Search the Community

That does sound like it is a bit on the low side. One time my mom was lying down on the couch, my daughter called me and said there was something wrong with mom. She was white as a sheet. She couldn't talk. She tried but no words came out, only a few whispers. She couldn't move. She looked like she was dying. We called an ambulance, they came in and measured her blood sugar and I believe it was in the 30's. So 58 is too low. So I think you are right about reactive hypoglycemia. Here is a link https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf According to their webpage: How can I prevent reactive hypoglycemia? You can help prevent reactive hypoglycemia by following your diet guidelines for bariatric surgery. • eat 3 healthy meals and 2 healthy snacks each day • space meals and snacks 2 to 3 hours apart • eat protein at each meal and snack time • avoid skipping meals and snacks • avoid or limit alcohol depending on what stage of diet your are at • avoid or limit caffeine depending on what stage of diet your are at • avoid sweets like cookies, cakes, candy, pop, juice and sweet drinks Instead of sugars and simple carbohydrates, eat complex carbohydrates because they release less sugar over a longer period of time. Having a complex carbohydrate with protein will slow this release even more.

Hi there, Sorry to hear of your struggles. We don't have the same type of surgery but I have reactive hypoglycemia. Some of us will develop this as a complication from surgery. Sounds like you are managing it. I use a glucose meter. I usually know when my blood sugar is crashing. I can feel it coming on. I agree this takes work even years out. I have times when I'm doing well. When I'm not, I peek back in here to get back on track. Wishing you the best, Jenn

Hi all, I haven’t been around here in a while but I’m working on a reset and wanted to check in. I’ll be 4 years out in a few weeks. I had RNY gastric bypass. I initially lost 125lbs and have slowly gained back around 20lb, it fluctuates a little. Some of that is definitely fat, I’m not always vigilant about my diet but I also weight train a few days a week and have added on some muscle mass. I had a bike wreck last summer which resulted in a broken hand, dislocated knuckles, and pretty severe scrapes and bruises. It could have been much worse, but it did put me on my butt for a few months. I get most of my exercise in the summer by riding. I put put on about 15 pounds and it was winter by the time I finished physical therapy. For the last 4 months I’ve been really committed to my gym routine. I’ve been watching my diet more closely, cutting back on my drinking which, was never a problem or excessive but it is empty calories. I’ve lost most of the 15lbs and put on a little muscle. Sorry for the book, just want to give you the full picture. 3 months ago I woke up in the middle of the night to let my dog out and suddenly had what felt like severe hypoglycemia. I was pouring sweat, shaking, dizzy ect. I got some juice in me, laid back down, and felt ok soon after. I don’t have a meter so I couldn’t test. I had a drink earlier in the evening after dinner, which I normally don’t do, so I thought that might have been the cause and made a mental note to not do that again. But this incident was also many many hours after that, much longer than a normal reactive hypoglycemia episode or dumping. 3 weeks ago, I had a fairly normal dinner, a couple of pieces of thin crust pizza with vegetables, fell asleep so on the couch, and woke up again the same state. I hadn’t had anything to drink that night. This time I was slurring my words and stumbling around. I got some juice and felt ok. 2 weeks ago, same story. Except this time I didn’t have juice, I rubbed some honey on the inside of my cheek and ate a tea spoon of it. I was home alone and the next thing I know I’m waking up on the kitchen floor with no idea what happened. I went to my doctor, she told me to go on a hypoglycemia diet, which is pretty similar to an RNY diet and she ordered a glucose tolerance test. Let me tell you, that was not fun. Considering I avoid sugary drinks and items, trying shove 75grams of it into my pouch was awful, it’s amazing I didn’t throw up. My test results came back yesterday and they were interesting. Fasting glucose was 82, 1 hour was 77, 2 hours was 67, and 3 hours was 78. They actually did a finger stick at hour 3 and said it was 58, i know the meters aren’t as accurate but I was surprised at the difference. Does anyone know if those are expected results from an RNY patient? I was surprised to see my blood sugar never really went up. I’m not sure what my doctor will have to say about it yet. It figures when I’m watching my diet and focusing more on exercise than I have I start having these issues. But I’m determined to keep going. I’ve been keeping a juice box and glucose tabs next to my bed. I’ve also been splitting my dinner up and eating a little later, so far i haven’t had another incident. I really hope that’s the end of it. I have a good friend that’s in the process of having the sleeve so I’ve been talking to her a lot lately and going to support group and it’s been such a great motivator. It’s funny people thing this surgery is an easy way out, at 4 years I’m working even harder on it now than I was at 4 months.

I have hypothyroidism/hashimoto as well as anemia and hypoglycemia. I was sleeved in December and really have to work on not bottoming out from the hypo and anemia. I am also allergic to iron tablets so I have to get my iron through foods. It is a struggle. Sent from my SM-J327T1 using BariatricPal mobile app

Also anyone else have hypo or is anemic ? Does it affect anything ?

The things I packed that I used the most were a pair of sweat pants (keeps you from mooning everyone when you walk around), an eye mask (lets you sleep even if your roommate has a light on all night) and ear plugs also for sleep. I used my phone and ipad a bit, but not a lot, most of the time I was asleep or walking. I was able to shower at the hospital and brining my own hypo allergenic shampoo and soap was important and useful.

I am 9 yrs out from RNY...have had reactive hypoglycemia for about 7 of those. It started when I stopped counting sugars. Dont go over 15 grams per sitting and see if that helps. I know RNY is differs from sleeve so this may be too many grams for you...just pay attention to your grams til u get it right. I am only treated with diet. 9 yrs. out

Several people have developed reactive hypoglycemia after bariatric surgery. This can affect individual even if they were not diabetic prior to surgery. I find it confusing that your doctor is treating the condition by prescribing Metformin. Metformin is generally used to treat high blood pressure but reactive hypoglycemia is a low blood sugar condition. Here are some links that describe the condition and how to minimize its affects. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf We had one individual in our bariatric surgery support groups who had developed this condition. It kind of through him for the first time he fainted, but then when he understood the condition he felt it was very manageable. He could detect when he was about to experience the condition and just took a little food or juice and he was good to go. He didn't need any prescription medicine to treat the condition - just awareness and the proper response.

I am a little over two years post surgery and now have developed reactive hypoglycemia and been put on Metformin and given a diet. Anyone else out there going through the same thing? Thanks.

It's up to you. I had the surgery because of my family history. I am perfectly healthy now, but being proactive is better than being reactive once something wrong happens. Plus the younger you are, I imagine, the easier it will be to bounce back after surgery. I'm in my 30s, good health, and bounced back quickly (I know it's not like that for everyone). BTW- This is *not* easy by any means. It's a hard decision, pre-op is hard, post-op is hard, changing habits is hard. But being obese is hard too, so choose your hard! good luck!

Hi Maryjo, I'm glad to hear from you. I had lap-band in 2006, did fairly well with it, but it got too tight and I had it removed last year. I tried life without it, but unfortunately gained a good portion of my weight back, so had a mini gastric bypass in September. I have PCOS and have had gestational diabetes 3 times. I'd been on metformin (long acting 1000mg) for several years to manage symptoms and as a preventative to DMII. All was going well and I was losing weight fairly steadily. However, about a month ago I started getting low readings (3.0) and was symptomatic. I went off the metformin about 3 weeks ago, but continue to have reactive lows (fasting is fine) about 2 hours after eating. I've cut out all simple sugars and am really trying hard with the protein, but still struggling. My GP thinks the metformin is still in my system. I'm trying to figure out if this is just big sensitivity to carbs and late dumping or something more significant. My GP isn't too concerned and the surgeon is across the country. I called the nurse and dietician at the surgeon's office, but they didn't seem to know much about the phenomenon. I'm thinking I'd like to discuss this with an endocrinologist. I'm pretty worried about this. Kerri MGB Sep 28/17

Hi forum... I am 13 years out from RNY and I am back into the cycle of insulin resistance and reactive hypo ... anyone else struggling with this? It all started about 7 years ago when I became allergic to wheat and had to switch to a rice based diet cause of my allergy... my body just pushes too much insulin out when I eat carbs... and rice really make a me spike... then crash and burn. Would love to hear from others who have struggled with this due to PCOS... that is what started he whole cycle for me. MaryJo RNY on 8/2/04 290/130/215 current

I had a very bad insulin problem: I went for my walk (as I always did) when i got home I decided that I needed to rake the leaves. I became so dizzy and weak I almost didn't make it in the house. I checked my blood sugar, it was 294. Before this (I was diabetic before I lost my weight) I was confused because my BS had been in the 120's. I drank a protein drink and headed to lie down. When I finally went to see my DR he looked at my ledger and seen what had happened. He told me that I had REACTIVE BLOOD SUGAR. My blood sugar had dropped so low that my Pancreas kicked out lots of insulin, that is why I had the super high BS. Strange but true. I hope you figure it all out. Good Luck

Our surgeon doesn't perform the DS, but maybe I will have my wife talk to him about it nonetheless. I am so sorry to hear about your RA, my grandmother-in-law has it, and I know first hand how much it affects her quality of life. For a while, she found relief with remicade, if that helps at all. It is extremely expensive and I think is delivered with an IV. Hopefully, the weight loss might help relieve the stress on some of the joints. I've also been reading up on C-Reactive Protein (Mine is quite high) and it's effects (Inflammation). I remember reading elsewhere that white adipose tissue markedly increases inflammation, so hopefully that will help as well. I have Eczema which is also an inflammation/immune system issue, and I am really hoping the weight loss will reduce or eliminate it.

Confusion can be caused by a variety of problems. This website lists 80 causes. https://www.healthline.com/symptom/confusion The ones I would focus on are numbers: 1, 7, 27, 28 and 62. #1 Hypoglycemia (low blood sugar). Many people develop a type of hypoglycemia after bariatric surgery called reactive hypoglycemia. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass This can also occur if you were diabetic prior to surgery and did not reduce your prescription medicine after surgery. #7 Low blood pressure. If you had high blood pressure prior to surgery and were taking prescription medicine for that condition. This may be an indicator that you may need to come off some of that medicine. # 27 Hypokalemia (low potassium levels). Make sure you are taking vitamin/mineral supplements for potassium. # 28 Hyponatremia (low blood sodium). Make sure you are getting enough electrolytes. # 62 Beriberi (B1 deficiency). I would also lump B12 deficiency into this one. After Gastric Sleeve surgery, my surgeon recommended 100 mg. Thiamine (vitamin B1) weekly and 500 to 1000 micrograms sublingual B12 weekly. While you were in the hospital, you were probably given a shot of B12 which is good for one month. Since you are 4 weeks post-op that is probably wearing off and you need to begin taking B12 weekly. I am not a doctor, so take everything I say with a grain of salt. But those are the areas I would explore.

Thanks Orion and Alcn! Brief update: Surgical nurse suggested it was possibly low BP or reactive hypoglycemia. I already had an appointment with my NUT the same day, and she said the hypoglycemia was unlikely based on symptoms and timeline, but she mentioned the sodium issue. I was cleared to start trying veggies, and I started with pickles yesterday bc I missed them so much. Should also cover any missing sodium, although I'll also pick up some electrolytic water to drink every day. I reached out to my primary care, and I'm waiting on a call back so they can look into the bp issue. Unfortunately we got about 10+ inches of snow yesterday so no one is open. Teri, I have asthma and am only 40 pounds into my weight loss journey, I am frequently out of breath. [emoji23] Sent from my SM-G900V using BariatricPal mobile app

Glad you have a meter to monitor what's going on. I was diagnosed with reactive hypoglycemia. (complication from surgery) I worked with my bariatric, sports medicine and diabetes dietitians to get better control over my blood sugars. Here is an article: If you are diagnosed, Work with your team to find what foods and meal frequency work for your body specifically. June 2015 Issue CPE Monthly: Nutrition Tips for Reactive Hypoglycemia After Bariatric Surgery Reactive hypoglycemia (also called postprandial hypoglycemia, hyperinsulinemic hypoglycemia, or noninsulinoma pancreatogenous hypoglycemia) is characterized by recurrent episodes of symptomatic hypoglycemia occurring two to four hours after a high-carbohydrate meal (or oral glucose load). Patients who have undergone bariatric surgery, especially those in whom the pylorus is bypassed (gastric bypass, biliopancreatic diversion/duodenal switch), may experience reactive hypoglycemia. The dietitian is key to helping these patients manage symptoms. Symptoms Patients may experience any of these symptoms one to three hours after a meal high in carbohydrates: hunger, feeling shaky, dizziness, sleepiness, sweating, anxiety, feeling weak, confusion, heart palpitations, fatigue, aggression, tremors, fainting, or loss of consciousness. Dietary Modifications Work with your patients to help them identify and eliminate from their diets simple sugars, concentrated sweets, high-fat foods, alcohol, caffeine, and lactose (possibly). They also should avoid skipping meals or consuming meals comprised only of carbohydrates. Focus on how you can help patients modify their diets, including the following: plan mini meals spaced equally throughout the day (three to four hours); make low-volume choices; consume high-protein levels at each eating occasion, pairing protein choices with complex carbohydrates, fruits, and vegetables; choose healthful fats; and separate food and fluid intake by 30 to 60 minutes. Soluble fiber from guar gum, glucomannan, and pectin and alpha-glucosidase inhibitors, (eg, acarbose) or somatostatin analogs (eg, octreotide) can help delay gastric emptying, increase small intestine transit time, and slow glucose absorption. Patient-Specific Tips Acknowledge that everyone may have different triggers for low blood sugar or reactive hypoglycemia. Advise patients to keep detailed food journals that you can review to identify patterns (eg, timing and amount eaten as snacks, meals, and drinks; blood sugar levels; feelings). Encourage patients not to use foods or drinks with added sugar to boost low blood sugar levels, as this can cause blood sugar crashes and spikes.

Wow! ((hugs)) You've been through the wringer backwards haven't you?!!! I don't know the answer to your question, but I do know you must do something. It can't hurt to start the process and schedule in a teaching hospital if possible. That way you may have more access to the surgeon to ask your questions. I do know you need to have your med issues sorted out prior to surgery...especially when they deal with thyroid and psych meds. But I don't think it's impossible. But I'm just a schmoe on the internet that makes crap up all damn day! I'm hypo. Take endocrine therapy to keep me in cancer remission. Have so many comorbidities and am on 3 bp drugs and still fight with blood pressure every day. My metabolism is crap. But I'm pursuing this surgery with the hopes that I will have a metabolic reset that might make it easier to lose the weight. Hang in there and congrats on fighting your way through the massive grief you've experienced. You're a fighter and survivor!!!

Hey everyone! *waves* THE SHORT STORY I've been hypothyroid for fifteen years. Is bariatric surgery effective and worth the risk for hypothyroid patients? THE LONG STORY So, I'm considering WLS. I can't believe I'm actually thinking about it. My husband had WLS about three years ago and is doing fine. He's regained some weight but is still far ahead of where he was. My son had WLS around the same time. He did not do well. He had extreme absorption issues and had to have a feeding port installed just weeks after his surgery. We lost him in November 2015. The official cause of death was cancer, but we wonder if the malnutrition contributed to his developing cancer. For me, my thyroid died somewhere around 2002. I was on the Atkins program, had lost about 70 pounds, and was on my way to single digit clothing size! Then, bam - one week I gained four pounds. The next week six. And then eight. All while still working out daily and eating the Atkins way. DNA? Age? Splenda? Who knows the cause, but my thyroid was done ... completely. The weight gain, it turns out, wasn't the worst part of hypo for me. It was the depression. My doctor put me on synthetic thyroid that didn't help at all. Finally, in 2009 I found Nature-Throid and a doctor who would prescribe it. Nature-Throid eased the depression, but my weight slowly and steadily continued to climb. In 2015, my hair began falling out. My skin had always been dry. Now it peels off in sheets. And I put on an additional fifty pounds within months. I chalked a lot of those symptoms to stress. The last few years have just been awful. In January 2015, my husband had emergency surgery to place a stent in his heart and I blew out my knee. Mid 2015, I had to shop for a nursing home for my mom. If you've ever done that, you know there aren't any good nursing homes. Mom died on Christmas Day 2015 ... six weeks after losing my son. August 2016, my brother was diagnosed with inoperable brain cancer. Next, I made a super poor career decision and lost my job in December 2016. My brother died January 30, 2017. Yet, I'm still standing ... just barely. Because both knees are now bone on bone. My blood pressure is fine. I'm not diabetic. No heart disease. Except for that damn thyroid, my blood work is all healthy. But I'm at an all-time high of 311 lbs. It hurts to move. It hurts to stand. I carry a lot of the weight in my hips and thighs which even makes it hurt to sit. I hurt and I don't want to hurt anymore. If you've read this far, thank you for letting me rant. I'd love to hear from other hypothyroid patients. What has been your experience with WLS? Pros? Cons?

Thanks, your reply definitely gave me some reassurance. We are really similar when it come down to losing weight while having hypo or PCOS. That was actually one the main reasons why I wanted to get the sleeve, because I knew I wouldn't be able to lose the amount of weight i need to, to be considered ''normal'' bmi. Thanks!

Give yourself credit for getting back on the horse and putting the focus on your health! We all start out with a basic lifting plan and progress. Weight loss and muscle gains do not happen overnight. Your goal right now is weight loss....right? Did your dietician give you a calorie and protein goal to hit? You will still eat according to your dieticians high protein plan. Weight lifters eat a diet to shred (lose weight to expose muscle) You can't eat a weightlifters bulking diet to gain muscle and expect weight loss. Get fit in the gym lose weight in the kitchen. One pound of muscle burns 50 calories. You are still going to gain strength and build muscle with time. Hypoglycemia is manageable. Get diagnosed and prescribed glucose testing kit. Keep track of your low blood sugars. You will sit down with your dietician and make adjustments to keep your glucose levels in check (I am three years out. I'm a type one diabetic. I have reactive hypoglycemia after surgery) I lift and distance run. I eat protein before and after the gym. I keep healthy snacks in my gym bag. I only eat them if my blood sugar drops below 70, You can reach your dream!!!! Build into a fitness bad ass!

So this is VERY serious! Start taking them again asap. Only quit them when you're working with your psych! Dayum!!! Quitting cold turkey can send you into a reactive phase that will literally double you over with bone/muscle pain. It makes all your neurotransmitters get proverbially locked up! In general, it takes almost as long to taper off meds as you've been taking them -- kinda...such as for every month you were taking them, it takes 1 week to 1 month to step down the dose depending on the individual. It's too late now, but honestly this stuff should have been reconciled pre-surg!!!! It's part of why we have so many hoops to jump through and so many doc appts! Your meds in general should only be crushed if they aren't enteric coated or time release. Psych meds need to be switched to non-time release. Think Effexor is one that can easily be changed. In addition to this, what @dreamingsmall said!! Truly magical thinking to think otherwise. ((hugs)) and get some meds into your system asap. Make an appointment with your psych asap and formulate a plan!

Hmmm, changes within the inner ear would account for the dizziness, but not for the darkening of vision while standing. That is almost always related to blood pressure. Either hypo or hypertension can cause vision issues like the ones described.

It could be due to a number of factors. If your blood sugar gets too low or if your blood pressure gets too low, fainting can result. 1. If you were diabetic prior to surgery and taking medicine for it, the amount that you take for this condition might need to be reduced or eliminated. The same may apply to those taking prescription medicine for high blood pressure. 2. Some individuals (irrespective of whether they had diabetes prior to surgery) get a condition called reactive hypoglycemia. Here is a couple links. https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778 https://www.verywell.com/what-to-know-about-reactive-hypoglycemia-1087744 3. It can also be due to dehydration or an electrolyte imbalance. Possible triggers of orthostatic hypotension include: dehydration – if you're dehydrated, the amount of fluid in your blood will be reduced and your blood pressure will decrease; this makes it harder for your nervous system to stabilise your blood pressure and increases your risk of fainting. https://www.medicalnewstoday.com/articles/182524.php Generally, electrolyte disturbance symptoms depend on which electrolytes are affected and the severity of the imbalance. Most electrolyte problems involve abnormal levels of sodium, potassium, or calcium. Typical mild symptoms of an electrolyte disturbance include dizziness and muscles cramps or weakness. https://draxe.com/electrolyte-imbalance/ It is important to drive this one to ground. Consult your surgeon's office. If you have a blood pressure monitor and a blood sugar monitor at home, you might be able to localize the cause immediately after your next episode.

Here are a few potential causes. 1. If you were diabetic prior to surgery and on meds, you may have to reduce your meds at this point. 2. You may be experiencing reactive hypoglycemia. Here are a few links that might help. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ http://www.todaysdietitian.com/newarchives/060415p48tip.shtml https://www.healthline.com/health/hypoglycemia-without-diabetes 3. Dehydration can also cause dizziness and lightheadedness. https://www.emedicinehealth.com/dehydration_in_adults/page3_em.htm