Reactive hypoglycemia in children - Page 2

[Tigerle]

What an interestung discussion this has turned into! Thank you everyone for weighin in.
I have enjoyed relaxing our rhythms a little after the strict eating schedule carried over from breastfeeding (I had an "on-the-clock-child" who more or less put himself on a strict three-hour rhythm and stuck to it"), but will try to go back to it as afr as possible, with protein-rich snacks.

heatherdeg, I think I will get that test this summer, before we start trying for #2. I was diagnosed with "possible pcos", because while I had the polycystic ovaries, my sugar test did not show insulin resistance - no spike. What it DID show though was consistently high blood sugar even when it should have gone down and they just shrugged their shoulders about that. Maybe there is more to find out. I just hate the needles involved

[Miss Information]

Originally Posted by 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.

I see what you are saying. I don't know the answer to that. I know dd2 came up normal on a fasting glucose test. From everything I've read about reactive hypoglycemia is that the fasting test won't detect it, you have to test during an episode where you see symptoms.

What sort of behavioral or physical changes could you see that might have been concurrent with your insulin levels being too high?

[snowmom5]

Originally Posted by Miss Information

What sort of behavioral or physical changes could you see that might have been concurrent with your insulin levels being too high?

This is an interesting question - looking forward to any responses - it's been a while since I looked at this with regard to kids, but I think in kids the signs of insulin resistance are things like skin tags and AN (darkening of skin in certain places), but there might be no symptoms (I'm not sure about the behavioral so I'm looking forward to hearing about that). I think in order for there to be outward physical symptoms, the levels would need to be pretty high.

I have pcos and my insulin doesn't even show up as high until hour 2 of a 3-hour GTT - or it didn't the last time I had that test, about nine years ago LOL - and of course that's only because insulin levels were checked in addition to glucose - my glucose is usually normal (though all bets are off now that I'm an old hag). My endocrinologist wants me on metformin for life anyway. I have no outward physical symptoms, just the pcos and resulting infertility issues (in spite of this surprise pregnancy; in a few minutes I'm leaving for my 1 hr GTT for GD, but I'm on metformin this time so it'll be interesting to see if the result is different from my last pregnancy about one year ago when I was not on metformin, even though I technically "passed" that time). As a young adult I had the usual pcos symptoms, acne and irregular cycles, but nothing extreme enough for anyone to notice until I had a workup by my OBGYN around age 31.

I would not be shocked if my kids inherited these genes from me, though I would be surprised and fascinated if there were actual symptoms - behavioral in particular - as a result. So I'm all ears...

[BCGifted]

I was a scrawny kid, and gifted (IQ 153 - how close to 160 do you have to be? lol). I can't believe it's taken me this long to find the connection between reactive hypoglycemia and giftedness. DD8 and DS6 are also both skinny, very hyper, and gifted, and are prone to mood swings when hungry. Hmmm...

My daughter, in particular, craves carbs almost constantly and has trouble focusing in school. She eats very slowly, and claims that they don't have time to eat much at snack time and lunch, so her lunch bag is almost full when she comes home. Lately I've been giving her protein meal replacement bars and yogurt shakes WITH her breakfast (not instead of!) and she's much happier - she says it's been helping her a lot :)

[spedteacher30]

My doctor "diagnosed" me with reactive hypoglycemia as a teen--though, I don't remember what kind of blood work led to that diagnosis.

I was a skinny little wisp of a child, with an IQ that met the 160 guidelines. I had all the behavioral signs of it--it has gotten better, though, there are still times when my partner just needs to hand me something to eat.

Our son has all the behavioral signs of it and has the physique I had as a child. Interestingly, after we moved him to a play-based daycare and not a Montessori school, the symptoms aren't as severe--maybe he isn't as cognitively taxed any longer?

Small snacks that include both a protein and a complex carb will be very helpful. cheese and whole grain crackers, cottage cheese and whole wheat toast. apples and peanut butter. celery and peanut butter. carrots and peanut butter. nuts and strawberries.

Of course, until very recently, our son was allergic to eggs, dairy and nuts. still has his nut allergies. it made high protein snacking very complicated. Since adding cheese to his diet, his crashes are less often...

[zebra15]

I dont have much time to type up an answer but DS has this.  I call him my 'Dr Jekyll and Mr Hyde'.  You do not want to miss the 2-3 min window when he is going downhill. 

[minkin03]

Originally Posted by Miss Information 


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.

As a child I was bone thin and until I turned 30 I was always considered thin despite eating as much as a horse. I'm average in size now. For as long as I can remember I've had problems with blood sugar, in particular problems with hypoglycemia. I get shaky, highly irritable, can't think straight/clearly, feel faint, and just plain yucky. Dh knows me well enough now that when I say I need to get some food in me that I mean business. I know I don't have diabetes as I have been tested and came up negative. Never had gestational diabetes either.

What I find interesting about what you posted is that I know I have some sort of sensitivity to epinephrine. Whenever I have dental work done I have to ask for the epi free novocaine otherwise I'll faint. Same thing happens when I have the epinephrine nasal spray at the ENT office. Happens every time.

[Chantal1212]

Excellent thread. It's so hard to find others who understand and "live" this. I have had the reactive hypoglycemia since I was a child, but negative GTT at age 15. Didn't figure all of this out until I was 32 and I crashed with my fibromyaglia and migraines. Have been on a low-carb diet since then, for almost nine years, and swear by it!

Am now pregnant with baby number two and diabetes, but still have the blood sugar swings if I don't eat for hypoglycemia. Am also noticing it more in my son who is five. Would appreciate any tips on what  "kid friendly foods" to prepare. Need to figure out an alternate source for birthday cake etc...

[Casha'sMommy]

OP-I wish I had time to read through everything else that's been said. I just don't. Maybe later tonight.

So far, I know that one of my dc have RH and we suspect two other dc as well. (maybe the baby as well, we'll see)

The first, dd17yo, has needed snacks in school since she was 6yo. She carries a protein bar or chunks of cheese with her to school everyday. Without these she's a basket case.

When she was younger though, she was not the one affected so much by food/drink at night but she'd just shut down during the day. The one that was greatly affected would run and run and run and run after dinner. I could not get that kid to settle down for bed time. He would go and go for two or three hours after dinner. I swear every gray hair has his name on it. lol

Then there's the now 6yo who has shown signs for the past 4 years. If that girl does not get her snack in the am she is an absolute bear. And, nothing can repair this. That is how she will be until she wakes the next morning and only after getting a couple of good meals and snacks in her body. We've been doing shakes and smoothies with added protein which the lo's think are a treat and it makes the day go so much better.

Epsom salt with a little tea tree and lavender essential oils in the bath each night also helps the lo's.

I saw Dr James T Webb give a presentation and he spoke of RH specifically for quite a while. To summarize, he said that testing has been done on some suspected to have RH and that no difference can be found in them even when it was clear that they were reacting at the time of the test. He suggested that no medical doctor will ever agree that RH appears to be an issue in the gifted. Also, that each child with RH will have different nutritional needs and some need more of something than another and that it's a trial and error kind of thing.

This likely doesn't help you in the least bit but it is nice to know that some professionals are recognizing it and are trying to be helpful.

[squimp]

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.
 

This is us too, except that it is DH and DD who get the irritable low blood sugar thing.  I know DH's college friends warned me to not "let" him get hungry.  And it didn't take me long to realize that it's true, once he mentions he is hungry we need to find him food.  

DD is just the same.  It has been an issue at school because she needs her afternoon snack but the teacher doesn't always give it to them.  I've had to talk with the teacher about this because if I pick her up hungry at 2:45, it is not pretty.  I have been trying to get her to take protein instead of fruit, but it's hard to find protein she wants to eat when she's hungry - everything seems really heavy.  So I appreciate the food ideas!    

Also, if she has juice on an empty stomach, those are the absolute worst fits ever.  I honestly did think there was some kind of major issue going on with her, but now I realize that hunger is a big trigger and I try really hard to avoid it.  

[A&A]

Originally Posted by 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!

Milk has protein in it, and yeah, it's not going to help him sleep. Your dh is right. A carb-loaded snack would be best for helping him sleep.

[forestmushroom]

my oldest son is HG+ (he's the only kid who has been tested) and is def. hypoglycemic. I was just diagnosed as well, as an adult.

he has to eat small snacks frequently and can behave *strangely* if he doesn't eat or eats too much sugar and then crashes. intense physical exercise can make it worse.
 

He is old enough to go on camping trips and over night camps where I can't follow him around making sure he eats. LOL

So having him learn to manage it and making sure he is aware of himself and the signs that he needs to eat is very important. He gets excited and doesn't "feel hungry" so it has been a learning experience for both of us...

[athletesmom]

Our son at 12 was having symptoms, headaches, cranky, and dizziness after athletic events, he plays for mulitple teams, sports and travels. The childrens hospital in Pittsburgh, Endo department, tested his sugar, during the 3 hr sugar test they came out in waiting room, questioning if he even drank that awful drink? He did, his sugar levels which started at 56 never rose past 76 thru-out 3 hr test! He craved simple sugars and chocolate and very thin...we are now on a very strict diet due to the fact they figured out he didn't have enough "stores." We needed to load more of the right things in his intake prior to activity and after restore it.

High protein and carbs prior to activity and fruit or protein fruit during activity after an hr (like if he had a 2 hr practice) and the important product was the Chocolate milk - Non fructose corn syrup on natural or organic- Tru Moo perfect one we use after activity - it restores alot after activity.  He has gained 7 lbs but still thin but we give high protein 3 hrs prior and high carb 2 hrs to 1 hr and always have protein bars or drinks around in his coaches bag. Good Luck, I never connected the gifted thing, but was told "high maintenance" kids or collic babies have grown to have this..My son was very collic and I have to say he is in the gifted program for school.

[ihugtrees]

Interesting to read this thread. I was diagnosed with RH as a teen. I struggle with my weight. I feel best when I eat low carb, high protein, but I am extremely picky and all I ever *want* to eat is carb heavy foods like bread and pasta. I'm also constantly on the go so I find it hard to carry lc snacks with me.

Doctors always look at me funny when I tell them I have hypoglycemia, and mention my weight issue. Is there a difference between RH and regular hypoglycemia?

[Tigerle]

Wow, this ancient thread of mine gets resurrected again and again...apparently this is a hot topic for a number of families.

I figured I might as well write a little update: while we're not slaves to the clock anymore, this issue has never really gone away.

In some ways things have gotten easier (mealtimes shifting an hour back or forth do not make that much difference anymore, so more flexibility during the day, and he's eating a good variety of foods) but also harder, as DS1 is now more responsible for his own food intake.

In preschool, the teachers would make sure that everyone had their snack by 11 am, in 1st grade, not so much. And on his own, DS1 is just way too distracted to get a meal inside himself without prompting.

So far, school's half days till 12.30, sometimes afternoon care till 13.15, but he has lunch at home everyday as i am currently on maternity leave and DH's schedule (teacher in a neighbouring school and on 70%)  works out so he can give him a lift. It will make enrolling him in afternoon care, as planned at some point, difficult though, unless i can get someone to monitor his food intake - it's in their best interest!

Feeling more relaxed about this at home these days, I often forget about the snack in the afternoon, so if I haven't thought of getting him to eat something by 5 pm, he'll go berserk about trivial frustrations. (He is still unable to realize he is hungry and ask for food - DD, almost 4 years younger, will say "I need something to eat!", DS1 will just explode). I have explained the problem to him, the scientific basis and how it runs in the family and that the only means for him to be able to calm down is to eat regular meals, but he is still unable to monitor his intake or even to just eat once I tell him that he has to in order to calm down. He'll just scream and refuse and I have to yell at him even louder to make him. It's exhausting, but I guess it's my fault - he does not feel hunger himself anymore than I can feel it for him, but is just not old enough to monitor his own meal schedule.

DH has been yelling bloody murder at finding his uneaten snack in his schoolbag again and again, and I have asked his teacher to keep an eye on it. Not that I am very sanguine about this with 24 kids in the classroom, but at least if he ever has an explosion in school (so far, he controls himself very well) I can shift some of the blame!