Reactive hypoglycemia only after breakfast

[bro123]

Does anyone get reactive hypoglycemia ONLY after breakfast? I have pots due to Lyme disease and other co infections but ever since I started taking antibiotics, I've been having reactive hypoglycemia only after my first meal. It has gone down to mid 30s which is extremely low. Does pots associated with Lyme disease go away after successful treatment? And how should I treat the reactive hypo? I want to find the underlying cause.

[MikeO]

1 hour ago, bro123 said:

Does anyone get reactive hypoglycemia ONLY after breakfast? I have pots due to Lyme disease and other co infections but ever since I started taking antibiotics, I've been having reactive hypoglycemia only after my first meal. It has gone down to mid 30s which is extremely low. Does pots associated with Lyme disease go away after successful treatment? And how should I treat the reactive hypo? I want to find the underlying cause.

Not sure what you are eating for breakfast. I am being evaluated for reactive hypoglycemia as well as postprandial syndrome not sure where this will end up but attached is a health fact i did get from my clinic. 

 

[Pistol]

@bro123 I have POTS and also suffer from hypoglycemic episodes directly related to the dysautonomia. I find that breakfast can be a cause for reactive hypoglycemia for me because most breakfast foods are high in sugar ( cereal, pancakes, syrup etc ). Even milk contains sugar! Instant breakfasts such as instant oatmeal etc are VERY high in sugar. If I eat them I will develop a sudden drop in blood sugar after about 1 hour after consumption, so I avoid high sugar foods. This is especially severe when eating a high sugar breakfast after not eating the whole night - kind of like a sugar-shock. I do much better with a light breakfast like toast and cheese or an egg, anything that is high in protein and low in sugar. 

What do you normally eat for breakfast when you experience these symptoms?

[bro123]

If I eat anything I will have the same effects. Of course when it is higher carb I will feel worse. But even if its protein and fats heavy, I still get the same effect. Even when my sugar is 100 after I eat, I feel bad, then it eventually crashes to below 70 before I eat something else. I am thinking about taking acarbose, but I want my reactive hypoglycemia to go away without the medication. I didn't know if other POTS patients were dealing with this and if so how did they treat it when dietary modifications weren't enough

[MikeO]

46 minutes ago, bro123 said:

I am thinking about taking acarbose

Had this talk about acarbose with my PCP. He does not like the drug. 

[bro123]

12 hours ago, MikeO said:

Had this talk about acarbose with my PCP. He does not like the drug. 

Why does he not like the drug?

[MikeO]

2 hours ago, bro123 said:

Why does he not like the drug?

He has seen a lot of side effects and is hard to manage.

https://medlineplus.gov/druginfo/meds/a696015.html

[MikeO]

After making a dietary change that was outlined for me the morning meal is tough to say the least. In the past i would almost alway skip this meal b/c i never feel well after eating. For now i don't have a glucose tester so i do not know what my blood sugar is after the morning meal (I will be tested Monday for reactive hypoglycemia) but i will become symptomatic after the meal.

Nutrition did stress that i need to pair a protein with a carb as well as avoiding sugars and high fat foods. What does work for me is a hard boiled egg (the protein) and a no fat low sugar yogurt (the carb) have done well this this. I have been ok with a piece of whole grain toast with a butter spread topped with a little onion and egg. I have tried other variations with the bread i.e.. a piece of toast with peanut butter or using Mayonnaise for the spread and has not been so good.

I am sure it will take some trial and error to find what works. the dietician also has me on a 6 small meal plan (knew i should be doing this but didn't) so far i have been seeing the benefits.

I will ask her at my next clinic visit in a couple of weeks as to what's up with the morning meal. 

[Sarah Tee]

If eating a low-carbohydrate breakfast still causes problems, how about skipping breakfast?

I was looking into RH a while ago (turns out I don’t have it) and some people with RH fast at the start of the day, or even longer into the day. One person has coffee with a slug of double cream.

Of course this might simply move your symptoms to whatever meal you have first, or make you wobbly, or make your POTS worse.

Just thought I’d mention it. Maybe you can try it on a day when you don’t have to go out.

P.S. I forgot to mention that I used to have my OI symptoms for about an hour after breakfast. Gradually it extended further and further into the day, until now, 18 years later, my symptoms go until about 11pm, at which point I feel normal.

I am still experimenting with skipping breakfast. I have felt better a few times when fasting, but also not. Trying to consistently replicate the benefits I noticed occasionally when fasting before blood tests.

[Macho319]

I also had experienced reactive hypoglycemia ONLY after breakfast. It comes as a result of high fasting insulin levels. The way I got it to almost completely go away is by intermittent fasting. I fast for 16 hours, then eat in an 8 hour window. Read the book The Obesity Code by Dr. Jason Fung. It will teach you so much about how the body works.