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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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Non-Diabetic Reactive Hypo

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Had two very severe non-diabetic hypos over the past two months after doing exercise. 

It's getting to the point where I'm quite scared now. Can anyone help?

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Can you give a little more detail about what happened?  Your first step should probably be to make an appointment with your primary care doctor to get their opinion first.

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You can help keep your blood sugar as stable as possible by avoiding sweets.  Even fruit juice has a great deal of natural sugar, so I avoid it.  Have bites of fruit rather than whole fruits.  Have protein and good fat (olive oil, coconut oil, or butter if tolerated) with every meal.  These things I have used to help stabilize my blood sugar.  I would get help also.  If you have celiac it will help to follow the diet and get generally healthy.  Oh, also make your exercise sessions have a time limit, so you don't stress the body too much at a time..

 

Dee

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I've been thinking on this and wondered if you know you were hypo because you tested yourself, or only assume you were because of how you felt. Because I can become hypo if I'm not careful with how I eat, and suffer from low blood pressure, I can tell you that both can feel very similar to each other. Cooling off after exercise could cause a dip, it's happened to me. I agree that you should definitely see a doctor in case something serious is going on.

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Had two very severe non-diabetic hypos over the past two months after doing exercise.

It's getting to the point where I'm quite scared now. Can anyone help?

Hi there,

I too have reactive (postprandial) hypoglycemia, and have also had serious episodes where I've blacked out and had massive convulsions. Have you been diagnosed by a doctor? It is very important to have it properly diagnosed, as it can be caused by tumor (insulinoma) or be something like Addison's Disease.

Assuming you have been diagnosed with RH, these where the instructions from my endocrinologist and/or things that I've discovered help me:

1. Switch to a low carbohydrate, high fat, moderate protein diet. She wanted me to go to 30% carbohydrate, but I found I do better around 40-45%.

2. Any carbohydrate/meal/snack should preferably be low-GI. The aim is to avoid your blood glucose SPIKING, since that's what causes it to crash after eating.

3. Any carbohydrate should be part of a mixed meal or snack.

4. Don't have too much carbohydrate at one time, even if it is part of a properly balanced meal.

5. Eat smaller meals but more frequently, say every 3 hours. Don't go too long without eating.

6. Get yourself a glucose monitor and start testing yourself before eating, and about two after after eating to see how that particular meal/snack effected you.

7. Check for added/hidden sugar in any processed foods that you buy!

8. Avoid caffeine.

9. Try to find what I all your 'magic' or 'rescue' meal. It's the one that stops your glucose from falling without making it shoot up again only to crash even more afterwards. For me that's peanut butter on a bit of carbohydrate (half a slice of bread or a couple of brown rice cakes, though I suspect the rice cakes don't work for everyone).

I too am an athlete, exercising up to 90 mins at a time. This is what I do:

1. I took a break from training while I stabilized

my blood sugar. It's too risky to workout when you don't know how a meal/snack is effecting you.

2. I make sure I have eaten beforehand, and not too long beforehand. I tend to eat about an hour before exercise, that way I'm not too close to my next meal nor too close to my workout that I may have GI issues.

3. Experiment with what works before exercise. I can't have too much protein beforehand or I'll be sick, so my carbohydrate is paired with a good amount of fat instead. My endo wanted me to split a protein bar in half to have before and after exercise. Obviously this didn't work for me, but it may work for you.

4. Depending on how long you're there, you may have to eat a bit while you're exercising. Just don't follow the usual sports diet approach of having high GI carbs, this is not for you!

5. Always, ALWAYS have something with you to eat immediately after you stop exercising. This is good advice for anyone, because eating after exercise helps you recover better from your training! But make sure it is the type of meal/snack that works for you - not the high-GI, high carbohydrate foods that sports dietitians recommend for most people! Get some protein into you in particular.

Let me know how you get on! There are so few of us out there it seems, and most doctors have never encountered it or know what to do. Have a hypo and they want to stick some pure glucose into you. No no no! You don't treat an episode of reactive hypoglycemia like regular hypoglycemia unless you want the person to continue dropping further after you spike their blood glucose!

Good luck!

PS: I found a YouTube channel 'blogsoidontforget' by someone with RH. You might find it helpful.

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Presuming that you're already eating enough calories, I'd research what vitamins exercise tends to drain from your body and the vitamins needed for your liver to metabolize some foods. Many of them overlap. Not only that, but many of them are also the vitamins that one finds in fortified wheat flour - which celiacs don't eat, making it more difficult to make up the losses.

If you get tested for vitamin deficiencies, get your results from your doctor because just being within normal ranges doesn't mean that you are at ideal levels. Research the maximum recommended doses before buying gluten-free supplements, and research the side effects so that you can tell if your body is trying to tell you that you're overdoing it.

If you do have deficiencies, you won't be able to correct them through diet or multivitamins alone, despite what many people think. But I personally despise supplements and their side effects, so I'd also recommend researching natural sources for the vitamins that exercise tends to drain away and try to get more of them in your diet as well. I'm also not keen on the idea of just taking a multivitamin because supplementing vitamins that you don't need can have negative consequences as well.

Next, do some research into the enzymes. There are several that come into play when it comes to keeping blood sugar levels normal and exercise can deplete them. I wouldn't take the easy way out and just drink a sports drink that is supposed to replace enzymes because most of them contain ingredients I wouldn't want to put in my body, even if it is just a matter of getting too much of a good thing.

Foods that are high in enzymes generally include raw fruits and veggies, nuts, and seeds and some have more than others. (Note that many nuts sold as unroasted aren't actually raw because in today's world of processing, they do get hit with a dose of high heat to kill off fungus or other pathogens. For many types of nuts, finding truly raw products in a store is almost impossible these days.)

But I might also add that there are a lot of myths out there concerning enzymes and raw foods so you have to pick and choose what to believe. Don't fall prey to those who try to sell the idea that 100% raw diets are healthy. They are not. And at the other end of the spectrum, don't believe people that say you don't need enzymes from food sources because your body will make all that it needs. And in the case of those with digestive problems, damage can inhibit enzyme production.

I'm less familiar with enzyme supplements because I've never taken them. But enzymes and vitamins work together to keep your bodies' processes running smoothly, and lots of exercise is a good way to deplete both.

I do recommend not consuming fewer calories per day than your basal metabolic rate. And if you aren't trying to lose weight, add on the number of calories that your exercise burns. 

I do agree with the previous comment about eating after exercise. Protein after is also supposed to help build muscle.

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Presuming that you're already eating enough calories, I'd research what vitamins exercise tends to drain from your body and the vitamins needed for your liver to metabolize some foods. Many of them overlap. Not only that, but many of them are also the vitamins that one finds in fortified wheat flour - which celiacs don't eat, making it more difficult to make up the losses.

If you get tested for vitamin deficiencies, get your results from your doctor because just being within normal ranges doesn't mean that you are at ideal levels. Research the maximum recommended doses before buying gluten-free supplements, and research the side effects so that you can tell if your body is trying to tell you that you're overdoing it.

If you do have deficiencies, you won't be able to correct them through diet or multivitamins alone, despite what many people think. But I personally despise supplements and their side effects, so I'd also recommend researching natural sources for the vitamins that exercise tends to drain away and try to get more of them in your diet as well. I'm also not keen on the idea of just taking a multivitamin because supplementing vitamins that you don't need can have negative consequences as well.

Next, do some research into the enzymes. There are several that come into play when it comes to keeping blood sugar levels normal and exercise can deplete them. I wouldn't take the easy way out and just drink a sports drink that is supposed to replace enzymes because most of them contain ingredients I wouldn't want to put in my body, even if it is just a matter of getting too much of a good thing.

Foods that are high in enzymes generally include raw fruits and veggies, nuts, and seeds and some have more than others. (Note that many nuts sold as unroasted aren't actually raw because in today's world of processing, they do get hit with a dose of high heat to kill off fungus or other pathogens. For many types of nuts, finding truly raw products in a store is almost impossible these days.)

But I might also add that there are a lot of myths out there concerning enzymes and raw foods so you have to pick and choose what to believe. Don't fall prey to those who try to sell the idea that 100% raw diets are healthy. They are not. And at the other end of the spectrum, don't believe people that say you don't need enzymes from food sources because your body will make all that it needs. And in the case of those with digestive problems, damage can inhibit enzyme production.

I'm less familiar with enzyme supplements because I've never taken them. But enzymes and vitamins work together to keep your bodies' processes running smoothly, and lots of exercise is a good way to deplete both.

I do recommend not consuming fewer calories per day than your basal metabolic rate. And if you aren't trying to lose weight, add on the number of calories that your exercise burns. 

I do agree with the previous comment about eating after exercise. Protein after is also supposed to help build muscle.

Thank you to those who replied, but I think this may have answered my question. Since I posted this story I have had other episodes of feeling severely fatigued for a number of days after minimal exercise (I played bat and ball on a beach for 10 minutes and was almost on my back for days afterwards) and I'm starting to think it's down to a Vitamin D deficiency. I was told I had a Vitamin D deficiency many months ago but didn't know it would become this serious.

My episodes feel very unusual and tend to begin within an hour after I "exercise". I start by feeling very weak, sometimes needing to sit down. But when I sit down I still feel as though something is washing over me: I feel incredibly exhausted, short of breath and feel like sitting down in a chair is still too much effort. I also feel short of breath and sometimes have to take a lung full to feel satisfied. When I lie down my heart beat feels very strong in my chest and ears and I often have to breathe deeply to feel comfortable. Even doing things such as moving slowly around my house feel difficult and draining. My memory and concentration also feel very cloudy when I'm on a downer.

This can last anywhere between 5 hours and 7 days and often feels very similar to chronic fatigue syndrome. 

Sometimes I crash completely and have to rush to the bathroom so that my bowels can relieve themselves - in extreme cases this normally triggers vomiting, but that has happened only once so far. I normally feel comfortable for 5 minutes after I've been to the toilet but the symptoms I've described above soon return. I'm getting quite worried about this now because I'm starting college again in two months and I may not be well enough to concentrate or even wake up in the morning and feel like going. 

Has anyone else has this problem?

 

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