If you think you might have the condition (click here for the top ten signs you may have reactive hypoglycemia), you should read this before you make an appointment with your doctor.
I knew my symptoms were reactive hypoglycemia before I went to the doctor. My ten-year-old son, Leo, has the condition, so it wasn’t difficult to figure out what might be causing my mental confusion, mood swings, heart palpitations, hand tremors, cold sweats and anxiety two hours after eating pizza. My doctor, however, had other ideas…
The Doctor’s Visit
I wouldn’t have made an appointment with my physician if I hadn’t been concerned that, considering both Leo and I had the same disorder, that we might have an underlying condition. A missing liver enzyme perhaps, or some other hereditary disorder.
My idea was that if the doctor could pinpoint a cause, he might be able to solve Leo and my problem with a simple supplement or the like, instead of a restrictive diet.
I specifically chose an Internal Medicine doctor from my health plan, thinking that an “expert” in puzzling, chronic problems would be my best choice (an internal medicine doctor is sometimes called “the doctor’s doctor” because of their expertise in pinpointing conditions with a myriad of symptoms).
The doctor, I’ll call him Dr. Brown, listened as I explained that my son and I had the same symptoms, that I had monitored my blood sugar and it appeared I might have reactive hypoglycemia. I also told him about how my son had been diagnosed by his pediatrician. I asked him if I should be concerned about any hereditary disorders.
He did a quick physical examination and asked me if I felt stressed. Puzzled, I noticed that my hands were sweaty. “My hands sweat when my blood sugar dips” I said.
He nodded, left the room, and came back with a sheet of paper. He handed it to me. The top of the sheet said “Signs of Depression” and included questions like “Are you having difficulty sleeping?” “Do you have thoughts of worthlessness?” “I’m not depressed,” I said. “I feel fine, except after I eat certain foods like potatoes or lasagna…” He nodded thoughtfully, told me I needed to lose weight because I was at risk for diabetes (I’m 5 pounds overweight and have no history of diabetes in my family), and handed me a sheet on diabetes. “Hypoglycemia is one of the first symptoms of pre-diabetes,” he said. “Lose weight, and exercise more. Avoid carbs and root vegetables like potatoes and carrots. Come back for a check up in six months.”
Don’t Avoid Carrots
I was stunned about how a physician with so much training in internal medicine could be so wrong. Here are just a couple of reasons he didn’t have a clue:
- According to the Mayo Clinic, the cause of reactive hypoglycemia isn’t usually pre-diabetes. In fact, without a whole lot of expensive testing, it often isn’t clear what the cause is at all. Researchers think that it could be caused by a sensitivity to epinephrine, or a glucogen deficiency, to name just two.
- Hypoglycemia can be a symptom of pre-diabetes, but reactive hypoglycemia and hypoglycemia are two very different diseases, and need to be treated as such.
If you have reactive hypoglycemia, please don’t avoid carrots. I was floored by the amount of misinformation there is out there on what reactive hypoglycemic should and shouldn’t eat. I even found one website that said to “avoid soups and breads of all kinds.” Oh my, no wonder people have trouble managing this disorder! If you are interested in reading more on diet see my diet post, and you can also check out my article The Top Five Common Misconceptions About Hypoglycemia to find out exactly why you shouldn’t stop eating carrots. You can also check out my cookbook too, which I wrote so other people won’t have to go through what my son and I did.
I’m not suggesting that you don’t go to the doctor. To the contrary–it’s a good idea to go for a checkup and a basic blood test to make sure you are otherwise in good health. But when you do go, go armed with the information, and if something sounds wrong or goes against your research, seek a second opinion: reactive hypoglycemia is an unusual condition and most doctors are simply not equipped to deal with it. Make sure your doctor knows that you want a hyperglucidic breakfast test (HBT), or better yet, buy a home glucose monitoring kit and tell him your results before asking for the HBT.
There are only two ways to diagnose reactive hypoglycemia: a Hyperglucidic Breakfast Test and a home blood glucose monitoring kit. Of the two, the home glucose monitoring kit is probably the easiest. See my article on Tests for Reactive Hypoglycemia for further info.
If only I knew what I knew now, I would have ordered a blood glucose monitoring device and saved Leo the uncomfortable experience (not to mention the expense…two copays at $35 each, and a $200 lab bill). A home blood glucose monitoring kit is the same kind of kit used by people with diabetes. They are small, inexpensive gadgets, and involve a tiny pin prick on the finger, smearing a tiny drop of blood on a test strip, and waiting for the machine to beep and tell you your blood glucose level. The entire process takes less than 5 minutes.
I used a Contour blood glucose monitoring device, which cost less than a single visit to the doctor. Once I figured out how to work the device (about ten minutes), I monitored my blood sugar every hour or so for a full day. It was almost painless: after the initial hesitation (it took me a few breaths to summon up the courage to prick my finger), I discovered that it wasn’t as bad as I thought it would be.
A normal blood sugar reading is 70 to 140 milligrams per deciliter or mg/dL. This chart, will give you an idea of what blood glucose levels look like normally, and what they look like for reactive hypoglycemia.
You cannot tell by this chart alone who has reactive hypoglycemia and who has prediabetes (amongst other things, your insulin needs to be checked too, to see if you are insulin resistant or insulin sensitive).
Here are a few of my readings from the first day I tested with the home blood glucose monitoring device. Bear in mind that the home test kits are not as accurate as a lab, and I’ve read reports that they can vary by as much as 20 mg/dL. However, it gave me a good idea of what was going on with my blood glucose when symptoms occured:
- 9 a.m. After a “good” breakfast of kamut flakes, wholewheat toast, jelly and coffee: 150 mg/dL.
- 11 a.m. (feeling weak, dizzy, and panicky): 30 mg/dL.
- 11:10 a.m. After I ate two glucose tabs (available from any pharmacy) and drank a carton (8 oz) of fruit juice: 60 mg/dL. I still felt shaky, and a little anxious.
- 11:30 a.m. After one more carton of juice: 70 mg/dL.
- 12:30 p.m. After lunch: 115 mg/dL I felt great…no longer panicky. My glucose continued to rise immediately after eating.
I continued to monitor my blood glucose for long enough to pinpoint that my glucose was dropping about 2 1/2 hours after eating. Not everyone’s blood glucose will drop at that point…for my son, his plummets after 3 hours (and when I say plummet…I mean plummet. He convulsed and went to the emergency room more times than I’ve been to see a doctor my whole life. See my other blog article called Why My Son Had Nightmares to read more).
At time of writing, one company out there offers a FREE home glucose monitoring kit that comes with ten free test strips. They’re betting that you’re a diabetic, and that you will continue to use their very expensive (over $1 each) test strips. Reactive hypoglycemics do not need to monitor their blood glucose except to diagnose the illness, and perhaps for a little while after diagnosis to aid in symptom recognition (i.e. I know now when my hands get sweaty that this is the first sign my glucose level is dropping, and that I need to eat).