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we all have the same goal, but we each have our own story

Reactive Hypoglycemia after Gastric Bypass Surgery

Reactive hypoglycemiaSo I went to see my doctor today with my laundry list of things to talk about as usual. I always go with a list unfortunately, I think it is all part of the getting old crap and let me tell you I don’t like it – not one bit!!

One of the things I wanted to talk to him about was these Sugar Binges I have been having from time to time. Do you remember my post back at the beginning of July – I was possessed and had a Late Night Sugar Binge? Well last night it happened to me again. Here is the story; We had gotten Chinese Food for lunch and I got Garlic Beef and Shrimp along with the Fried Rice Combo. I ate part of it for lunch and saved the rest for dinner. So later at night I heated up the leftovers which now was mostly rice and some veggies and not much protein left in it. I knew I probably should not eat all that rice, but like an idiot went ahead and ate it – all of it. It was probably about 1 1/2 cups of rice left in there – rut roh that’s a lot.

Not long after I got really sleepy as I always seem to get after eating a heavy dose of carbs. But I had some stuff to do on my computer and did not want to fall into a carb coma. As I was on my computer about an hour or so later I started to not feel right. I was able to feel this wave go through me as my blood sugars dropped along with my blood pressure probably. I started to get a bit shaky, weak and drunk feeling and feel as though I needed to eat sugar ASAP. So up the stairs I went to my baking cabinet, pulled up the chair and went nuts.

Reactive Hypoglycemia 2My daughter sat there and watched as I ate Gummy Jolly Ranchers, Sweettarts, Rock Candy and then I poured some Sour Blue Sugar stuff in my mouth. It is almost as though I get into a sugar trance as I have said in my other post – it is crazy, really crazy. The picture to the right is my blue tongue after I was done binging that I texted to my friend telling her I had another sugar binge.

So why were these crazy episodes happening to me? Of course after the one last night I got online and googled my symptoms and found it matched what is called Reactive Hypoglycemia. Of course I was not going to officially diagnose myself with that until I spoke to my doctor. So today when I saw the doctor I did not tell him what my thoughts were and explained what was going on. Now this is my regular doctor not my Bariatric doctor. Well I was right, Yup I actually correctly diagnosed myself via the internet – can u believe it? lol.  Best part – what is going on with me has a name other than CrAzY.

So here are the deets….

What is Reactive Hypoglycemia?

Hypoglycemia means low blood sugar. Reactive hypoglycemia is having low blood sugar after eating a meal or snack. This may happen after eating foods that are high in sugar or simple carbohydrates. It is thought to be related to dumping syndrome.

The Gastric Bypass Connection

Reactive hypoglycemia is common after gastric bypass surgery because of the lack of a pylorus. Following gastric bypass, food passes through the pouch via the stoma. In many cases, this can occur relatively rapidly, leading to quick absorption of carbohydrates in the small intestine. Under normal circumstances, the pylorus gradually introduces food into the small intestine. Following gastric bypass, the mechanism for moderation is removed, and food is “dumped” into the small intestine. This is the same mechanism behind dumping syndrome.

You have Reactive Hypoglycemia if you have:

Any symptoms listed below a few hours after having a meal or snack and these symptoms go away after eating or drinking

What are the symptoms of Reactive Hypoglycemia?

You may feel one or more of these:

• hungry
• sweaty
• shaky
• anxious
• dizzy
• weak
• sleepy
• confused

What should you do if you think you have reactive hypoglycemia after having a meal or snack? For starters don’t panic you can fix it by bringing your sugar levels back up.  Having low blood sugar is not good for your overall health and can be life-threatening. I know scary right?

They say to pick up a Blood Sugar Meter which I am going to do to have on hand myself now that I know this is what I have.

If you think you are having a reactive hypoglycemia episode and have a meter check your blood sugar. If your blood sugar is less than 4 mmol/L, you need to treat it to bring your sugar above 4 mmol/L. Following the steps below.

When your blood sugar is less than 4 mmol/L:

1. Take 15 grams of a fast acting carbohydrate right away. This will raise your blood sugar quickly. Examples of fast acting carbohydrate include:
• Chewing 3 to 4 dextrose or glucose tablets (read the label),  Drinking ¾ cup (175 ml) of juice, Peanut Butter and Crackers or Cheese to name some that will help.
2. Wait 15 minutes and check your blood sugar again.
3. If your blood sugar is still below 4 mmol/L treat again with one of the fast acting carbohydrates listed above.
4. Repeat these steps until your blood sugar is above 4 mmol/L.

You may feel like eating sweet foods like cookies, cake and candy. Even though these foods are high in sugar and can raise your blood sugar, your blood sugar will go too high too fast which is not safe. This can then lead to another low blood sugar because too much insulin is released. This is something I have been doing and I come to find out it is a no no.So if I have another episode I will no longer raid my baking cabinet that is for sure.

How can you prevent Reactive Hypoglycemia?

You can help prevent reactive hypoglycemia by following your diet guidelines for bariatric surgery.

• eat 3 healthy meals and 2 healthy snacks each day
• space meals and snacks 2 to 3 hours apart
• eat protein at each meal and snack time
• avoid skipping meals and snacks
• avoid or limit alcohol depending on what stage of diet your are at
• avoid or limit caffeine depending on what stage of diet your are at
• avoid sweets like cookies, cakes, candy, pop, juice and sweet drinks

Instead of sugars and simple carbohydrates, eat complex carbohydrates because they release less sugar over a longer period of time. Having a complex carbohydrate with protein will slow this release even more.

So this is yet another thing I was never told about prior to having my Gastric Bypass Surgery and will have to live with this going forward. I did not have this in the beginning probably started about a year post op which they say is about when it can occur for most. But wait there is more… My doctor wants me to get an appointment with my bariatric doctor to discuss this issue and have more testing done. There is another part of this called NIPHS Noninsulinoma Pancreatogenous Hypoglycemia Syndrome. This diagnosis is more rare, but not uncommon and it effects Gastric Bypass Patients. This sometimes requires surgery to have part of your pancreas removed. I honestly do not think I have that it is the more extreme side of things if you have the drop in sugar pretty much after every meal. Like I said that is very rare and I cannot even find a good link to share with you explaining exactly what it is, so sorry about that.

I will make an appointment with my bariatric doctor and see what he has to say about it all, but again I know it is just the Reactive Hypoglycemia. I will however do the following going forward… I will never eat a meal that is only carbs which is when it happens to me in all the times I have had episodes. I will also be purchasing a Blood Sugar (Glucose) Meter and glucose tablets to keep on hand.

If you think you may be experiencing Reactive Hypoglycemia please make an appointment with your doctor to discuss. I am glad I found out what it was that has been going on with me and now I will avoid doing the things that cause it to happen and hopefully not go through that again.

Reactive Hypoglycemia 3

I also spoke to my doctor about my SAD Seasonal Affective Disorder as I explained in my last post and I will be adding some Wellbutrin to the Celexa I currently take now for my depression just for the fall/winter months to help try and avoid that depression from hitting me hard.

Then I got a cortisone shot in my right shoulder (pictured above). Normally I get them in my left one, but now my right has been acting up and in lots of pain so he did that one today. I cannot wait to wake up tomorrow without that pain – so excited. Notice the smiley on my band aid? My doctor likes me and knows how much I hate needles so he does that just for me!!

Then we added another new med to my pile for this damn bladder issue I have had for quite some time now. My bladder does not seems to empty all the way when I go (Yes TMI TMI). So I will try this new med to see if it helps and also go for some testing to see what may be going on. Not looking forward to the side effects being dry eyes and mouth, but if it helps who cares right?

Oh and he also looked at my sinuses which are always a mess and I have horrible swollen turbinates in there. I get horrible sinus headaches all the time and do sinus spray before bed cause when I wake up in the morning is when it is at its worst. Well he said one side was pretty swollen, but being I still smoke (I know I do not need the lecture) it irritates them worse – which I knew. So I will continue my Flonase, allergy meds, warm compresses and whining for now.

So as you can see I keep my doctor on the ball with all my issues huh? Yup I am a mess. As I continue to age my body is just falling apart.

But in the end at least I am skinny now right?

So that was my day today. I would love to hear from you if anyone has experience with this Reactive Hypoglycemia. If you do please comment below. Sorry this was a long post, but wanted to give u all the update.


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19 Responses to Reactive Hypoglycemia after Gastric Bypass Surgery

  1. Kirsten S. says:

    Please be aware that those hypoglycemic episodes can progress to something called hypoglycemia unawareness. I am affected by this and my Endocrinologist and I thought my sugar drops were getting to be fewer. That was not the case I was actually having more but now my sugar has to hit low 40s before I get any symptoms. I carry a glucagon pen every where because I become disoriented and extremely agitated. I had RNY just over 2 yrs ago, then had to have my pouch completely removed due to gastroparesis and now I am on a feeding tube long term and tolerate very little orally. I use a port now for IV access and home hydration. Even though my story is not typical if you have frequent hypoglycemic episodes your body begins to build a tolerance and eventually it turns into hypogycemia unawareness, which in turn means you become home bound because you can’t tell when or where it will happen. Not trying to be negative but spread awareness. Also go online and most glucose meter companies will mail you one for free! Or Walmart has one that is their brand and the test strips are super affordable. That is the costly piece of monitoring.

    • admin says:

      OMG I am so sorry to hear about your story and while it may be rare it should be shared. Would you be willing to write a guest post so that I can share your story? I would love to put it out there because we all should be aware of these things and that is one of the reasons I share my story and everything that comes with it. Let me know if you would be willing to share your story on my blog about this diagnosis. You can email me – slashes (at)

  2. Great post! I have also heard this referred to as “late dumping”. I have this also and never leave the house without a protein bar, or granola bar in my purse. Nothing worse than when it happens and you’re out!

    • admin says:

      That is true – I put a baggie with some hard candies in my purse, but I will also add in some Glucose Tabs when I get to the store and purchase some. I have not had it happen while I am out yet and would also hate for that to happen.

  3. Tami says:

    I also suffer from SAD and am NOT looking forward to the upcoming colder months here in New Englad! I have been on the Welbutrin/Celexa cocktail for quite a few years and it makes a HUGE difference! Good luck with it!

    • admin says:

      Thanks for sharing and I hope my new cocktail will help with it too. Gonna start it now so it is in my system. SAD is horrible.

  4. Kori says:

    I am positive I also have the reactive hypoglycemia. My friends didn’t believe that my blood sugar was dropping AFTER eating sweets. Luckily, a co-worker of mine had a glucose meter one day when I knew my blood sugar was low. Sure enough, it was. I would eat something else sweet to bring it back up and usually felt fine afterwards. After reading your post, I’ll use peanut butter next time!

    • admin says:

      Yeah it is crazy, but now I also know that running and gorging on sweets can be just as dangerous to me. Peanut Butter will be one of my go to snacks if that happens now as well.

  5. Rebecca Osborne says:

    My name is Rebecca and I am a 39 year old Cancer Survivor (surgically removed in January 2011 – Renal Cell Carcinoma Stage 3 Tumor Grade T3) and after that, a gastric bypass patient. My bypass surgery had occurred back in January of 2012 and since then I have lost 120 pounds (I now weigh 142). I am very happy with the results…for the most part.

    Back in May of this year as I was driving my car home from work, and began to feel funny. Very quickly following the initial onset my vision became shaky, like I was in some sort of vibrating chair, and I started to sweat…profusely. All I could think was that I needed to pull over and call my husband. Before I could get pulled over, I had lost consciousness behind the wheel of my car. Thankfully it was rush hour, and I was already driving slow. I did not hit any other vehicles, but did have a low impact collision with a sign. I did not regain consciousness until I was being worked on in the ambulance. I spent 3 days in the hospital as they feared I may have had a stroke. After the 3rd day, and the angiogram, it was determined that was not the case. I was sent home with no answers and a follow up appointment with a Neurologist. I have had a few episodes since the initial, the one preceding being the only one that I had actually lost consciousness. However, the vision disturbances remain, the shaking, profuse sweating and weakness remain as well. After these bouts I find myself very, very weak and rather confused (it happened last night and I could not figure out how to turn off the TV – which was very aggravating). I have talked to the Neurologist about this, and now find myself wearing a Holter monitor for a month. All EKG’s that have been recorded using this device have been normal.

    When I was in the hospital, and the ER when these episodes occur, I usually do not have my blood drawn for an hour or two after the episode. Everything comes back normal…but SOMETHING is VERY wrong. And I do not know what to do. I work full time, and need to get to and from work. The driving every day and not knowing when an episode will come on is very scary.

    I started researching online and found NIPHS this morning. Waiting for the doc to call me back…

    • Rebecca Osborne says:

      Well, actually the test results have not been normal. I was told today that my heart rates are reaching 150 at times. Does anyone have any feedback? I am going in to see my bariatric physician today…

    • admin says:

      OMG that sounds so scary and I would love to know what they find – please keep me updated on your condition. I pray they find you answers and that is will be a quick fix for you.

      • Darren spencer says:

        I have had fundoplication surgery 3 weeks ago and im getting reactive hypoglycemia symptoms 1-2 hours after food and i get shaky and dizzy and have to eat something sweet. My sugar levels went to 3.2 today and now i have constant anxiety

        Does this get better in time or am i mucked up because of this surgery

  6. ashly rathbone says:

    I understand what all you are going through, and I’m sorry it is not a fun experience at all. I had my RNY in Feb. 2011 and it was about a year and a half later when I first started having problems with low blood sugars. Having never had problems with my blood sugars i was very unaware what was happening when I started having the shaky, sweaty, blurry vision symptoms. Luckily I have a younger sister who had issues with low sugars during her pregnancy and so she was able to suggest that being the problem. My mom was diabetic and had meters so i borrowed one and started testing. Yep that was the culprit mine have got so low at times the Dr. have wondered how I stay conscious, most people are in a coma by the time they get that low. Luckily it will wake me if I’m sleeping because i get so sweaty that is my biggest fear is to sleep through an episode and then slip in to a coma. I was really nice to see I’m not the only one that this happens to. My bypass Dr. is over 6 hrs away and the Dr.s around here have very little knowledge of bypass so just finding out why this was happening took some time. Wish you all the best.

  7. Trish P says:

    I was very glad to read that I am not alone in experiencing these symptoms after bariatric surgery (RNY 3/2009).

    I as well have been having issues with low blood sugar after eating certain types of foods/meals. My symptoms are pretty classic – sweating, nausea, dizziness, tiredness….similar to feeling motion sick. I usually just wait them out. I start to feel better after half an hour or so after the onset of uncomfortable symptom.

    On occasion, I also get pain in my extremities…sort of like growing pains. I noticed this after eating Dr. Odeker pizza. I had it twice to make sure it actually was resulting from what I was eating and not something else. I’m wondering if anyone else has pain or if anyone has ever heard/read about pain and hypoglycemia.

    I recently had my A1c checked. It came back 5.8, which is suppose to mean I am at risk for diabetes or have “pre-diabetes” as they call it. I was rather shocked since every time I check my sugar with the meter, I get low numbers.(75 on empty stomach to 90 two hours after lunch).

    I realize now that I have to improve my diet. Reduce refined carbs. Eat more whole foods. Eat protein with each meal/snack. Simple, right? At least I can keep my super crunchy peanut butter!

  8. Danielle Alvarez says:

    Hello, I am having several issue- where do I start…. First surgery was April 24, 2013- could not stop vomiting after, tore open hernia repair, no tolerance to anything, initial surgery was supposed to be simple sleeve, well not so simple, 5 months later had to have revision RNY with second repair of tear and Endoscopy after endoscopy to try and stretch my trachea opening for liquids to flow through because closed to tight after hernia repair was not allowing liquid down, well after second surgery RNY still could not tolerate liquids- dropped 116 pounds in less than 6 months, had to be hospitalized due to blockage and kink in intestine, doc attempted to intubeate without success- well i was put on ativan because of this traumatic experience, so on top of the zoloft for anxiety and depression and all the fibro meds and lumbar disc meds and migraine meds and injections that were supposed to be taken away, I was no put on a PICC line for feeding and now out of work going on 7 months mind you I was yelled at at work by a sup and have a claim because they wrongfully suspended me but are now telling me to hurry and get back before i loose my work station, anywho, i am on this feeding line, still cant eat my thyroid starts attacking my body, I now have developed hashimotos thyroiditis more meds, scans, ultrasounds, the good stuff, well I fuinally force myself to get semi better enought to go back to work so they can stop harrassing me and all of a sudden the room starts spinning, i start shaking, sweating, cant remember a word I am saying, and feel like I am about to pass out, this happens a few more time before I finally go to my Endo doc who tells me its my blood sugars and check them, well there at 32. well now I am several things to try and keep them up and nothing ia working, now finally VICTOZA, I am hoping thia is it. I am dizzy now typing, sugars dropping as I type, they drop fast, dont go up fast like they drop, doc says if this doesnt work I will loose my pancreas and induce diabetes the whole reason I had the surgery to avoid diabetes and to loose the weight, but like you said it, AT LEAST IM SKINNY NOW!!!!!!!

  9. Kathy Nicholson says:

    I see that most comments are from past years, but my reactive hypoglycemia was just diagnosed this past year. I had GB in 2005. I feel ok in the mornings but in the afternoon between 2:00 and 3:00 I feel exhausted and all I want to do is sleep(and when I sleep it is for hours)! Also at the same time or even later my legs feel like they will give out and I feel like I can’t go another step. My doctors have no answers. I feel this is all related to gastric bypass and want to know how to work with it. Especially my legs. I joined the YMCA to get more strength but cannot go in the afternoon (too exhausted). I want my energetic life back!! Any help or information would be appreciated!! Is this all diet related?? Thanks so much.

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