Reactive Hypoglycemia Diet: What do I eat?

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A reactive hypoglycemia diet is not a diabetic or hypoglycemic diet. A tailored diet, specific for the blood sugar highs and lows is necessary for a Reactive Hypoglycemia Diet. Often, diabetic cookbooks will recommend a larger meal at lunchtime, a skimpy meal at dinner, and no evening snack. This is blood sugar doom for reactive hypoglycemics; A diet like this will not alleviate your symptoms.

Reactive Hypoglycemia Diet: Contents.

What should be in a reactive hypoglycemic diet?
What should I do if my blood sugar drops?
Top 10 Foods to Avoid on a Reactive Hypoglycemia Diet.
Breakfast tips for a Reactive Hypoglycemia Diet.
A typical day of a reactive hypoglycemia diet.
Another day of a reactive hypoglycemia diet.
And yet Another day of a reactive hypoglycemia diet!
Notes on Saturated Fats and The Atkin’s diet.
The Truth About Cinnamon in the Reactive Hypoglycemia Diet.
The lowdown on diets: DASH diet, Mayo Clinic Diet, Paleo Diet, Southbeach Diet, Atkin’s diet.

What should be in a Reactive Hypoglycemia Diet?

Some characteristics of a hypoglycemic diet are also applicable to a reactive hypoglycemic diet: a high-fiber, restricted-simple sugar diet full of fruits and vegetables is a must. In other words, skip the Big Mac and have a Southwestern Salad instead. Load on all the veggies at Subway, choose the wholewheat bread and skip the chips and soda (yes, even the baked chips).

Do not restrict carbs from your reactive hypoglycemia diet. Your body needs carbs to regulate blood sugar. You may see some sites recommend things like “55% of energy as carbohydrate” in a diet or “try a low carb, high protein diet” or “less than x grams of simple carbohydrate daily.” That’s easy for a dietician to plan, but who really has time to plan meals like that? Additionally, do you follow the high carb, or the low GI diet? As well as being confusing, in the meantime, your blood sugar is up and down like a yoyo, and who feels like cooking then? The simple answer is to follow a few easy steps, and gradually make changes in your diet.

Swap white bread and noodles for whole grains.

Complex carbohydrates like whole grain crackers, bagels, and cereal deliver glucose over a longer period of time, resulting in a slower sugar response. Choose cereals carefully. Shop in a health food store if you can, as you are more likely to find “hidden” ingredients in cereal like High Fructose Corn Syrup or Sugar. Did you know that the first ingredient in Apple Jacks is sugar? I only found that out after my son, Leo, consumed a large bowl and hours later was in a bad mood thanks to a blood sugar drop. I look for low-carb, no sugar cereals like Kamut Flakes or Kashi Whole Grain Puffs. Ezekiel 4:9 bread is Low GI, and full of protein. We use that instead of regular bread, but you can try another (no sugar) whole grain product.

Drink water or non-caffeinated tea instead of soda

Buy spritzer water or lime-flavored sparkling water. Avoid anything with sweeteners: Even artificial sweeteners. You may be able to tolerate caffeine on a reactive hypoglycemia diet. I learned to restrict coffee to one, very small cup in the morning. any more precipitates a blood sugar crash.

Eat every two hours

Only you can determine how often you need to eat on a reactive hypoglycemia diet. That’s why it’s a good idea to check your blood sugar using a home blood glucose monitoring device: see How to Get Diagnosed for Reactive Hypoglycemia for more info). The two hour rule works for most people to avoid a crash on a reactive hypoglycemia diet. That equates for me to eight meals a day, starting at 8 a.m. and finishing at 10 p.m. Instead of a breakfast of cereal and toast, I eat the cereal at 8 and the toast at 10. I do the same for lunch, and divide what I would normally eat into two meals (i.e. a sandwich and fruit).

Read Your Labels

I shop at a local health food store, because I became so frustrated at buying products at local grocery stores. Food manufacturers sneak sugar and High Fructose Corn Syrup into everything! For example, I bought home two jars of Planter’s Dry Roasted Peanuts. I was dismayed to find out later on that they put sugar on them as a coating. Even small amounts of sugar spike my blood sugar and cause a crash so I absolutely have to avoid it if I am to maintain and even blood sugar level! I had a similar problem buying yogurt, bread, and just about every product you can think of. Organic products, and vegan products (i.e. soy yoghurt instead of regular) tend to be sweetened with evaporated cane syrup. Evaporated can syrup does not cause blood sugar spikes like sugar and high fructose corn syrup.

Learn to Love Fruit and Veggies

reactive hypoglycemia diet

Top: Low-fat cottage cheese, bing cherries, raspberries, black berries, sliced apricot, mint leaf and sweetpea flower. Bottom: Mr Crabby! Thinly sliced cucumbers, red bell pepper strips and rounds, lime slices and dolmas

A reactive hypoglycemia diet took some getting used to, but we purged our cupboards of snack foods except for whole grain crackers, vegan cream cheese, and fruits/veggies. We eat stir frys, soups, salads, vegan chili, and other dishes bursting with vegetables. A diet rich in fruits and vegetables is a must for a Reactive Hypoglycemia Diet.

Drink and Eat Before You Exercise

Exercise lowers your blood sugar, which is great for diabetics, but not so great for the reactive hypoglycemic. I have to drink fruit juice and eat half an energy bar before I exercise, and fruit juice plus the other half of the bar afterward. Otherwise I cannot exercise without feeling sick.

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What do I do if my Blood Sugar Drops if I’m on a reactive hypoglycemia diet?

When blood glucose drops, high carb foods can bring it back up to normal; At the first sign of low blood sugar (shakes, sweaty hands, churning stomach or another symptom which may be specific to you), you must eat a a meal or a snack. Diabetics will often consume sugar, candy, or soda to raise blood sugar quickly. This is a bad idea for reactive hypoglycemics, and is unnecessary. If you learn to eat at the first sign of symptoms, you will ward off a hypoglycemic attack. In an emergency, choose glucose tablets (available in the diabetic section of your local pharmacy) followed by nuts or a wholegrain bagel, or fruit juice over candy or cola, which will quickly spike your blood sugar and encourage it to fall rapidly.

Carry a Snack Everywhere You Go

Packs of nuts, a piece of fruit, a healthy drink (i.e. s small carton of apple juice). Carry something so that at the first sign of something amiss…you can eat.

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Breakfast Tips

If you have reactive hypoglycemia, many studies have shown that you’re more likely to have hypoglycemic episodes in the morning. This may be because your body has been starved overnight — depleted of glucose levels. A breakfast that’s a typical modern-day breakfast (orange juice, coffee and toast or cereal), can spike your blood sugar levels and lead to a mid-morning crash. The problem can become even worse if you wait until later in the morning or lunchtime to eat.

Eating a nutritious breakfast that’s high in protein (like scrambled eggs with cheese) can help to restore your blood sugar levels effectively, without the risk of a mid-morning crash. Proteins are especially important for reactive hypoglycemia, because they are absorbed more slowly into the body than carbohydrates. They can therefore help your glucose levels stay more stable than say, orange juice, which will give you an immediate spike immediately after drinking it but it doesn’t maintain levels in the same way protein does.

Breakfast Suggestions

  • Eat a protein source along with a fat source to stabilize your blood sugar. As well as eggs and cheese, you could also opt for scrambled eggs and buttered whole wheat toast, nuts, a vegetable and cheese omelet, a high-bran cereal with milk, or a protein-rich shake made with whole or 2 percent milk.
  • Avoid sugar at breakfast. This includes fruits high in natural sugars like orange juice, pineapple juice or apple juice. Sugars increase the insulin response in the body and will almost certainly make your hypoglycemia worse.
  • Eat a source of fibersuch as whole wheat toast, beans, nuts or bran cereal. Fiber is slow to digest and helps to slow digestion of other foods. Slow digestion will help keep your blood sugar stable.
  • Avoid caffeine. Stick to decaf coffee or tea in the mornings. Excessive caffeine intake can make your blood sugar symptoms worse
  • Eat a nutritious snack mid-morning, with a high protein content such as a low-sugar health food bar or cheese and berries (berries are high in fiber).

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Top 10 Foods to Avoid on a Reactive Hypoglycemia Diet

If you are reactive hypoglycemic, chances are it will take you some time to tweak your diet and figure out which foods cause your blood sugar to go haywire. Some people, for example, can use the sweetener Stevia, while others are sensitive to it and experience a drop in blood sugar. Start with making the changes recommended above. To aid you with making changes in your diet, I have compiled a list of “musts” that reactive hypoglycemics should avoid.

A general list of foods to avoid on a Reactive Hypoglycemia Diet

  1. white bread, bagels, pizza, burger buns, or other “white” bread products: substitute whole grain products instead
  2. white spaghetti noodles: substitute whole grain products
  3. most breakfast cereals: substitute no-sugar whole grain varieties, or oatmeal2775018154_2a5395a26d_m
  4. anything that has “sugar” or “high fructose corn syrup” as an ingredient
  5. caffeinated beverages
  6. pastries, muffins, cakes, and other “treats”: check health food stores for treats that are low GI and/or whole grain
  7. restaurant meals: unless you are 100% certain that sugar is not one of the ingredients. This is such a problem that we rarely eat at restaurants any more!
  8. white potatoes, including baked potatoes and fries: except in small amounts, in a soup for example: substitute a small portion of sweet potato fries
  9. high fat meats: substitute low-calorie, nutrient dense products like Quorn, vegan burger crumbles, tofu, bean burgers, or other meat subtitutes
  10. potato and tortilla chips: substitute baked, whole grain tortilla chips (available at most grocery stores in the health food section)

A typical day of a reactive hypoglycemia diet

Daniel, over at the Yahoo Group for Reactive Hypoglycemia, sent me an email last week, asking me to post a sample menu for a reactive hypoglycemia diet.

“Since you seem to be so good at keeping Leo’s and your hypoglycemia at bay, I was wondering if you could post about few typical menus that would prevent reactive hypoglycemia episodes in predisposed people.”

Absolutely! It’s currently 10:20 a.m. and I have finished my Arrowhead Mills Kamut Flakes with Soy Milk. Kamut Flakes are one of the few cereals I can tolerate on a reactive hypoglycemia diet; It’s whole grain, high fiber, and sweetened with fruit juice instead of sugar.

Kamut Flakes

Here’s what I ate yesterday (Leo had a sleepover at a friend’s house, so I’m not sure what he ate :) ).

  • 8 a.m. 1 cup decaffeinated coffee with 2T Silk Vanilla creamer. 1 slice of Ezekiel 4:9 sprouted grain toast with 1T peanut butter.
  • 10 a.m. 1 cup Arrowhead Mills Kamut Flakes with 1 cup (unsweetened) soy milk.
  • 12 noon. 1 cup Amy’s Organic Lentil Vegetable Soup, 1/2 sandwich: whole grain bread, vegenaise, lettuce, tomato, tofurkey, vegan cheese.
  • 2 p.m. 1/2 banana, 12 peanuts.
  • 4 p.m. 15 wholegrain, baked tortilla chips with 1/4 cup fresh salsa and 4T Queso cheese.
  • 6 p.m. stuffed green pepper (lentils, brown rice) with a garden salad (home grown tomatoes!) and curried chickpeas. (Note, I make a big batch of the peppers and garbanzos so all I have to do is remove it from the freezer and microwave).
  • 8 p.m. 8 mini sourdough crackers, 2 slices cheese, mustard pickle relish.
  • 10 p.m. handful (1/8 cup) of mixed nuts.

The hardest thing for me when I started this reactive hypoglycemia diet was to try and remember to eat exactly every two hours. The first few weeks I forgot, but then it became a habit. You can find the recipes for the stuffed pepper and chickpea curry in my Reactive Hypoglycemia Diet Cookbook.

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Another day of a reactive hypoglycemia diet

I’ve received a couple of emails asking me to post more of what reactive hypoglycemia diet I follow to combat my hypoglycemia. A brief piece of background info if you’ve just found the site: I haven’t had a reactive hypoglycemic spell in months, and I feel great! Before I switched my diet to vegetarian, my life was often miserable for many hours a week.

My Reactive Hypoglycemia Diet Plan

Anyone who has had the misery of low blood sugar and the accompanying shakes, sweats, mood swings, blurred vision and nausea knows how truly debilitating a disorder it is. But it is treatable in the most cases by dietary change, and that’s what I decided to do. At first i started on a very restrictive vegan diet but gradually added foods. I feel so great on this reactive hypoglycemia diet that I actually forgot to buy glucose tabs and ran out two weeks ago. To my surprise, I haven’t needed the tablets lately.

Food for a Reactive Hypoglycemia Diet

Here’s what I ate and drank back in June 2009 (my blood sugar stayed at normal levels, around 80-120 all day):

  • 8 a.m. cup of 1/2 caffeinated coffee with 3T Silk (soy) vanilla creamer
  • 8:30 a.m. 1 slice Ezekiel 4:9 toast, 1T Earth Balance buttery spread, 2T all fruit blackberry preserve (no sugar, just fruit).
  • 10:30 a.m. 1 banana, 1/4 cup cashews, 10 oz water mixed with 2 oz cranberry juice.
  • 12:30 p.m. Chickpea curry with cauliflower and broccoli (Indian curry with cumin, garam masala, chili pepper, cilantro, green chili), 1/6 cup brown rice, 1/6 cup wild rice

chickpea curry by

  • 2:40 p.m. About 14 baked, blue corn tortilla chips and 1/4 cup salsa.
  • 4:40 p.m. 10 oz water mixed with 2 oz cranberry juice.
  • 5:00 p.m. mixed herb salad, carrots, onion, clover sprouts, tomato. Topped with 1/4 cup Quorn stir fried in 2T peanut oil and a peanut/ginger sauce (pre-made in a jar from the grocery store–no added sugars), handful of cashews and 1/6 cup grated soy cheese.
  • 6:30 p.m. (before a 20 min swim): 5 oz water mixed with 1 oz cranberry juice and 1/2 a chocolate peppermint Luna bar.
  • 7:30 p.m. (after swim): 5 oz water mixed with 1 oz cranberry juice and 1/2 a chocolate peppermint Luna bar.
  • 8:30 p.m. cup of herbal lemon tea
  • 9:30 p.m. 2 oz white wine mixed with 2 oz soda water. About 6 baby carrots and 3T hummus. 4 Triscuits.

In addition I drank about 16 oz of water

I do not count calories for many reasons, including the fact that I have better things to worry about than calories (like not having a hypoglycemic episode!). I can tell how much I should be eating and if weight creeps on I just make an effort to exercise more or eat slightly less. I don’t typically count anything, when it comes down to it. I’m a fairly good cook and I seem to intuitively know how to cook a balanced meal. For example, the curry and Quorn both have splashes of fat, adequate protein and lots of vegetables (fiber, vitamins etc.). I think it’s important with reactive hypoglycemia to eat both fat and carbs–although I do get the majority of carbs from veggies!

I’ll post more of these kinds of menus again soon.

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And yet another day of a reactive hypoglycemia diet!

I’ve had a few emails now from readers who say that they’ve found my articles on diet to be really helpful, especially where I itemize everything I eat for a day. Thanks to me being very careful about what I eat, I am no longer shaky after eating — which for me, was possibly the worst symptom of RH. One or two hours after eating, I would start to get the shakes, which was soon followed by chills, lethargy, and sometimes fainting. I’m learning to love food again!

If you are shaky after eating and you suspect your shakiness is caused by reactive hypoglycemia, changing your diet can’t do any harm. The daily suggestions I make suit my palate, so you’ll probably want to switch out items to suit your tastes. I don’t count calories, but I’m very aware of calories — meaning I rarely, if ever, eat nutrient poor foods like sweets, cakes or soda. So this list is everything I put in my body yesterday (except for water!).

Not that this isn’t a diet to lose weight! It’s a diet to keep low blood sugar from happening. That’s why the meals are small and spaced out. Please also note that I’m 6′ tall and 185 pounds, so my calorie requirements are a bit higher than average. That’s why I’ve tried not to focus on portion sizes — it’s the food itself that matters, not how much I ate of it.

Rise (8 a.m.): 2 cups of decaf coffee with 2 T Silk Vanilla creamer

Breakfast (9 a.m.): Handful of dry roasted peanuts and a small apple

Brunch (11 a.m.): 1 egg white with a little grated cheese, onions, red peppers and tomatoes. 1 slice of gluten free toast with vegan margarine. Cup of black tea with rice milk as creamer.

Lunch: Bowl of home made Thai peanut soup. You can probably have any type of soup (as long as it has sufficient protein), but I make home made soups to avoid unwanted ingredients and carb-overload. Thai peanut soup is one of my favorites and it’s 30% protein, which is about right.

Afternoon snack: Hummus with baby carrots. Black tea with rice milk creamer.

Dinner: Home made vegetable curry with brown rice.

Evening snack: A few organic whole-grain tortilla chips, topped with a little grated cheese and salsa. Two glasses of wine.

Close to bedtime: A hunk of cheese.

I pretty much avoid processed food. I make my own soups, curries, pies and pasta dishes. Every week I get a bag of organic veggies delivered to my door and I base my week’s dishes on that. I’ve heard people say that they don’t have “time” to cook — but when my RH was sever, it was eating up hours of my day — I’d feel sick and lethargic most of the time. Now I feel great. Sure, I cook for a couple of hours a day, but when I compare that to feeling GREAT and full of energy for the remaining 22 hours of the day (minus sleep!) the investment in cooking my own food, so I know what I’m eating, is worth it.

Shaky after eating? Check those food labels for hidden sugars!

You might also notice a lack of condiments in the list I wrote. As a general rule, I make flavorful meals with fresh ingredients so no ketchup, mustard or pickle relish is required. These are all places where high fructose corn syrup and sugars can hide, so as a general rule I avoid them.

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Notes on Atkins and Saturated Fats

I came across an odd article this week. Researchers at the Mayo Clinic devised a diet for 23 heart patients that was high in saturated fat. Patients (eight of whom were reactive hypoglycemic) ate “forbidden” saturated fats for a year and lost 20% of their body weight following the prescribed reactive hypoglycemia diet. The interesting point about this article for reactive hypoglycemics is that we typically have trouble losing weight (because of the excess availability of carbs in our bodies), and yet the reactive hypoglycemics in this study–all of whom were obese–had no trouble dropping the weight!

Why Atkins Shouldn’t be Part of Your Reactive Hypoglycemic Diet Plan

A diet high in saturated fats was prescribed for the patients (saturated fats in my diet come from eggs, vegetable oils and tropical oils). However, unlike the Atkin’s diet, where carbs are restricted, fruits and non-starchy vegetables were allowed in prescribed amounts at each meal (while portions were recommended, the patients didn’t keep to a specified amount of these). The only other rule the patients had to follow was no starch (no rice, wheat, potatoes etc.).

Although the patients only ate an average of 3 meals a day (600 calories each), they all reported feeling full. After one year, patients with reactive hypoglycemia lost around 20 percent of their body weight–this is despite eating both saturated fats and carbs!

The lesson to be learned? This research is just one piece of evidence to suggest a low-carb (not carb-restricted, like the Atkins, which puts your body into starvation mode) balanced diet that includes saturated fats and carbs is the way to go for losing weight and controlling reactive hypoglycemia.

Hays, J. et. al. Effect of a High Saturated Fat and No-Starch Diet on Serum Lipid Subfractions in Patients With Documented
Atherosclerotic Cardiovascular Disease. Mayo Clinic Proceedings November 2003 vol. 78 no. 11 pp. 1331-1336

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The Truth About Cinnamon in the Reactive Hypoglycemia Diet

Last week, my best friend told me that cinnamon can help stabilize blood sugar levels when added to the Reactive Hypoglycemia Diet. A quick search on Google revealed pages of claims that backed up her statement, claims like: “Cinnamon spice produces healthier blood!” and “Cinnamon Extract Spices Up Sugar Metabolism!” But before you charge out and start sprinkling cinnamon on your cereal, consider these facts.

A couple of major studies have found cinnamon to be beneficial to type II diabetics: a 2006 Swedish study and a 2003 Pakistani study. The first study demonstrated a reduction in postprandial blood glucose due to a slight slow down in the stomach’s emptying rate. If the contents of the stomach empty more slowly, that could benefit reactive hypoglycemics. The findings of the second study suggested a small amount (1,3,or 6g of cinnamon per day) reduces blood glucose levels as well.

Unfortunately, several other studies have failed to reproduce the same promising results. One 2006 study from the Netherlands was published in the Journal of Nutrition under the heading “Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients.”

Scientists at the Department of Agriculture are considering patenting their research on cinnamon extracts, which make cells more sensitive to insulin. This could be great news for diabetics, but consider this: while diabetes is caused by insulin resistance, reactive hypoglycemia can be caused by high insulin sensitivity…the exact opposite. Imagine already being insulin sensitive, and then taking a compound that magnifies your hypoglycemia issues!

Should cinnamon be part of the Reactive Hypoglycemia Diet? As of 2012, The Mayo Clinic’s stance is that cinnamon is an unlikely candidate for having any future promise in the stabilization of blood sugar. I don’t to take a chance that my hard earned blood sugar stabilization with go down in a cloud of cinnamon dust. So for right now, I think I’ll spend my hard earned cash on some good ol’ fresh vegetables.

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The lowdown on reactive hypoglycemia diet options: DASH diet, Mayo Clinic Diet, Paleo Diet, Southbeach Diet, Atkin’s diet

If you are looking for a reactive hypoglycemia diet, you’ll find a lot of “quick fixes” on the internet. From the Paleo diet to the Atkin’s diet and beyond. But which diets actually work as a reactive hypoglycemia diet? I researched the effectiveness of some of the most popular diets for reactive hypoglycemia so you don’t have to:

DASH Diet: Originally touted as a diet to treat hypertension (high blood pressure), the DASH diet has shown promise for preventing diabetes (i.e. in controlling reactive hypoglycemia). The diet is almost identical to the approach I take in my Reactive Hypoglycemia Cookbook — a focus on fruits, vegetables, whole grains, lean protein, and low-fat dairy (I’m not a low-fat dairy fan…I think it’s a bit tasteless). For purposes of a reactive hypoglycemia diet, I don’t think it matters what dairy items you choose unless you want to lose weight) while sweets and red meat are discouraged.

Mayo Clinic Diet: While the diet is certainly healthful, it may not be the best diet for a reactive hypoglycemia diet with its 21 percent protein recommendation. My endocrinologist recommends 30 percent protein at meals.

South Beach Diet:Although it can help with weight loss, the diet isn’t geared towards controlling reactive hypoglycemia. Despite a high-protein/low-carb plan, no reasonable evidence exists to support that the South Beach diet can either control reactive hypoglycemia or prevent diabetes.

Vegan Diet: A strictly vegan diet has received high marks as an anti-diabetes diet. However, it can be time-consuming and restrictive. It can also be challenging to receive all of the right amounts of nutrients.

Atkin’s Diet: The Atkin’s is popular for short-term weight loss. However, many experts (including the Mayo Clinic) has questioned the diet’s performance in nutrition, safety and heart health. Therefore it seems very unsuitable as a reactive hypoglycemia diet option.

Paleo Diet: There is no evidence to suggest that a Paleo diet is beneficial as a reactive hypoglycemia diet.

The overall results? Skip time-consuming and expensive diets. You’re better off eating a well-balanced, moderate protein diet, rich in vegetables, fruits and whole-grains.

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Want more ideas about what to eat, and what not to eat on a reactive hypoglycemia diet? Take a look at my reactive hypoglycemia cookbook, full of recipes and tips for controlling your blood sugar.

98 thoughts on “Reactive Hypoglycemia Diet: What do I eat?

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  7. Waldo

    I was wondering what you suggest for use in baking. I love to bake and have always naturally reduced sugar because I don’t like that overly sweet taste, but I’m pretty sure now that I have reactive hypoglycemia so I was wondering what I can use instead for when I do bake? Is Splenda a good choice? Or what could I use. I’d use honey, but that makes for extremely expensive baking.

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  9. michael

    I, too, enjoy baking, and have done so without using refined sugar for quite some time now. However, I am now finding that agave nectar is not a good alternative to sugar for a reactive hypoglycemic. I see that you recommend fructose for baking. I do not react well to that due to IBS. I noticed that you recommend evaporated cane juice in other articles. Would using sucanat (the dried form of evaporated cane juice) be a good replacement for sugar in baking?

  10. Hemal Patel

    Though there are no clear understanding of this issue from medical science, I worked on following theory to cure my condition

    1. Chronic dehydration, I was not drinking enough water: In absence of adequate water body shuts down functions not
    absolutely essential [This is a scientific fact]
    2. Because of constant eating body always had sugar supply
    3. Due to lack of exercise liver is not simulated to convert fat to sugar

    Above 3 factors over long time results in body finally loosing ability to convert fat to sugar when needed and depends on external input of sugar, any by always eating when sugar is low we encourage this pattern.

    I started drinking 3 liters of water a day
    cut down on my food intake, exercised a little and lost 10 pounds of weight, my hypoglycemia is gone.

    Body weight in kilos X 35 ml of water a day is the key to solving this problem, also read the book “You are not sick you are thirsty” by Dr Batman


  11. David Boothman

    It is a mistake to state that carbohydrates are needed to regulate blood sugar. The opposite is perhaps the case. Traditional Inuit eating a traditional zero carbohydrate diet simply do not exhibit any diseases related to a failure to regulate blood sugar, including metabolic syndrome and type 2 diabetes. However the introduction of carbohydrates does create very high rates of metabolic syndrome, type 2 diabetes and even any cancers. That carbohydrates are an essential macro-nutrient is a myth.

    1. Steph Kenrose

      I don’t believe the Inuit eat zero carbs. They gather local foods like berries and seaweed, which do have carbs. The health benefits of a very active lifestyle can’t be underestimated either!

  12. Jenna

    Was anyone able to “cure” reactive hypoglycemia? If so, what was your method(s)? What is your advise? What changes did you make to “cure” yourself of reactive hypoglycemia? by “cure” I mean that you don’t have to eat every two-three hours per day, but good 3-4 meals and no/less symptoms of reactive hypoglycemia (RH). How long did it take you to get to that point and what did you do? It’s really sad/ridiculous that there isn’t as much research available for this disease and the medical community has such negative outlook/attitude towards RH. Even the medications that are available “suck”! Please share your experiences with me. Are there any books that you would suggest for me to read?

    1. Steph Kenrose

      I no longer suffer from RH, although I did for several years. Everything I know I put on this site and in my book, so please take a look around. I wish you luck!

  13. Jessica

    I love your site. Would you mind If I referred to your site in the video blogs I am starting to help people with Reactive Hypoglycemia? It seems like there is not much help out there for us. Also I just read that you no longer have it!! I can believe that! Because after I was diagnosed I stopped eating sugars as much as I could. I was very strick on myself and I am a lot better these days. I can actually eat little bits of sugar and not have a problem. So once again Thanks.

  14. Jessica

    I love your site. Would you mind If I referred to your site in the video blogs I am starting to help people with Reactive Hypoglycemia? It seems like there is not much help out there for us. Also I just read that you no longer have it!! I can believe that! Because after I was diagnosed I stopped eating sugars as much as I could. I was very strick on myself and I am a lot better these days. I can actually eat little bits of sugar and not have a problem. So once again Thanks.
    Oh, forgot to tell you my user name on youtube is :: blogsoidontforget:: so if you want to look me up you sould be able to find me that way or you can find one video called:: I want to help you deal with Hypoglycemia and Attention Deficit Disorder!

  15. Jenna

    Stephanie Kenrose,
    I just found your book online and I look forward to reading it. My goal is to rid of this disease and get my life back. I would really like someone to talk to and I was wondering if you would mind if I spoke to you in private (email) about this disease. It’s a struggle for me and a good support system would be so helpful esp from someone who understands RH. Thank you for the book!

    1. Steph Kenrose

      Hi, Jenna,

      Unfortunately the sheer volume of emails I was getting led me to the difficult decision to shut down email for the site. I was getting in excess of 50 emails per day and as much as I would LOVE to help everyone personally, I just couldn’t. I’ve been away from the site for many months due to non-related personal issues, but I’ll keep an eye on comments and try to respond personally whenever I can. I hope you have had good luck with your journey to combat your RH!


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  24. Marie-Lise

    Dear Stephanie,

    Many thanks for all the hard work on this website. Having read about reactive hypoglycemia in relation to giftedness, it is a pleasure to find a well structured and very informative source of information. This will help many people, including me. Thank you for that.

  25. Sandra

    I am so lost. I am 62 and recently told i do NOT have hypoglycemia after testing but still have to eat like I am. I was told i just dont eat enough good carbs so my sugars drop. I have had two hypoglycemic episodes this past month .. I am disabled, cant cook…cant get out to a s tore to get what I need to eat properly and am floundering ..I eat alot of whole wheat crackers and peanut butter in between meals along with cheese and grapes. I dont know what the hell I’m doing. My sister prepares dinner for me..typical meals..a meat..i preer chicken or fish but I have to eat what she cooks or dont eat period..usually a carb..i try to stick to sweet potatoes but again it could be a white pasta or it could be mashed potatoes w/gravy along w/a veggie..i prefer broccoli or spinach or carrots..she usually has green beanss cause that’s all anyone will eat here..I feel like I am doomed…I just dont know what to do..I’m afraid of the nights..I dont sleep well..can you please talk to me ? Thanks

    1. Steph


      Please, please call United Way and tell them about your situation. There are so many organizations out there that can help (perhaps meals on wheels can deliver better meals?). Cheese and grapes, crackers and peanut butter are good choices. Is there a way you can buy healthy frozen meals? A packaged frozen meal from a health food store is going to be better for you than pasta! has a great selection of natural and organic soups and mini meals. Soup and salad doesn’t sound exciting for dinner — but it’s your health!

      Best of luck,


  26. Sandra

    you said ot stay away from artificial how would I sweeten my oatmeal or decaf coffee ? is it ok to drink decaf coffee ? thanks

    1. Steph


      I drink decaf, so in general I’d say it’s fine. I don’t sweeten anything, lol. But…if you do…try agave nectar (a small amount). Make sure you get organic, unprocessed agave, as some brands are processed too much and are as bad as sugar. You could also try Stevia.


  27. Sandra

    oh another question…i’m confused about fruits. Which fruits are safe for us to eat and how much ? i eat grapes mostly ..with my cheese and whole wheat crackers..

    1. Steph


      The only way to know for sure is to eat fruit and then test your blood sugar/note signs and symptoms. For me, I cannot eat a whole banana or other tropical fruits without a protein source (like nuts). But I can eat a few grapes or apples just fine. Basically, stay away from high sugar tropical fruits, and keep an eye on what happens to your body after you eat fruit!


  28. Sandra

    I was also told it’s the complex carbs that will keep my sugars i eat alot of that..whole wheat crackers, oatmeal , whole wheat bread.but I have skimmed the web and heard that whole wheat isnt so good for us..i’m so’s hard to do this at 62 after having a lifetime of the other way of eating..old tricks ??

    1. Steph


      I was almost an “old dog”, lol. But! If you want to get rid of this miserable disease and it’s symptoms (I was very desperate) then you’ve got no choice. If you don’t it’ll only get worse and diabetes, or worsening of your symptoms, will be the likely end result. That is ten times worse than RH! It’s really not such much about what you eat, as what you shouldn’t eat. Stay away from sugar, HFCS, unhealthy fats and carbs of any kind (i.e. French fries!). I eat processed grains in very small amounts. I eat a lot of legumes, nuts, vegetables. And I feel in PERFECT health. I wouldn’t go back to my chocolate cake and pizza days for anything :)

      Best of luck with your dietary transition,


  29. Sandra


    What would be a ‘ healthy frozen meal ‘ ..i didnt think there was any such animal ! lol…they are loaded with sodium for one thing. I have heard Stoffers offers some good choices..but as we all know..I’m the new kid on the I’m learnng as I go and I so appreciate all your input. I love pasta but I know..I know..pasta doesnt love me how about the whole wheat pastas ? and if that’s ok what is the portion size ..i know i have to also count and take into consideration the carbs in the tomatoe sauce..and allow enough adequate protein to make it balanced.
    The website..the natural and orgnic soups and mini meals..can you offer me a few ideas ..suggestions..selections ? thanks so much

    1. Steph

      Check out Whole Foods or your local Natural foods store. You’ll find some healthy frozen meals :). Look for organic, no additives/sugars, plenty of veggies.

  30. kay

    Have you ever tried trader joes? They carry ezekial bread plus their brand which is less expensive. They also have a larger number of “quick” foods that limit the sugar, simple carbs, and additives.

  31. Pingback: Thanksgiving to My Health, Part 3: My Reactive Hypoglycemia Diet « just call me raegen

  32. Serena

    Hi Steph,

    Your site has been very helpful to me but at the same time I’m still very confused. Basically I’m scared to eat, everytime I eat I get super spacy, I feel almost high and I find it hard to focus. Everything from a veggie cheese wrap, peanut butter on sprouted bread, to fried eggs in the morning. Ill feel spaced out for hours and then I can feel myself returning to normal but then Ill get the shakes, confused etc. ive been eating every two hours, chick peas, cottage cheese, almonds, lots of veggies, salad all day but then I’ll have an attack at night. I will get anxiety, nervousness, scared and feeling horrible. And I’ll have to have some juice to get back to feeling normal. I’m just not sure what I’m doing wrong. I’m so scared to eat, then I’m scared after I eat because I get all spacy. I feel like I never know what’s going to happen. Hopefully you can explain to me why I get spacy after I eat. I might mention, I’m a fitness trainer, own my own studio, mom of three, and a husband who works out of town, I know I have been burning the candle at both ends. I just recently stopped working because I was living off of adrenalin. Do you think this is one reason why I got RH in the first place. Hope you can help, I’m just so confused on what to eat with out getting spacey. Especially when I wake up. Thanks Steph.

    1. Steph


      I wish I had some quick answers for you. Do you know the cause of your RH? If you have a disorder like a systemic yeast infection, you need to treat the disease before your RH will improve. I would talk to an endocrinologist or a naturopath to try and figure out the root cause. Best of luck,

  33. sandra

    Thanks I have struggled for two years now, I even lost my job of 10 years. I tried the Ezekiel bread oh my gosh!!, It worked!!!!! Whoop hoo! I used to buy whole wheat bread with 2 grams of sugar. But the Ezekiel worked much better. I have been following your plan and it is a life saver!!

  34. Serena

    Hi Steph,

    Quick question; I’m just wondering from your cookbook, you have the diet you followed for the first month, I’m wondering what symptems you had? I’m feeling I’m on the mend but I’m terrified to add complex grains and fruit back into my diet. I’m craving carbs all the time and feel I never have any energy or can think clearly, I also always have an itchy tongue after eating and always feel dehydrated. Im scared to add any carbs as they might creat a low blood sugar with all the fun symptems (anxiety, heart palpitations, muscle spasms, internal trembling). Ive been eating non starch vegetables, meat, eggs and cheddar cheese for about two months now and have lost 15lbs (Im 5’5 and was 125 now 110) I’ve also been keeping track of my BG and its staying in the range of 70-90, morning fasting its around 85 but it use to be under 70. Any feed back would be very helpful.

    Thank you

  35. sandra

    Serena, I was like you when I first started hypoglycemia. I was scared to death to try anything new. My Dr told me to start with legumes (beans) since these tend to take a long time to digest, there would be no sugar spike. I started with hypoglycemia two years ago. So even today if I’m having a bad sugar day, beans help me get in control. Also, my doctor gave me Acarbose medication. I would take one pill three times a day with each meal. It realky helped me get my sugar in control. I took it for one year. Now I only take it as needed on a bad sugar day. I don’t need it that often. Mostly I use it now if I get stressed. For example my brother in law passed away suddenly and all the stress made my sugar out of control. So I used Acarbose med to get me back to normal. Now I’m better. I hope I helped. Hang in there you can do it!!

    1. PAMM

      How can you take Acarbose Medication with Low/Reactive Blood sugar when its meant to lower blood sugar in diabetes? I am a mother and grandmother and desperate for answer. Thank you

  36. sandra

    Oh Serena in case your wondering what Acarbose is, its a medication that helps your carbs last longer. You cannot eat any table sugar with it. It works with complex carbs to get your sugar in control.

    1. Serena

      Thanks Sandra, I really appreciate the help. I’ve done tons of research finding conflicting info, three doctors (one thought for sure it was Insulinoma other said he doubted it), Ive become even for confused. But I have to say the adrenalin attacks are gone and I pretty much sleep through the night. The problem is I can never think straight, alway tired and lacking energy and unsure of myself, (becoming more introverted and not wanting to leave the house much, especially by myself) I use to be full of energy and happy. I’m thinking I did a real number on myself (over worked as a trainer, owned a small gym, three kids, husband works out of town) so now I’m thinking I just need to reverse what I caused.
      I was going to try a natural doctor, get checked out for candida but Im going to look into that drug. I just want to feel myself again. I’m also going to start eating the suggest diet on this site. I need to add more carbs, thank you for the carb suggestion. I’m going to start that tomorrow. What other food have helped you?

  37. sandra

    Oh my gosh!! I have a problem.with my adrenaline also. And like you, I worked two and sometimes three jobs.
    Celexa has helped to slow down my adrenaline. Once my adrenaline slowed down it was easier to get my sugar in control. Also the Acarbose worked wonders! It’s hard for me to type a lot in this box. If you’d like you can e mail me and I can type more info on what helped me. List of foods, how the Acarbose works. If you feel comfortable feel free to e mail me. If not, let me know and I ‘ll try to type more info on this site.:-) Don’t worry it will get better. Just be consistent and keep a journal of what foods agreed with you and what didn’t. That will help you look back and know what foods you want to stick with.

    1. PAMM

      I have adrenal disease so I have these adrenal attacks during the sugar episodes where I turn bright red and shake really bad. I take steroids for this disease. This is where my Reactive Hypo comes from. It has been life changing. I have had it almost a year. Worst thing I have ever experienced :( Even worse then the adrenal disease.

      1. Steph_anie

        I’m sorry to hear about your illness. And I can agree with you…I’ve had a few things, and RH is definitely a life-changer (and not in a good way).


  38. Schelle

    Hi Sandra, I obviously came to your site because RH has been thrown around regarding my spaciness and low blood sugar. I’m currently awaiting results from a blood test by my endo. I am new to reading blogs; this is the first time I’ve written to one. I am reading with such great interest Serena’s posts because it’s like I’m reading my own story! Even her follow-up questions are mine! I think she mentioned not having anyone to talk to about what she’s going through and I feel the same way! I also have 3 kids, my own business, probably burnt myself out, feel like I could reverse this because I brought it on myself, have no one to talk to about it, freak out when my husband isn’t around to save me should I pass out when I’m caring for my kids, etc., etc. Is there anyway that Serena and I could exchange email addresses or is that not allowed? Are we supposed to just write everything in the blog to each other? Thank you so much for creating this site! And Serena, thanks for sharing your story!

    1. Steph

      If Serena sees your post and responds, I’ll be happy to send you each your email addresses. Or you could post a comment with your email in it?

    2. Serena

      Hi Schelle,

      My email is Email me anytime, I’ll try to help anyway I can. I’m still sick and figuring this out but I have a lot more information I can share with you. I’m actually going in the hospital for a 72hour fast at the end of the month, insulinoma is not as rare as they say it is. Ask your doctor for a fasting insulin test. Email me we can also connect on FB. Serena :)

  39. Schelle

    Oh, also, I would love the list of foods that helped and more info on Acarbose, but I didn’t want to take the liberty of emailing you (see post before…) Should I just email you as well?

    1. Steph

      Hi, Schelle,

      Thanks for stopping by, however I don’t really have more information. Everything I find out I post here :)


  40. debbie

    I have reactive hypoglycemia for 2 years iam not over weight and i eat no sugartoday i had swiss chard with a little marinara sauce and my sugar went to 146 than to 92 in thirty minutes what am i doing wrong help its ruined my life iam fifty five years old

  41. sandra

    I’ve had severe reactive hypoglycemia for three years. I always eat:
    Complex Carb
    Together. Have to have a high protein diet with just enough carb to bring your sugar up but can’t over do it or you can feel shaky if you have too much carb.

    Protein helps your complex carb last longer. Beans are excellent for controlling sugar. They digest through small intestine thereby making your sugar last longer. Also stress can cause your sugar to get out of hand also.

    Hope this helps!!

  42. Vanessa

    Hi, I have found using Rice Malt Syrup a good substitute to honey or sugar for cooking in health cakes/slices with lots of seeds/nuts/dried fruit etc with brown rice flour or wholemeal spelt. Rice Malt Syrup is low GI.
    A site that I think is an excellent reference for people like us that might add a few more things to ponder is on Adrenal Fatigue. A lot of the guidelines are the same as here and he explains that people with Adrenal Fatigue (which is probably a huge amount of the population considering the stress we live in) have often entered the state of Reactive Hypoglycemia. After many decades of looking for answers and constantly swinging around in all aspects of my health, I feel a lot of the dots are starting to join to together. I have just been diagnosed with Reactive Hypoglycemia after doing the Glucose/Insulin test. It explains a lot, and fine tuning the highs and lows will be an ongoing opportunity to eat better I think. It seems the biggest advice I keep getting is to make sure I eat small frequent snacks or meals with protein ie: nuts with small amount dried fruit etc (not sure peanuts are ever a good option).
    I think water hydration is definitely a big one too. I have also found Tulsi tea and Rooibos good substitutes to regular tea when I still want something with flavour. Not sure about GI etc.
    Good luck all. It’s no fun when you’re swinging around and don’t feel you can put your finger on exactly why!
    Thanks for the Blog,
    Regards Vanessa

  43. Carrie

    Hi, Thanks for all the advice on this site. Quick question on the one thing I don’t understand (as I try to figure out whether I might have reactive hypoglycemia or andrenergic postprandial syndrome)… if I do have one of these then why it that I struggle hugely if I haven’t eaten for 4 hours (irritable, fuzzy head, shaky) and yet I don’t eat anything for 10-12 hours overnight but am not a disaster in the morning before breakfast?! Thanks in advance for your advice!

    1. Steph

      Carrie, the only way to tell the difference between the two is to test your blood sugar. You can use a home testing kit. Eating is the problem (the “reactive” part), which is why you’re fine overnight. Your blood sugar might dip and you might not even realize it as you’re asleep!

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  55. Fadwa Elmasri

    I have been diagnosed with hypoglycemia about 20 years ago. was told to keep sweets or dates in my bag and eat whenever I felt shaky. For the past 6 years I’ve been having chronic headaches, as well a migraines. A couple on months ago, I started having migraines especially during the weekends. It turned out that when my blood sugar drops (while asleep past my waking time. 6.00 am)
    I have been diagnosed with fibromyalgia. I’ve had a brain scan for the headaches, one doctor told me I ‘stressed out’ and I have nothing wrong with me and prescribed anti depressants. The last doctor I went to two months ago told me to eat six meals a day, with protein in each meal. The I decided to do my own research.
    I am not a meat eater, and my digestion is not that good. I am a teacher, starting school at 7.30 with a break at 10.10, I eat at 6.30, leave home at 7.00. Can I take a pill to help me through the classes till I eat so I am not hit with a migraine?
    Please read and advise. I am Sudanese and live in the Sudan, so some food stuffs are not available.

    1. Steph_anie

      Hi, Fadwa,
      I’m not a doctor, so I can’t really advise. I don’t know of any pill that will substitute for food though.

  56. Ess


    Just note that, if you are someone with allergies, an autoimmune condition, or kidney problems, the 30% protein diet is not necessarily a good idea. In these cases, low-protein diets are recommended (see Dr. Andrew Weil’s advice on these, for example). As someone with both reactive hypoglycemia and one of the above, I am careful not to end up overeating proteins and irritating my already-irritated immune system.

    All the best,

  57. Christina Souza

    I had gastric bypass surgery 18 months ago and am now battling reactive hypoglycemia. I am actually under weight at this point and cannot sustain a normal weight. I tolerate very little sugar including natural (i.e. fruit, bread, etc.) nor can I tolerate much fat. I’m not sure how to get my weight up when I can’t tolerate most of the foods that would increase my weight. I’ve recently started having “seizures” due to low blood sugar (29 at the last one) and that was caused by dried cranberries (who would have thought). My drs have no answers including the specialist. My blood pressure is also incredibly low. How do I break the cycle? How do I bring up a dramatically low blood sugar without sugar? I’m going to look up the medication you talk about and see if that is a possibility for me. Thanks in advance for any help you may offer.

  58. Carmen Alicea

    I have experienced reactive hypoglycemia. I was hospitalized to be monitored, many test were performed witha negative response. This is all new to me, but I would like to start on the right foot to combat this reactive hypoglycemia.

  59. Lori

    My husband has reactive hypoglycemia which he has learned to control fairly well. For years he has had the symptoms and reported them to his doctors, but none ever took him seriously. They would check his blood sugar and say it was fine. I bought a blood sugar monitor and he tested every time he felt shakey and several times after every meal as well as in the morning. I did tons of research and it became obvious he has reactive hypoglycemia. He reported this to his doctor who said it was unlikely. My husband also showed them these odd spots he had on his legs. They said they were diabetic shin spots and were convinced he was diabetic and insisted that hypoglycemia would not cause diabetic shin spots. Well, after testing they found he is not diabetic but insist the shin spots are not caused by hypoglycemia and can’t explain why he had them. After changing his diet to a hypoglycemic friendly diet and never letting his sugar levels drop, the sores started to heal. Now they are almost completely gone, and he feels fantastic. Why are doctors so reluctant to diagnose reactive hypoglycemia? One of his doctors told him that there is no such thing. Needless to say, he has found another doctor. It’s sad to think of all the people, including my husband, that have suffered for so long, unnecessarily because of arrogant and ill informed doctors. It just shows how important it is to due your research and take responsibility for your own health. If a doctor doesn’t take you seriously then find another doctor.

  60. Tina

    Hi Stephanie,

    I am not sure if you still reply to comments here since the last comment has been in 2013 but I thought I will give it a try. I have read so many blogs and sites and this one is helping me the most. I have recently found out that I have RH, and I am on a strict no carbs or sugar diet. I am advised by my doctor to religiously follow this diet for six weeks. One week has passed and I am running out of foods to eat. I am also confused as to what to eat. I am eating 7 to 8 meals a day and finding it difficult to follow as a preschool teacher. I guess my questions are .. Will it get better? Will I get used to it? Is eating the same veg such as cucumbers everyday ok?
    I am also suffering from cravings. I really really want cake or chocolate.

    Thank you,


    1. Steph_anie

      The cravings will pass. I eat a whole foods diet now, as I developed other allergies. No candy, choc, bread, anything processed. I rarely get a craving, but if I do I can stave it off with something else. i.e. sweets: strawberries. Shop at a famers market and find new veggies to discover. Good luck :)

  61. Shannon

    Hi – I am pretty confident my 5 year old son has RH and shown symptoms since he was 12 months old. His major symptoms are extreme irritability and anger, red face and bloodshot eyes.
    He needs to eat every 2 hours or it seems the whole family pays. His anger subsides within 5 minutes of eating. The big thing here though is that the only thing that works is animal protein. Nuts and nut butters do not last. He might get 30 min of relief but with animal protein it is 2 hours. Is this the case for anyone else?

  62. Andy

    My RH started after months of supplementing my diet with cinnamon capsules. Coincidence? After stopping the supplements and avoiding cinnamon in general my RH symptoms subsided, but have not yet completely stopped. Time will tell.

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