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I have a hypothyroid second to Hashimotto Disease. I still have my Thyroid, but it's not in good shape. I just wanted to let you know that we have a Hypothyroid thread or 2 on this site. Just type in Hypo thyroid Bandsters, and it should come up.

I have hypo thyroid and i am 2 months out. I have lost 45 pounds so far. My doc is a debbie downer as he thinks that is slow, but ai m half way to goal so I am concidering it a win

Hi. I had Graves Disease & now I'm hypo, so I shared your concern. You will def lose weight. I'm about a month out & so far have lost about 24 lbs. I think that's pretty good! My hypo dose of med is 225 mg and I have to crush my pills before I take them & that's not as bad as I thought it would be. Talk to your dr about your concerns. It really might make you feel better. Anyway, good luck & see you on the "losers bench"!

Don't think of losing weight as if it were a given symmetrical line going down for each day you burn more than you consume. Your body is a reactive machine and will retain fluids if it's TOM, or you consume processed flour/sugar, or too much sodium or simple carbs. Fluids can create plateaus that last months. If you're exercising, you will retain some fluids due to your body rebuilding torn muscles. If you exercise, you can lose fat but gain weight. Weight vs. fat are two different animals. Burning fat cells and replacing them with muscle cells will make many weight scales stop moving or even increase. This is a long long journey and one or two weeks or even months here or there are inconsequential in the long run. tmf

I'm confident it will come off and I'm very happy with how I feel and my progress. I am a post-menopausal woman with hypo-thyroidism who is almost 54yrs old. I've lost 29lbs in eight weeks and I can see a huge difference. I've gone from a tightly fitting size 22 to a comfortable fitting sz18 and hope to fit in sz16 by summer's end. I am not discouraged or impatient at all, merely curious. :-) I am curious if, among the other factors I mentioned, age or menopause has anything to do with the rate of weight loss. I see some people who lose 75-80lbs in the first few months and others who average 30-40 in the same time frame. I was wondering if there is a reason, or maybe several reasons, for the vastly different rates of weight loss. So curiosity and boredom (it's been raining) have been the reasons behind my question. :-)

We had a free health screening at work so I figured id see what my numbers were looking like almost 4 months post op. My cholesterol was down from a little over 200 a year ago to 109 now which is great and my blood pressure was perfect but my glucose levels were low. It was only 57 which seemed to concern the person taking it. I ate a banana about an hour before. Anyone know if this is a normal glucose level for an RNY patient? Or could it be reactive hypoglycemia from the banana?

Dumping is diarrhea and that was not mentioned. Several other posts have these exact symptoms and more like reactive hypoglycemia where too much or little sugar in the system and insulin is released.

The "Hair loss" is called Telogen Effluvium https://www.webmd.com/skin-problems-and-treatments/hair-loss/effluviums#1 It's not really "Hair loss" it's just a larger % of your hair follicles going into rest at once, so when they reactivate they shed the hair they were holding and that gives the appearance of "hair loss". Fear is normal, NSAIDs are not the only pain relief out there, there are options. Pretty much everything you've listed is normal fears, and pretty much, all of those fears, you'll laugh at down the road. I was 370 at my largest. I'm 210 now, I have some extra saggy skin, but it's really not THAT bad and it's totally hidden under even decently tight clothing. Just remember, staying overweight *WILL* kill you. If something was to happen during your surgery, the best place for that to happen, is in a hospital. No one but you can tell you if what you are going to do is right for you. You have to make that call. Weigh out all the pros and cons, and make your decision based on that, no one is going to look down on you for making the best decision for your life that you can.

A search of the internet shows that others reported problems with balance after RNY surgery. There are probably several potential causes. For example a Vitamin B12 deficiency can cause dizziness. Some people experience reactive hypoglycemia after surgery and this can lead to dizziness. Also if you were diabetic prior to surgery and are still taking some blood sugar medicines, your dosage may need to be adjusted. Normally at the 1 year mark they have you undergo blood work. This allows them to fine tweak your Vitamins. Make sure when the time comes that you undergo this. Here is some discussion about this topic. http://www.bariatric-surgery-source.com/lightheaded-and-dizzy-after-gastric-bypass-surgery.html

I found after the operation that I could only use sugar in forms of liquid for my hypo's as I couldn't eat sweet food quick enough and it would make me feel sick, so I have apple juice cartons and small glucose ( liquid) with me for my hypo's

tizzylish My co-morbidities were, high blood pressure, diabetes, sleep apnea, hypo-thyroid, bad back & knees. I have lost 82 pounds, I now take less medication. Exericse for the bad knees & back try water aerobics. I know you don't want to be in a swim suit in public but it does burn a lot of calories and is easy on the knees and back. There used to be a thread on this site that list the insurance companies and stories of people & the problems and successes of getting approved. Hang in there.

I am hypothyroid and take Synthroid (100 mcg) daily. I normally take it first thing in the morning and I have been fine after surgery. I was recently given direction to take my Nexxium twice daily (morning and evening). My doctor said I can't take Synthroid with a PPI because it causes problems with absorption. So this morning I take my Nexxium when I wake up and figure I will take my Synthroid about an hour before lunch. By 930 AM I was sweating profusely and felt like I was having a hot flash! The RN who works with me asked if I had taken my Synthroid. I took it at at 10 AM and within 20 minutes the sweating and hot flash was back under control. Since I hadn't thought about it, I figured I would post for the other Hypo's out there after surgery.

Hello, My name is JJ. This week I have taken the first step in getting my health together. My insurance covers weight loss surgery after 6 months of supervised dieting. Today I saw my GP and she is completely supportive of this journey, and was genuinely honest about it being a tool, not a cure all. I appreciate the honesty. I have chosen a Dr. and will attend his seminar in a few days. At that point I will fill out the paperwork and go from there. About a year ago I had a major surgery that improved my health by 75%. Since then I realize how great I can feel, and the immense pleasure of being a part of life without pain. My BMI is 41. I am 5'1" and 219lbs @ 39 yrs of age. I have thyroid disease (hypo), high triglycerides, mild sleep apnea, depression (after losing a child) and am pre-diabetic. Around 10 years ago all self-esteem issues vanished for me after the birth of our child. I finally started living life as much as possible, only being held back by pain. I buy clothes that fit, and look nice, and never agonize about what I am wearing or how it fits. I take care to look up to date, and presentable for me. I like looking nice and feeling good. My husband is FABULOUS. When we met I was around 150 and as I grew through the years his devotion and commitment to me grew even deeper. He's not a chubby chaser, but loves me and respects me. He looks like a male model still, and I have grown obese. I know I have a good, good man. My goal is to feel as great as I can, be 100% a part of life, and come off of all my meds. I am ready for this change. Thank you to everyone that is so forthcoming on this site. Just what I have read in the last few days has helped with questions and curiousness!

I've read so many times in various threads about people eating super low calories, and it always worries me. And also high fat, high Protein, low carb diets... I wanted to post about the dangers of very low calorie diets and of high fat/protein low carb diets, so here is some info and the sources it comes from: "When you want to lose weight, a very low-calorie diet can seem attractive. After all, the sooner you lose weight the better, right? Well...no, that's not right. Eating fewer than 1000 calories a day can, at best be a short-lived attempt at dieting, at worst it could be a recipe for long term health problems. Your body is not designed to function well on a very low calorie diet. In fact, it goes into starvation or famine mode and tries to preserve essential functions at the expense of the less essential ones. So what happens to your body on fewer than 1000 calories a day? Your metabolism slows down to conserve energy. Your body uses blood sugar, made from carbohydrates, for fuel just as a car uses gas (petrol). Without blood sugar, the brain and central nervous system, as well as other bodily systems, will cease to work efficiently. To try to counteract the lack of blood sugar from carbohydrates in the diet, your body will break down fat, which is what you want, but it will also breakdown muscle and other lean body tissue. Losing lean body tissue can be very dangerous. Even organs can be broken down to use as fuel. Losing lean body tissue can also be counter-productive. Muscle tissue increases the resting metabolic rate. With reduced amounts of muscle, your metabolism will slow. When you come off the diet, increased fat cells will form because your metabolism is slow and so your body needs less blood sugar for fuel. It is also a survival mechanism in case of another 'famine'. With very low calorie diets, an imbalance in minerals and electrolytes can occur, which can be dangerous. These govern the balance of fluids in the body allowing nerves and muscles to function. Osteoporosis can be another danger, especially for women. Often dairy products like eggs, milk and cheese are cut out of a very low calorie diet so cutting out a major source of Calcium leading to loss of bone mass. Anaemia (a lack of Iron in the blood) can also be another risk. If taken to extremes, women can find that menstruation (periods) becomes irregular or stops altogether. A lack of serotonin in the brain can be another problem which leads to clinical depression. You might find that the lack of essential nutrients on a very low calorie diet leads to a deterioration in the condition of your hair and nails. One of the great dangers of this kind of dieting is that you can become acclimatised to it. As your body reduces some of its functions, including those of the brain and nerves, and as depression takes hold due to a lack of serotonin, you can slip into anorexia nervosa - a truly life threatening condition. As mentioned above, when you finally come off this diet, you will almost certainly regain all the weight you have lost plus more leading to yoyo dieting, now believed to be dangerous. Altogether, very low calorie diets are a danger to physical and mental health. They are counter-productive and can lead to long term problems as well as a lifetime of yoyo dieting. It is far better to lose weight safely and slowly on a sensible diet." (source reference: http://www.allinfoaboutdietsnutrition.com/index.php?page=21 ) "Low-carb/high-fat diets pose dangerous health risks and may increase the risk of contracting serious chronic diseases. Studies have linked extreme low-carb/high-fat diets to an increased risk of developing certain disease states, including: • Alzheimer disease • blindness and macular degeneration • some forms of cancer • cardiovascular and heart disease • c-reactive protein/inflammation • metabolic syndrome and insulin resistance • osteoporosis • kidney stones This is due to increased levels of saturated fat and dietary protein in the diet, with inadequate nutrition coming from plant-based phyto-chemicals. [/url]Low-carb diets may increase the risk of birth defects and childhood cancers. Bread, Pasta, Breakfast cereals and orange juice — foods that are “off-limits” in a low-carb diet — are fortified with folic acid, a micronutrient essential to the neurological development of fetuses. The U.S. food and Drug Administration currently requires that enriched grain products be fortified with the essential Vitamin folic acid (the synthetic form of naturally occurring folate, or vitamin B-9, found in many leafy green vegetables, fruits and legumes). Since the fortification of grain-based foods with higher levels of folic acid, beginning in 1999, there has been a remarkable 19 percent drop in neural tube birth defects in the United States. Followers of a low-carb diet do not receive the benefits of folic acid fortification. Low-carb/high-fat diets are not more effective for weight loss. According to studies published in the New England Journal of Medicine and the Journal of the American Medical Association, there are no significant differences in weight loss between low-carbohydrate diets and conventional weight-loss plans. The study published in the Journal of the American Medical Association (April 9, 2003) reviewed studies of low-fat diets conducted between 1966 and 2003, and found that weight loss from low-carbohydrate diets was associated with length of diet, pre-diet weight, and the number of calories consumed, but not reduced carbohydrate content. The study published in the New England Journal of Medicine (May 22, 2003) found greater weight loss with a low-carbohydrate diet than a conventional diet during the first six months, but no significant differences in weight were observed after one year.1 Low-carb diets are perceived to be effective because of the rapid, initial weight loss. However, the weight loss is primarily due to the loss of muscle glycogen and Water — not body fat. Loss of muscle glycogen can result in lethargy and fatigue.1 Foods high in carbohydrates, such as fruits and vegetables, are generally more filling — more “bulky” — than foods high in fat, and less prone to overeating. Foods high in fat can increase energy intake (calories) because they are more energy dense, not as “bulky,” and taste good, leaving eaters desiring more and making it easy to over-consume them. A lifestyle that is high in high-fat foods and low in exercise can lead to weight gain. Carbohydrates, such as pasta, do not make you fat. Consistently overeating calories— whether they’re from carbohydrates, fat, or protein — will make you fat. The only genuine, time-tested principle of healthy, long-term weight loss is to take in fewer calories than your body burns. Low-carb diets may cause cognitive difficulties. Carbohydrates are the only source of fuel that the human brain — the most energy-demanding organ in the body — can use. Muscle cells can burn both fat and carbohydrates, but the brain does not have the “machinery” to burn fat. Depriving the brain of carbs means depriving it of energy — and the shortfall can affect intellectual performance, such as memory and cognitive processing.1 Once the body’s glycogen reserve is exhausted, the brain ends up using ketones, a by-product of the breakdown of fat. Ketones are not the optimal energy source for the brain, and their increase in the body has been shown to impair mental judgment.2 Low-carb diets can make people — especially women — short-tempered. A new study at the Massachusetts Institute of Technology found that the brain produces serotonin — which regulates moods and emotions — only after a person consumes sweet or starchy carbohydrates, in combination with very little or no protein. A shortage of serotonin can lead to mood swings and depression. Eating a healthy pasta meal encourages the brain to make serotonin; eating a steak actually stops it from being produced.3 A Healthier Choice According to the American Dietetic Association, the voice of nutrition in America, there are no good or bad foods — only good or bad diets. At “Healthy Pasta Meals,” a recent Barilla-sponsored conference in Rome, Italy, a team of 38 nutrition scientists from around the world concluded that the “Mediterranean diet” is an excellent choice for maintaining overall health. The Mediterranean diet includes abundant plant foods (such as vegetables and pasta); olive oil; dairy products; fewer than four eggs weekly; fish and poultry in low-to-moderate amounts; red meat in low amounts; and wine with meals, in low-to-moderate amounts. A 2003 study in the New England Journal of Medicine found that the Mediterranean diet reduces the risk of death from heart disease and cancer.4" Low-carb/high-fat diets pose dangerous health risks and may increase the risk of contracting serious chronic diseases. Studies have linked extreme low-carb/high-fat diets to an increased risk of developing certain disease states, including: • Alzheimer disease • blindness and macular degeneration • some forms of cancer • cardiovascular and heart disease • c-reactive protein/inflammation • metabolic syndrome and insulin resistance • osteoporosis • kidney stones This is due to increased levels of saturated fat and dietary protein in the diet, with inadequate nutrition coming from plant-based phyto-chemicals. Low-carb diets may increase the risk of birth defects and childhood cancers. Bread, pasta, breakfast cereals and orange juice — foods that are “off-limits” in a low-carb diet — are fortified with folic acid, a micronutrient essential to the neurological development of fetuses. The U.S. Food and Drug Administration currently requires that enriched grain products be fortified with the essential vitamin folic acid (the synthetic form of naturally occurring folate, or vitamin B-9, found in many leafy green vegetables, fruits and legumes). Since the fortification of grain-based foods with higher levels of folic acid, beginning in 1999, there has been a remarkable 19 percent drop in neural tube birth defects in the United States. Followers of a low-carb diet do not receive the benefits of folic acid fortification. Low-carb/high-fat diets are not more effective for weight loss. According to studies published in the New England Journal of Medicine and the Journal of the American Medical Association, there are no significant differences in weight loss between low-carbohydrate diets and conventional weight-loss plans. The study published in the Journal of the American Medical Association (April 9, 2003) reviewed studies of low-fat diets conducted between 1966 and 2003, and found that weight loss from low-carbohydrate diets was associated with length of diet, pre-diet weight, and the number of calories consumed, but not reduced carbohydrate content. The study published in the New England Journal of Medicine (May 22, 2003) found greater weight loss with a low-carbohydrate diet than a conventional diet during the first six months, but no significant differences in weight were observed after one year.1 Low-carb diets are perceived to be effective because of the rapid, initial weight loss. However, the weight loss is primarily due to the loss of muscle glycogen and water — not body fat. Loss of muscle glycogen can result in lethargy and fatigue.1 Foods high in carbohydrates, such as fruits and vegetables, are generally more filling — more “bulky” — than foods high in fat, and less prone to overeating. Foods high in fat can increase energy intake (calories) because they are more energy dense, not as “bulky,” and taste good, leaving eaters desiring more and making it easy to over-consume them. A lifestyle that is high in high-fat foods and low in exercise can lead to weight gain. Carbohydrates, such as pasta, do not make you fat. Consistently overeating calories— whether they’re from carbohydrates, fat, or protein — will make you fat. The only genuine, time-tested principle of healthy, long-term weight loss is to take in fewer calories than your body burns. Low-carb diets may cause cognitive difficulties. Carbohydrates are the only source of fuel that the human brain — the most energy-demanding organ in the body — can use. Muscle cells can burn both fat and carbohydrates, but the brain does not have the “machinery” to burn fat. Depriving the brain of carbs means depriving it of energy — and the shortfall can affect intellectual performance, such as memory and cognitive processing.1 Once the body’s glycogen reserve is exhausted, the brain ends up using ketones, a by-product of the breakdown of fat. Ketones are not the optimal energy source for the brain, and their increase in the body has been shown to impair mental judgment.2 Low-carb diets can make people — especially women — short-tempered. A new study at the Massachusetts Institute of Technology found that the brain produces serotonin — which regulates moods and emotions — only after a person consumes sweet or starchy carbohydrates, in combination with very little or no protein. A shortage of serotonin can lead to mood swings and depression. Eating a healthy pasta meal encourages the brain to make serotonin; eating a steak actually stops it from being produced.3 A Healthier Choice According to the American Dietetic Association, the voice of nutrition in America, there are no good or bad foods — only good or bad diets. At “Healthy Pasta Meals,” a recent Barilla-sponsored conference in Rome, Italy, a team of 38 nutrition scientists from around the world concluded that the “Mediterranean diet” is an excellent choice for maintaining overall health. The Mediterranean diet includes abundant plant foods (such as vegetables and pasta); olive oil; dairy products; fewer than four eggs weekly; fish and poultry in low-to-moderate amounts; red meat in low amounts; and wine with meals, in low-to-moderate amounts. A 2003 study in the New England Journal of Medicine found that the Mediterranean diet reduces the risk of death from heart disease and cancer.4" (source: http://www.barillaus.com/Dangers_of_LowCarb_Diets.aspx ) Take care of yourselves! and research the effects of your choices!!! XO Leila

I had my thyroid removed in Aug of last year. I am just now getting my thyroid replacement meds adjusted. I gained a lot because I went from hyper to hypo. I am on 225mg of Synthroid now and hopefully I've finally hit the right mark!

Your list of symptoms included: * Extreme fatigue * Feeling dizzy upon standing * Feeling fainting when standing up too long * Feeling weak after eating. Several individuals that undergo RNY gastric bypass surgery experience a condition called Reactive Hypoglycemia. It is a form of low blood sugar. This occurs in individuals that had diabetes prior to surgery but also in those that don't. You experience a large drop in blood sugar around from 1-3 hours after a meal. It catches some people by surprise because they faint, dropping onto the floor. But it can also be corrected by recognizing the signs of low blood sugar and reacting or by modifying the way you eat. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass This link describes some of the symptoms of the condition. http://www.weightlosssurgery.ca/before-after-surgery/reactive-hypoglycaemia-post-gastric-bypass/ If this matches some of your symptoms, you might read up on the condition using the internet. I am not sure about some of the other symptoms but you are taking quite a bit of medication (vistaril, remerom, zoloft, wellburtrin) and you may have some bad interactions happening. The most important elements after RNY gastric bypass surgery is to meet your Protein, Fluid and Vitamin daily requirements. food is secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved by meal volume control. At 10 months post-op, this should be around 3/4 cup per meal. So back to basics, reverify that you are meeting the prescribed requirements for protein, fluids and Vitamins. This article describes my experience after RNY gastric bypass surgery. http://www.breadandbutterscience.com/Surgery.pdf Life is full of trade offs. In my case I had high blood pressure, diabetes, sleep apnea and severe acid reflux (GERD) prior to surgery. I traded my love of food for good health. At 3 years post-op, I am content with that decision. I have been able to find some pleasure in eating again. I found mixing food groups together provided some flavor. I also found that softer foods such as chili and Soups went down much easier than harder foods such as steak. I hate Protein shakes and no longer take these. But I did this by fortifying the protein that I consume in meals. "Protein First". Anyways at the end of the article, I have included some recipes if you care to try them.

Hello Everyone! I just created my bariatricpal account. I am 5'2 and 1/2. I'm curious if they will base my BMI off of 5'2 or 5'3. I'm also right around the 200lb mark, give or take a few pounds. I am hoping to get approved for the surgery because I am 35 and already on medicine for high blood pressure and I'm hypo thyroid which makes it a b*itch to get the weight off. I'm getting mixed reactions from my family about deciding to meet with a weight loss surgeon. I just really want to be healthy for years to come. I don't want to follow my father's path and end up having heart issues in my later years. I just wanted to say hello and I look forward to being involved with this group. I want to thank each and everyone one of you for being on here to get support and provide support! You are my friend!

I would suggest that you make an appt with your pcp to get checked out. There are lots of things, including thyroid conditions, that can cause fatigue. Be aware that they have recently lowered the "normal" range for TSH, so if you were borderline before, you might be considered hypo now. I tested high-normal for years before I became hypo, and I feel 100% better since I started taking meds. You may also be at point where you have to exercise to lose weight. In my experience, even before banding, if I eat 1200-1400 cal/day, don't exercise and don't drink enough Water, I won't lose any weight, and I might even gain a few lbs. I think that FitDay really overestimates the calories burned for basal metabolism. Good Luck! Melissa

How elevated is your TSH? What medication are you taking? I have been both hypo and hyper, finally had half of my thyroid out in Oct. of 2010 and have not had an issue since. I would check with your surgeons and get his/her opinion.

I've seen a number of posts from sleevers about Reactive Hypoglycemia which, for people who have had gastric surgeries, can happen when food passes too quickly through the digestive system. Maybe this is what some of you have been experiencing?

If you suffer from acid reflux then bypass is the best option. I know this because when I originally was going to have surgery I wanted the sleeve and was preparing for the sleeve but when I met with my gastric doctor he told me to have the bypass because of GERDS. I listened and I've had great success and even though I got Reactive Hypoglycemia which only 2% of gastric bypass patients get it I would do it all over again in minute. Reactive Hypoglycemia is different then regular Hypoglycemia and is really a very low risk of getting it. Good luck in your decision and best to you on your journey to a healthier you. P.S. I hope I haven't scared you with what I disclosed to you and if it worries you discuss it with your surgeon or nutritionist.

Reactive hypoglycemia is a form of dumping. There are 2 basic forms http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=134&ContentID=107 Also http://en.m.wikipedia.org/wiki/Reactive_hypoglycemia Dumping more common for bypass especially if sugary foods gets "dumped" into small intestine quickly without usual stomach to digest it. But is happens to 10-15% of people who have had a partial gastrectomy (which the sleeve is) whether for weight loss or other medical reason. True dumping would not last overnight. It resolves itself in a few hours at most. Hopefully sooner! And it would have cardiovascular symptoms like palpitations and also flushing, etc. Falafel a are deep fries and not full of sugar so may not have been dumping precisely. This could have been just over eating for the sleeve which would also make you feel yucky but not dumping. I ate a falafel too quick a couple weeks ago and felt pretty yucky for a while. In any case hope you feel better soon and remember to eat very slowly any new food.

I have been struggling with hypothyroidism for the past 6 years....still trying to get levels evened out! My Endocrineologist was very supportive and my Bariatric doctor said I would have NO PROBLEM with hypo and the band. I can still take my meds (they are small enough), but you do have to take caution when eating anything with Calcium within 3 hours of taking your meds....that makes Protein shakes something that I have in the afternoon or evening! It has been a great experience so far! Good luck!

Do you just have to exercise to lose weight? I was planning on starting to walk after my surgery. But I've been on a high protein low carb diet before my surgery, and I use MFP to keep track of my calories and keep in mind I'm not exercising. I'm suppose to be able to eat 1800 and some calories, seems like a lot to me , but that's what it said. I'm not loosing anything. I thought it was calories in calories out kind of thing. Is it simply a matter of exercise or is it to many calories or both? And yes I hate exercise and have a bad knee, but do plan I doing it I know I have to. But I was just curious why I am not losing something. I don't want this to be what happens with the band. Can you just be unable to lose. I am 5'3 and 277 pounds, plus I am 47 yrs old, and was thinking my metabolism might be shot or something. I do have a thyroid (hypo) problem but it is OK on meds. I'm guessing the answers going to be to exercise Actually I hope it is that simple. Not easy but simple. BTW my nut said he has no calorie or quantity restrictions for me he said just eating healthy would take care of everything when I get the band..

Good to see this topic, as a diabetic on two insulin's myself my motivation for this surgery is to get off the meds and hopefully go into full remission (fingers crossed). The optifast is helping me immensely to the point I have to be extra careful with my dosages as I've had 2 hypos since I started 7 days ago.