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Has any one else been diagnosed with reactive hypoglycemia after bypass. Just got the diagnosis today. My blood sugar was dropping so low my symptoms made me appear drunk. It finally got to the point it went to low and I passed out. Just wondering if anyone else has gone through this and how they are doing. Thanks

What do you do for the reactive hypoglycemia?

Goodness yes. I am incredibly emotionally reactive right now -- and prior to all this, as an adult I've always been very non-reactive, to the extent that I used to wonder if I was a sociopath. The past two-ish-weeks I've been on a rage bender, and now I'm starting to see that ease but now instead I get teary when I tell my dog I love her, etc. XD

Used to happen to me earlier on in what I’m guess was reactive or post prandial hypoglycemia. Now it only happens if it’s a sugar/carb item not properly paired with protein and fats, so essentially an unbalanced meal. It was like an extreme food coma. It can get better with time or figuring out the offending food.

I have severe reactive hypoglycemia my blood sugar goes up over 220 even with even a protein shake then 1-2 hours later drops dramatically it has dropped as low as 38. With blood sugar I slow down and appear confused, but no pain. Dumping I am sweating and doubled up in pain. Luckily I don’t get dumping often.

I went to turkey. Paid around 3.5k all in. Aftercare is through whatsapp and calls. It was okay for me and they are pretty reactive (get back to me with in a day) on any questions I ask. They send lists of blood tests to do every once in a while. I'm 4 months out.

that sounds more like orthostatic hypotension (OH) than dumping syndrome. OH is not uncommon the first few months after surgery. But your doctor may want to do a full work up just to be sure. I had some dizziness issues when I was about a year out and they checked for a UTI, OH, inner ear issues, and post-prandial hypoglycemia (also know as reactive hypoglycemia, which can also happen to bypass patients). But given your drop in blood pressure, it sounds like it's most likely OH - but check with your doctor. The "cure" for that is just to get up slowly.

I was told 80 grams of mozzarella a day was OK that's why I split it over 2 meals and I was having home made air fryed chips instead of the seafood sticks but I suffer from reactive hypoglycemia so I tent to avoid potato as much as I can and switched to seafood sticks and the advice I was given from the hospital also was a boiled egg is a perfect snack between meals

Hello all, I am in the same boat, I have regained 50 of my 98, it had been slow at first and now the last year it has been 15 pounds in one year. I never got my hunger back, for years I barely ate and loved it. What I didn't love was only pooping every fifth day. My Ferritin levels were super high, (I think it was related) My surgery was 2018 in Feb, so I am in my 7th year post-op. I'm considering trying Ozempic / Wegovy. I know my metabolism was completely shut down. I was struggling with reactive hypoglycemia, which I think I have under control. I am working on eating as much protein daily as possible and also getting any fluids in, (not soda). I am going to read as many posts as I can in order to seek out others who are in the same boat thanks Dawn Marie

I want to echo the possibility of reactive hypoglycemia -- I've a relative who suffered a long time before they figured out what it was. But it sounds pretty similar. The problem is, I feel like the symptoms of so many things are similar. If you're suddenly having 'low tolerance' (rather than outright intolerance) of lactose, or cacao, etc, it could manifest in the same way. It might also be a pre-cursor to dumping? Like your body telling you "Heck No, Stop RN!" before you have enough of something that would trigger a full-out dumping attack. I've had awful dumping syndrome four times now post-OP, but have had near-misses several times that I catch the warning signs early enough on that I'm able to prevent it. (I really have to get better at knowing what constitutes 'dry' food. Broccoli & Cauliflower steamed or in broth? Fine. Broccoli or cauliflower in a thicker creamy soup? Just kill me already. This is why I stick to leafy veg and green beans lol.)

1. Iv been eating like this for about 6 months now. 2. 5 foot 11inch (180cm) male. 3. The only thing I do suffer from is reactive hypoglycemia which means when I eat cars my body produces to much insulin and my sugar levels drop very low that's why I try to avoid cars. When I spoke to the hospital last I was talking to them about portion sice and calories ect and there reply was as long as I stick to the bariactric place then calories and portion size will never be an issue

i've self-diagnosed myself with reactive hypoglycemia (i think alot of us have on here probably)...aka late dumping syndrome. i noticed it the first time i had (like 2 sips!) of a very sugary drink about 1 month post op. i've had it ever since, though i will say it is not as horrible as it used to be. A bad episode before was like wanting-to-die-on-the-bathroom-floor bad, bad episodes now are me passing out on couch for a couple hours. management of it basically consists of not having too much sugar at one time, or on an empty stomach (note that what "too much" means to me will be different for someone else...so people need to figure out what thier own limits are). as well as having small regular meals throughout the day. unfortunately i don't always do that so, yeah. p.s. i'm 5+ years out.

I have reactive hypoglycemia also. It is true that each surgeon/office will have their own ways of doing things. You're comment: "portion sice and calories ect and there reply was as long as I stick to the bariactric place then calories and portion size will never be an issue" - I submit there will be an issue. You can pile that plate and still are getting too many ounces of food. I can say right now, we have veggies only rather than fruit (carbs) and veggies and salad. Carbs, we don't have that, we have fruit. There's one issue I can see. The only carbs we get are in the fruit and we are to go for low calorie fruit (meaning not bananas or grapes). Berries are what they discuss.

Aww, thanks! I'm glad it helped! It is amazing at how sensitive and reactive our tummies are post-op. They definitely have opinions! How are you feeling now with another week having passed? Early out things can change so quickly looking back on it but in the moment feel like they take forever. I blame it on the "drinking water like it is your only job" thing, the day seems to stretch on sooo long when you have 64oz worth of baby sips to take! 🤣

This sounds a little like what I occasionally experience if I rush my breakfast or have it too early. General weak feeling, a little nauseous, doesn’t last long. From what I’ve worked out it’s related to hypoglycemia specifically reactive or postpradial hypoglycemia which can occur if you’ve had stomach surgery like us. It occurs after you eat unlike hypoglycemia which occurs when your glucose levels drop because you haven’t eaten. ( I have this occasionally too which I manage by eating regularly & taking electrolyte drinks with me if doing anything more strenuous than usual.) They think your body produces more insulin than you need to digest what you’ve eaten which then cause your glucose levels to drop which is why it occurs shortly after you eat. Maybe the bite or two of dessert or chocolate, signaled your body to produce additional insulin to process the sugar??? I don’t have added sugar in my breakfast but of course there’s natural sugars in the milk & blueberries which I think triggers mine.. Generally it doesn’t occur as often as it originally did which could be being more careful about situations that can cause it or just time since my surgery. Wouldn’t give up about not being able to have a small sweet treat at some time in the future. Worth a conversation with your doctor anyway.

I had this issue about a year out from surgery and had a complete workup because it could be due to many things - orthostatic hypertension, inner ear imbalance, low blood sugar, even a UTI. In my case, everything from my workup came back completely normal, so they were baffled. But a couple weeks later, I was at a retirement party and ate a piece of cake. A whole piece - not just my usual one or two forkfuls. About an hour or two later - dizzy. Very dizzy. I told my PCP. She suspected reactive hypoglycemia, sometimes known as "late dumping". She said to try eating something about every three hours - a protein. Or if a carb, then pair it with a protein. I haven't had that issue in a long time, so in my case, that was likely the culprit. It's just that my glucose level might have been normal when I was there for the workup; thus, they didn't catch it. In your case, it could be one of those other things mentioned, too (orthostatic hypertension is pretty common - although that tends to hit pretty early out from surgery - although that could definitely be the culprit, too..) P.S. I just re-read your post. Since it seems to be happening when you're standing, sitting, etc - then it sounds like it might be orthostatic hypertension in your case. Hopefully you'll get some answers soon!

Anyone having issues with irregular heartbeats since having gastric bypass? I have been having problems with AFIB when I went through dumping the first few months and now 1 year out since February I have been in constant PVC (Premature ventricular contraction). My cardiologist is baffled. Been through all kinds of tests and my heart is healthy and have no blockages BUT even with meds it’s not going away. I am constantly having PVC’s AND when I eat my heart gets worse! I flutters like CRAZY!!!! Feels like I horrible panic attack, sometimes feel like I am going to have a heart attack or something. I have been in hospital, being monitored and back in hospital for testing and been on heart monitors. In 1 week wearing a monitor they recorded over 38,000 PVC’S 😱 I am at a loss here and never had these issues until I was revised to gastric bypass. I went back to Bariatric surgeon and he put me on reactive hypoglycemia diet he said that cannot cause PVCs, but it can cause heart, palpitations, and being on that diet has not made any changes. I go back to the cardiologist again for the 11th time on Tuesday after wearing my third monitor and I don’t know what is going to be done at this point. It’s really freaky that after I eat whether it’s healthy or not so healthy my heart does a freaking jiggly jig dance!!!! I thought I’d come on here to see if this is a problem that anybody else has heard of or experienced ?

Have they tested you to see if you are having issues with reactive hypoglycemia? This usually kicks in 1-4 hours after a meal, but since you've had a bypass it is possible it could kick in faster for you if your food is transitioning faster. I've seen FB groups for bariatric patients that have this issue. I've noticed it often happens years out from surgery... I used to have issues with this before bariatric surgery, even on a low carb diet. Eating small meals often with fat and protein paired with your carbs is usually what they advise to treat it, along with other dietary adjustments. Personally if I don't eat every 2-3 hours, I aggressively crash energy wise. It is very pronounced. I have to carry snacks with me everywhere to prevent me going past that 3 hour mark or I look like the Energizer Bunny without his battery! LOL

Following up with a GP is good for general health, but following up with your bariatric surgeon is crucial if you are still having complications from bypass. There are a number of things that can be causing your symptoms, some that can be easily corrected by procedures during an endoscopy. As far as the blood spike, do you mean your blood sugar? Some people that have bypass can develop reactive hypoglycemia which can definitely make your blood sugar levels bounce around and cause fatigue and such. I'm sorry you are feeling bad!

TL/DR: Worried about losing weight by not eating enough. | Looking for tips to reach protein/calorie goals when not hungry. | Looking for others' experiences with lack of hunger this far out in WL Journey. ------------------------- I meet with my nutritionist for check-ins about every 3 months. For this last one, my 9-month, she told me not to be upset if I hadn't lost, as a stall was expected. Yet, I had lost just as much as I had been. We went over what I had been eating & she wasn't concerned about content but suggested increasing variety. [I'm a meal repeater 🤷‍♀️] Though, she again warned me that it is now especially likely that I would stall since I hadn't yet. Since that appointment, I've still been losing weight. I know it might appear strange to worry about meeting the goals we are here to meet, but my nutritionist is big on trying to relearn the natural cues of the body. So, as they are absent, you can notice pressure in your stomach, sighing, or a runny nose as indications of fullness. As indications of hunger return, you can utilize them to increase portions within the parameters of slow eating and not exceeding controlled sizes. The thing is, I don't know that the initial increase after, you know, the literal wounds healed, I have really expanded much more. I don't really get hungry until 'early-bird dinner' time. So eating during the day is purely done out of obligation. [& if I'm being truthful, there are times when I forget entirely until after work.] So obviously, that leads me to try to have all of my calories in one 'meal' in the day, which I have to eat over a couple hours [even if it is small] if I don't want to get nauseous or actually regurgitate. [The regurgitation has improved slightly over the last couple of months. I had a very reactive stomach that required me to prolong my dependence on protein shakes. Pre-surgery, I don't think I came even close to needing to vomit since pre-school 🙁.] To be fully upfront, I have not counted a single macro or calorie or weighed a single food item during my entire journey. I've tried tracking before in my weight-loss journey, and it was not healthy mentally for me. I realize that I may be under goals rather than over them, but straightforward counting of calories is just not something that would be part of a successful journey for me. So, all of this is a longwinded way to say: - Is anyone else struggling to eat enough this far out? - What helps you to reach your protein/calorie goals when you don't really want to eat? - Any other tips/tricks/specific brand or meal suggestions?

The following is a list of abbreviations commonly used on this board. ACL = Anterior cruciate ligament AGB = Adjustable gastric banding AMRAP = As Many Rounds As Possible (crossfit) AT = Aspiration Therapy BB = belly button bc = because BCBS = Blue Cross/Blue Shield BDD = Body Dysmorphic Disorder BED = Binge Eating Disorder bf = best friend BM = bowel movement BMI = Body Mass Index bp = blood pressure BPD = Borderline Personality Disorder or Biliary Pancreatic Diversion bs = blood sugar btw = by the way C25K = Couch Potato to Running 5K 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 CT = Computed Tomography (commonly called CAT Scan) cw = current weight CXR = Chest X-Ray DDD = degenerative disc disease Dr. = doctor DS = Dumping Syndrome or Duodenal Switch EBT = Endoscopic Bariatric Therapies EGD = Esophagogastroduodenoscopy EKG = Electrocardiography ER = emergency room ESG = Endoscopic Sleeve Gastroplasty ff = fat free f/u = follow up GB = gastric bypass GERD = gastroesophageal reflux disease GI = gastrointestinal GIF = Gastric Intrinsic Factor 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 IGB = intragastric balloons IF = Intrinsic Factor IMHO = in my humble (honest) opinion IMO = in my opinion IUI = Intrauterine insemination LAP Band = Laparoscopic Adjustable Gastric Band LES = lower esophageal sphincter lol = laughing out loud LSG = Laparoscopic Sleeve Gastrectomy med = medicine MFP = my fitness pal MGB = Mini Gastric Bypass msg = message NAFLD = nonalcoholic fatty liver disease 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 omw = on my way 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 OTC = Over the counter Oz = Australia PB = Productive Burps PCOS = Polycystic Ovary Syndrome PCP = Primary Care Physician PICC= Peripherally Inserted Central Catheter 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 Rx = Prescription medicine RYGB = Roux-en-Y gastric bypass SADI-S = single anastomosis duodeno–ileal bypass with sleeve gastrectomy s/f or sf = sugar free SG = Sleeve gastrectomy SIPS = stomach intestinal pylorus-sparing surgery smh = shaking my head, scratching my head SO = significant other SOB = shortness of breath st = stones (a unit of weight measurement) sw = weight at surgery tmi = too much information TPN = total parenteral nutrition TT = tummy tuck TTC = trying to conceive Ty = Thank you. [but according to the urban dictionary “Ty” is also an abbreviation for “a total stud with a massive carrot”.] 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

Check your blood sugar when this happens. This sounds like what happens to me and it is reactive hypoglycemia and happens if I eat too many fast digesting carbs. My glucose will go into the 50’s and I need to eat 5- 10g or so fast acting carbs to raise it back again. (But not too many or it will keep swinging) This is something I have developed since having sleeve surgery over 10 years ago and the only way to control it is with diet and not eating high sugary volume of stuff.

Gold and silver are softer and therefore more porous on a microscopic level, and can "pit", meaning bacteria or other irritants can cling to them. They can also flake off into the open wound, and are more reactive with body fluids. They're generally fine for a healed piercing (which can take a few weeks to several months depending on what kind of piercing it is), but because they're not as hard and non-reactive as something like surgical steel or titanium. I worked, unfortunately, at a Claire's in a mall for several years when I was in college, and I know that stores like that push gold as being "safer" when really it is "more profitable". I had nothing but problems with piercings done in gold with a piercing gun. I have since gotten SEVERAL more piercings done with a single-use hollow needle at a piercing parlor, and have had none of the same issues. The right establishment should almost feel like a medical office.

There is a good reason to avoid the RNY revision if you can - the reactive hypoglycemia and marginal ulcer (and all of the medical care limitations that stem from it) issues, but it's not the end of the world, either if that's what you need. It's a common procedure that's been done in one form or another for 140 years, so its quirks and features are well known (but I would rather avoid its quirks if I can). I would certainly get a second, and even third, opinion on it, as while the sleeve is a fairly straightforward procedure most to do these days, repairing one that isn't working correctly is not necessarily so. Most bariatric surgeons started out with the bypass, so that is their comfort zone and they often prefer to go back to the familiar when things get a bit complicated, while there are some who have gone deeper into the sleeve and specialized in it and related procedures, such as the DS, and they are more comfortable doing things that others wouldn't do. We sometimes hear on these forums that "you can't do a Nissen (fundoplication) on a sleeve as there isn't any fundus left (well, not much) yet there are some who routinely perform them. Between that and meshing, there are options, and an RNY doesn't necessarily fix the potential recurring problem, as it, too, yield a small stomach pouch that is subject to herniating. If possible, for a second opinion, I would seek out a surgeon who does the DS (duodenal switch) as that is a good proxy for one who is well experienced with dealing with sleeves, and is more comfortable with more complex procedures as well. If they recommend an RNY revision, too, then that's a pretty solid confirmation of what's appropriate for your specific case.