Hypoglycemia While Running

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GmC

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Do you know what blood glucose level you're at when this occurs?

I my glucometer read 71 mg/dl

How did your endocrinologist make that diagnosis? What tests did he run? Can you provide the values? I'm hoping you have a copy of each test result.

Attached there is an image of my results. They are in Portuguese. If you need translation ask me and i will help you.


So eating white rice won't make you hypoglycemic? Since it doesn't contain gluten.

White rice is one of the strongest foods without gluten that cause me reactive hypoglicemia.

Not sure why that is if you have hypoglycemia. In my case before, I would get hungry or sleepy 3 hours after each meal where my carb is white rice. Eating brown rice helped.

I always have hungry 3 hours after any meal, with our without eating white rice.

Have you tried taking blood sugar values over 5 hours, every hour after say, lunch? A time vs blood glucose curve gives a better snapshot of your blood glucose regulation.

My values today were:

Fasting, and before breakfast ( 08:30 ): 88mg/dl
2 hours after lunch( 15:23 ): 110mg/dl
2 hours after snack ( 18:25 ) : 111mg/dl
2 hours after dinner ( 21:58 ) : 110mg/dl

Hope it answer your questions.

G.C.
 

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yerrag

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Cortisol has effects on insulin and then when you eat a meal or take something that finally lowers the cortisol you can get a reactive episode.
Cortisol effects on insulin are miniscule compared to blood sugar's effects on insulin. When blood sugar is high, there is insulin reaction. Insulin is secreted by the pancreas. Does cortisol have that same effect?
can bring this on over and over and over just by eating too little calories. I will get reactive after breakfast. Sometimes after dinner too depending on how long I waited to eat.
By reactive I assume you refer to an insulin reaction. There seems to be one, but it's not due to cortisol, it's due to having high blood sugar after a meal. Your body tissues are not absorbing blood sugar well enough, and the sudden rush of glucose into your blood accumulates and leads to high blood sugar. This is what elicits a strong insulin reaction. This instructs the liver to convert the blood sugar to either glycogen or to fat, quickly lowering your blood sugar. When blood sugar gets very low, you feel 'reactive.' How you feel at this point varies - Hungry, irritable, sleepy, runny nose, cough, hiccup. Sugar replenishment will make you feel better. In this kind of condition before, I change to eating brown rice instead of white, and the sudden rush of sugar after a meal becomes a more manageable steady drip thst lasts longer and doesn't let blood sugar go way high to elicit an insulin reaction. A stop-gap measure.
I don't have the studies handy to show you the insulin stuff at the moment.
That's good. A lot of these studies have to be vetted. A lot of mumbo jumbo especially when it comes to blood sugar. Many conflate causes and effects. And then they dive deep into cortisol territory and end up in a quagmire.
 

InChristAlone

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Cortisol effects on insulin are miniscule compared to blood sugar's effects on insulin. When blood sugar is high, there is insulin reaction. Insulin is secreted by the pancreas. Does cortisol have that same effect?
By reactive I assume you refer to an insulin reaction. There seems to be one, but it's not due to cortisol, it's due to having high blood sugar after a meal. Your body tissues are not absorbing blood sugar well enough, and the sudden rush of glucose into your blood accumulates and leads to high blood sugar. This is what elicits a strong insulin reaction. This instructs the liver to convert the blood sugar to either glycogen or to fat, quickly lowering your blood sugar. When blood sugar gets very low, you feel 'reactive.' How you feel at this point varies - Hungry, irritable, sleepy, runny nose, cough, hiccup. Sugar replenishment will make you feel better. In this kind of condition before, I change to eating brown rice instead of white, and the sudden rush of sugar after a meal becomes a more manageable steady drip thst lasts longer and doesn't let blood sugar go way high to elicit an insulin reaction. A stop-gap measure.
That's good. A lot of these studies have to be vetted. A lot of mumbo jumbo especially when it comes to blood sugar. Many conflate causes and effects. And then they dive deep into cortisol territory and end up in a quagmire.
What is causing the cells not to absorb sugar then? Especially when I can reproduce this after meal effect by not eating enough the day before. My insulin sensitivity is GREAT otherwise. So we are not understanding each other. That's okay. Maybe cortisol isn't the direct hormone responsible but it seems to happen mostly in the morning for me at least, the cortisol is highest in the morning hrs. So maybe it's not directly involved but like I said on days where I wake up early and can't get back to sleep (instead of being able to sleep in like a teenager) and need food stat this is one of the biggest signs for me that there will be drop after breakfast.
 

yerrag

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I my glucometer read 71 mg/dl
This doesn't seem that low to me. Maybe you're more sensitive. But there's the chance it's not a blood sugar issue as much as it's your lack of oxygen getting into your tissues. Or both.

Have you or your doctor considered this possibility?

White rice is one of the strongest foods without gluten that cause me reactive hypoglicemia.
Okay good. At least we know it's not a problem confined to gluten. It also happens with carbs that don't contain gluten.
I always have hungry 3 hours after any meal, with our without eating white rice.
Being hungry 3 hours after a meal - that used to happen to me. That is already a sign of hypoglycemia. But people would tell you that's natural. That you're a grazer. That you are the type that needs to eat more but smaller meals during the day. A lot of myths.

My doctor didn't know how to diagnose me. I had him give me a 5hr OGTT (oral glucose tolerance test). Results came out. He pronounced me normal. I made my own analysis by examining a plotting a curve of time vs. blood glucose. I compared to a book on hypoglycemia. My curve matches that of a hypoglycemic.

Most conventional doctors, and even many naturopaths will still get this wrong.
My values today were:

Fasting, and before breakfast ( 08:30 ): 88mg/dl
2 hours after lunch( 15:23 ): 110mg/dl
2 hours after snack ( 18:25 ) : 111mg/dl
2 hours after dinner ( 21:58 ) : 110mg/dl

It doesn't seem like you're hypoglycemic from these values. 88 mg/dl, your fasting blood glucose, is excellent. This is optimal actually.

Your 2hr results appears on the high side. Considered normal, but not optimal.

But an OGTT would give a better idea of your blood sugar regulation.

You don't even need to do an official OGTT. You can do one that's close enough to giving you one, since you have a blood glucose meter.

0 point - before lunch
1 point - 1 hour after you finish lunch.
2 point - 2 hr
3 point - 3 hr
4 point - 4 hr
5 point - 5 hr.

Don't eat nor drink. Have someone with you. If you feel like fainting, eat some carbs. But this stops the test.

The only difference with an OGTT - You take 70g of glucose or maltose instead of your meal.

Until we see your results and graph them. you couldn't really call yourself hypoglycemic.
Attached there is an image of my results. They are in Portuguese. If you need translation ask me and i will help you.
Sorry. The scan is too small. Please send a larger image. When you attach, don't choose the thumbnail.

p.s. Many OGTTs nowadays are 3 hr tests only. Shortened and butchered actually. Done because testing companies are afraid of a lawsuit when subject faints. You've got only American lawyers to blame for this.
 

yerrag

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In summary, not sure if you're really hypoglycemic. It can be something else.

But 71 running at just the half hour point and 88 fasting seems to indicate you're using up a lot of sugar. Perhaps your metabolism is not optimal. You get tired and probably sore too points to lactic acid buildup. I suspect hypoxia from poor tissue oxygenation. The cause of hypoxia could be low serum CO2 or could be hypoxemia. Hypoxemia could be from mercury toxicity.

Not sure if this can lead to some answers, but do you have an oximeter to get spO2 readings?
 

yerrag

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No need to be aggressive. I know the world is in chaos but we don't need to be. Cortisol has effects on insulin and then when you eat a meal or take something that finally lowers the cortisol you can get a reactive episode. I can bring this on over and over and over just by eating too little calories. I will get reactive after breakfast. Sometimes after dinner too depending on how long I waited to eat. I don't have the studies handy to show you the insulin stuff at the moment.

Sorry I missed replying to this. RRRROOOAAARRR!! My blood sugar was at 10.

Cortisol effects on insulin are miniscule compared to blood sugar's effects on insulin. When blood sugar is high, there is insulin reaction. Insulin is secreted by the pancreas. Does cortisol have that same effect?
By reactive I assume you refer to an insulin reaction. There seems to be one, but it's not due to cortisol, it's due to having high blood sugar after a meal. Your body tissues are not absorbing blood sugar well enough, and the sudden rush of glucose into your blood accumulates and leads to high blood sugar. This is what elicits a strong insulin reaction. This instructs the liver to convert the blood sugar to either glycogen or to fat, quickly lowering your blood sugar. When blood sugar gets very low, you feel 'reactive.' How you feel at this point varies - Hungry, irritable, sleepy, runny nose, cough, hiccup. Sugar replenishment will make you feel better. In this kind of condition before, I change to eating brown rice instead of white, and the sudden rush of sugar after a meal becomes a more manageable steady drip thst lasts longer and doesn't let blood sugar go way high to elicit an insulin reaction. A stop-gap measure.
That's good. A lot of these studies have to be vetted. A lot of mumbo jumbo especially when it comes to blood sugar. Many conflate causes and effects. And then they dive deep into cortisol territory and end up in a quagmire.

What is causing the cells not to absorb sugar then? Especially when I can reproduce this after meal effect by not eating enough the day before. My insulin sensitivity is GREAT otherwise. So we are not understanding each other. That's okay. Maybe cortisol isn't the direct hormone responsible but it seems to happen mostly in the morning for me at least, the cortisol is highest in the morning hrs. So maybe it's not directly involved but like I said on days where I wake up early and can't get back to sleep (instead of being able to sleep in like a teenager) and need food stat this is one of the biggest signs for me that there will be drop after breakfast.

Not absorbing sugar - could be you still have lotsa fatty acids in your system and you're burning fats and not sugar (that explains why you have adapted to eating plenty fats as well as carbs). Could be low potassium stores. Even with low potassium, accompanying potassium with a meal still helps. Having no meat, for example, in a meal of carbs and fats, would leave you with little potassium to help tissues absorb sugar - as meat contains plenty of potassium. Stopping PUFAs for 4 years plus enabled me to do well with white rice, as previously I had to eat brown rice to cope with my hypoglycemic state (I explained why brown rice earlier).

But you can still have high blood sugar and still feel hungry though, and it's because your insulin could be low. When insulin is low, it doesn't trigger many things. It doesn't tell the liver to stop converting glycogen to glucose. It doesn't inhibit lipolysis, so you end up with plenty of fatty acids in your blood needing to be metabolized, in the process blocking the absorption of glucose. I'm in this condition now, which I observed happening to me. A longer story is needed to explain how this happened, but it is has to do with bacteria and its enzymes that inhibit insulin secretion.
 

InChristAlone

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Sorry I missed replying to this. RRRROOOAAARRR!! My blood sugar was at 10.





Not absorbing sugar - could be you still have lotsa fatty acids in your system and you're burning fats and not sugar (that explains why you have adapted to eating plenty fats as well as carbs). Could be low potassium stores. Even with low potassium, accompanying potassium with a meal still helps. Having no meat, for example, in a meal of carbs and fats, would leave you with little potassium to help tissues absorb sugar - as meat contains plenty of potassium. Stopping PUFAs for 4 years plus enabled me to do well with white rice, as previously I had to eat brown rice to cope with my hypoglycemic state (I explained why brown rice earlier).

But you can still have high blood sugar and still feel hungry though, and it's because your insulin could be low. When insulin is low, it doesn't trigger many things. It doesn't tell the liver to stop converting glycogen to glucose. It doesn't inhibit lipolysis, so you end up with plenty of fatty acids in your blood needing to be metabolized, in the process blocking the absorption of glucose. I'm in this condition now, which I observed happening to me. A longer story is needed to explain how this happened, but it is has to do with bacteria and its enzymes that inhibit insulin secretion.
Yes it very well could be free fatty acids as a result of lack of glycogen? I'm not sure but I am able to get through the night eating more fats than a lot of healthy eaters do. When I was on a very high carb diet and very lean I would wake up every 2 hours needing sugar. That's with plenty of potassium as I was drinking milk and OJ. And that's also when the post breakfast adrenaline was the worst. I generally cured this but it recently came back after several months doing coffee again. And now I'm working against it again even off the caffeine. It feels a little like starting over. So that's why I said it feels stress related. Not sure how blood sugar dysregulation isn't stress related. Again my blood glucose is normal. 88 fasting, rises to maybe 110 and goes back down again.
 

yerrag

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Not sure how blood sugar dysregulation isn't stress related.
It is stress-related. Saying that doesn't make the distinction what is cause and what is effect.

You'll notice journals and articles that hem and haw like to use this term, just for the sake of appearing they know something yet leave you hanging high and dry, and wasting your time reading their peer-reviewed circumlocution.

On blood sugar and why seeing doctors can't help, here's one article I highly recommend. @Wilfrid shared this originally. This article will clear out the junk you've accumulated on sugar. It cleared mine.
 

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InChristAlone

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It is stress-related. Saying that doesn't make the distinction what is cause and what is effect.

You'll notice journals and articles that hem and haw like to use this term, just for the sake of appearing they know something yet leave you hanging high and dry, and wasting your time reading their peer-reviewed circumlocution.

On blood sugar and why seeing doctors can't help, here's one article I highly recommend. @Wilfrid shared this originally. This article will clear out the junk you've accumulated on sugar. It cleared mine.
Thank-you I will read it tomorrow. Yes I probably have accumulated some falsehoods surrounding insulin. But they made sense as to what I was going through. But now that I think of it... The adrenaline IS worse if something is bothering my gut, so maybe I am putting more of the puzzle pieces together.
 

yerrag

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Thank-you I will read it tomorrow. Yes I probably have accumulated some falsehoods surrounding insulin. But they made sense as to what I was going through. But now that I think of it... The adrenaline IS worse if something is bothering my gut, so maybe I am putting more of the puzzle pieces together.
The article is well-written, the kind we don't usually see. I've read it many times over. Each time there's some gem that I missed the last time around. This happens when it's packed with golden nuggets.
 

GreekDemiGod

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@GmC You are insulin resistant. @yerrag is right. I know if tough to swallow, but it is how it is.
Do an OGTT with both glucose and insulin measurements taken at 1hr and 2hr mark. That will tell the whole picture.
You can pass an OGTT on glucose. But if you can fail it on insulin and that's a problem.
Type 2 diabetes can be detected years in advance by doing this test.
 
OP
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GmC

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This doesn't seem that low to me. Maybe you're more sensitive. But there's the chance it's not a blood sugar issue as much as it's your lack of oxygen getting into your tissues. Or both.

Have you or your doctor considered this possibility?


Okay good. At least we know it's not a problem confined to gluten. It also happens with carbs that don't contain gluten.

Being hungry 3 hours after a meal - that used to happen to me. That is already a sign of hypoglycemia. But people would tell you that's natural. That you're a grazer. That you are the type that needs to eat more but smaller meals during the day. A lot of myths.

My doctor didn't know how to diagnose me. I had him give me a 5hr OGTT (oral glucose tolerance test). Results came out. He pronounced me normal. I made my own analysis by examining a plotting a curve of time vs. blood glucose. I compared to a book on hypoglycemia. My curve matches that of a hypoglycemic.

Most conventional doctors, and even many naturopaths will still get this wrong.


It doesn't seem like you're hypoglycemic from these values. 88 mg/dl, your fasting blood glucose, is excellent. This is optimal actually.

Your 2hr results appears on the high side. Considered normal, but not optimal.

But an OGTT would give a better idea of your blood sugar regulation.

You don't even need to do an official OGTT. You can do one that's close enough to giving you one, since you have a blood glucose meter.

0 point - before lunch
1 point - 1 hour after you finish lunch.
2 point - 2 hr
3 point - 3 hr
4 point - 4 hr
5 point - 5 hr.

Don't eat nor drink. Have someone with you. If you feel like fainting, eat some carbs. But this stops the test.

The only difference with an OGTT - You take 70g of glucose or maltose instead of your meal.

Until we see your results and graph them. you couldn't really call yourself hypoglycemic.

Sorry. The scan is too small. Please send a larger image. When you attach, don't choose the thumbnail.

p.s. Many OGTTs nowadays are 3 hr tests only. Shortened and butchered actually. Done because testing companies are afraid of a lawsuit when subject faints. You've got only American lawyers to blame for this.


Good evening everyone.

Thank you so much for all the inputs.

As recommended, i took 8 samples of blood to analyze my blood glucose ( with glucometer ) during the next 5 hours after lunch.
My lunch was, one table spoon of mashed potatoes, one table spoon of spaghetti, 1 tomato, 200 g of cooked spinach with chicken.

For a better " picture ", the last 2 readings were taken, during my running session. The first one was taken 30 minutes after starting my exercise, and the last one 1 hour after the exercise.
After lunch i didn´t eat or drink.

1st sample ( 13:20, before lunch ) - 98 mg/dl
2nd sample ( 14:20 , 1 hour after lunch ) - 93 mg/dl
3rd sample ( 15:45 , +/- 2 hours after lunch ) - 104 mg/dl
4th sample ( 16:33 , +/- 3 hours after lunch ) - 87 mg/dl
5th sample ( 17:32 , +/- 4 hours after lunch ) - 107 mg/dl
6th sample ( 18:06 , +/- 5 hours after lunch ) - 97 mg /dl

7th sample ( After 30 minutes of Running ) - 93 mg/dl
8th sample ( 1 hour after exercise ) - 86 mg/dl

Once again thank you so much for all your knowledge and inputs.

G.C.
 
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yerrag

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That was fast!

First, this tells you that you're not hypoglycemic, whether at rest or whether you were running. Do you agree?

Had you taken a short version of an OGTT, you wouldn't have gotten the whole picture.

Had your 4th hour and 5th hour showed values of around the high 70s to the mid 80s, you would be considered to have good blood sugar regulation.

Had they dipped below 70, whether or not they stabilize (say at 65), you're hypoglycemic.

But past the 1st hour, your blood sugar went up; past the 3rd hour, your blood sugar went up and even higher. Glycogen is being converted to glucose when this happens at a rate much higher than the rate sugar is being used up for metabolism. So there is a rise in blood sugar, instead of staying steady or going down.

Possibilities:

1. Insulin resistance as @GreekDemiGod says. Means it takes more insulin to inhibit glycogenolysis (as well as lipolysis, proteolysis, etc. - read the article if you havent't)
2. low glucose metabolism -
  • presence of large amount of fatty acids in the blood and running on fatty acid metabolism?
  • inefficient glucose metabolism?
    • low oxygen supply from hypoxia
      • low serum CO2
      • hypoxemia
    • hypothyroid - check heart rate, temperature, verify with Achilles tendon reflex or ECG QTc value, or a full thyroid panel that includes rT3
    • deficiencies
      • cytochrome c oxidase - exposure to sun light will help to increase (or red light); high estrogen will lower eat
      • b1 or thiamine -
      • b3 or niacinamide
What you ate is very low carb though. Any reason why? Is it because I said the real OGTT test used 70g of glucose/maltose? Or is that a typical meal you take?

But your values explain why you feel okay when you're not running.

But when running, even with blood sugar that's fine, and you're getting exhausted, I suspect inefficient glucose metabolism. You're probably running on either low oxygen supply (hypoxemia) or low tissue oxygenation (hypoxia).

To verify hypoxemia, we need to get some spO2 readings. Can you get hold of a pulse oximeter? A Samsung Galaxy S6 and higher models, with the Samsung Health app, can do this.

To verify hypoxia, get a urine pH test strip with range 5.5 - 8. I've used the Hydrion brand from Amazon US.
 

jet9

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Good evening everyone.

Thank you so much for all the inputs.

As recommended, i took 8 samples of blood to analyze my blood glucose ( with glucometer ) during the next 5 hours after lunch.
My lunch was, one table spoon of mashed potatoes, one table spoon of spaghetti, 1 tomato, 200 g of cooked spinach with chicken.

For a better " picture ", the last 2 readings were taken, during my running session. The first one was taken 30 minutes after starting my exercise, and the last one 1 hour after the exercise.
After lunch i didn´t eat or drink.

1st sample ( 13:20, before lunch ) - 98 mg/dl
2nd sample ( 14:20 , 1 hour after lunch ) - 93 mg/dl
3rd sample ( 15:45 , +/- 2 hours after lunch ) - 104 mg/dl
4th sample ( 16:33 , +/- 3 hours after lunch ) - 87 mg/dl
5th sample ( 17:32 , +/- 4 hours after lunch ) - 107 mg/dl
6th sample ( 18:06 , +/- 5 hours after lunch ) - 97 mg /dl

7th sample ( After 30 minutes of Running ) - 93 mg/dl
8th sample ( 1 hour after exercise ) - 86 mg/dl

Once again thank you so much for all your knowledge and inputs.

G.C.
wow, you have similar issues to me:
-rice gives me hypoglecimia
-carrots give me headache / make me irritable
-too much sugar (fruits) and then exercise = blood sugar crash

i learnt that i have to be careful with what i eat and when.

Here is the regiment that works best for me and keeps me productive:
7:30am exercise
8am breakfast: meat or fish/shellfish or chicken + cooked veggies + 1 piece of fruit (sometimes i skip the fruit)
1pm lunch: meat or fish/shellfish or chicken + cooked veggies + 1 piece of fruit (sometimes i skip the fruit)
6pm dinner: meat or fish/shellfish or chicken + cooked veggies + sweet potato or regular potato

As you can see:
-i exercise fasted, fasted exercise greatly diminishes frequency of hypoglecimia for me, there are lots of studies to back this up (google fasted exercise and insulin sensitivity)
-i eat starch only for dinner, it helps me sleep, gives more energy for morning exercise and does not crash me. If i eat starch for breakfast or lunch i crash
-i don't eat artificial sugar no drink commercial juices, and only eat 1-2 pieces of fruit a day
-there is about 14 hours fasting period from dinner to breakfast, it's very important
-i eat !!!no grains!!!, no artificial sugar, no dairy, no legumes, no nuts, etc
-i eat relatively balanced diet without going into extreme (let's do only fruits and meat, or let's eat 0 carb/keto, or no starch, or let's eat 1 meal a day, i tried it all - balance is the key)
-daily sunshine helps a lot too, especially in the morning (circadian rhythm)
-it's important to have solid breakfast and lunch (circadian rhythm)

Lots of this things are anti peat, but that what works for me.
 
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berk

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i think (correct me if i wrong) hypoglycemia is very normal with atletes because they are very very insulin sensitive.
How more insulin sensitive you got, how easy'r it is for your body using sugar for energy, how easy'er its get to have a hypo.
i know bodybuilders they have a very strong insulin sensitive that they got hypo's all the time if they dont eat ever 1 or 2 hours.
This is a good/healthy thing, but you weren't prepared for it and was eating to less carbs.
Probably your sensitivity is increased recently, and you are burning more carbs in shorter time.
So the answer to your problem is that you need more carbs.
 

Mthrash

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@GmC. Any update or discoveries? I have the exact same experience and have for years. I simply don‘t eat anything sweet within a couple of hours of my run. If I do, it’ll hit me at about the 25 min mark. I’ll feel totally lethargic! I usually run through it but sometimes walk for a few mins. Once I start back up and it passes, I feel terrific for the back half.
 

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