Everything about Reactive Hypoglycemia totally explained
Reactive hypoglycemia is a medical term describing recurrent episodes of symptomatic
hypoglycemia occurring 2-4 hours after a high
carbohydrate meal (or oral glucose load). It is thought to represent a consequence of excessive
insulin release triggered by the carbohydrate meal but continuing past the
digestion and disposal of the
glucose derived from the meal.
The prevalence of this condition is difficult to ascertain and controversial, because a number of stricter or looser definitions have been used, and because many healthy, asymptomatic people can have
glucose tolerance test patterns said to be characteristic of reactive hypoglycemia. It has been proposed that the term reactive hypoglycemia be reserved for the pattern of
postprandial hypoglycemia which meets the
Whipple criteria (symptoms correspond to measurably low glucose and are relieved by raising the glucose), and that the term
idiopathic postprandial syndrome be used for similar patterns of symptoms where abnormally low glucose levels at the time of symptoms can't be documented.
Common symptoms
Although symptoms vary according to individuals' sensitivity to the elevation and decline of glucose levels, some of the more common symptoms are:
- fatigue
- dizziness
- light-headedness
- sweating
- headaches
- palpitations
- depression
- nervousness
- irritability
- tremors
- flushing
- craving sweets
- increased appetite
- rhinitis
- epileptic-type response to rapidly flashing bright lights
Causes
There are different kinds of reactive hypoglycemia:
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1)
Alimentary Hypoglycemia (consequence of
dumping syndrome; it occurs in about 15% of people who have had stomach surgery)
2)
Pre-diabetes
3)
Hormonal Hypoglycemia (due to lack of some hormones; for example, hypothyroidism)
4)
Helicobacter pylori-induced gastritis (some reports suggest this bacteria may contribute to the occurrence of reactive hypoglycemia)
5)
Congenital enzyme deficiencies (hereditary fructose intolerance, galactosemia, and leucine sensitivity of childhood)
6)
Idiopathic reactive hypoglycemia
7)
Late Hypoglycemia (Occult Diabetes; characterized by a delay in early insulin release from pancreatic B cells, resulting in initial exaggeration of hyperglycemia during a glucose tolerance test)
To check if there's real hypoglycemia when symptoms occur, you can have an
OGTT, or even more accurate for this kind of diagnosis, a "breakfast test".
(External Link) Then, additional tests may be applied to see if there's another disease (for example hypothyroidism) causing the reactive hypoglycemia.
Treatment
To relieve reactive hypoglycemia, some health professionals recommend taking the following steps:
Eat small meals and snacks about every 3 hours.
Exercise regularly.
Eat a variety of foods, including meat, poultry, fish, or non-meat sources of protein, foods such as whole-grain bread, fruits, vegetables, and dairy products.
Choose high-fiber foods and food with a moderate-to-low glycemic index.
Avoid or limit foods high in sugar, especially on an empty stomach.
Avoid alcohol, caffeine, and highly starchy foods such as white rice, potatoes, corn, and popcorn (all very high on the glycemic index).
Adding soluble fibers (for example, 5 to 10 grams of hemicellulose, pectin, or guar gum) to a meal may help to relieve symptoms, especially in dumping syndrome. (External Link)
Your doctor can refer you to a registered dietitian for personalized meal planning advice. Although some health professionals recommend a diet high in protein and low in carbohydrates, studies have not proven the effectiveness of this kind of diet for reactive hypoglycemia. If the diet doesn't provide a relief in symptoms, there are some medications which can be useful in reactive hypoglycemia, and that should be administrated only by a physician.
Postprandial Syndrome and Adrenergic Postprandial Syndrome
If there's no hypoglycemia at the time of the symptoms, this condition is called Postprandial Syndrome. It might be an "Adrenergic Postprandial Syndrome" - the glycemia is normal, but the symptoms are caused through autonomic adrenergic counterregulation. Often, this syndrome is associated with emotional distress and anxious-behaviour of the patient (External Link) (External Link).
Dietary recommendations for reactive hypoglycemia can help to relieve symptoms of postprandial syndrome.
Further Information
Get more info on 'Reactive Hypoglycemia'.
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