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I too am experiencing severe episodes of reactive hypoglycemia. I’ve been hospitalized 3 times in the last 2 months. My sugar drops rapidly. It’ll go from 60 to 37 in minutes. Assigned to an endocrinologist team my last hospitalization and have now been prescribed Acarbose & a told to eat 6 small meals, high protein some fat & no more than 30 grams of carbs each meal. Just started med yesterday and concentrating very hard on following diet. It’s basically the keto & I could stand to loose about 10-15 lbs so I’m eager to try this. I’m wearing a freestyle glucosemeter (no pricking) to help track sugar & bump it up before I start feeling the symptoms. I’m also carrying glucose tablets to bump it up quickly. I have an appointment next week with endo to discuss progress & decide if anything additional or different needs to be done. I pray that something can be done because living with this has turned my life upside down. I’m afraid to drive long distances; lots of confusion; no interest in usual activities and also depression has set in. I feel awful that I’ve put my family through this worry simply because I chose to have the surgery. But I would have it all over again if given the choice of being very unhealthy & obese and my life as it is now. I just have to remember that and I’ll get through this! Sorry for being long winded. I just felt if anyone would understand my feelings it would be my fellow bypass friends. Take care, I’ll keep all posted as I go thru this. 😊

We are all different. My doctors’ instructions for my reactive hypoglycemia may not work for other people. It may help to contact your Dr. that has your medical history or an endocrinologist who works with diabetes/hypoglycemia. I’m fortunate that hypoglycemia was a lesser complication after surgery. Just like a diabetic manages blood sugars you also learn to manage reactive hypoglycemia.

Thanks! I already eat full fat but with the surgery I think I absorb only 20-50% of it. Same with protein. The only thing I absorb at 100% is sugar but that's what gives me the reactive hypoglycemia!

So, I know it sounds like this is a great problem to have, but... I had my SIPS (modified Duodenal Switch) surgery just about 2 years ago. Since then, I have gone from 268 to 98 lbs. (I'm 5'1.") I haven't had my period in almost a year. I don't fit into adult sizes anymore (even J Crew petite 00 is too big!) and have to shop in the kids section. I get reactive hypoglycemic reactions 1-2 times a week (even from just half a glass of orange juice.) I'm permanently on iron supplements due to chronically low iron, hemoglobin, etc and these make my stool really fun lol. I had skin removal surgery (abdominoplasty + brachioplasty) in late October 2018 when I thought I was done losing weight (at 125) but then the weight loss randomly started again and I've lost an additional 25 lbs since the skin removal, which makes it less effective (still very happy I got it though!) I'm a bit torn, because on the one side, this surgery has been HUGELY successful. I'm still not technically underweight for my height since I'm so short. But I'm hating all the comments I'm getting that I'm too skinny, why am I still losing weight, the weird looks if I have the reactive hypoglycemic thing where I'll be super nauseated, lightheaded, and shaky for 20-30 minutes. Has anyone else experienced this? If so - what did you do?

It sounds like (non expert, non doctor here) that it may be reactive hypoglycemia, which is fairly common in the bypass world, as it is a result of rapid stomach emptying due to the lack of pyloric valve in that procedure, causes an insulin spike followed by low blood sugar triggering hunger. With the sleeve, we can also experience somewhat rapid emptying due to our small stomach size. DIfferent foods affect this, too - the so-called "slider" foods that slide on through because they don't trigger the pyloric valve to close, typically highly processed carbohydrates. If this is what is going on, try sticking to meats and high fiber vegetables that tend to stay in the stomach longer and see if that helps. If it is not RH, then an endrocinologist may be in order to see what is going on with this imbalance. Whether or not your sleeve was botched, you should check with a bariatric surgeon to evaluate this - if you go to your original surgeon, a second opinion from another may be in order to verify whether or not it was "botched" (would the original doc really admit that he goofed?) good luck in working this out,

I just go back to basics when I need to lose weight. Protein first, then non-starchy vegetables. If I have room after that, maybe a small serving of fruit or whole grains. I don't think I could go all the way back to shakes only at this point. I also have reactive hypoglycemia. Eating something every 3-4 hours helps with that. Either a protein or, if I do a carb, then I pair it with a protein - for example, some apple slices with peanut butter.

I dont have a sleeve. Does that matter? I had gastric bypass. Plus I have reactive hypoglycemia, what do I do about that? Sent from my SM-G970U using BariatricPal mobile app

It might be, but probably not. Presumably, the doc has prescribed omeprazole, or similar PPI medication for it. The sleeve is predisposed toward reflux problems as the stomach volume is reduced much more than the acid producing capacity, and it takes a while for the body to adjust (doesn't mean that one will have that problem, just that the odds are higher than the general population, in comparison, the bypass is predisposed toward marginal ulcers, dumping and reactive hypoglycemia, so there are potential problems with whatever procedure one chooses. ) Usually, the problem goes away as the body adjusts, but sometimes it doesn't completely and one needs to stay on some type of medication for it, or in extreme cases, revise the surgery.

Some stretch, or growth or adaptation is to be expected - we don't stay at eating only 3 tablespoons forever. This doc gives a good idea of the progression of meal volume that can be expected, and is consistent with my experience - You may or may not get along with his prescription for countering this effect, but it is a viable one. In short, we need to learn to accommodate some increase in eating volume without allowing the calories to get out of hand - taking up that added volume with high bulk, low calorie veg is a good way to do it. As to which procedure to go for a revision, the first thing I would want to know is whether the stretch that your doc sees is unusual - sleeves done by docs early in the learning curve of doing sleeves (and 2012 is consistent with that for many surgeons) may have undue stretch if it wasn't formed well to begin with. Sometimes excess fundus (the stretchy part of the stomach that is largely removed with the VSG) is left behind at the top or bottom of the stomach, or other shaping issues may lead to the problem. If the sleeve is nominally well done, there is probably little to gain be resleeving it - you will lose some at the outset from low capacity due to surgical inflammation and the very restricted diet that we have early on, but overall you shouldn't expect great things from it. Likewise, a bypass is similar in its overall power to the sleeve, but does have some temporary caloric malabsorption that can help get a little extra weight off, but doesn't do any better when it comes to resisting regain; in some patients it is worse in that regard due to reactive hypoglycemia inducing more inter meal hunger. Overall, when I think in terms of revisions, I see a procedure that is more complicated than the original virgin WLS, and usually less effective overall (think in terms of your stomach originally having a capacity of 32-64 oz, and now a few years post op it may have a capacity around 6 oz, so there is less difference to play with. Being more complicated both in implementation and in the reason for doing it in the first place, I like to get a second, or even third, opinion on the matter - different surgeons have different experiences and perspectives on these things. There is also the aspect that while doing a virgin sleeve is a fairly straightforward procedure, and most surgeons are now fairly well up the learning curve in doing them, repairing or revising a faulty sleeve is another matter, so I would look to a surgeon who has done lots of them. In NJ, I would suggest Dr. David Greenbaum as a good guy to consult with. A final thought - what is the capacity of your sleeve now? How much chicken or steak (and nothing else) can you comfortably eat? We usually remain fairly restricted on firm meats for a long time, but can eat an almost unlimited amount of "sliders" - things that just slide on through with limited restriction, which are frequently also pretty junky.

Early on I had 'meat sweats' a few times right after eating, and the dizziness and would need to lie down. It's sounds like reactive hypoglycemia https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.eigerbio.com/resources/Goldfine-2016.pdf&ved=2ahUKEwj12ZTU94niAhUNvKwKHU2qAx8QFjASegQICBAB&usg=AOvVaw3_1GW7msGkeuZlxOShhfXR

Thanks ladeedee - like you I wish there was more for vets. I have a horror of being where I was and am so aware that it's psychology as much as physiology. I get reactive hypoglycemia if I overeat sugar. It's happened more than once. That statement tells me all I need to know about sugar but I struggle to act on it. Well done you for your own stats. And maybe the key is gradually changing behaviour rather than back to the see saw. I can do 7lbs in a week intermittent fasting. But I can't sustain it. I need something for everyday that I can comfortably do! Anyway. We get to give ourselves back pat's. We're doing okay !

I had gastric bypass surgery around 6 years ago and I am very pleased with the results. It is sort of like the gold standard for bariatric surgery. They have most of the bugs worked out. Mini-gastric bypass is somewhat new so I can not really assess it. In general, many people try various kinds of diets prior to eventually getting gastric bypass surgery. Most of the time these are referred to as yo-yo diets. Because the individuals will lose some weight but then over time give up the diet and then gain the weight back and then some. So it is like a yo-yo. In your case it went to the extreme and you slid into anorexia. So the only advise here is that the psychological treatment component is very important for you for the surgery to work. (the package with the 12 phycologist sessions). Also if things go south sometimes after surgery then reactivate the physiological component. The three most important elements after gastric bypass surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight.

Never give up, chatted with a lady who was worried because she was 3 years out, wondered if it benefited her? Reminded her You're still alive, there's a bonus right THERE, when you start out at 300 or 400 pounds all you hear is Doom, Gloom and You're Gonna Die Soon! Are you still hearing this from doctors? No? Good Step! I even had my pastor get on my case, wondered how soon he would have to preach my funeral? Told him put the prayer books and Bible away, I am not plotting my demise in the near future, if anything happens , I'll have my son call YOU!❤ Yeah I too have Thunder Thighs and a Hubba Hubba Heinie, joked I could feed an entire cannibal family off one butt cheek for Easter dinner! As I lose weight, I hardly recognize myself, I used to have pudgy chipmunk cheeks, round-square shaped face, now my face has narrowed out and I am starting to resemble several dead relatives, never saw a likeness before. I think my color is off, live in Ohio so winter pallor, sunshine has yet to kiss my face, of course when it does I will either freckle or it will reactivate my rosacea, the curse of a Celtic ancestry. Its hard to be accused of being a lush ( just because I'm Irish) for my blotchy cheeks and 👃. Few attempts I made at alcohol made me only sleepy, if I'm gonna get taken advantage of, might as well stay awake to enjoy it! Yeah, I once might have been as big as the Blarney Stone but inside me resides a leprechaun spirit, don't take a lot serious anymore, I'm more fun at 73 and losing down weight than I was at 30, or even 50-60, I now have hope and that enlivens all the facets of my life. The world had discounted me as fat, worthless, might as well die, well I am proving them wrong, they were looking at a. fat shell, they didn't try to know me, the real me inside. For a while I couldn't visualize any changes in my exterior, thought it was useless. Then I started being able to sit in chairs I used to have my son help pry me out of. I could stand up off of furniture without him holding and yanking me up. I was having better luck having strength to go places, pay my bills, do all those little errands. And clothing that used to split me where I was trying to sit, suddenly I had wiggle room. And those little things kept mounting up. One of my latest, bought an outfit for an upcoming doctor appointment, hung it in the closet, morning of the appointment I started dressing, pulled on the pants and they fell down! Good thing I had saved all the tags. Back they went to get a size smaller. Still didn't believe it totally so I tried the next lower size on! OMG I really was that much smaller, fit better than any others had recently. I had a lot of " well it's close to right, I'll just have to settle for that." All of the sudden I can try clothes on, choose what I really want, not to panic and buy something just because you're afraid they won't get that size again. And it is so blasted cool to have such an option. Now I Am not the Largest size they carry!💦Tears of Joy!

I get a variation of dumping with my sleeve where I get reactive hypoglycemia if I eat too much sugar (for example, I ate a pack of Skittles earlier this week, and within an hour or 2 my blood sugar was crashing and I was shaky and sweaty). It feels awful. It's a result of the massive changes to my metabolism causing hypersensitivity to insulin, and my body being used to dumping insulin into my system whenever I eat sugar. Hopefully it will balance out. If not, I'll just have to cut out all refined sugars (which I know I should do anyway!)

13. One skill or hobby you want to take up. I have three and I can't choose between them. When I get down a bit more, Imma reactivate my scuba license; take up horseriding with my daughter and start doing zumba/aerobics Sent from my SM-G930F using BariatricPal mobile app

I am 2.5 years out from gastric bypass. I had lost 100 lbs but have gained about 15 back. In November my blood sugar started dropping out of nowhere. I have seen my both my gastric doctor and my pcp and they both tell me to cut carbs and eat every two hours. Those are both ok but I have found that if I eat some carbs along with protein I have many less episodes which is great except I'm scared I'm going to gain. Anyone with experience or advice on this? I have an apt with a endocrinologist that specializes in bariatric patients but it is not until November. Sent from my SM-J700T using BariatricPal mobile app

Correction: reactive hypoglycemia

Look up RH reactivate hypoglycemia after gastric bypass

I choose to look at it a different way. I look at it like I have accountability partners to help me keep from rationalizing poor behaviors and dubious choices. It helps me stay firm and convicted. If I know all eyes (pretend--cuz most people aren't watching) are on me, then I'm not gonna allow the laxness of the moment to take control and allow me to slide. Or to slide "too much." And as for banana, sure your doc says you can eat it. And in limited amounts it's not too high in sugars for a lot of people. But we are each individual, and I'm extremely carb sensitive. So if it doesn't give me reactive hypoglycemia, or high blood sugars, it will absolutely make me hungry within an hour or two. So bananas are on my "no fly" list. I do use banana flavored protein powder though.

Reactive hypoglycemia is low blood glucose (sugar) that occurs within four hours after eating. Symptoms of reactive hypoglycemiamay include anxiety, fast heartbeat, irritability (feeling very stressed or nervous), shaking, sweating, hunger, dizziness, blurred vision, difficulty thinking and faintness. But, reactive hypoglycemia post–gastric bypass generally can occur in patients one year or more after their bariatric surgery. ... The further out from surgery you are, the more tuned in to your body and reactions to food you become. Since you are 9 days post-op, I suspect this is not the problem. Another possible explanation is that you were diabetic prior to surgery. If that was the case and you were taking blood sugar medicine, it might be time to reduce the amount of medicine your were taking. So you might want to check with your doctor and reset your prescription. I was diabetic prior to surgery and I went off all my prescription medicine the day I left the hospital after surgery. Another possibility is that it is not a blood sugar problem but rather an electrolyte imbalance. Common electrolytes include sodium, calcium, magnesium, and potassium. ... When the amount of electrolytes in your body is too high or too low, you can develop dizziness, cramps, and problems with an irregular heart beat (heart rhythm) or symptoms of mental confusion. This may happen if you don't take in enough fluids daily. Another possibility is dizziness can be caused by a blood clot. Embolism can occur when an embolus, or blood clot, forms around a heart valve that is not working properly, or is released within the arteries to the brain, causing a stroke. The effects of a stroke may include temporary dizziness. However, if the embolus travels to the vestibular system, it can cause severe dizziness. This is a very serious condition. Or there are other possible causes for dizziness and fainting. I would refer to your hospital discharge directions. There should be a page that describes when to contact you surgeon's office. On my discharge directions it states: Chest pain, rapid heartbeat and/or dizziness. Better to be safe than sorry!

I dont have a thyroid at all anymore, so im hypo. Its wht made me go for the gs. I couldn't budge it. My bmi was 35. 10/24/18 sw 219 Current weight 180 Goal is 150. I only had about 70 to lose at the start, maybe thts y its going slower. But its coming off n no skin sagging...just want to keep on Sent from my SM-G965U using BariatricPal mobile app

Sorry I hadn't noticed this post sooner. Let me start by saying, I am a very lazy person, hence the reason I got fat. My time in the gym has been ZERO. I do walk a lot with my wife. I babysit a 3 years old 5-6 days a week 12 hour days. I love skateboarding again. But as far as exercise, workouts? Nope, not my cup of tea. 95% of my weight loss has come through the kitchen. I am blessed in as much, I am now reactive hypoglycemic. I cant cheat with sweets without paying a dear price. I have gone unconscious 3 times since surgery from low blood glucose below 50. Also my appetite has been a struggle. I have to force myself to eat. Trust me I could lose more if I wanted to. I am 6'3" and 163 lbs is already skinny enough. I was a very skinny young man, and I think post op my body went back to its natural state. I was about 145 lbs into my early mid 30's. So yeah I was quite skinny. Diet wise, I was probably stricter with myself than I needed to be. I eat eggs, cheeses, meats of all types, green vegetables. Very little fruit, sugars aren't my friend. I use TESPO liquid vitamins. I'm not a good example. I enjoy the occasional chili dog. I eat the occasional chip. My portions are obviously a fraction of what they were in the past. There are much wiser, better examples of peoples disciplines and diets on here than mine. Again, I am not typical in that I have to force myself to eat. I actually seek out fattier foods now just to maintain weight. Not necessarily junk food, but not the leans foods most of us have to eat. It has taken me many months to stop losing. My doctors were starting to get worried. for my health based on how rapidly I lost and my inability to maintain. I am doing much better now though.

Oh lads, I had THE WORST DAY. It started off with a protein pancake. It was a sample from the chemist and it tasted so fake, so I put some canned whipped cream and sugar-free syrup on it and by breakfast end I'd used up over 300 calories without feeling satisfied so I ate a protein bar but then I felt sick. So I didn't eat lunch, got hungry and lost the battle that had been raging in me for over a week to buy junk (yeah, I crapped out on the challenge). So I'm stuffing my face with chickadees and Mars Bars knowing full well its going to make me as sick as a dog. Lads, the taste wasn't even good! The chocolate was sickly sweet and the chickadees were overly salt and processed nothingness. THEN came the dumping and reactive hypoglycaemia. After I recovered I ate a white bread roll with smashed banana and chicken nuggets. I literally don't know what happened to me. I have been SO GOOD for months with only a minor slip up now and again. What the heck??? Back in the saddle tomorrow and I'll assess the damage at next weigh-in, but I feel like an alcoholic that is on that naxalone drug and I couldn't even get "high" just sick and now I'm regretting everything. Sigh. Oh lads, just when I thought I was in control. Oh well, onwards and upwards. Sent from my SM-G930F using BariatricPal mobile app

There are two types of dumping, and late dumping is usually also referred to as reactive hypoglycemia. I wouldn’t recommend riding out a blood sugar of 35 or so. https://www.mayoclinic.org/diseases-conditions/dumping-syndrome/symptoms-causes/syc-20371915

I usually get my K and Na from propel or Gatorade zero - no sugar but electrolytes. Mu Fe is normal, I had medical issues before surgery, so I have elevated RBC, C - reactive protein, and platelet count, but low Na and low K. I by no means have a high sodium diet, my average intake is less than 1,000 and average around 700 with the propel or Gatorade. Sent from my SM-N950U using BariatricPal mobile app