I'm good to go. From lunch time until the end of the day, I try to eat mini-meals every few hours. Nuts and yogurt are good as somone mentioned. I also find cheese, popcorn and bananas are good too. Everyone's different so it's all about finding what works for your body.
My chest also starts getting 'junky' late in the morning. Probably around 10:30am. I've always been curious as to the cause.
 

mamerth

New member
I have never known what is called until now... I guess I have reactive hypoglycemia as well.

If I don't eat quite enough for breakfast my sugars fall very quickly (less than 2 hours after eating breakfast). I eat oatmeal (1/2 a serving), 2 slices of peaches, and whole grain toast AND a large fried egg. I finally had to add a few ounces of orange juice and a tiny amounts of peanuts and it sometimes helps.

Some mornings I have no issues with it and some mornings I feel so awful that it exhausts me for hours. Luckily my sugars don't fall past the low 70's. 2 hours after I eat, I have a nature valley granola bar (the green package) and my sugars are usually great for the rest of the day.

My lungs are pretty junky in the mornings until I do my mid morning treatment. After that no problems.... unless I am fighting something.
 

Welsh_BP

New member
I have these events in the morning too - about 2-2 1/2 hours after eating breakfast. I have worked out that certain honey / sugary cereals (which unfortunately I love) are the trigger. I can almost bet on it - if I have my normal low-sugar cereal and coffee, I'll have no problem. If I have a sugar-high one, I'll crash around 10:30/11am and feel absolutely awful for about half an hour until snacks kick in. I try to limit my fave cereals to the weekend, when I'm able to deal with it better. I think like all things, once you know what the triggers are, you can take more control over your life.
 
H

Hail2Pitt

Guest
Thank you so much for starting this thread!

I have it too, and I’ve battled it most of my adult life. Though, I wasn’t “officially” diagnosed until about two years ago. My CF clinic feels that it isn’t related to CF, as most CF patients don’t have it, but I’ve had trouble believing it's unrelated.

My crashes are the worst in the morning, though they can occur all throughout the day if I’m not snacking enough and/or eating the right things. Also, they’re greatly exacerbated by certain antibiotics (e.g., Bactrim). My docs told me that Bactrim doesn’t cause this, but I have quantitative proof (sugars in the 50s) that it does!

I’ve personally found that there isn’t a lot of great advice out there on how we're supposed to eat. I've received bits of advice here and there, but it's been difficult for me to translate it into a menu. So, it’s really helpful to hear what you all do to help control it. For me, I have to avoid simple sugars. Also, I have to eat a good balance of protein, fat, and complex carbs. For every 1 gram of carbs I eat, I know I have to eat 0.5 grams of protein at the same time. I don’t really know how much fat I need, so I just make sure I’m eating some fat as well with everything I eat. The other key for me is fiber – fiber slows down digestion, and I can see that it keeps my sugars steady for longer. So, I eat a lot of fiber, especially in the morning.

As with all of you, breakfast is key with me. I’ve found a formula that works, and I never stray from it. I make a big smoothie with coconut milk, flaxseed, unflavored protein powder, broccoli, carrots, spinach, raspberries, pear, and apple. It’s not the tastiest thing in the world, but it’s not too bad. I picked fruits and vegetables that are for the most part low in sugar and high in fiber, and the coconut milk adds fat. Flaxseed adds additional fiber, and the protein powder adds, of course, protein. I drink this when I’m getting ready in the morning, and then follow it up with peanut butter on toast (using Ezekiel bread). This keeps me steady for much of the morning.

When I need a quick snack, I eat Glucerna bars, and also have started eating Fiber One Meal bars. Both of these work pretty well for me. I also snack on cheese with whole grain crackers.

I’m sorry to hear you all are dealing with this too, but I’m admittedly glad I’m not alone! :)
 

rmotion

New member
Are people having this without taking insulin?
If you are on insulin then you have to adjust how much you are taking.
I take insulin and have this problem, so curious to see why it is so prevalent with CFRD.
There is an issue with carb malabsorbtion too. you'll have to google it




Thank you so much for starting this thread!

I have it too, and I’ve battled it most of my adult life. Though, I wasn’t “officially” diagnosed until about two years ago. My CF clinic feels that it isn’t related to CF, as most CF patients don’t have it, but I’ve had trouble believing it's unrelated.

My crashes are the worst in the morning, though they can occur all throughout the day if I’m not snacking enough and/or eating the right things. Also, they’re greatly exacerbated by certain antibiotics (e.g., Bactrim). My docs told me that Bactrim doesn’t cause this, but I have quantitative proof (sugars in the 50s) that it does!

I’ve personally found that there isn’t a lot of great advice out there on how we're supposed to eat. I've received bits of advice here and there, but it's been difficult for me to translate it into a menu. So, it’s really helpful to hear what you all do to help control it. For me, I have to avoid simple sugars. Also, I have to eat a good balance of protein, fat, and complex carbs. For every 1 gram of carbs I eat, I know I have to eat 0.5 grams of protein at the same time. I don’t really know how much fat I need, so I just make sure I’m eating some fat as well with everything I eat. The other key for me is fiber – fiber slows down digestion, and I can see that it keeps my sugars steady for longer. So, I eat a lot of fiber, especially in the morning.

As with all of you, breakfast is key with me. I’ve found a formula that works, and I never stray from it. I make a big smoothie with coconut milk, flaxseed, unflavored protein powder, broccoli, carrots, spinach, raspberries, pear, and apple. It’s not the tastiest thing in the world, but it’s not too bad. I picked fruits and vegetables that are for the most part low in sugar and high in fiber, and the coconut milk adds fat. Flaxseed adds additional fiber, and the protein powder adds, of course, protein. I drink this when I’m getting ready in the morning, and then follow it up with peanut butter on toast (using Ezekiel bread). This keeps me steady for much of the morning.

When I need a quick snack, I eat Glucerna bars, and also have started eating Fiber One Meal bars. Both of these work pretty well for me. I also snack on cheese with whole grain crackers.

I’m sorry to hear you all are dealing with this too, but I’m admittedly glad I’m not alone! :)
 
M

Mark_s83

Guest
Me too. Same issues. Hard boiled eggs seem to help and they can carted around for snacks.
 

Epona

New member
I discuss this extensively on my website at this blog post: http://cfnaturalhealth.weebly.com/blog/reactive-hypoglycemia and about CF-related blood sugar issues here: http://cfnaturalhealth.weebly.com/cf-related-diabetes-and-impaired-glucose-tolerance.html.

The main issue is that CFers have a delayed insulin response, so by the time the insulin hits the blood stream the sugars have already been absorbed into the cells, and this causes hypoglycemia. The solution is to eat a low-carb or no-carb breakfast, and to avoid eating too many carbs until later in the day. I get reactive hypoglycemia any time I eat more than 30g of carbs for my first and/or second meal of the day. A better approach is to load up on fat or protein for breakfast. Fat is fabulous! But only saturated fats are good for us (with a few monounsaturated fats being ok), specifically those from animals or coconut oil. I add coconut oil to everything. Avoid polyunsaturated vegetable oils. Also avoid any processed foods, especially high-carb or sugary ones like protein bars. The only snack bars I eat (later in the day) are Larabars which have only two ingredients: dried fruit and nuts. I never get reactive hypoglycemia anymore because I am aware of what triggers it. Experiment and see how many carbs you can handle before you cause a spike and then crash in blood sugar. Or just be safe and avoid carbs altogether until later in the day.

Also, cinnamon is fantastically effective for modulating blood sugar. When taken in conjunction with low or moderate carb intakes it can prevent sugar spikes and crashes. It can also be taken with insulin. I take 1 or 2 pills of it when I don't eat enough carbs for an insulin shot. I took cinnamon many years before I needed insulin and it always helped me. If you can get your BS under control and reduce the stress you are giving to your pancreas by triggering these hypoglycemic reactions, the longer you may be able to stave off diabetes. The less insulin you secrete the better. The less carbs you eat while still maintaining weight, the better.

And yes, there can be an interaction between hyper or hypoglycemia and lung mucus. But mostly I think you are eating something that is hard to digest for you, which causes gut irritation and increased gut mucus, which causes increased lung mucus. I discuss this on my website as well. Anytime we inflamed the guts by eating sugar or foods that we don't digest well, we stimulate mucus production throughout the entire body (all epithelial cells are connected via the vagus nerve).

Most MDs know close to nothing about nutrition or reactive hypoglycemia (even most endocrinologists are 15 years behind the science) so we unfortunately can't count on them for good info. Try some experiments and see what works for you.
 

megan420

New member
Hi, I have hypoglycemia too. My doctors didnt take me seriously at first because it would just drop at random and they couldn't monitor something that didnt happen in front of them......but i tried everything to get them to believe me, finally got blood sugar checker. Then recorded some of my drops, they listened up to that. I told them I tried everything I could think of to make it better, food always was the trick. I mean they sure couldn't argue with numbers as low as 30. So, they just told me to always keep some sort of food with me, preferably not straight sugar either. So, now I make sure every time I leave the house, that I have something. I also use the glucose tablets you can buy at WalMart as a last resort way. ALWAYS have food and tablets in your purse. Letting the people, I hung out with the most in my life, know of my situation. So now whenever it happens, wherever we are, we immediately look for food. Even in Walmart or the grocery store, Ill be walking down the aisle eating something. Try and eat hearty foods too when it happens; any meat, bread, potatoes, peanut butter. Even after a huge meal, it can happen.....it does for me sometimes. Hope this helps.
 

randomgirl

New member
I've had CFRD for about 11 years and almost never had a problem with getting low after eating until few years ago. After my lung and liver transplant, I was told I have gastroparesis (my stomach nerve got cut so food takes a looong time to move through). Anyways, that means that reactive hypoglycemia happens more often now than it used to. I was ok with it for about a year and a half but for some reason my gastroparesis is acting up. So now I get low blood sugar sometimes within minutes after eating a meal. It helps if you decrease your insulin if you are taking insulin. Otherwise, maybe you can add more carbs and less protein to see if that helps. Protein does stabilize blood sugar but you can't raise blood sugar with just protein. If you are hypoglycemic then the best way to get your blood sugar higher and faster is carbs and sugar.
 

Twistofchaos

New member
Yeah I've been having that a lot most of my life and seems common with CF'ers. As we are not quite yet CFRD but our pancreas might have a sort of delayed insulin responce it might get the amount of insulin wrong sometimes.

But it's also a natural response to switching eating and activity around. (First eating and then getting active. While evolutionary speaking the body is more suitable to being active, getting hungry, hunting/eating and then sleeping.)

So in the morning we eat, then get active, and the body estimates our activity levels wrong and produced or is producing too much insulin causing an insulin spike/sugar crash/hypoglycemia.

Possible solution worth trying.:
I'm a bodybuilder or live like one, and a couple years ago tried something called intermittent fasting mainly because of the reported good effects on blood sugar. Pretty much the point is to eat as much as you otherwise would but put it in a smaller feeding window of the day. Say 6 to 10 hours and fast the rest. If you work out or get really active on that day try to consume most of the food after the activity. Lots of info about it on the web.
Has been great for me. Can't recall a single sugar crash since then and my average blood sugar has come down significantly which has been amazing people at my clinic because I have always been testing borderline CFRD before.
The 14-16 hours of rest from taking in food/digesting also has significant positive effects on my digestive issues. Less cramps, more solid stools. Give it a try..
 
H

Hail2Pitt

Guest
Epona, I think your advice is really interesting. When I wake up in the morning, my blood sugar is good (around 90), and it seems to stay that way until I eat. Though I'm usually really hungry and I eat right away, I know that when I wait a couple hours, it's typically stable during that time. The smoothies I make have a lot of fat and protein, but they do have a decent amount of carbs too. So, while they work way better for me than just about anything else I've tried, I can still get low sugars at times. I've never tried not eating any carbs until later in the day, but logically it makes sense. If I'm not eating carbs with breakfast, my blood sugar should probably stay relatively stable. And, I know that my body deals with them much better as the day goes on. I'm going to try it! Do you mind sharing what you eat for a typical breakfast, morning snack, lunch, etc.?

Twistofchaos, I've never heard of intermittent fasting, but that's really interesting too. I'd be curious to hear more details on how you do it. For example, do you work out first thing in the morning? Do you not eat until after your workout (or perhaps during it)? What do you typically eat and when?

Thanks!
 

Epona

New member
My morning routine is eating a small breakfast after I wake up and before my breathing treatments. This consists of my morning non-coffee drink (chicory root powder + 1 tbsp coconut oil + hemp milk + stevia), and maybe 1/2 a granny smith apple with tahini, or a stalk of celery with tahini and raisins on top, or something like that. As long as this first meal remains below 30 carbs I do not get hypoglycemia, even if I must take insulin with it. If it's just above 30g of carbs, I take a cinnamon along with my insulin, but if you don't take insulin, just the cinnamon will help. If I need a very quick bfast, I might have a larabar (only dried fruits and nuts) with the chicory drink, or a piece of pre-cooked meat or deli meat. Then after my treatments 2-3 hours later I have my second breakfast, which is usually something like sausage and a salad, or another apple or celery with tahini, or some other kind of meat like a ground beef patty with lettuce as a bun. This is a more substantial meal than my first breakfast. I then exercise for an hour or two, then my lunch can be higher in carbs (up to ~ 60 g), like pre-frozen potatoes that are reheated + lots of fat, or a veggie stirfry with lots of fat (bacon fat or coconut oil), or a big fatty green smoothie... can you tell I love fat? If this is a heavy carb meal, I exercise again after it to help my body uptake the glucose and improve its insulin sensitivity. Even a short-ish walk will help with digestion and blood sugar control. Dinner can be any of the combo of the foods previously mentioned, though I try for it not to be too high carb (I digest carbs better in the mid-day). Meats and/or veggies are best for me for dinner. Recently I've been having a pre-bed snack (to try to gain weight) of a larabar (cherry pie flavor) - it's about 30g carbs and I think this may help me gain weight as I store the carbs as fat instead of using them in activity.

I must say that 90 is a little bit high for fasting blood sugar in the morning. I shoot for 75-85, the lower the better (within this range, but not below 70). Taking a cinnamon with the last meal of the day will probably help you reduce your blood sugar overnight.
 

imported_Momto2

New member
Yup, had this problem for years. Eat a breakfast with little to no carohydrates (and NO sugar) and I'll bet it gets a lot better. Before I figured this out my blood sugar use to skyrocket then crash into the 30-40 range. If ANY little trauma happen then (smushing a finger in a drawer, seeing something upsetting, etc) I would have a seizure. Now I've figured out the symptoms. I get irratable, a little irrational, then sweaty and shaky, and finally if I ignore that, about 1 minute before I seize I have the coppery taste of blood in my mouth. *yum* Now, 20 years later, I have problems with hyperglycemia....looks like cfrd...
 
Top