Reactive hypoglycemia (suspected): low carb/ high protein diet.

[Swissgirl]

Hello everyone. : I have suspected reactive hypoglycemia ( Hashis, MCAS, ME/ CFS, Fibromyalgia, amongst other diagnoses, as well as perimenopausal). Thyroid Meds: Armour NDT.

The RH has not yet been confirmed by a medical professional, but due to the ongoing and worsening symptoms, and extreme carb intolerance, I’ve had to restrict my meals to high fat, high protein and low carbs ( basically only very restricted fruit and veg due to major food intolerances). For a while, I was able to manage by eating only like this for breakfast, but now have had to do same for lunch and supper as well, as even though I was eating first the protein, then veg and last the carbs ( eg brown rice) the symptoms have become extreme.

Therefore my question is: will the ingestion of the carbs I am able to tolerate ( e.g apples, mangos, blueberries, blackberries, pomegranate, courgette, cabbage, carrots, fennel, macadamias) provide me with enough carbs to avoid my thyroid levels being affected medium to long term due to decrease in conversion of T4 to T3? Thanks for your feedback.

[Cheryl118]

Hey, I'm not sure re the carbs affecting thyroid levels, but zymptom.ai could help you figure out how different foods affect your symptoms, by finding the patterns for you. It's better than the trial and error option at least

[Swissgirl in reply to Cheryl118]

Hi. Thank you for your reply. Yes, that's basically what I have been doing for the past few years; first due to intolerances such as lactose, dairy, gluten, soy, eggs and later on histamine, and now carbs!

[Jazzw]

I think I’ve understoof from your note at the top that you take Armour (NDT)? So you have T3 in your medication, which makes the issue of conversion somewhat less pressing.

I can speak from my own recent experience in doing low carb while taking Armour that I seem to be absolutely fine—I haven’t experienced any ill-effects. Haven’t done a blood test to be certain but I feel absolutely fine and haven’t changed my dosage at all.

If you were solely on levothyroxine it might be more of an issue (theoretically anyway).

What’s your theory for why you’re experiencing RH? Could you be developing diabetes (type 2)? Are you on sufficient thyroid medication at the moment?

[Swissgirl in reply to Jazzw]

Hi. Thanks for your reply. Yes, that's right, I am on Armour NDT, so getting T3 as well as T4. Am currently on 260.5mg split in 3 doses (a.m.- lunch-p.m.). It's good to hear that you seem fine on a low carb diet while taking Armour I've just started ca. 3 days ago, so will see how I go. I am definitely not crashing after meals as I was, so it definitely seems to be helping. Only problem is that meals are not lasting as long before I get hungry again, as for energy my body also seems to need some slow release carbs. Bit of a challenging situation atm. I do regular thyroid blood tests at the GPs every 3-4 months including fT3, so will see how my values are in comparison to the last test. They were optimal for me last time (TSH supressed, T4 mid-high and T3 right at top of range). I sincerely hope that I am not developing T2 Diabetes, but must admit am concerned, as the carb intolerance has got increasingly worse in the past few months. Unfortunately not only Hashis but also MCAS/Histamine can cause blood sugar issues. Being in perimenopause and heading towards menopause surely doesn't help either! I started with having issues after breakfast, and now same issues after lunch and supper. Am now trying to ensure that I don't allow my blood sugar to drop too low between meals by having a small snack in between, which seems to be helping. Bit hard to fit round 3x/daily Armour so have decided to ignore the usual no food 1 hour before and 2 hours after rule, as otherwise makes it impossible. My diet is severely restricted due to Hashis and MCAS which also makes it challenging. My GP did various insulin based tests and my insulin was very low in the morning, so next step is to do a fasting glucose test. Have been putting it off though as am scared how awful I may feel ( I know I need to put on my big girl pants and get it done;). The reason I think I have RH is due to the really debilitating symptoms I have if I eat carbs with a meal - severe fatigue (which can last for up to 3 days), migraines (which can also last for up to 3 days), feeling 'hungry' ca. 1 hour after meal, cold sweats, going very pale and feeling like I will pass out.

[SteveT3]

brown rice is quite harsh and hard to digest. I have been through similar phases of intolerances to many different grains, fibres and fruits, not because they are carb rich but because of the fibres, fructose, phytates and various herbs that slow liver detoxification. I found benefits like you from first excluding them then finding balance and keeping a food diary. I don't mix fruit with anything or dairy and keep it mono and eat slowly and regular but small volume per meal. Then I tried reintroduction of a small amount on its own, and I used an enzyme which helps with grains - Alpha-galactosidase. Something like enzymedica bean assist 20 minutes before food with glass of water. Over time of timed meals and gradual adaptation I can now eat porridge, chickpeas, banana in quantity. I still cant eat almonds, lentil, brown rice, and can have small amounts of brown bread like once a week in a supermarket sandwich.

Your gut was trained as a baby and can be trained again. The gut needs time to acclimatise the microbiome. You just have to give it time to heal from inflammation and adapt it slowly.

There are assists like enzymes but there are easier hacks like water fasting for a few days. Zinc carnosine, slippery elm powder to heal the stomach. Taurine and magnesium to aid bile acid. Not eating before bed and exercising to move the lymph and support the liver.

I would advise avoiding paracetamol/tylenol, blackpepper, grapefruit, berberine goldenseal, milk thistle liver herbs etc as they actually slow detoxification. You want to support your organs.

Best of luck.

[Swissgirl in reply to SteveT3]

Hi SteveT3. Thank you for your reply and all the info - very helpful. I am on a very restrictive diet due to Hashis and MCAS, and because of having to follow a very low histamine and low sulphur diet (suspected SIBO), as well as all the food intolerances I have (which is a very long list!) it makes it very difficult to experiment. I also have to be very careful with supplements and their ingredients. I am on digestive enzymes and a DAO suppplement, as well as LDN, quercetin and sodium chromoglycat to help with mast cell/histamine symptoms, as well as a lot of vitamins, minerals and amino acids. Have just started L-carnitine to help with blood sugar control. You mention a few things that I have and others that I haven't heard of, so will investigate, thank you. Fasting unfortunately does not work for me, as I feel absolutely terrible and can't function at all. I wish it did, as think it could help to settle my digestive system.

[Escapologygirl]

I'm told to follow high protein low carb diet and I'm stage 4 endometriosis and underactive Thyroid on armour meds the last 2 years. I'm 46 so probably perimenopausal and just the last 6months I'm struggling as all I crave are corn cakes and cheese. I need to do a reset badly. I constantly look pregnant.

[Swissgirl in reply to Escapologygirl]

Hi Escapologygirl. Thanks for your reply. I am sorry to hear that you are also struggling. I am also perimenopausal heading closely to menopausal, which doesn't help either. Bloating can be due to food intolerances (eg gluten/wheat, dairy, histamine) and our bodies often crave what we are intolerant to! Have you read Izabella Wentz's books/websites?thyroidpharmacist.com/. She is a mine of excellent information. I can also recommend Trudy Scott's book and website everywomanover29.com/blog/. All the best.

[Escapologygirl in reply to Swissgirl]

Thanks for replying and will look into these books. I was diagnosed coeliac 20yrs ago so I am very strict about my food.

[Swissgirl in reply to Escapologygirl]

I completely sympathise. Am not coeliac but have NCGS so have to be very strict with gluten too. I am on a very restrictive diet due to Hashis and MCAS, and because of having to follow a very low histamine and low sulphur diet (suspected SIBO) as well, and dealing with all the food intolerances I have (which is a very long list!) it makes it very difficult to experiment.

[Escapologygirl in reply to Swissgirl]

Sometimes all you want is something fun to eat , sending you a big hug

[Foxylady1066]

due to also being diagnosed type 2 diabetic and not wanting to take meds, I control my carb intake to around 30g per day max, these are from veg.

I no longer eat bread, pasta, rice and potatoes.

I’ve lost weight and feel better for it.

I still take 150 mg of Levothyroxine daily and supplement vitamins.

We don’t have to eat carbs our bodies will function without them.

[Swissgirl in reply to Foxylady1066]

Hi Foxylady1066. Thank you for your reply. I am very sorry to hear that you've been diagnosed with T2 diabetes. This is what I am worried about and am trying to avoid, along with the debilitating symptoms after eating carbs with a meal (except for the few fruit and veg that I tolerate). It's really good to hear that you are able to control the diabetes without meds and you feel well on a very low carb diet, as well as losing weight. I've just started taking L-carnitine which is supposed to help with blood sugar regulation.

[Escapologygirl in reply to Foxylady1066]

I love that, do you mind if I msg you about how you do it? I was doing so well and now lately I'm struggling

[Foxylady1066 in reply to Escapologygirl]

Send me a personal msg

[jamesal0]

Re high fat, high protein and low carbs . I'm on 120mg NDT and I recon that plus some prunes to keep you lubricated is the perfect diet. What are your actual symptoms "Reactive hypoglycemia" isn't a lot to go on.

[Swissgirl in reply to jamesal0]

Hi jaessal0. Thank you for your reply. I am currently on 260.5mg NDT. The reason I think I have RH is due to the really debilitating symptoms I have if I eat carbs with a meal - severe fatigue (which can last for up to 3 days), migraines (which can also last for up to 3 days), feeling 'hungry' ca. 1 hour after meal, cold sweats, going very pale and feeling like I will pass out. My diet is severely restricted due to Hashis and MCAS which also makes it challenging. My GP did various insulin based tests and my insulin was very low in the morning, so next step is to do a fasting glucose test. Have been putting it off though as am scared how awful I may feel ( I know I need to put on my big girl pants and get it done;).

[jamesal0 in reply to Swissgirl]

For me absolutely every medical challenge ultimately comes back to NDT dosage. I think I have some rare disease - but no I just have my NDT dosage wrong for this time of the year. Example I got sore joints 5 years ago and I worked out through trial and error, I was just taking too much NDT at 180mg. TSH was on the low side but everything else looked fine. Went to Rheumatologist, special blood tests, bla-bla-bla. Nothing. Ended up having a few days off NDT then changed back to Levo. And after a few weeks felt fine. Then of course all my Levo conversion issues started coming back, head ache, brain fog, getting fat, dry eyes, no energy, brittle hair and skin, bleed like a fish. So back on NDT 30mg to start with, optimise up slowly and this time I didnt push the optimisation so hard and stoped at 120mg. Sore joints is 98% fine. I mean - I'm nearly 60 and played contact sport all my life so stuff that has been broken is a bit clicky and arthritic but in general ok.

For you it's more difficult because you have to eat and you have food groups that you know up upset you. But you might consider dropping back on the NDT for a few weeks and just seeing if things get better or worse. You can easily live on a min of 60mg per day (you won't die). You look for low thyroid conditions as your guide. Feel cold, low heart beat, putting weight on, need a nana nap at 5pm . Find your minimum dosage. Then if you like experimenting on yourself you can go the other way and find your maximum dose. Heart palps, anxiety, crawly scalp, loosing weight, feel hot in bed, finger tips hurt when press things etc . Then you try and live on an NDT dose somewhere between your min and max.

The main question in the end , (if you decided to experiment on yourself) does it help your RH symptoms or not ?

good luck

J

[radd]

Swissgirl,

Some of the carbs you refer to are very high and quick to be ingested. For instance I wouldn’t be eating any fruit at this stage and very little rice, but using carb sources from slow chickpeas, lentils and beans which encourage blood glucose to stabilise whilst giving you enough calories.

I switched to three smaller meals a day all containing protein (both first & second class), snacked on Pulsin’ protein bars in between (which are clean) so never allowing myself to get hungry which exacerbates the glucose swings, and supplemented Glucofit and Berberine.

One of the biggest clues is feeling hungry after a meal. This stopped happening quite quickly with the protein enriched meals and I felt blood sugar stabilise but managing to maintain good glucose levels took about a year as the knock on effects to insulin, leptin and cortisol all have to reverse. Now I can eat any carbs and feel fine.

It is not just food intake that influences glucose mechanics but any thyroid hormone not being utilised correctly by the body will become ‘excess’ and increase lipolysis and secretion of insulin and glucagon, which will create or worsen an existing glucose condition. I would also point out many wouldn’t manage FT3 top of range with blood glucose issues as T3 is known to increase hepatic glucose production, independent of the gluco-regulatory hormones.

[Swissgirl in reply to radd]

Hi Radd. Thank you very much for your input, my apologies it's taken a few days to reply. I eat protein with every meal (chicken, fish or quails eggs) and have done for quite a while, but realised that the order I was eating in was affecting my blood sugar levels as well. I switched to protein, veg then carbs in that order, which helped for a while, until the symptoms of RH became intolerable. I subsequently found a study in which they had researched how diabetics reacted to the order in which they ate carbs/protein/vegetables and how this affected their levels. The only carbs I tolerated in small amounts were brown rice, wholewheat rice pasta, and homemade oat and chia bread, as well as the few vegetables and fruit that I tolerate. Unfortunately, I am on a very restricted diet - no gluten, dairy, egg (chicken), soya, nightshades, corn, yeast, low histamine, low sulphur. I don't tolerate nuts (except macadamias), seeds (except chia)nor any pulses at all. I can also only use ghee (which funnily enough I am OK with, even though it's dairy! and coconut yoghurt as a fat source. Therefore there is very little I can eat as a snack in between and my meals are also quite monotonous. If I also eliminated all fruit, I don't know how I would manage, as the fruit I tolerate is also minimal. However, I am trying lunch and supper with only protein and vegetables (and maybe an apple), and this seems to have helped and I am not crashing afterwards as I was previously. I am also now taking L-Carnitine as recommended by Izabella Wentz for blood sugar stabilisation.

I hadn't heard of the supplement Glucofit, so thanks for that recommendation. Bereberine I haven't tried yet. I know some people can have awful reactions to it. I have to be extremely careful with new supplements, herbs, etc. as I never know when I'll have a mast cell reaction and to what.

I also didn't know that having top of the rangeT3 increases glucose production. Unfortunately , I have to keep it at that level as otherwise I would be totally bedridden. The chronic fatigue I suffer from is better if my T3 levels are high in the range, but I still suffer from it, possibly due to the MCAS.