Hulaw2007

Gastric bypass related hypoglycemia anyone?

Recommended Posts

I think I'm having a type of hypoglycemia related to my gastric bypass surgery from April 2017. I've been having episodes of intense sweating /shaking/feeling faint/feeling weak and fatigued.   I also had an episode so bad last week that I actually collapsed and almost blacked out as soon as I pulled my car over.  Unfortunately I was 3 hours away from home at the time and driving alone. The scariest thing I think I've ever experienced in my life. I saw my PCP as soon as I made it back to town and now have an appt at with an endocrinologist for January 5. I had a bariatric check up last week and they thought it was not related but I think it is. I've also had minor episodes like this for the last two months varying in intensity. Including headaches, excessive hunger, feeling weak, bad insomnia. Any thoughts? 

Share this post


Link to post
Share on other sites

Usually, gastric bypass normalizes blood sugar, within hours of the surgery. In your case though it sure sounds like something is going on.

Do you have a blood glucose meter? You need to test yourself as soon as these episodes come on, to see what your numbers are at that moment. The meters are cheap, you can pick one up at Walmart etc. Your PCP probably has one at the office that is for giving away.

Share this post


Link to post
Share on other sites

Hulaw,

I'm with Michael - you need to get yourself a glucose meter because it does sound as if you're having hypoglycemic episodes.  And buy some glucose tablets to keep to hand at all times. 

It's something I've learnt to deal with and I know my triggers so keep my carbs very low.  But we don't all react the same.  I have to avoid carbs from starchy sources - no breads, crackers etc. and I limit my beans to a scant 1/4 cup.  Those foods are guaranteed to send my blood sugars nosediving. 

Keep a detailed record of what you eat (and the times) and if you start feeling symptoms, test your blood and record the result.  That information is going to be helpful to the doc when you get to see him/her.

 

Share this post


Link to post
Share on other sites

I experience the same kind of episodes although I believe mine started pre-op after having lost most of my excess weight. So in my case probably not directly surgery related but definitely weightloss/diet related. While my blood sugar drops during these episodes it's not yet measured scary low.....my blood pressure on the other hand becomes very borderline low when they occur, then switches to racing heartbeat as it try to correct itself. My surgeon has suggested I have a banana in the car when driving because they provide a mix of high and low GI carbohydrates. From what I could gather she was suggesting that the high GI carbs would get me out of trouble quickly, and the low GI carbs would stop the cycle from repeating itself as I came down from the induced high. My family doctor had suggested carrying sweets, which I knew wasn't the answer because it would just start a high then low sugar spiral. When these episodes happen I generally have no option but to sleep them off, so I avoid high GI carbohydrates like the plague these days especially when away from home.

Share this post


Link to post
Share on other sites

I keep chewable glucose tablets with me.  It doesn't happen often but it's scared when it does.  Try to eat a little every few hours.  

Share this post


Link to post
Share on other sites

Thanks everyone. I'm seeing a cardiologist on Friday because my psychiatrist thinks it might be related to the carotid artery because he had something similar happen to him and that was his problem. I also have an appointment at for January 5 with an endocrinologist. Hopefully between these two I can figure out the problem. My wife has a glucose meter because she is diabetic. Maybe I could use that one. Thanks everyone for the replies. I've lost 108 pounds in 8 months and my bariatric surgeon thinks I'm doing very well with the weight loss. I'm only 50 pounds away from my goal now. 

Share this post


Link to post
Share on other sites
3 hours ago, Hulaw2007 said:

My wife has a glucose meter because she is diabetic.

Excellent! Even now, you could spot check yourself every few days and get an idea of where your sugars are running. Anything in the 80's to 120's would generally be considered normal. But if you were consistently running on the lower side, then I'd say it would give some credence to your hypo- theory. Having that info when you meet with your indo will probably be illuminating.

Share this post


Link to post
Share on other sites

Just to add to the comments from @Michael_A  @Aussie H  @cinwa and @Cheesehead - I had a sleeve, but several months ago at an hotel in Jakarta I had some home-made yogurt there that must have been, in retrospect, 50% sugar.... and I had a classic episode of sweating, fast heart rate, feeling faint, etc. Just to be an experimentalist, I ate the darn things the next morning and the same thing happened. Must have had a giant insulin rush to the sugar and then went low. Was pretty shocking to me since I thought I was not susceptible to this after a sleeve, unlike a bypass. I do eat some carbs (home made bread, some grains) without incident so this must have been above and beyond what my system could tolerate. Glad I wasn't driving or doing anything critical then. 

Share this post


Link to post
Share on other sites
9 hours ago, Hulaw2007 said:

Thanks everyone. I'm seeing a cardiologist on Friday because my psychiatrist thinks it might be related to the carotid artery because he had something similar happen to him and that was his problem. I also have an appointment at for January 5 with an endocrinologist. Hopefully between these two I can figure out the problem. My wife has a glucose meter because she is diabetic. Maybe I could use that one. Thanks everyone for the replies. I've lost 108 pounds in 8 months and my bariatric surgeon thinks I'm doing very well with the weight loss. I'm only 50 pounds away from my goal now. 

While it's always a good move to be checked out when there could be a major issue going on please try not to get too concerned while waiting for your appointments and diagnosis. What you're describing fits perfectly with what in Australia is referred to as "late dumping syndrome"....and described perfectly by  @BurgundyBoy...with regard to insulin spiking after sugar consumption followed by a rapid drop in blood sugar levels.

While I haven't seen the different descriptions anywhere but here in Australia, my post surgery paperwork describes two kinds of dumping syndrome. The "early dumping syndrome" which they say happens 30-60 minutes after ingesting sugar is what many here describe where they get diarrhoea, vomiting, intense abdominal pain etc.when the sugars or fats are initially hitting the intestine and causing it to react. The "late dumping syndrome" is described as occurring 1-3 hours after ingesting sugars and causes the dizziness, faint feeling, sweats, heart palpitations etc. this occurs when the sugars eaten have hit the bloodstream and the insulin spike has hit to quickly lower your blood sugar again. It is just the new normal body reaction to sugars for some of us. Totally controllable simply by avoiding  high GI carbohydrate intake. It's scary when it happens....but it's a lesson well taken in staying away from high sugar foods and drinks. Some patients going into bypass surgery actually want to be affected this way as a means of controlling their desire for sugars.....I guess that until you experience it you don't see the virtue in the saying "be careful what you wish for".

Edited by Aussie H

Share this post


Link to post
Share on other sites

I was on the standard low carb, low fat, high protein diet for years with little issues with low glucose (occasional dumping} About 8 years post-op, I started to get sick every morning, with no change in my eating. I had to take time off from work. It went on for two years before my PCP figured it out. Another side effect of RNY is "reactive hypoglycemia"...a 4 hour glucose tolerance test will tell you more.The home glucose test wouldn't catch the lows in time and keep saying I was in normal range.   I drop to a glucose of 27 at the 2 hour post 70gram glucose drink! Eating a glucose tab just sets up the cycle all over again, with another real low in 2 hours. 4 years ago,  I switched to ketogenic diet and have very little symptoms since.  

Share this post


Link to post
Share on other sites

My internal medicine guy said: reduce the size of your portions,  eat more slowly, and eat more often (if you're not eating six times a day already). Both will help prevent a large amount of food getting into your intestine at once (which sparks the reactive hypoglycemia). Works for me.

Share this post


Link to post
Share on other sites

My bariatric surgeon is pretty insistent that this is unrelated to my gastric bypass but I'm not buying that. I think what all of you have said is spot on. I think the endocrinologist I am seeing on Friday would possibly know about this. I'm hoping. 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now