Your posts have finally begun to shed some light on my symptoms. I’m not diabetic, I train 12-15 hours/week and I got a CGM bc my A1c is 5.7-6.2. My CGM shows I have pp hypoglycemia (and I FEEL it!!) as well as post exercise (and often during exercise) hypoglycemia. Eating more carbs before exercise makes it worse. Also dairy makes it worse. I’m already eating protein (100-120g/day) and 40-50g of fiber/day. I’ve been to 4 dieticians and 3 sports med doctors and no one has any advice. The only thing that helps is not training. 🤷♀️ there is something going on, but the usual low glycemic advice isn’t working as well. I look forward to more posts and hopefully I’ll be able to pull out a helpful thread.
I am experiencing this but I’m in recovery from anorexia so it is very hard to follow restrictive advice when I’m meant to be upping my intake of everything. I make sure I always include fats and protein but still suffer - shivers, blurred vision, shakes. I’m not recovering from a super low weight, I wonder if the reactive hypoglycemia will right itself with consistent eating and healthy weight? I severely restricted carbs for years and reintroducing them has had an incredible benefit to my mood…Hard as GP not interested so am trying to navigate it on my own! Any suggestions who to go to for help?
I have another question. The low GI/carb recommendations do seem to be effective for general meals at home, but isn’t this leading to more carbohydrate sensitivity and making this problem worse when higher carb foods are the only choices, such as sharing a meal away from home? It’s pretty rotten to have to decide between sharing a fun evening with friends and having a hypo reaction.
Very interesting! I have pp reactive hypoglycemia. Also have EPI so maybe my pancreas doesn't make enough glucagon--I've not been tested for glucagon levels. For me, insulin doesn't go overly high.
I make dietary modifications like those you mention: lots veggies, lower glycemic carbs, high fiber, always protein and fat with every meal.
Is it true that it's not just cooled pasta that causes lower glucose excursions, but most cooled high carbohydrate foods?...because of resistant starch? I enjoy plenty of complex carb-rich leftovers.
Thanks for covering a topic not much discussed and providing suggested dietary modifications!
Very helpful post! What do you make of low glucose levels in the absence of symptoms ? After getting some bloodwork done my glucose levels were at 60 after having eaten bowl of porridge with milk about two hours before the blood draw, but I felt fine at the time.
Thanks for this, your glucagon graph just explained why my glucose levels are uncomfortably high ( 6-7 UK units) on my low carb diet - I’ve massively increased my protein intake over recent years as we’re all being encouraged to do in order to build muscle! This probably explains why a lot of people in the LMHR facebook groups and the carnivores also find the same thing. My next question then is - is this harmful? I’m inclined to believe it’s not good for me to have such consistently high glucose, even if there are no large excursions, which gives me an HbA1c of 5.7%. I fear I may be glycating left, right and centre! So it’s not the increased protein being turned into glucose ( which biochemistry people tell me is not going to happen unless I’m starving to death)but rather an increase in glucagon as a response to the protein which then tells my liver to chuck out more glucose.
On the point of people having symptoms of hypoglycaemia when their glucometer says otherwise, I have found that when I do a prolonged fast 48-72hrs I will choose to stop because I suddenly feel weak, shaky, hot/cold, light headed etc. my glucose will at last be reading normal (4-4.5) but I’ve often had the lower levels for 12hrs or more by then and had a lower reading ( say 3.5) in that previous 12 hours - so it’s not a sudden drop. This might be like a very slow reactive hypo for me if my normal levels run 5.5-6.5? I did read somewhere that maybe what I was experiencing could be a sudden low in sodium ( or maybe all of Na, K & Mg) which might fit better with the fact that eating doesn’t bring immediate relief, but takes a couple of hours. Seems less likely this would be the problem for people who are eating 3 meals a day though as they’re electrolytes wouldn’t have had time to get out of balance.
Thank you for posting this! I’m not diabetic, but after hitting perimenopause and beyond I developed really bad sensitivity to refined carbohydrates like bread and pasta. Eating two slices of toast with breakfast is enough to give me a surge of adrenaline-like anxiety and racing heartbeat 30 minutes later. It gets worse towards the end of the month when my hormones are low, and better during the middle of the month, so I believe it’s hormone-related. I’ve been managing it using the strategies you already mentioned above, and also found that a heavy workout will improve it for a few days afterwards. It’s been frustrating dealing with this not being able to find any information about it, so thank you. 🙏🙏🙏
Your posts have finally begun to shed some light on my symptoms. I’m not diabetic, I train 12-15 hours/week and I got a CGM bc my A1c is 5.7-6.2. My CGM shows I have pp hypoglycemia (and I FEEL it!!) as well as post exercise (and often during exercise) hypoglycemia. Eating more carbs before exercise makes it worse. Also dairy makes it worse. I’m already eating protein (100-120g/day) and 40-50g of fiber/day. I’ve been to 4 dieticians and 3 sports med doctors and no one has any advice. The only thing that helps is not training. 🤷♀️ there is something going on, but the usual low glycemic advice isn’t working as well. I look forward to more posts and hopefully I’ll be able to pull out a helpful thread.
I am experiencing this but I’m in recovery from anorexia so it is very hard to follow restrictive advice when I’m meant to be upping my intake of everything. I make sure I always include fats and protein but still suffer - shivers, blurred vision, shakes. I’m not recovering from a super low weight, I wonder if the reactive hypoglycemia will right itself with consistent eating and healthy weight? I severely restricted carbs for years and reintroducing them has had an incredible benefit to my mood…Hard as GP not interested so am trying to navigate it on my own! Any suggestions who to go to for help?
Hi Natalie, I am in a very similar position so also interested in any suggestions.
Wishing you all the best in your recovery.
Thank you Sam, and to you too.
Did you see this study from Tokyo? https://www.nature.com/articles/s43856-025-00819-5
I have another question. The low GI/carb recommendations do seem to be effective for general meals at home, but isn’t this leading to more carbohydrate sensitivity and making this problem worse when higher carb foods are the only choices, such as sharing a meal away from home? It’s pretty rotten to have to decide between sharing a fun evening with friends and having a hypo reaction.
Very interesting! I have pp reactive hypoglycemia. Also have EPI so maybe my pancreas doesn't make enough glucagon--I've not been tested for glucagon levels. For me, insulin doesn't go overly high.
I make dietary modifications like those you mention: lots veggies, lower glycemic carbs, high fiber, always protein and fat with every meal.
Is it true that it's not just cooled pasta that causes lower glucose excursions, but most cooled high carbohydrate foods?...because of resistant starch? I enjoy plenty of complex carb-rich leftovers.
Thanks for covering a topic not much discussed and providing suggested dietary modifications!
Very helpful post! What do you make of low glucose levels in the absence of symptoms ? After getting some bloodwork done my glucose levels were at 60 after having eaten bowl of porridge with milk about two hours before the blood draw, but I felt fine at the time.
Thanks for this, your glucagon graph just explained why my glucose levels are uncomfortably high ( 6-7 UK units) on my low carb diet - I’ve massively increased my protein intake over recent years as we’re all being encouraged to do in order to build muscle! This probably explains why a lot of people in the LMHR facebook groups and the carnivores also find the same thing. My next question then is - is this harmful? I’m inclined to believe it’s not good for me to have such consistently high glucose, even if there are no large excursions, which gives me an HbA1c of 5.7%. I fear I may be glycating left, right and centre! So it’s not the increased protein being turned into glucose ( which biochemistry people tell me is not going to happen unless I’m starving to death)but rather an increase in glucagon as a response to the protein which then tells my liver to chuck out more glucose.
On the point of people having symptoms of hypoglycaemia when their glucometer says otherwise, I have found that when I do a prolonged fast 48-72hrs I will choose to stop because I suddenly feel weak, shaky, hot/cold, light headed etc. my glucose will at last be reading normal (4-4.5) but I’ve often had the lower levels for 12hrs or more by then and had a lower reading ( say 3.5) in that previous 12 hours - so it’s not a sudden drop. This might be like a very slow reactive hypo for me if my normal levels run 5.5-6.5? I did read somewhere that maybe what I was experiencing could be a sudden low in sodium ( or maybe all of Na, K & Mg) which might fit better with the fact that eating doesn’t bring immediate relief, but takes a couple of hours. Seems less likely this would be the problem for people who are eating 3 meals a day though as they’re electrolytes wouldn’t have had time to get out of balance.
Love your stuff on Diabetes!
Thank you for posting this! I’m not diabetic, but after hitting perimenopause and beyond I developed really bad sensitivity to refined carbohydrates like bread and pasta. Eating two slices of toast with breakfast is enough to give me a surge of adrenaline-like anxiety and racing heartbeat 30 minutes later. It gets worse towards the end of the month when my hormones are low, and better during the middle of the month, so I believe it’s hormone-related. I’ve been managing it using the strategies you already mentioned above, and also found that a heavy workout will improve it for a few days afterwards. It’s been frustrating dealing with this not being able to find any information about it, so thank you. 🙏🙏🙏