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@@bellabloom - I am so sorry you are dealing with this and my response is a bit off topic, but I wanted to mention something. Have you ever been tested for autoimmune diseases? The reason I ask is that many of your symptoms sound like what I had when they discovered I had Graves disease (and likely Hashimotos but long story on that). Graves is when your immune system attacks your thyroid and you become Hyperthyroid (not hypo which is what you hear most people have). it was discovered when I was 44 and still at 320 pounds. The thing is, I had massive hot flashes, sweating, sudden weight loss, tremors, heart palpitations, etc. With Hashimotos, your thyroid will swing wildly back and forth between hyper and hypo and some of your symptoms sound hypo (hair loss, cold, low heart rate). (I too swung back and forth which is why I think mine was also Hashimotos but they had already destroyed my thyroid before testing for Hashis.) Anyway, all to say, is it at all possible there is something else going on in your body? A good rheumatologist can run a lot of tests but if it is thyroid related, they will refer you to endocrinologist. Might be worth checking out.... Best wishes on your recovery.

It seems that several individuals that underwent RNY gastric bypass surgery have experienced sleepiness after eating a meal. A search on the internet seems to give a variety of reasons rather than just one. My only advise is to make sure that you are following the guidelines for daily Vitamin, Protein and Fluid requirements. This is extremely important. Next, some people experience "reactive hypoglycemia" after surgery. After consuming a meal, your blood sugars can drop suddenly. 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.

@@Killian I am 8 weeks post op, and I am steadily losing weight. Lost 12kg (26.4 Ibs) so far. When is your surgery, and what type of surgery are you having? Sleeve or Bypass? I am finding that the more weight I lose, my Thyroxine (Synthroid) levels get too high, and I am swinging back to Hyper thyroid again .... I am glad to learn that you also skip Sunday dose. I will start this Sunday, and see what happens. I had RAI in August last year (2015), and went Hypo in December last year, 2015 On Thyroxine since January 2016, so this is a new learning curve for me. I have to have 6 weekly blood tests post surgery, seeing my Endo every 3 months, unless I get issues ..... I take my Thyroxine early in the morning, when I first wake up, on empty stomach, then go back to sleep. This way I can have my coffee and Breakfast when I get up. Calcium, I take it in the evening. With weight loss, the Synthroid levels can be affected, and doses need to be monitored and adjusted, if needed. Good luck with your surgery Cheers, Margo

@@Killian - that's a pretty high dose. Have you ever tried taking it in the morning on empty stomach? Might be able to have a lower dose that way as I think food and other meds affect it. Having said that, as long as you are consistent, that is the key. I am same as you (graves, RAI in 2012, hypo by 6 weeks post-Rai). Good news is it hasn't hindered my weight loss at all. I am down about 115 pounds since surgery (11 months). I have had to increase my med as it doesn't absorb as easily post-op (at least with bypass). Good luck to you!! Sent from my HTC One M9 using the BariatricPal App

Someone posted something similar happening to him earlier this week. Search reactive hypoglycemia and you will find it. He ended up fainting twice and was in the ER. Here it is. http://BariatricPal.com/index.php?/topic/366629-Reactive-Hypoglycemia?

@ Grave's disease here too. Had my thyroid destroyed by RAI (radioactive iodine) swallow when I was in the Navy Sometime in 1999. Been Hypo and on Synthroid since 1999. I am Pre-op and hope my thyroid does not hinder my weight loss progress. Time will tell. Currently on 300 Mcg tablet once a day and skipping Sundays. I never knew about taking it with Calcium..will have to watch for that. I take it everynight at bed time and my levels have been steady ever since. I see an Endo once every 6 months, I find the Endo knows a bit more about Graves then my PCP.

@proud3bme Thank you for your response. My surgeon said it's not uncommon for WLS patients to have "reactive hypoglycemia" from eating carbs. He said to avoid carbs. BUT...that's the thing, I haven't been eating them. Yesterday I had 9 g of carbs and that would be typical for me at this point due to the restricted diet they have me on. So he's not right...it's not reactive hypoglycemia (I researched it)...he was no help. I think I'm going to add in a few more complex carbs each time I eat from nutrient dense foods like sweet potatoes. Maybe that will help. I drank 1/2 of a Protein shake before bed and it didn't help at all.

I don't have diabetes. I was sleeved on 4/4 and have lost 34 lbs (HW was 277). The last few days I've woken up shaky. I decided to test my blood sugars - this morn it was 58 - anything below 70 is considered hypoglycemic. My surgeon said its not unlikely for WLS to develop reactive hypoglycemia - but that is caused from eating carbs. I'm just now 5-6 days into my pureed food diet and I haven't been eating carbs. Yesterday I had 9g of carbs that came from my Protein shakes - ones that are approved by them. I also had 510 calories and like 68 g of protein. What is going on? Anyone else deal with this? It sucks, it's scary and it makes me feel like crap! Sent from my iPhone using the BariatricPal App

Hi Jen: Are you seeing a Rheumatologist? If not you might want to consult one to help with a diagnosis. I went to doctors or 14 years, most of them told me that my symptoms were all in my head. It wasn't till I sat down one day and wrote down everything I though was a symptom and when I was done I had 2 sides of a piece of paper. I went and saw a new Rhematologist and gave him the paper with the symptoms, he spent an hour and a half with me going over everything and then sent me for a million x-rays and tons of blood work and some other tests. He had told me he thought I had reactive arthritis. I went home and looked it up and thought hum, that doesn't sound too bad. When he got my results he told me I have Ankylosing Spondylitis! I said what the HELL is that I can't even pronounce that. It is also a form of arthritis and is an autoimmune disease with no known cure. I also have a secondary diagnosis of rheumatoid arthritis , along with Fibromyalgia. He is constantly testing me though for Lupus, that's what they thought I might have in the beginning, but it is hard to diagnos. Don't give up on a diagnosis, only you know your body and you need to keep pressing the doctors for a diagnosis, not just arthritis of unknown origin. I am pre-op right now, but will be getting sleeved in July. My doctors say it should help with some of the issues I have. Also when you have one autoimmune disease, it is possible to have more than one of them. I hope you get a clear diagnosis in the near future it will help put your mind at ease when you have a name to what is causing you so much troiuble. Sorry for the long post....Jill

@@Daisee68 Yes, I kept my beta blocker for "just in case". I have both propranolol and atenolol, and I am glad that I kept both. This disease can make life so much harder, especially when trying to get back on track with all the responsibilities, and social interactions. I have been on 100mcg of Thyroxine since January this year. 4 months after my RAI and thyroid destroyed, I swung to TSH 17.4 Now, back to square one .... My Endo doesn't want me to cut my pills (ironically I got another refill for more 100mcg script, recently, and still have 1/2 box of the currrent 100mcg .....) She just wants me to take my med for 6 days, then not take it on 1 day per week. So, I am to take it Monday-Saturday, then not take it on Sunday My blood tests are due in 6 weeks time, then again 6 weeks later. Yes, I have to monitor it carefully. If in 2-3 weeks I don't see a change, I may have to cut the tablet, and try it that way. I don't want to go hypo, but hyper is tough too ..... Thank you for your support.

@ - I am so sorry to hear this! I know how miserable that is. Glad you have a beta blocker on hand. If it helps, even when I only adjusted by 1/4 of a pill per week (ie only 37.5mcg pet week, I felt better pretty quick - within a couple of weeks). Are you scheduled tiniest again in 6 or 8 weeks? 100mcg per week is a pretty. If adjustment and I don't want it to make you hypo and not catch it. Keep an eye on your symptoms and try to wait out the 8 weeks before retesting. Again so sorry you are miserable. It will stabilize eventually! Hugs!! Sent from my HTC One M9 using the BariatricPal App

Thanks Jamie, I thought it was a lot. I wonder if I should reduce the carbs a bit. I thought it might be to prevent hypos..which I have had anyway Sent from my iPhone using the BariatricPal App

Can i please ask for some advice, I am an insulin dependant diabetic and the pre op diet they have me on includes some carbs...a weetabix for Breakfast, 2 crisp breads at lunch and 3 tablespoons of rice at dinner...along side that I am having a small amount of lean meat, salad, and some vegetables. My surgery is next Tuesday.. Will this still shrink my liver enough? I am following what the hospital gave me. Many thanks X (I am still experiencing the had aches, irritability, feeling lethargic, and have had a hypo) Sent from my iPad using the BariatricPal App

Hiya all, I'm new to here and just was wanting to make contact. I am insulin dependant diabetic with sever insulin resistance, I am 1 week away from rny surgery and on day 3 of the pre surgical prep. From what I have seen I don't really have much to moan about, as I am still able to eat actual food, but wondered..did anyone else have extreme cravings, headaches, insomnia, low mood, and agitation when doing the prep? Also did anyone feel just generally really unwell? It's only day 3 but it's kicking the hell out of me. I am able to have the following each day (which I know is more than most), but am worried that I am maybe eating a bit too much to shrink my liver, or that I am just getting it all wrong. The hospital have me the following diet: Breakfast - 1 weetabix Lunch- small portion of lean meat or fish, salad (no dressing), 2 crisp breads or a slice of bread Dinner- small portion of lean meat or fish, 3 small potatoes or 3 spoons of rice, vegetables 1/2 pint of skimmed milk per day (to be used in tea or coffee and my breakfast) A sugar free & fat free yoghurt No sauces no alcohol no fizzy drinks I had a hypo today I am currently 106kg, I weighed 122kg at the start of my journey 2 years ago. I have gone from a 44 inch trouser to a 34/36 inch. Am having the surgery for diabetes reasons not so much for weight loss. Thank you in advance for any replies xx Sent from my iPhone using the BariatricPal App

Hiya all, I'm new to here and just was wanting to make contact. I am insulin dependant diabetic with sever insulin resistance, I am 1 week away from rny surgery and on day 3 of the pre surgical prep. From what I have seen I don't really have much to moan about, as I am still able to eat actual food, but wondered..did anyone else have extreme cravings, headaches, insomnia, low mood, and agitation when doing the prep? Also did anyone feel just generally really unwell? It's only day 3 but it's kicking the hell out of me. I am able to have the following each day (which I know is more than most), but am worried that I am maybe eating a bit too much to shrink my liver, or that I am just getting it all wrong. The hospital have me the following diet: Breakfast - 1 weetabix Lunch- small portion of lean meat or fish, salad (no dressing), 2 crisp breads or a slice of bread Dinner- small portion of lean meat or fish, 3 small potatoes or 3 spoons of rice, vegetables 1/2 pint of skimmed milk per day (to be used in tea or coffee and my breakfast) A sugar free & fat free yoghurt No sauces no alcohol no fizzy drinks I had a hypo today I am currently 106kg, I weighed 122kg at the start of my journey 2 years ago. I have gone from a 44 inch trouser to a 34/36 inch. Am having the surgery for diabetes reasons not so much for weight loss. Thank you in advance for any replies xx Sent from my iPhone using the BariatricPal App

My friend, I would be concerned about adding a weight suppressant right now. Didn't you just recently start another new med? I think I would ask if THAT med might be revving up your appetite. It's weird how meds reactive so differently within individuals. Until you can find out about the med and its possibilities pertaining to you new appetite, I wouldn't be adding anything new. I'll always side on "changing the existing recipe" before "adding another ingredient". Decisions, decisions. Why do we always have to be making them? Prayers going up for you---and me.

That is so wonderful that you have such great control of your diabetes. Are you a Type 1? I'm just curious because most diabetics (T2's) go into remission. That isn't to say that they still wouldn't have a reactive hypoglycemia happen if they ate just a carb with no protein follow up. I am T2 and still wearing my pump, however my numbers are behaving much better than they were prior to surgery. Actually, aside from the weight I gained from insulin use and not being able to drop it, and the horrible insulin resistance I have is why I had this surgery done. Keeping my fingers crossed that at some point the insulin will not be needed. I'm only 3 weeks out, and I've been diabetic for over 21 years, so it may take the weight loss to lower the insulin resistance. I'll be patient; I have no choice. But, much happier that I'm not pumping in tons of insulin with my numbers staying high anymore.

Hi @@Phoenix40! So last Thursday I went for my Nutrition/Surgeon/Coordinator appointment. I'll describe each appointment below: First you are weighed in and your height is taken Nutrition: The nutritionist is a very nice lady and she will ask you about what type of diet you have been on (I started following the 1200 calorie diet after orientation). You will have to describe what you usually eat for breakfast, lunch, dinner, Snacks,etc. She also talks about Vitamins and what type you will need post op (this will depend on if you get the sleeve or bypass) and what to expect as far as diet goes in the first weeks after surgery (i.e. liquids, soft foods, etc) She also informed me about the different types of Protein drinks and answered any questions I had. Surgeon: Dr. Hahn was very patient. He went over my BMI, co morbidities, medications, etc to ensure that I would be a good candidate for surgery. He said it would be my choice whether to go for sleeve or bypass as I would be great candidate for either (I don't have acid reflux). We talked about the differences between sleeve and bypass (right off the bat he discouraged from the lap band so we were in agreement about that). He reiterated that regain was possible with either surgery and so is dumping (so it really comes down to the patient being willing to put in the work to not only lose the weight but keep it off). He went into detail about possible complications withe each procedure (ulcers, reactive hypoglycemia, reflux, etc). He then set a weight loss goal for me. Normally they ask the patients to lose 10% of their body weight but Dr. Hahn only requires a 7-8%, of total body weight, loss. For me 7-8% was 19 pounds (I had already lost 9 pounds since orientation and he credited me so I needed to lose 10 pounds to get a surgery date and 5 pounds to get a psych appointment). The only other requirements Dr. Hahn set out for me, besides weight loss, is attending at least one support group, and an EKG (I already finished my bloodwork). Coordinator: She was very pleasant. She informed of what my next steps to surgery are (support group, psych appointment, etc) and that to be sure I call monthly to update them on my weight and progress. Before the psych appointment each patient must fill out a surgery quiz (located in Chapter 9 of the Bariatric binder) and send it in before the appointment. Overrall it was an interesting yet quick appointment. I was told to expect to be there for 3 hours but for me it was more like 2 hours. Sent from my SM-G925T using the BariatricPal App Thank you for posting this! Your timing was perfect! I was struggling with one of my bad habits when I saw this and it helped me get passed it. Hearing about the appointment made me excited for my next step and reminded me why I am doing this. You are very welcome! I can't wait to hear about your appointment. Always remember..you are not alone in this journey:) Sent from my SM-G925T using the BariatricPal App

Hi @@audaciousmarie! Hi @@Phoenix40! So last Thursday I went for my Nutrition/Surgeon/Coordinator appointment. I'll describe each appointment below: First you are weighed in and your height is taken Nutrition: The nutritionist is a very nice lady and she will ask you about what type of diet you have been on (I started following the 1200 calorie diet after orientation). You will have to describe what you usually eat for breakfast, lunch, dinner, Snacks,etc. She also talks about Vitamins and what type you will need post op (this will depend on if you get the sleeve or bypass) and what to expect as far as diet goes in the first weeks after surgery (i.e. liquids, soft foods, etc) She also informed me about the different types of Protein drinks and answered any questions I had. Surgeon: Dr. Hahn was very patient. He went over my BMI, co morbidities, medications, etc to ensure that I would be a good candidate for surgery. He said it would be my choice whether to go for sleeve or bypass as I would be great candidate for either (I don't have acid reflux). We talked about the differences between sleeve and bypass (right off the bat he discouraged from the lap band so we were in agreement about that). He reiterated that regain was possible with either surgery and so is dumping (so it really comes down to the patient being willing to put in the work to not only lose the weight but keep it off). He went into detail about possible complications withe each procedure (ulcers, reactive hypoglycemia, reflux, etc). He then set a weight loss goal for me. Normally they ask the patients to lose 10% of their body weight but Dr. Hahn only requires a 7-8%, of total body weight, loss. For me 7-8% was 19 pounds (I had already lost 9 pounds since orientation and he credited me so I needed to lose 10 pounds to get a surgery date and 5 pounds to get a psych appointment). The only other requirements Dr. Hahn set out for me, besides weight loss, is attending at least one support group, and an EKG (I already finished my bloodwork). Coordinator: She was very pleasant. She informed of what my next steps to surgery are (support group, psych appointment, etc) and that to be sure I call monthly to update them on my weight and progress. Before the psych appointment each patient must fill out a surgery quiz (located in Chapter 9 of the Bariatric binder) and send it in before the appointment. Overrall it was an interesting yet quick appointment. I was told to expect to be there for 3 hours but for me it was more like 2 hours. Sent from my SM-G925T using the BariatricPal App Thank you for posting this! Your timing was perfect! I was struggling with one of my bad habits when I saw this and it helped me get passed it. Hearing about the appointment made me excited for my next step and reminded me why I am doing this.

Hi @@Phoenix40! So last Thursday I went for my Nutrition/Surgeon/Coordinator appointment. I'll describe each appointment below: First you are weighed in and your height is taken Nutrition: The nutritionist is a very nice lady and she will ask you about what type of diet you have been on (I started following the 1200 calorie diet after orientation). You will have to describe what you usually eat for Breakfast, lunch, dinner, Snacks,etc. She also talks about Vitamins and what type you will need post op (this will depend on if you get the sleeve or bypass) and what to expect as far as diet goes in the first weeks after surgery (i.e. liquids, soft foods, etc) She also informed me about the different types of Protein drinks and answered any questions I had. Surgeon: Dr. Hahn was very patient. He went over my BMI, co morbidities, medications, etc to ensure that I would be a good candidate for surgery. He said it would be my choice whether to go for sleeve or bypass as I would be great candidate for either (I don't have acid reflux). We talked about the differences between sleeve and bypass (right off the bat he discouraged from the lap band so we were in agreement about that). He reiterated that regain was possible with either surgery and so is dumping (so it really comes down to the patient being willing to put in the work to not only lose the weight but keep it off). He went into detail about possible complications withe each procedure (ulcers, reactive hypoglycemia, reflux, etc). He then set a weight loss goal for me. Normally they ask the patients to lose 10% of their body weight but Dr. Hahn only requires a 7-8%, of total body weight, loss. For me 7-8% was 19 pounds (I had already lost 9 pounds since orientation and he credited me so I needed to lose 10 pounds to get a surgery date and 5 pounds to get a psych appointment). The only other requirements Dr. Hahn set out for me, besides weight loss, is attending at least one support group, and an EKG (I already finished my bloodwork). Coordinator: She was very pleasant. She informed of what my next steps to surgery are (support group, psych appointment, etc) and that to be sure I call monthly to update them on my weight and progress. Before the psych appointment each patient must fill out a surgery quiz (located in Chapter 9 of the Bariatric binder) and send it in before the appointment. Overrall it was an interesting yet quick appointment. I was told to expect to be there for 3 hours but for me it was more like 2 hours. Sent from my SM-G925T using the BariatricPal App

So I am one of the unlucky ones who gets reactive hypoglycemia. It is not fun and I am still trying to figure out the combination of foods that cause if for me. I have had it happen about 12 times since surgery 20 months ago. When it comes on, you don't even realize it is happening until it is almost too late. I suddenly don't feel right, I start shaking and I crash very fast. It takes a lot to get my sugars back to normal. I was a very controlled diabetic before surgery. I will usually have a Protein shake for break fast but occasionally I like a small bowl of cream of wheat. On the days I have that cream of wheat I have to be very careful eating some protein within an hour of the cream of wheat. If I don't do that I am almost guaranteed a episode. Once you have an episode it is very difficult to get control of it without eating more carbs all day long so the trick is never getting there in the first place. I had an episode last week and looking back at why, I know my carbs were higher than normal and my body simply does not like that. It is a very scary condition and if it gets too severe and you don't figure out what causes it, the only cure is having your bypass reversed which is absolutely not a solution for me. So, I have to be diligent about eating right and checking your sugar the minute you feel weird. Last week when I felt it I tested my sugar and I was at 43. Scary! I hope you figure out what might be causing your situation. Make sure you get to the bottom of it so you don't break your face!

The following are some of the common abbreviations used on this message board: ACL = Anterior cruciate ligament AMRAP = As Many Rounds As Possible (crossfit) BB = belly button bc = because BCBS = Blue Cross/Blue Shield BED = Binge Eating Disorder bf = best friend BM = bowel movement BMI = Body Mass Index bp = blood pressure BPD = Borderline Personality Disorder or Biliopancreatic Diversion (Scopinaro procedure) bs = blood sugar btw = by the way CBT = cognitive-behavioral therapy CC = common channel c diff = clostridium difficile cos or cuz = because CPAP = continuous positive airway pressure CRNP = certified registered nurse practitioners cw = current weight CXR = Chest X-Ray Dr. = doctor DS = Dumping Syndrome or Duodenal Switch EGD = Esophagogastroduodenoscopy EKG = Electrocardiography ff = fat free GERD = gastroesophageal reflux disease GI = gastrointestinal GNC = General Nutrition Corporation store GP = general practitioner or family doctor HBP = high blood pressure hr = heart rate hw = highest weight ICU = Intensive Care Unit Idk = I don’t know IMHO = in my humble (honest) opinion IMO = in my opinion IUI = Intrauterine insemination LAP Band = Laparoscopic Adjustable Gastric Band lol = laughing out loud LSG = Laparoscopic Sleeve Gastrectomy med = medicine msg = message NASH = Nonalcoholic steatohepatitis nf = non fat NG = Nasogastric NP = nurse practitioner NSAIDS = Non-steroidal anti-inflammatory drug NSV = non-scale victory (“scale” means “weight scale”) NUT = nutritionist OA = Overeaters Anonymous Onederland = a magical place or destination for those trying to lose weight. It might correspond to attaining a weight in the hundreds or losing a hundred pounds. op = operation OSA = Obstructive sleep Apnea Oz = Australia PB = Productive Burps PCOS = Polycystic Ovary Syndrome PCP = Primary Care Physician PM = private message (email) PMS = premenstrual syndrome POSE = Primary Obesity Surgery Endolumenal postop or post–op = post-operation or post-surgery PPI = Proton Pump Inhibitors ppl = people preop or pre-op = pre-operation or pre-surgery PTSD = Post-Traumatic Stress Disorder PVC = Premature ventricular contractions RA = Rheumatoid arthritis RH = reactive hypoglycemia RN = registered nurse RNY = Roux-en-Y RTD = ready to drink SADI-S = single anastomosis duodeno–ileal bypass with sleeve gastrectomy s/f or sf = sugar free SIPS = stomach intestinal pylorus-sparing surgery smh = shaking my head, scratching my head SO = significant other SOB = shortness of breath sw = weight at surgery tmi = too much information TPN = total parenteral nutrition TT = tummy tuck TTC = trying to conceive u = You UGI = Upper Gastrointestinal VSG = Vertical Sleeve Gastrectomy Vit = Vitamin wks = weeks WLS = Weight Loss Surgery WOD = Workout of the Day w/o = without wt = weight : ) or :-) = = smiley face : ( or :-( = = sad face

Typically with reactive hypoglycemia, or even hypoglycemia for that matter, you would feel very shaky, racing heartbeat, you may be sweaty, and nauseous all before passing out. Typically you do not just faint. That could be blood pressure. But also I would think you would feel dizzy or lightheaded from low blood pressure. I hope whatever is going on you find out what is going on and it is dealt with.

Here is a short article on reactive hypoglycemia (RH) after gastric bypass surgery. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ The individual that I know who had this problem did not have diabetes prior to surgery. I believe the first time he encountered the condition he fainted. But ever since then he learned to detect the signs and took immediate steps to preclude the onset. So after the first incident, he never repeated it. It seems that RH occurs between 1 1/2 to 3 hours after a meal. Since you woke up at 3 A.M. this might not be RH. Since your blood sugar when you had it check the next day was 60, that is on the low side. So the condition might be related to low blood sugar (hypoglycemia) or something else. Another possibility is orthostatic or postural hypotension. Here is a link to that condition. http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/symptoms-of-heart-and-blood-vessel-disorders/dizziness-or-light-headedness-when-standing-up This is one of those problems that you will need to discuss with your medical professionals.

I know only what I've read -- this condition afflicts some RNY patients (as I recall, it was in the double digit percent of patients) and also to some but fewer sleeved patients (single digit percent). I don't recall the numbers - sorry. As I recall, when it appears, it seems to be a major pain in the ass and is addressed to some extent by eating certain food combinations throughout the day -- not at the "grazing" level, but just strategic snacking. I've read several research studies on this condition. Here are a couple I remember finding earlier: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190577/ http://spectrum.diabetesjournals.org/content/25/4/217.full That's all I got. P.S. Of course, this may NOT be reactive hypoglycemia, but something else, including some kind of bug. But I knowyou'll let an M.D. diagnose what's going on with you. Best wishes.