Non Diabetic Reactive Hypoglycemia

[I'm.No.One]

Female/37/5'4/133lbs / this will be kinda long I'm sure. It's weird.

So about 3 months or so back one morning I felt odd & discovered my blood sugar had plummeted to 30.

At the time I thought it was from the extra aspirin I had taken (650mg versus my usual 325) combined with bee pollen/propolis.

However, the next morning after eating breakfast & taking no supplements at all my blood sugar, within 30mins, dropped to Lo reading, which indicates in the 20s.

Each time I had to use milk/maple syrup & or glucose tabs to bring myself back into 90s.

It took about 2 weeks for these rapid drops to stop happening in the mornings.

I went with the theory I might be extremely vit B deficient, working with hot water extracted brewer's yeast & Thorne vit B complex made the drops less severe.

Now I'll wake up with a 90-103 morning blood sugar, eat, & rapidly drop into the 70-80s. Which is better but still feels like ***t.

My average glucose level is 90, but my C peptides are through the roof. The Dr said "woah" when she saw the low glucose but C peptides high.

I've seen a Dr, done all the labs, finally have an appointment with an endocrinologist but not until October.

The Dr is basically at a loss because I don't do all the things she would have me stop doing. I don't drink, smoke, eat a standard american diet, I don't live a sedentary life.

I did come from a place of pretty bad under eating (I was only in the 90lb range all of my life) a few years back now but even then I didn't eat much man made PUFA/basically lived off of sugar/carbs, just didn't eat often enough.

All of my health gains feel like they're sliding back as my pancreas relentlessly pumps out insulin that I am absolutely still sensitive to.

Most days I'm hovering in the 80 glucose range, 90s if I really work at it.

My life is now brain fog, numb mouth/big toes, emotional with no reason behind it, simple cuts aren't healing, heart skips beats, I'm no longer sleeping well, basically all of the fun stuff that comes from chronically low blood sugar.

It also does not matter what I eat.

I have tried EVERY combo of food.

The other day I ate a piece of fu(king meat, like a small slice of asada & within 15 mins my blood sugar dropped.

Low fat didn't help.

Less carbs didn't help.

Basically anything I eat, especially in the morning, drops my blood sugar.

My pancreas tested fine, there are no signs of a tumor.

My kidneys are fine.

No autoimmune.

My liver is within mid range levels on labs.

My cortisol is fine.

Last hormone panel showed rock bottom T, sky high progesterone, fine DHEA, low end of normal estrogen. That's been a few months now, I'm sure it's changed some especially since I stopped cycling with Progest-E.

TSH is a bit elevated, not surprised. However, even the tiniest amount of thyroid, even topical, almost throws me into a thyroid storm & one drop will spin me out like a horrendous stimulate & the last time it lasted 13 hours...

My vitamin D is in the 89 range, no supplements. Just lay naked in the sun alot ha.

Beyond occasional bloating typically triggered by stress I go to the bathroom like clock work, ghost wipes, no effort 1-2 times a day. Although I did start having small burps, which sounds normal but I've never really been one to burp much.

I tried working with Danny Roddy, he's a great guy, but he takes a week+ to reply to his Patreon members & often gives one sentence replies to in-depth emails/copy-pastes link's to Pete's work.

(Which is fine but isn't worth $100 a month IMHO)

After I said my vitamin D was not just fine but amazing & I didn't respond to thyroid well, he basically just gave me Ray's email once I began asking about possible issues outside of vit D/Thyroid.

I did find a study about cypro that caused increased insulin production in non diabetics, but if that was the cause it's not resolving after months of not using it.

Effect of cyproheptadine administration on insulin secretion in acromegalic, diabetic and normal subjects. - PDF Download Free

The effect of cyproheptadine (Cypro) and Placebo administration on insulin secretion and glucose utilization following i...

docksci.com

Even before these episodes I hadn't used it much in some time & always topically.

Basically I'm at a loss at how to slow down this over production of insulin & it's genuinely beginning to impact my ability to provide for my family/self.

The only supplements I'm currently using is the vitamin B complex from thorne (always mid day/with carbs to minimize risk of blood sugar dropping) & the brewers yeast water.

I'd appreciate any insight/ideas/experience/studies/suggested labs etc.

 

[InChristAlone]

Peat said the parasympathetic cholinergic system can lower blood sugar are you eating nightshades everyday? They are cholinesterase inhibitors. Can raise acetylcholine too much lowering blood sugar. Also definitely don't use progesterone anymore. Cypro should actually help since it's anticholinergic.

 

[qminati]

I'm hypoglycemic and nothing works better than fresh squeezed oj for me, I won't go near store bought OJ. And protein tanks blood sugar when your hypoglycemic. Also stay away from too much physical activity where possible which will also tank your blood sugar.

Aspirin niacinamide combo seems to help a little. Also, don't trust blood work too much as it doesn't always tell the whole story. I was told my liver was in amazing shape which is a joke based on my history of liver abuse. Hypoglycemia comes down to liver issues as far as I know. But your situation is kinda weird since u seem healthy.

 

[I'm.No.One]

Peat said the parasympathetic cholinergic system can lower blood sugar are you eating nightshades everyday? They are cholinesterase inhibitors. Can raise acetylcholine too much lowering blood sugar. Also definitely don't use progesterone anymore. Cypro should actually help since it's anticholinergic.

Don't eat nightshades daily but also am not sensitive to them.

Haven't used progesterone in months.

About a month ago I took a single drop of cypro on my arm because of a horrendously stressful day & the next few days I actually had much lower dips/felt like extra garbage.

 

[I'm.No.One]

I'm hypoglycemic and nothing works better than fresh squeezed oj for me, I won't go near store bought OJ. And protein tanks blood sugar when your hypoglycemic. Also stay away from too much physical activity where possible which will also tank your blood sugar.

Aspirin niacinamide combo seems to help a little. Also, don't trust blood work too much as it doesn't always tell the whole story. I was told my liver was in amazing shape which is a joke based on my history of liver abuse. Hypoglycemia comes down to liver issues as far as I know. But your situation is kinda weird since u seem healthy.

Yeah I have a nice press juicer & would buy big bags of Oranges. Had to stop because it crashes me like crazy, basically while everything does cause a crash any carbs that hit fast for sure make it more immediate, like I can literally feel the symptoms of it dropping when I'm eating/drinking.

So hypoglycemia & reactive hypoglycemia are two different beasts.

Although I have no doubt the liver for sure plays a role in both reactive hypoglycemia means my pancreas is freaking out anytime I eat & over producing insulin to the point it crashes me.

I think with standard hypoglycemia it's more about the liver not effectively storing glucose right?

I have ordered some milk thistle (not worried about the potential estrogen as I won't be taking huge amounts) & will see if that helps.

Not doing physical activity is a challenge for me as my business is pretty demanding & requires me to tromp through the woods on the regular, on top of we also own a farm.

The most frustrating part, research wise, is like 99% of anything about reactive hypoglycemia is just about diabetics using too much insulin or people saying it's rare/a lifestyle disease.

I see mention of some hormone issues causing it but no actual studies I can really find.

The crazy thing is just how hard/sudden it hit after the extra dose of aspirin. That notion kinda led me down the rabbit hole of it potentially depleting me if vitamin B's+ my MTHFR mutation.

I did read about protein crashing blood sugar for some, I guess I'm just at my wits end if every food I eat crashes it.

 

[yerrag]

I'm not familiar with C peptides. So I'll admit that drew a blank with me.

The irregular heart rate, that speaks to deeper issues. It can be acid base balance issues at the least, but likely involve electrolyte mineral balance. These would not cause the blood sugar issues, but like blood sugar issues are effects of poor sugar metabolism. And there are many factors that are involved in sugar metabolism. Your sugar metabolism being a chain and that chain being as strong as the weakest link.

That said, if we simply focus on your poor blood sugar control, where we don't see stability and we see your blood sugar dropping to such low levels after a meal, it helps to get a picture of how your blood sugar fluctuates after an intake of a large bolus of glucose, rather than rely on the rather useless metric called the HbA1c, which is made for the convenience of doctors and nothing else.

What I refer to is a 5 hr oral glucose tolerance test. But since you are subject to wild swings towards hypoglycemia, this test is rather risky for you as you might faint from your reaction to a large bolus of glucose used in the test.

In your case, what may serve you well is the use of a COM (continuous glucose monitoring) device. There are a few threads on it by @ecstatichamster and by @David PS .

But based on your recounting, the large drop may be attributable to high insulin levels, but if you haven't taken insulin readings to confirm that, it could be also low glycogen stores in your liver and/or low cortisol production, or poor conversion of protein into glucose.

You said that you didn't take to meat very well, and that could could mean your body doesn't convert protein to glucose very well. That inability could be a factor why your blood sugar drops steeply. It is probable that your liver does not store enough glycogen either. Which would explain your bs dropping precipitously.

There are workarounds to help you manage your condition as you determine the true cause/s of why your blood sugar goes into hypoglycemic levels.

Finding the true cause is halfway to fixing your problem.

 

[I'm.No.One]

I'm not familiar with C peptides. So I'll admit that drew a blank with me.

C peptides are an amino acid that the pancreas creates & the primary way diabetes 1 or 2 is diagnosed. No C peptides means you're not producing insulin (type 1), high C peptides means you're pancreas is producing too much insulin.

Typically, if you had type 2 you'd have high C peptides + high blood sugar.

Basically the range is 0.5-2.0

Mine tested at 6.9 which means my body is slammed with insulin.

What is C-Peptide Used For, and What Are Its Normal Levels?

if you have a condition like diabetes, it’s important to know the proper information, the tests you should be taking, and how to monitor your condition to try and live the best life possible

conciergemdla.com

The irregular heart rate, that speaks to deeper issues. It can be acid base balance issues at the least, but likely involve electrolyte mineral balance. These would not cause the blood sugar issues, but like blood sugar issues are effects of poor sugar metabolism. And there are many factors that are involved in sugar metabolism. Your sugar metabolism being a chain and that chain being as strong as the weakest link.

The irregular heartbeat directly correlates with my low blood sugar, it's a super common symptom & I never had the issue prior to the blood sugar drops.

That said, if we simply focus on your poor blood sugar control, where we don't see stability and we see your blood sugar dropping to such low levels after a meal, it helps to get a picture of how your blood sugar fluctuates after an intake of a large bolus of glucose, rather than rely on the rather useless metric called the HbA1c, which is made for the convenience of doctors and nothing else.

What I refer to is a 5 hr oral glucose tolerance test. But since you are subject to wild swings towards hypoglycemia, this test is rather risky for you as you might faint from your reaction to a large bolus of glucose used in the test.

I talked about this with the Dr & she agreed it would be dangerous, she also said they do a different test now (I don't recall the name at the moment) but it was an overnight fast + early morning lab.

It's typically only for hypoglycemia, it didn't show anything because I don't actually have blood sugar control issues as someone would think.

I have an over production of insulin, which slams the glucose into my cells so rapidly my blood sugar drops.

I mean, yeah that's absolutely a blood sugar issue, no denying that! I just mean it's not related to lack of glucose storing ability as it is my pancreas won't stop pumping out insulin.

In your case, what may serve you well is the use of a COM (continuous glucose monitoring) device. There are a few threads on it by @ecstatichamster and by @David PS .

But based on your recounting, the large drop may be attributable to high insulin levels, but if you haven't taken insulin readings to confirm that, it could be also low glycogen stores in your liver and/or low cortisol production, or poor conversion of protein into glucose.

I absolutely have confirmed sky high insulin levels.

Cortisol levels are fine.

You said that you didn't take to meat very well, and that could could mean your body doesn't convert protein to glucose very well. That inability could be a factor why your blood sugar drops steeply. It is probable that your liver does not store enough glycogen either. Which would explain your bs dropping precipitously.

I take to meat okay, I was simply indicating something that wasn't a carb (in the traditional sense) eaten in the morning crashed me.

Basically ANYTHING I eat in the morning crashes me. So I was working my way through the pairings, one day I was like let's just eat some meat. It crashed me just the same as anything.

It was the last thing to try (just protein) & it didn't make a damn difference.

There are workarounds to help you manage your condition as you determine the true cause/s of why your blood sugar goes into hypoglycemic levels.

Finding the true cause is halfway to fixing your problem.

For sure, but finding the cause is the only way to solve the problem or learn how to adapt to it.

 

[aliml]

Glucagon-Like Peptide-1 (GLP-1) increases insulin and decreases glucagon levels, which will result in decreased blood glucose [8, 9].

GLP-1 may also be involved in some potentially detrimental pathways. In some animal studies, GLP-1 appeared to increase the stress response and anxiety [22, 21].

Bile acids are one of the factors that increase GLP-1.

What is GLP-1 & Does it Affect Weight & Cognition? - SelfHacked

Glucagon-like peptide 1 (GLP-1) lowers blood sugar and agonists are used as anti-diabetics. How does it affect wellness & can you increase it naturally?

selfhacked.com

Glucagon is a hormone that helps maintain glucose balance in the body. When glucose levels are low, the pancreas releases glucagon, which signals the liver to release glucose. When glucose is high, the pancreases stops glucagon release [1, 2, 3].

Glucagon and insulin are like the yin and yang of the pancreas – one counters and balances the effects of the other. While insulin ensures blood sugar doesn’t spike too high, glucagon ensures it doesn’t drop too low.

Glucagon release is also influenced by the nervous system, amino acids, free fatty acids, and other hormones [4].

Glucagon has some important functions in the body. For a long time, glucagon was considered insulin’s “bad” counterpart. But aside from increasing blood sugar, glucagon also acts to [5]:

• Burn fats and reduce fat stores
• Increase energy use
• Balance food intake
• Increase satiety
• Reduce the production of Bile acids

Glucagon: High & Low Levels + Normal Range - SelfHacked

Abnormal glucagon may indicate issues with the pancreas. Learn what high & low levels mean here.

selfhacked.com

Given that bloating and belching are symptoms of gallbladder disease and bile acids also cause hypoglycemia by increasing GLP-1 and decreasing glucagon, so clearing bile sludge may help increase your blood sugar!

 

[yerrag]

C peptides are an amino acid that the pancreas creates & the primary way diabetes 1 or 2 is diagnosed. No C peptides means you're not producing insulin (type 1), high C peptides means you're pancreas is producing too much insulin.

Typically, if you had type 2 you'd have high C peptides + high blood sugar.

Basically the range is 0.5-2.0

Mine tested at 6.9 which means my body is slammed with insulin.

Thanks for the info. I've never dealt with the insulin aspect so this is new to me.

I talked about this with the Dr & she agreed it would be dangerous, she also said they do a different test now (I don't recall the name at the moment) but it was an overnight fast + early morning lab.

AFAIK, they just do the funny HbA1c, which is about how they described it to you.

It's typically only for hypoglycemia, it didn't show anything because I don't actually have blood sugar control issues as someone would think.

It's a blood sugar control issue, just that doctors pretend hypoglycemia does not exist. Tell people you have diabetes, and it's ho hum. Tell them you have hypoglycemia, and you have to explain what it is.

I have an over production of insulin, which slams the glucose into my cells so rapidly my blood sugar drops.

Insulin doesn't do that as much as it regulates metabolic processes such as lipolysis, glycogenolysis, proteolysis, neoglugenesis, and most especially, the conversion of glucose into fatty acids. Potassium is more crucial to blood sugar absorption into cells.

I absolutely have confirmed sky high insulin levels.

Cortisol levels are fine.

I take to meat okay, I was simply indicating something that wasn't a carb (in the traditional sense) eaten in the morning crashed me.

Carnivores say they feel better because they cannot handle sugar well. Instead of dealing with the complexity of solving their sugar metabolism (and regulation) issues, they just skip carb intake and let their bodies convert amino acids into sugar, bypassing the sugar intake problem.

They do very well eating meat. But you don't. That is a question that deserves to be asked.

 

[InChristAlone]

If it isn't acetylcholine/nervous system related it could very well be burnout. I struggled with post meal crashes extensively and it always happens when I'm in the recovery phase of large amounts of stress. If they have ruled out an insulin producing tumor, it could be overreacting due to stress hormones. Cortisol tests are unreliable in diagnosing adrenal burnout. I didn't even take a cortisol test when I was going through it. The way I got through it the first time was to abandon Peat stuff and eat the food. I am going through it a second time, and cypro is helping me because I think for me there's a cortisol rebound that helps keep my blood sugar and blood pressure up. (Though I never would 'catch' a low I had all the adrenaline symptoms by the time I could get a reading, a CGM would be useful here).

 

[I'm.No.One]

Given that bloating and belching are symptoms of gallbladder disease and bile acids also cause hypoglycemia by increasing GLP-1 and decreasing glucagon, so clearing bile sludge may help increase your blood sugar!

I should say the belching is extremely mild & bloating is always caused by stress/rapidly resolves with breath work.

If I was low enough in bile wouldn't my digestion be horrible?

Suppose the milk thistle will be a good test to see if my gallbladder is somehow triggering my pancreas to make huge amounts of insulin after I eat.

 

[I'm.No.One]

If it isn't acetylcholine/nervous system related it could very well be burnout. I struggled with post meal crashes extensively and it always happens when I'm in the recovery phase of large amounts of stress. If they have ruled out an insulin producing tumor, it could be overreacting due to stress hormones. Cortisol tests are unreliable in diagnosing adrenal burnout. I didn't even take a cortisol test when I was going through it. The way I got through it the first time was to abandon Peat stuff and eat the food. I am going through it a second time, and cypro is helping me because I think for me there's a cortisol rebound that helps keep my blood sugar and blood pressure up. (Though I never would 'catch' a low I had all the adrenaline symptoms by the time I could get a reading, a CGM would be useful here).

It very well could be a rebound into burnout as that's what I had recovered from coming into pro-metabolic, I did have my parathyroid tested. It landed right in the middle of the scale, I know that's not an adrenal test but it being a part of the HPA axis I wonder if it's at least a side stepped insight.

Cypro & Aspirin are what genuinely helped me recover from severe burnout, like horrendously flipped cortisol.

However, cypro makes me feel like garbage now & it markedly makes my drops worse. The study I showed in my initial post is pretty interesting & also kinda fits the over production of insulin I'm experiencing.

 

[I'm.No.One]

Thanks for the info. I've never dealt with the insulin aspect so this is new to me.


AFAIK, they just do the funny HbA1c, which is about how they described it to you.


It's a blood sugar control issue, just that doctors pretend hypoglycemia does not exist. Tell people you have diabetes, and it's ho hum. Tell them you have hypoglycemia, and you have to explain what it is.

I know it is, I guess I just meant it's not a typical one where my liver isn't storing glucose so much as my pancreas won't stop pumping out insulin.

Insulin doesn't do that as much as it regulates metabolic processes such as lipolysis, glycogenolysis, proteolysis, neoglugenesis, and most especially, the conversion of glucose into fatty acids. Potassium is more crucial to blood sugar absorption into cells.

Regardless insulin absolutely prepares glucose to be pushed into our cells, so without insulin resistants like in type 2 it lowers blood sugar.

Because I'm swimming in insulin without resistance when my pancreas over reacts when I eat (anything)my blood sugar drops.

I am curious about the low Glucagon aspect, really interested to see what the milk thistle does when it arrives.

Carnivores say they feel better because they cannot handle sugar well. Instead of dealing with the complexity of solving their sugar metabolism (and regulation) issues, they just skip carb intake and let their bodies convert amino acids into sugar, bypassing the sugar intake problem.

They do very well eating meat. But you don't. That is a question that deserves to be asked.

My main point was everything I eat crashes me. So saying I don't handle eating meat well, in my particular situation, is like saying I don't handle food well because no matter if it's meat/carbs/fat/one time a glass of water, crashes me from my pancreas dumping insulin relentlessly.





What I find interesting is that while I can crash in the mid day/evening the primary & damn near reliable crash happens with my first meal.

Of course when I tell the Dr I can't get my blood sugar above 90 she thinks that's great. But it's not if it's not even rising after a meal even if it doesn't crash.

 

[aliml]

If I was low enough in bile wouldn't my digestion be horrible?

Suppose the milk thistle will be a good test to see if my gallbladder is somehow triggering my pancreas to make huge amounts of insulin after I eat.

You don't have a lack of bile, it's excess bile that causes glucagon suppression and hypoglycemia.
So anything that increases bile acids production, like milk thistle, will lower your blood sugar again!

 

[I'm.No.One]

You don't have a lack of bile, it's excess bile that causes glucagon suppression and hypoglycemia.
So anything that increases bile acids production, like milk thistle, will lower your blood sugar again!

That's interesting, how in the world does one support liver function without increasing bile considering a happy liver triggers ample bile?

 

[I'm.No.One]

Forgot to add:

They did test my amylase/lipase enzymes to rule out pancreas inflammation, that came back fine.

 

[aliml]

That's interesting, how in the world does one support liver function without increasing bile considering a happy liver triggers ample bile?

Beans and psyllium husk powder or anything with good bile acid binding capacity. You're not going to stop bile production, just increasing its excretion.

Beans are a bile magnet. Bile and beans have an incredible affinity or liking for one another. They make a sort of chemical bond that is almost impossible to break. Most of the other foods with which bile binds in the intestinal tract are foods with which the bile makes temporary bonds. But when the bean enters, the bile leaves all other foods behind and rushes to make a permanent bond with the bean.

 

[I'm.No.One]

Beans and psyllium husk powder or anything with good bile acid binding capacity. You're not going to stop bile production, just increasing its excretion.

I can do that. I also eat a somewhat regular amount of cooked oat bran, that one drops me less than other carbs.

What would be other symptoms of over producing bile if you happen to know any off the top of your head?

 

[pondering]

I did come from a place of pretty bad under eating (I was only in the 90lb range all of my life) a few years back now but even then I didn't eat much man made PUFA/basically lived off of sugar/carbs, just didn't eat often enough….

My life is now brain fog, numb mouth/big toes, emotional with no reason behind it, simple cuts aren't healing, heart skips beats, I'm no longer sleeping well, basically all of the fun stuff that comes from chronically low blood sugar.

It also does not matter what I eat.

I have tried EVERY combo of food.

The other day I ate a piece of fu(king meat, like a small slice of asada & within 15 mins my blood sugar dropped…..

Basically anything I eat, especially in the morning, drops my blood sugar….

I'd appreciate any insight/ideas/experience/studies/suggested labs etc.

I have a host of issues and one of them is reactive hypoglycemia. I’m not too good with all the technicals you are all discussing. However, I have been seeing a functional medicine doctor who’s been treating me for this (along with Hashimoto’s thyroiditis, digestive issues, peripheral neuropathy, and a host of food sensitivities). He says you get it it from eating junk, not eating enough, or not eating frequently enough. I have historically skipped meals. His recommendation has been to eat every 2 to 3 hours. And because I was initially on a low-carb diet to deal with SIBO, I actually found that I had to eat every hour practically. He's explained that if you have reactive hypoglycemia, since your body is always trying to reach balance, after you eat, your blood sugar spikes, then drops. He has also recommended some supplements to keep my blood sugar steady (taken with meals and between meals). I did find initially that eating protein or fiber first thing in the morning was challenging, as my body did not have enough blood sugar to process them. As time has passed and I’ve tried to stay mindful of eating regularly, things have improved. In my case, there’s also been a liver/gallbladder issue and my body does not seem to produce enough hydrochloric acid, which is esp important for digesting proteins.

PS. First time poster, apologize for any oddities

 

[yerrag]

@aliml brings out a good aspect of blood sugar control with regards to GLP-1 and incretins.

I'll share with you a post I made with regards to DPP4 enzymes that has to do with why blood sugar drops so quickly after a meal.

I hope it will give you a new angle to explore and help you out of your current bind:

Post in thread 'Using The Glucose Tolerance Test To Prove Fructose Intake Is Safe For Diabetics' Using The Glucose Tolerance Test To Prove Fructose Intake Is Safe For Diabetics