Reactive hypoglycemia in children

[Tigerle]

I have been trying to find out more about this because I suspect it in my child (and remember when I was little my mom would always say "I know, you're hungry!" when I got unusually irritating or difficult.

I could find very little specific to gifted kids, mostly the info seems to be about diabetic adults. ..
I would love to hear from parents who are dealing with this. What are your experiences and tips? What meal schedule have you found out works for you, what kind of snacks would you recommend to keep around (avoiding peanut butter because I hate even the smell of it...).

Is there anything specific to milk I should be aware of? My husband suspects that the bottle of warm milk he gets every night at bedtime (I know! before brushing his teeth!) revs him up physically. When we put him to sleep he starts tossing and turning and sweating, with a rapid heartbeat. I was thinking it is a sensory thing and a separation anxiety thing from when I had to leave in the morning before he woke up, and the sweating is from cuddling up close to help him calm down, but would love to hear thoughts from anyone who has had similar experiences.
Thank you!

[Miss Information]

According to Misdiagnosis and Dual Diagnosis of gifted Children, the authors had seen 5-7% of gifted children also having reactive hypoglycemia. They say most of the children with that had IQ's in excess of 160. Now, I'm pretty sure dd2 has reactive hypoglycemia, but I doubt has an IQ past 160.

The theory is that the brain, which is fueled by glucose, is burned much faster in highly gifted individuals, resulting in a crash and burn every few hours.

YOu can read more here

To help, the child needs more protein and complex carbohydrates. The protein slows the digestion of carbs. Since the reactive hypoglycemic reacts between 3-5 hours after a meal, it's better to have more frequent, protein rich meals.

About the milk at night thing. It would probably be better to give it no later than 2 hours before bedtime, so if your son were to be alerted by it, it wouldn't be just before bed. We would do dinner, milk about an hour later, warm bath, stories, bed.

Protein rich foods - almond butter (might smell better than pb), cheese, Fruit with yogurt dip, fruit smoothie with protein powder (yogurt, frozen strawberries, blueberries and/or raspberries (bananas optional, I’m not fond of them myself), a little milk, some protein powder, wheat germ (optional)).
avocado (yes hi in fat, but good fat, hi in protein and other vitamins), hard boiled egg, beans (white Northern beans are pretty bland), hummus (chickpea spread).

[heidirk]

yes, that.

and, my ds1 whom I suspect to be gifted always does better on a higher protein/fat dinner, although in the morning it's all over carbs.


maybe cheese and crackers instead of peanut butter? I have also found he sleeps better if I let him snack on nuts during the day. he loves cashews.

[Tigerle]

Thank you for your thoughts, I'll start filling the fridge. Cheese, hard-boiled eggs and nuts will go over great here, hummus and beans not so much - I'm afraid they'll count as a vegetable. We're still working on those. Yoghurt is iffy, too...Maybe I will have to offer more meat, that works as well.
Miss I, that was a great link! So hypoglycemic kids are usually thin, huh? How about adults? Probably am not thinking enough anymore to burn enough calories, that would explain a lot!
I don't think our son is in the 160+ range at all, and neither was I. I wouldn't call what I'm seeing "crash and burn" either - just sudden bad behaviour like hitting, spitting, pulling the cats' tail, culminating in whining for chocolate - that's when I start preparing dinner at high speed, but a handful of nuts in time might help us a lot here, I suspect. Maybe that is what's meant, though - the sudden change. It does not seem to happen when he is with my inlaws, who let him graze and serve juice which I'm not to happy about either, but it might stave off the "crash" until he goes home with me.
Food for thought, heh heh!

[Miss Information]

Originally Posted by Tigerle

Miss I, that was a great link! So hypoglycemic kids are usually thin, huh? How about adults? Probably am not thinking enough anymore to burn enough calories, that would explain a lot!

My dd2 child I'm referring to is skinny as a rail, my other two are more filled out.

Originally Posted by Tigerle

I don't think our son is in the 160+ range at all, and neither was I. I wouldn't call what I'm seeing "crash and burn" either - just sudden bad behaviour like hitting, spitting, pulling the cats' tail, culminating in whining for chocolate -

Actually, I have seen a friend of my daughter's who has diabetes go from sweet endearing child one moment to bossy/controlling/quick to anger as a result from her blood sugar being too dangerously low. So, yeah, anger is just another kind of behavioral aspect of low blood sugar.

It makes sense he's asking for chocolate - a quick burst of sugar, and over all, chocolate has a "feel good" chemicals and theobromine, a stimulant.

Originally Posted by Tigerle

Maybe that is what's meant, though - the sudden change. It does not seem to happen when he is with my inlaws, who let him graze and serve juice which I'm not to happy about either, but it might stave off the "crash" until he goes home with me.
Food for thought, heh heh!

Not only that, you have to figure he feels "safe" with you to let all the bad feelings out, and he's probably given more 1 on 1 attention at grandmas because they don't see him everyday.

[heidirk]

skinny as a kid, overweight as an adult.


ds 1 is quite thin, despite eating constantly, which pretty much describes me as a kid.

[no5no5]

Originally Posted by Tigerle

How about adults? Probably am not thinking enough anymore to burn enough calories, that would explain a lot!

I'm glad I'm not the only one thinking this as I read this thread. (Not that I'm overweight, but I'm definitely not stick thin as I was until my mid-twenties.) I used to eat & think like a maniac (a lot, and often), but lately both have tapered off considerably. Food for thought, eh? (pun intended )

Anyway, thanks for this thread. It fits DD also. The first time I gave her candy she ate it, paused, and then turned around and hit me.

[Poogles0213]

I diagnosed myself with reactive hypoglycemia after about 2 years of feeling flushed, tired, irritable (just generally crappy) about 1-2 hours after I'd eat. I was going to my doc to try and figure it out but they weren't helping much. They checked my blood-sugars after a fast, but it was within normal limits. When I discovered reactive hypoglycemia, it fit perfectly with what I was experiencing! It's pretty much been under control since I made some changes to my diet.

From what I researched, it seems that big meals (especially those high in simple carbs or sugar) cause the body to over-produce insulin in reactive hypoglycemics which then causes the blood-sugar level to crash, leading to feeling tired, flushed, irritable and depressed (for me).

Here's some quotes from Wiki:

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...

Please go to the wiki page to see symptoms and treatments: http://en.wikipedia.org/wiki/Reactive_hypoglycemia

Personally, I eat 6 small meals a day, about 2 1/2 hours apart, make sure there is protein and/or fat in every meal and stop eating at least two hours before bedtime (all of this also helps with my indigestion problem too). When I follow this strictly, I am fine. When I forget to eat, or load up on sugar etc. I feel terrible. HTH!

[Miss Information]

Originally Posted by no5no5

I'm glad I'm not the only one thinking this as I read this thread. (Not that I'm overweight, but I'm definitely not stick thin as I was until my mid-twenties.) I used to eat & think like a maniac (a lot, and often), but lately both have tapered off considerably. Food for thought, eh? (pun intended )

Anyway, thanks for this thread. It fits DD also. The first time I gave her candy she ate it, paused, and then turned around and hit me.

You have to figure age (changes in metabolism) in and hormonal changes from birth (and breastfeeding if that was done). And plain old simple stress and fatigue from caring for them , chasing after them or worrying about our kidlets' behaviors.

I know I went through a really difficult time after the birth of my third (3rd birth in 3.5 years). Plus, with my dh's working midnight shifts, and I bf dd3 for 3 years 1 month. I was on high stress alert for the longest time. I didn't think about much except pure survival (dd2's chronic meltdowns were killing me).

But in the last year, with my blogs and my dd2s condition giving me lots to think about and write about, I have been on overdrive with brain activity (good brain activity).

I was never thin as a rail, but I do experience a lot of those symptoms Poogle listed and I get really cranky without good comfort foods (for me, the combo of protein and complex carbs does it).

I did found this though which was very interesting:

from about.com (and btw their articles are supposed to be reviewed by a medical review board.

http://diabetes.about.com/od/whatisd...hypoglycem.htm

"What is the cause of reactive hypoglycemia?
The exact cause of reactive hypoglycemia is still unknown, but there are several hypothesis that might explain why it can happen.

* Sensitivity to epinephrine, a hormone that is released in the body during times of stress.
* Insufficient glucagon production. Glucagon is also a hormone which has the opposite effect of insulin. It raises blood glucose levels.
* Gastric surgeries can also cause reactive hypoglycemia because food may pass too quickly through the digestive system.
* Enzyme deficiencies can also cause reactive hypoglycemia, but these are rare and occur during infancy."

However, in another article about reactive hypoglycemia from about.com

"Reactive hypoglycemia with no known cause is a condition in which the symptoms of low blood sugar appear 2 to 5 hours after eating foods high in glucose.

Ten to 20 years ago, hypoglycemia was a popular diagnosis. However, studies now show that this condition is actually quite rare. In these studies, most patients who experienced the symptoms of hypoglycemia after eating glucose-rich foods consistently had normal levels of blood sugar--above 60 mg/dL. Some researchers have suggested that some people may be extra sensitive to the body's normal release of the hormone epinephrine after a meal. "

Interesting stuff, though one article says epinephrine comes from stress, the other, from normal release after a meal, so I'm not sure who to believe on that one. Though, I suppose for us it doesn't matter, dd2 has enough stress from her social anxiety so it really could be either or even both.

[tanyalynn]

Some people find that eating a food they are intolerant to causes an increase in heartrate. I would consider whether dairy could be an issue (it is for us).

[heatherdeg]

Okay... so I'm really interested in this whole thread because:

1) ds is an absolute behavioral NIGHTmare if he's not eating every 2 hours and we don't get some kind of food into him as SOON as he wakes up (and yeah--carbs first thing don't seem to be a great answer unless it's whole grains); and

2) I have hyperinsulinism--which is the overproduction of insulin (especially in response to eating) which is usually misdiagnosed as hypoglycemia (or even mild hypoglycemia). The difference is that my insulin levels are always high although the sugar tests I had for decades (including a glucose-tolerance test) came back "normal" or "mild hypoglycemia".


Ultimately, not treating the hyperinsulinism (that was un- and misdiagnosed for 17 years) has caused other problems and if it had gone untreated, my pancreas would eventually burnout and I'd be diabetic.

I will have to go back when I have time to read the links in this thread to understand the difference between reactive hypoglycemia and what I have and either way--what ds might have.

[AllisonR]

OMG! This thread has been an eye-opener. I am self-taught reactive hypoglycemic, meaning getting a diagnosis has been impossible, so I have figured it out as I go along. :

DS takes after me. Neither of us can function until we have had our OJ in the morning. And having candy, chocolate, junk food after a long time between meals is a definite no-no: gives us a roller coaster high and then a hard crash. If I want candy, I make sure we have a healthy item with it. We also snack, and luckily DS kindergarten does mid morning and mid afternoon snack as well. The only thing in the posts that was off was the IQ - I am pretty darn sure neither one of us is close to 160+!

[Whistler]

I'm hypoglycemic (diagnosed, although I wasn't for years) and I wrote a long post here about what I do to control it. I have not observed it yet in my kids but I feed them healthy food on a pretty regular schedule so even if they did have it, hopefully it is already well under control.

[kindacrunchy]

Wow! That article that Miss I put a link to is spot on with my son. No wonder why he is craving sweets all the time!
I also have to eat something healthy when I have a treat. Now my treat is TLC dark chocolate chip cookies. All whole grain with enough chocolate to curb the craving.
Very interesting info.
I have always eaten ALL DAY LONG. I know my son needs to as well but he fights it. Then he is beyond hungry and a total monster. He seems to do ok at school. NO behavioral problems there, but they do have a snack time around 10:30.
Very interesting!

[Bekka]

Very useful article

I have 3 kids that are in this category!!! My oldest not so much hairtrigger, but especially dd2 and ds. Thanks very much. Dd2 I discovered by accident/trial and error--if she gets crazy I hand her a spoon with peanut butter (we like it here) or a few slices of cheese. She self regulates too when protein is available--have you ever seen a 50 lb kid put away 3 pieces of chicken?

[snowmom5]

OMG, this might be what I have been struggling with ds over (he's 6 y.o., about 43 lbs). The last several months he's become increasingly super-wired/hyperactive and I wondered if he's just really overtired due to allergies or something (so I'm going to be investigating that angle too; he has had swollen tonsils for months but he doesn't snore; has asthma and on meds for it; also does nasonex for the nose/sinus). But it would make sense for this to be the reason instead. I was even thinking that his behavior would look a little like ADHD except that there's no way he would meet the criteria for it.

Problem: he's a very, very picky eater and doesn't eat enough protein. He has a peanut allergy and we're a nut-free house. His primary sources of protein are pathetic - milk, hot dogs, the occasional chicken nugget. (ray of hope - a few days ago he agreed to try a piece of my baked chicken in lieu of practicing piano LOL - and he appeared to like it though he didn't exactly ask me to make it for his dinner - he'll never admit to liking it). His dinner usually involves buttered pasta. (he claims to not like mac and cheese though I make a decent homemade one.) He will eat pizza sometimes, probably the most protein he has in a single meal. Pizza is the only situation in which he'll deign to eat either cheese (or bread; I know I've got to get him over this somehow). Right now in his lunchbox, how pathetic is this: one pillsbury crescent roll, of which he'll eat half; five crackers; grapes (he loves fruit); and a box of chocolate milk from costco (if he drank the whole thing it has 10g protein but I highly doubt that he finishes it every day). I can't even get him to try Sunbutter, which is what we use on my other kids' sandwiches and seems to have a decent amount of protein as compared to peanut butter.

Fortunately lots of fruits and a few vegetables are not a problem, he eats them. Lots and lots of fruit. Let's not talk about cookies.

Any creative ideas for protein for a very picky eater that don't involve nuts or cheese? (I wonder if I could get him to eat some sort of mini-"pizza"...)

(yeah, he's the one who I didn't bother to get evaluated for SPD lol, unlike two of his sibs.)

Also, FWIW, there is a family history of insulin/glucose issues - I have pcos, my dad was a thin type 2 diabetic.

[LynnS6]

What, you mean not everyone becomes impossible when they're hungry? My entire family is like this, so I didn't realize that it wasn't normal until I met dh. It was a real eye opener for dh to have me meltdown when we traveled and I didn't get to eat regularly.

Both of our kids are like this, which is somewhat of a problem because dh is home with them in the late afternoons and doesn't do a great job of making sure they get appropriate snacks before dinner.

The link that was posted was interesting to me because dd definitely becomes much more sensitive to pain, in addition to become more difficult, and I hadn't linked the two.

Is it possible to have milder forms of this? I wonder if it's a continuum of some sorts. I don't get dizzy unless I'm REALLY hungry; the first sign is usually irritability. (Doesn't everyone get irritable when they're hungry?)

Ds is quite thin and dd is not. I wasn't thin as a child, but am definitely overweight now -- my eating issues escalated when I had small kids because I would eat preventatively to make sure I didn't lose my temper because I was hungry. So, I was consuming a lot more calories than I needed. I'm doing weight watchers now, and it's an interesting experience. I am grumpy some times, but I've also added more whole grains and I'm becoming more careful with protein which helps.

[LauraLoo]

Originally Posted by snowmom5

Any creative ideas for protein for a very picky eater that don't involve nuts or cheese? (I wonder if I could get him to eat some sort of mini-"pizza"...)

If he'll eat cookies, muffins and breads that you make from scratch, then you can hide all sorts of grains/flours and wheat germ in them for added proteins. I do a lot with muffins including a pumpkin one thats a big hit with my kids. If he'll do a smoothie, then you can also add in yogurt and other stuff. I mix a lot of stuff in tomato sauce (spinach and other pureed veggies.) Just some ideas. Will he eat eggs? There's a million different ways to add eggs into things.

[greenmamapagan]

Originally Posted by LynnS6

What, you mean not everyone becomes impossible when they're hungry? My entire family is like this, so I didn't realize that it wasn't normal until I met dh. It was a real eye opener for dh to have me meltdown when we traveled and I didn't get to eat regularly.

Ditto. DH doesn't need to eat anywhere near as frequently as me and it was a source of tension in the early years of our relationship from both sides. He couldn't see why I so desperately needed to stop and get food for example when driving long distance and our destination was only another hour away :

Is it possible to have milder forms of this? I wonder if it's a continuum of some sorts. I don't get dizzy unless I'm REALLY hungry; the first sign is usually irritability. (Doesn't everyone get irritable when they're hungry?)

I would think so. I follow the same pattern, except when pregnant (as now). In pregnancy I go straight to the dizziness if I haven't eaten protein and it must be as frequently as every two hours then if I don't eat as soon as the dizziness starts the nausea sets in
DD is similar, she needs to eat something with some good fats and/or protein every threeish hours when she's awake. Luckily DH got somewhat used to me needing to eat frequently before she came along but he still lapses sometimes A six-year old we know displays it much more obviously - she will literally go from boisterous to floppy in ten seconds if she passes the magic time-marker that she needs to have protein in. Then have a slice of deli ham or something and be straight back to boisterous. DH has watched that in action a few times so he can see how it relates to our own DD's moods.

[heatherdeg]

I don't know... I'm reading the links above and can't figure out how they would definitively distinguish reactive hypoglycemia from what I have (hyperinsulinism or hyperinsulinaemia). None of those articles talk much about testing INSULIN levels--just sugar levels... which is how I went misdiagnosed (and undiagnosed) for 17 years while I suffered.

Of course, dealing with the presumed hypoglycemia and following the ADA diet--plus eating smaller meals throughout the day--certainly helped me a lot. But it wasn't actually addressing the true problem--which continued to do damage.

I guess I just worry that people could be misdiagnosed. And on MDC, there is a contingent that wouldn't bother with a doctor for something they could handle themselves (I'm one of those, btw). But having been through this and it being wrong (and looking exactly like reactive hypoglycemia), I'm worried.

I would just suggest that anyone that gets any kind of sugar testing INSIST on a fasting insulin level as well.