I think I have reactive hypoglycemia. How can I address my symptoms?

Answers from Todd B. Nippoldt, M.D.

Reactive hypoglycemia (postprandial hypoglycemia) is low blood sugar that occurs after a meal — usually within four hours after eating. Low blood sugar (hypoglycemia) usually occurs while fasting. Signs and symptoms of reactive hypoglycemia may include hunger, weakness, shakiness, sleepiness, sweating, lightheadedness, anxiety and confusion.

It's possible to have symptoms that are similar to reactive hypoglycemia without actually having low blood sugar. True reactive hypoglycemia symptoms that are caused by low blood sugar occurring after eating are uncommon. For the majority of people with postprandial symptoms, the actual cause of the symptoms is not clear but may relate to what food was eaten or variations in the timing of the food moving through the stomach and intestinal tract.

Generally, a medical evaluation is done to determine whether symptoms are caused by low blood sugar — and whether symptoms resolve once blood sugar returns to normal. Further evaluation of reactive hypoglycemia depends on the severity of signs and symptoms.

For the majority of people, reactive hypoglycemia usually doesn't require medical treatment. It may help to pay attention to the timing and composition of your meals:

  • Eat several small meals and snacks throughout the day, no more than three hours apart during the waking hours.
  • Eat a well-balanced diet, including lean and nonmeat sources of protein, and high-fiber foods, including whole grains, fruit and vegetables.
  • Avoid or limit sugary foods, especially on an empty stomach.
  • Be sure to eat food if you're consuming alcohol and avoid using sugary soft drinks as mixers.

For some, particularly those who have had intestinal surgery (gastric bypass or surgery for the management of ulcer disease) further evaluation by a doctor may be warranted, but dietary changes are still recommended.

It's also important to include physical activity in your daily routine.

May 15, 2013 See more Expert Answers