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Reactive Hypoglycaemia

I spoke with my surgeon today about some weird symptoms I have had since surgery.

I have only experienced about 3-4 episodes of it since having surgery, but it tends to happen if I haven't eaten for a substantial amount of time (like nothing until 2/3pm).

The following happens:

  • shaking
  • light headedness
  • dizziness
  • sweating
  • anxiety
  • palpitations
  • pale presentation of skin
  • weakness
  • disorientation

He has suggested that I have reactive hypoglycaemia - has anyone else experienced this? I have heard it is quite common after bariatric surgery

  • Replies 16
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  • SpartanMaker
    SpartanMaker

    Post-bariatric surgery hypoglycemia (PBH) is super common. It's one of those side effects they don't seem to ever mention pre-surgery. ? I don't tend to have too much of a problem with it anymore, s

  • I have it too. Random episodes but I also experienced it before surgery. Friends used to laugh and say it was an excuse not to do any strenuous type exercise (which was when I mostly had episodes) unt

  • Bypass2Freedom
    Bypass2Freedom

    Thank you everyone for sharing your experiences & advice - it is nice to see I am not alone in this experience and that it is actually manageable! I will be going to Tesco today just to get

Featured Replies

31 minutes ago, Bypass2Freedom said:

I spoke with my surgeon today about some weird symptoms I have had since surgery.

I have only experienced about 3-4 episodes of it since having surgery, but it tends to happen if I haven't eaten for a substantial amount of time (like nothing until 2/3pm).

The following happens:

  • shaking
  • light headedness
  • dizziness
  • sweating
  • anxiety
  • palpitations
  • pale presentation of skin
  • weakness
  • disorientation

He has suggested that I have reactive hypoglycaemia - has anyone else experienced this? I have heard it is quite common after bariatric surgery

I doubt I will ever know if I have it because I eat round the clock ? . Sounds horrible though. Do you just get busy and forget or is it that you do not have anything with you?. I keep a protein bars in my purse in case I get stuck out and they have saved the day quite a few times. Even little nut butter packets would work in a pinch. I also have them little cracker sandwich packets in my car for absolute emergencies since they can get hot and be okay and they last a really long time. Of course that’s not a very nutritious choice. If it’s the former maybe set alarms. I have them set as recurring alarms in my phone that repeat everyday. I really find that eating on a schedule works best for me. I don’t think I could ever get all my protein in if I didn’t.

  • Author

@ShoppGirl I probably should be doing that ? I think it is down to lack of preparation, and just not having those hunger signals, especially in the morning!

I think I am going to have to buy some emergency snacks so I am not caught out like you say!

Eating to a schedule might actually make sense for me too...I need to try and work on that one!!

18 minutes ago, Bypass2Freedom said:

@ShoppGirl I probably should be doing that ? I think it is down to lack of preparation, and just not having those hunger signals, especially in the morning!

I think I am going to have to buy some emergency Snacks so I am not caught out like you say!

Eating to a schedule might actually make sense for me too...I need to try and work on that one!!

Yea. Just start with the times that you naturally do actually eat anyways and then pick other times that are convenient from there. I also do a proffee in the morning (just protein shake and coffee to make an iced coffee like drink). I really am not a breakfast person but I have to do vitamins 5 different times a day so I do that with my soluble fiber mixed in and take my multivitamin once I get that down. It’s fast and it’s liquid too so it’s a good start to the day getting fiber, protein, fluids and my first vitamin done. I like the premiere protein caramel and I just mix it with some chilled coffee. I use the whole shake in a tall cup and add coffee the rest of the way but I am one of those people that are asked if I want some coffee with my cream and sugar so adjust as needed. But for sure, start with the snacks. They are a must if you have reactive hypoglycemia. Then add alarms to remember to eat those snacks. Maybe around 1 if you haven’t eaten yet you need to get something soon or have one of your snacks to avoid the 2-3pm issue. Hopefully that will help.

  • Author

@ShoppGirl Thank you for the suggestions, I really appreciate it :)

I haven't actually tried making my own proffee yet - I tend to just buy protein coffee pre-made in cans ? Will probably be more cost-effective if I make my own so I will look into that!

I shall get the snacks going & alarms set! :D

Yes - I have that. Or at least that is what my physician thought after I had occasional symptoms like that and they couldn't find anything else wrong with me (had the workup about four years ago). She said to eat something about every three hours - preferably a protein or something paired with a protein. It works - I rarely have those symptoms any more.

P.S. any kind of protein is fine - even a thing of yogurt.

Edited by catwoman7

  • Author

@catwoman7 Very good to hear that it has become a rare thing for you to experience now. It does seem I am going to have to put more effort into eating regularly - I struggled with this pre-surgery, and post-surgery it has proven even harder!

7 minutes ago, Bypass2Freedom said:

@ShoppGirl Thank you for the suggestions, I really appreciate it :)

I haven't actually tried making my own proffee yet - I tend to just buy Protein coffee pre-made in cans ? Will probably be more cost-effective if I make my own so I will look into that!

I shall get the Snacks going & alarms set! :D

Of course!! I have my alarms set for 9, 12, 3, 6 and 9 (every 3 hours). I am up before the 9am but I do my Yoga or walk in the morning and then it takes me a while to drink that big proffee drink so it’s usually 8:30 or 9 when I finish it. It’s more of a reminder if I set it down and forget about it. Lunch at noon, small snack at 3, dinner at 6 and small snack at 9. This works really well for me for food and I am able to get my multi, 3 calcium’s and then my magnesium and hair vitamin all separated by a few hours. Ooh and Chomps Turkey Jerky is a good snack to keep on hand as well. They have mini turkey sticks but the pepperoni ones are better tasting. I just eat half and save half for later. I also have a pack of ziplocks in my car.

Post-bariatric surgery hypoglycemia (PBH) is super common. It's one of those side effects they don't seem to ever mention pre-surgery. ? I don't tend to have too much of a problem with it anymore, since I stopped trying to only eat 3 meals a day. As long as I eat every 3 hours or so I'm fine, but too much more than that and I start getting woozy.

I have it too. Random episodes but I also experienced it before surgery. Friends used to laugh and say it was an excuse not to do any strenuous type exercise (which was when I mostly had episodes) until they witnessed me experiencing it. Freaked them out.

Yes, keep little snacks on hand. Eat to a routine. (I started to do this early after surgery because of the lack of hunger and any interest in eating. I knew I had to eat to get in the nutrients my body needed. I still do 5 years out.) Have an electrolyte drink on hand if you know your day will be busy and you may miss meals. (I added a hydralyte tablet to a bottle of water when I knew I would be out or at work.) And I plan ahead in situations I know may cause an episode. For example, sometimes I pop out before breakfast to grab a few groceries. To ward off an attack I’ll have a few blueberries before I leave.

My last attack was 4 weeks ago at hospital. The hospital doesn’t provide the sandwiches or cheese & crackers after you have surgery any more. That night I had an episode. It had been 24hrs since I’d eaten and when I spoke to a nurse, she informed me o had to order my own meals through an app or ring an order through. Sorry but still rather out of it from the anaesthetic, sleepy and having a hypoglycemia episode does not make downloading an app and creating passwords, etc. easy. Plus the phone & menu was out of my reach because of the IV and being plugged into those pulsing leg wrap things. Due to my woozy befuddled brain, I totally forgot I had packed a few protein bars which would have got me through. And yes, I had identified I had hypoglycemia on my admitting records.

  • Author

Thank you everyone for sharing your experiences & advice - it is nice to see I am not alone in this experience and that it is actually manageable!

I will be going to Tesco today just to get some emergency snacks, and I am about to try and eat breakfast ?

@Arabesque I can't believe that they didn't even help you with that, considering it was on your records too...Apps definitely aren't accessible to everyone either, so the fact they rely on that and also don't even inform people about it is insane!

7 hours ago, Arabesque said:

I have it too. Random episodes but I also experienced it before surgery. Friends used to laugh and say it was an excuse not to do any strenuous type exercise (which was when I mostly had episodes) until they witnessed me experiencing it. Freaked them out.

Yes, keep little Snacks on hand. Eat to a routine. (I started to do this early after surgery because of the lack of hunger and any interest in eating. I knew I had to eat to get in the nutrients my body needed. I still do 5 years out.) Have an electrolyte drink on hand if you know your day will be busy and you may miss meals. (I added a hydralyte tablet to a bottle of Water when I knew I would be out or at work.) And I plan ahead in situations I know may cause an episode. For example, sometimes I pop out before Breakfast to grab a few groceries. To ward off an attack I’ll have a few blueberries before I leave.

My last attack was 4 weeks ago at hospital. The hospital doesn’t provide the sandwiches or cheese & crackers after you have surgery any more. That night I had an episode. It had been 24hrs since I’d eaten and when I spoke to a nurse, she informed me o had to order my own meals through an app or ring an order through. Sorry but still rather out of it from the anaesthetic, sleepy and having a hypoglycemia episode does not make downloading an app and creating passwords, etc. easy. Plus the phone & menu was out of my reach because of the IV and being plugged into those pulsing leg wrap things. Due to my woozy befuddled brain, I totally forgot I had packed a few Protein Bars which would have got me through. And yes, I had identified I had hypoglycemia on my admitting records.

In the US, they always send out surveys every time you go to a medical facility (so often it’s actually annoying). If I were you, I would definitely be mentioned in that experience if you get one. I mean their medical professionals and you were I their care immediately after surgery they should’ve been asking you to make sure that you have eaten given your diagnosis. And definitely after you were already experiencing symptoms. She could have easily got you something right away. I’m 99% confident that they have like orange juice right there for people who experience hypoglycemia due to diabetes. Not sure if that would’ve helped. . That can even cause seizures if it’s the same as diabetes. How can a nurse not take that seriously?!

Edited by ShoppGirl

5 hours ago, ShoppGirl said:

In the US, they always send out surveys every time you go to a medical facility (so often it’s actually annoying). If I were you, I would definitely be mentioned in that experience if you get one. I mean their medical professionals and you were I their care immediately after surgery they should’ve been asking you to make sure that you have eaten given your diagnosis. And definitely after you were already experiencing symptoms. She could have easily got you something right away. I’m 99% confident that they have like orange juice right there for people who experience hypoglycemia due to diabetes. Not sure if that would’ve helped. . That can even cause seizures if it’s the same as diabetes. How can a nurse not take that seriously?!

the kind of reactive hypoglycemia that some people get after bariatric surgery isn't necessarily related to diabetes. It can happen to non-diabetics, too (I'm not diabetic). I've also seen it referred to as "late dumping", because it tends to happen a couple of hours after you eat (as opposed to soon after, as is the case with regular dumping). I mentioned in my response above that my physician couldn't find anything wrong with me when she did the workup, but she told me to let her know the next time I had that experience. The next time was a couple of weeks later. I'd been at a retirement party and had a whole piece of cake (instead of a couple of forkfuls, like I used to have back in those days). A couple of hours later, there it was again - dizziness, etc. She said it was likely reactive hypoglycemia (AKA post-prandial hypoglycemia), and it may not have shown up at the workup because my glucose might have been normal the day I went in for that. Anyway, yes - it's not uncommon after WLS, . It often appears when you're a year or so out (although sometimes sooner...or later). They say to eat protein - or a something paired with a protein - every three hours or so to prevent it (I know it's orange juice or something similar for regular hypoglycemia - but she specifically said protein with this type - may be something to specific to the WLS-caused version)

This explains the reaction from the WLS center from my recent bloodwork. I had fasted like they had asked and my blood glucose levels were at 70. That’s the cutoff within normal range. I’d never had a problem fasting before surgery, and was never diabetic. This must be a more common post WLS issue. I also asked why one apple slice can make me dump? The answer was that I’ve fine tuned my body for only low glycemic levels so little bites can send it spiraling. The doc and dietician said to eat protein to counteract it, and to pair (whatever) with protein. It was the same response Catwoman got.
4 hours ago, catwoman7 said:

the kind of reactive hypoglycemia that some people get after bariatric surgery isn't necessarily related to diabetes. It can happen to non-diabetics, too (I'm not diabetic). I've also seen it referred to as "late dumping", because it tends to happen a couple of hours after you eat (as opposed to soon after, as is the case with regular dumping). I mentioned in my response above that my physician couldn't find anything wrong with me when she did the workup, but she told me to let her know the next time I had that experience. The next time was a couple of weeks later. I'd been at a retirement party and had a whole piece of cake (instead of a couple of forkfuls, like I used to have back in those days). A couple of hours later, there it was again - dizziness, etc. She said it was likely reactive hypoglycemia (AKA post-prandial hypoglycemia), and it may not have shown up at the workup because my glucose might have been normal the day I went in for that. Anyway, yes - it's not uncommon after WLS, . It often appears when you're a year or so out (although sometimes sooner...or later). They say to eat Protein - or a something paired with a protein - every three hours or so to prevent it (I know it's orange juice or something similar for regular hypoglycemia - but she specifically said protein with this type - may be something to specific to the WLS-caused version)

Okay. I don’t know that much about it, but it’s still appalling that any medical professional would just leave you to figure out some silly app while you were having any kind of blood sugar issues that they should’ve prevented to begin with. My guess is they probably have some kind of protein right next to the orange juice if that’s what people need. They have a little refrigerator with stuff like that in it. Stuff that they don’t want to have to go to the cafeteria for. It’s the same place They put the sugar-free ice pops for people who had bariatric surgery. I know because I didn’t like the flavors that they had and they asked if I could have my husband bring me a box and they said yes they were just put my name on them. And even if they didn’t have anything the Least they could do was order it for her. You learn a lot about things when you spend five days there walking laps around the halls

Edited by ShoppGirl

I spoke with the nurse and she told me they don’t have anything any more on the floors. It’s terrible. They were told it was because the stock would expire and would have to be disposed off so they stopped the supply for budgetary reasons, Also have to order water via the app (or by phone which as I mentioned was out of my reach at the time). What happened to those lovely ladies who would top up your water, offer you a cup of tea, a little chat, fixed your flowers (if you were lucky enough to receive any) when you were in hospital. So sad. They don’t even have the little fridge in the room anymore like they used too.

I had my hypoglycemia years before my sleeve surgery, I just experience it more often now. I sometimes find even a cup of tea (green so no milk) helps me. Strange but true. But generally I go for something a little sweet hence the blueberries or electrolyte drink.

Oh, I have the survey & don’t worry I will be filling it out detailing my experience.

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