The Diabetes Care & Education dietetic practice group of the American Dietetic Association specializes in working with patients with hypoglycemia. You can find a dietitian at the American Dietetic Association. Include your zip code or city / state and the type of service you want (individual consultation) with expertise in diabetes and hypoglycemia.

Try contacting the Norwegian Dietetic Association.

Click on the nutrition topic hypoglycemia which is listed in a column on the left side of Ask the Dietitian's main page. Then using your browser's find feature, search for reactive. There are several questions about reactive hypoglycemia and foods to eat / avoid.

If you question is still not answered, please write back. I do not provide "diets" per say or menus at my website. If you need further nutrition counseling, please consult a registered dietitian in your area by calling your medical clinic or local hospital.

Yes, ketosis is not recommended even for hypoglycemia.

If you chose to lose 1 or 2 pounds per week and my calculator reported 1470 calories given the data you entered, then yes that is how much you should eat.

No, you don't want 50% of your calories from protein. The max recommended would be 20%.

Wait, I think you have something a bit mixed up. Insulin is a hormone. Your body over produces insulin in response to carbohydrate.

Sweetened soft drinks aren't recommended, but diet ones are OK. I would recommend you limit diet soda to 2 cans per day.

You can eat any fruit (fresh, canned in fruit juice or unsweetened frozen) or unsweetened fruit juice. Three servings per day would be sufficient.

Regarding a GTT (glucose tolerance test), it is not recommended that a hypoglycemic, once diagnosed repeat this test due to the rapid drop in blood sugar and risk of losing consciousness. People with hypoglycemia do not usually have a sharp rise in blood sugar like a diabetic and actually have the opposite problem diabetics have - too much insulin. Hypoglycemia is generally considered a pre-diabetic condition in that the pancreas is not appropriately secreting insulin.

The OJ or milk would be OK, but why don't you try glucose tablets that diabetics take. Each one has 15 grams of carbohydrate, just enough to bring your blood sugar up a bit before the protein kicks in.

Glad to hear you are going to see an RD. She or he should be able to read your chart and recommend the appropriate medical nutrition therapy while answering any new questions you have.

Your doctor was incorrect and the dietitian is following the current medical nutrition therapy for hypoglycemia. She needs to find a baseline amount of carbohydrate that will produce no or infrequent symptoms while providing you with the nutrients you need to meet your Recommended Dietary Allowances. Since hypoglycemia symptoms are in response to food, you should be able to stabilize your blood sugar by regulating your carbohydrate intake.

It appears that your dietitian is concerned about the glycemic index of carbohydrates as well. The glycemic index is a list of how certain carbohydrates affect blood glucose. Those with a high glycemic index cause a greater rise in blood sugar. Those foods with a low glycemic index have a low rise in blood sugar. Ask your dietitian about a glycemic index for foods.

Low blood sugar reactions are hard on a fetus's brain, as that is the organ that uses the most amount of glucose. I don't have any current references regarding stabilizing hypoglycemia during pregnancy, but doesn't it make sense that you follow a healthy diet to develop a healthy baby? It is a good idea to get your hypoglycemia under control, but I would discuss getting pregnant with active hypoglycemia with your gynecologist. For some women, the hormones of pregnancy can increase blood sugar levels above normal to the point that some people with normal glucose metabolism become diabetic during pregnancy.

Because of limiting carbs, you may feel like you have few choices, but as your symptoms stabilize, your carbohydrate will be increased to the point where you start having more episodes of low blood sugar. At that point is the threshold of carbohydrate that your body can tolerate without having low blood sugar reactions.

Sound like you have learned how your body handles carbohydrates and have adjusted to a reasonable diet to achieve your health goals. You're consuming about 169 grams of carbohydrate a day, so you must have your hypoglycemia under control. How do you keep track of your food intake? How do you monitor your protein and carbohydrate content? Do you use the exchange list or computer software?

There is a lot of misinformation on the Internet about hypoglycemia, so beware of persons without nutrition credentials, testimonials (it worked for me, so you should try it too) or selling dietary supplements.

Good luck with the DT exam and your continuing dietetic education! Thanks for your kind words.

Anorexia means the loss of appetite. To the public, anorexia more often refers to girls who restrict their food intake willingly. That disease is called anorexia nervosa. Loss of appetite and resulting weight loss should always be investigated until a cause is found.

Typically the nutritional symptoms of Addison's disease can be hypoglycemia due to the body's inability to create new glucose from amino acids and fat. Sodium levels in the blood may also be low which may have to be corrected immediately using intravenous solutions. Weakness, feeling faint when standing up quickly and pigmentation where tissue-overlying skin is thinner are early symptoms. Weight loss is one of the later developing symptoms. Because the disease can be slow to develop, a misdiagnosis of psychological cause may be made. The treatment is usually with cortisone or steroid compounds and no specific dietary recommendations unless the steroids cause secondary problems.

By the way, the information in my nutrition topics is the result of people asking questions. No one has asked about Addison's disease before. Thanks for asking.

First, have you discussed your symptoms with your dietitian and what has she recommended?

Do you also feel weak and shaky like you are going to faint and break out in a sweat without expending any exercise? Or is the heavy head and sluggish feeling unrelated to low blood sugar?

Sounds like you may be eating too much food at one meal. Without changing how much or when you eat, I would suggest you keep a record of what you eat for the next three days. Show these food records to your dietitian who can evaluate your meals for calories and carbohydrates.

Weight gain on a hypoglycemic diet would result if you ate more calories that your body needed. Weight gain is not a usual occurrence. Your diet seems appropriate and not excessive except for the 1 cup of tuna at bedtime.

Exercise may increase your body weight due to muscle, which weighs more than fat. However, your exercise program doesn't seem to indicate this is the reason unless you are only doing weight training. The biggest caution to exercise is preventing low blood sugar due to prolonged exercise without eating. It would be wise to have some protein snacks like cheese or a low fat dairy product along.

The appropriate diet is a high protein (20% protein calories, low carbohydrate (at least 130 grams to prevent ketosis) moderate fat (30% fat calories) with 6 small meals per day.

I would suggest you see a Dietitian who could monitor your food intake and exercise program along with instances of low blood sugar. Maybe, a dietitian could see a pattern to your problem with low blood sugar.

Your symptoms are not uncommon and typical for how the human body responds to high levels of fats and concentrated sweets. Carbohydrates (especially foods high in simple sugars) are sleep inducing and protein (meats or cheese) will help keep you awake. (See Eating Habits topic for more information on this.)

In addition concentrated sweets will draw water into your gastrointestinal tract as well which may contribute to your "funny stomach". Foods high in fats can cause indigestion depending on your body's ability to produce bile by the liver. Simply put, maybe your body cannot use that many calories at one time. Next time try a smaller amount (less than one serving) of the same food to see if you get the same reaction.

How much do you eat at a time? If you only eat one pastry or one donut and feel discomfort, you may want to talk to your doctor about this.

While pastries and donuts are high fat, high sugar foods should be an exception to a healthy diet, I do not believe in eliminating whole groups of foods even in a healthy diet.

The information you have received sounds confusing to me too. A low carbohydrate (less than 130 grams per day) is no longer used for hypoglycemia.

First off hypoglycemia results from an over production of insulin, poor glycogen reserves in lean muscle tissue (liver and muscles) and usually a sporadic food intake that includes concentrated sweets (candy, pop, desserts). Many doctors consider hypoglycemia a pre-diabetic condition because insulin production is abnormal. Your body produces too much insulin in response to sugars and carbohydrates in food which is opposite to a diabetic who produces too little insulin (Type 2) or none (Type 1).

I would not suggest you experiment with foods to see what works. As your blood sugar falls to around 50 milligrams percent, you may pass out. Your brain uses more glucose than any other organ in the body and when there is not enough fuel, you may lose consciousness. To another person, low blood sugar symptoms resemble alcohol intoxication and you may not be treated appropriately.

If you feel weak and shaky like you are going to faint (hypoglycemic), eat protein like cheese or luncheon meat. This is different than the recommendations for a diabetic experiencing an insulin reaction who is instructed eat sugar-containing foods like orange juice. Sugar would temporarily bring your blood sugar up, but it would fall rapidly again within a short time.

Nausea with or after eating is not normal and should be addressed by your doctor and a dietitian. The amount of food you eat (one piece of fruit or half sandwich) is probably not sufficient to prevent or cause hypoglycemic symptoms between meals. Do you sporadically eat much larger meals at other times? Or binge eat? Or fast?

One 12 ounce can of soda (carbonated beverage) contains 9 tsp. of sugar or 45 gm of carbohydrate. How much soda do you drink a day or at one time?

Simple carbohydrates are sugars like those found in candy, soda and desserts as well as fruit (fructose) and milk (lactose). Complex carbohydrates are starches and fiber found in bread, cereal, rice, pasta and vegetables like potatoes, corn and peas.

Protein containing foods are meat, poultry, fish, cheese, lunchmeats and sausages. Milk contains protein as well as milk sugar (lactose).

The dietary treatment for hypoglycemia is slightly reduced carbohydrates (50% of calories), slightly increased protein (20% of calories) and six small meals per day. With a regular meal pattern, your hypoglycemic symptoms should lessen and you will probably feel better. This diet is very similar to a diabetic diet that does not include sweets or sugars. Two 4" pancakes or 2 frozen round waffles are allowed and can be exchanged for 2 starch breads for breakfast, but no syrup. Try fresh fruit (1/4 to 1/2 cup) on the pancakes or waffles instead.

I would suggest you see a Registered Dietitian who is a professional trained in nutrition therapy who could provide you with a list of what foods to eat and plan a meal pattern of foods you like.

At first this may sound like the opposite of diabetes because your body makes too much insulin. Hypoglycemia in fact is considered a pre-diabetic condition. It can be diagnosed by symptoms, but more accurately with a 4-hour fasting glucose tolerance test. The good news is simply eating six small meals and avoiding simple sugars can reverse your symptoms.

Reactive hypoglycemia is an over production of insulin in response to eating simple sugars. Some persons who experience hypoglycemia don't eat regular meals and may over eat simple sugars. I have worked with hypoglycemia patients who have a can of soda and a candy bar for lunch. The pancreas over responds by producing too much insulin which causes a rapid and sharp decrease in blood sugar, usually falling below fasting blood sugar levels (normal fasting blood glucose 70 - 90 milligrams per deciliter) 2 hours after the meal. If your blood sugar falls below 45 milligrams per deciliter, you may experience symptoms such as weakness, sweating, shaking or headache.

Unlike a diabetic who eats something sweet when having an insulin reaction, you should eat protein. Try eating cheese, luncheon meat or a hot dog with or without the bun. If you were to eat sweets to get your blood sugar back up, you would experience hypoglycemia again within another 2 hours or less.

Your blood sugars can be evened out by eating six small meals per day. Usually the carbohydrate is restricted to 50% of total calories or about 200 grams per day. The protein is usually higher around 20% of total calories because protein does not increase blood sugar. Fat intake is recommended at 30% of total calories, not as low as your diet at 17 25%. In fact, when the fat content of a person's diet goes much lower than 25%, it can negatively affect satiety and lead to binge eating.

Your eating plan should include increased complex carbohydrates like starch and fiber (corn, peas, carrots and onions are OK in normal servings) and decreased simple sugars like candy, soda and desserts. Caffeine is sometimes restricted because it can produce the same symptoms as hypoglycemia. Also, you should avoid alcohol, which can lower blood sugar. If you were overweight, weight loss would improve your body's ability to use insulin because fat increases your resistance to insulin. What that means is that your body may need more insulin to get past the cell membrane and metabolize glucose to energy.

First, work on leveling out your blood sugars, then reduce the number of calories you eat to no less than 1200 per day.

Sounds like you could use some individual nutrition counseling. Call your doctor and ask to see a dietitian.

Also, fruit does not usually cause a "urinary tract infection" type sensation. A urinary tract infection is usually described by patients as a burning sensation when urinating. I would encourage you to discuss this with your doctor.

If your doctor diagnosed you as having hypoglycemia, you probably took a three-hour glucose tolerance test or at least a blood glucose test two hours after a meal. People with hypoglycemia (low blood sugar) produce too much insulin and their blood sugar drops rapidly after eating. A sharp drop in blood sugar can produce a faint feeling or weakness. This is especially evident when the blood sugar drops below a person's fasting level of 70 to 90 milligrams percent. If the blood sugar drops to 40 or 60, generally, a person will lose consciousness. The body uses its blood sugar as fuel for the body to function. The brain uses more blood sugar than any other organ. The faint feeling is the result of a low blood sugar and not enough fuel for your brain.

Yes, you do have to follow a diabetic diet, but no, you are not a diabetic. The diet that seems to work best for people with hypoglycemia is six small meals with 50% of your calories from carbohydrates. It is an excess of sugars in your diet that triggers the excessive production of insulin.

Until your symptoms are under control, you should not make any changes in the diet your doctor gave you. You must eliminate all simple sugars (cakes, pies, cookies, candy, ice cream and regular carbonated beverages). A diet fairly high in protein (20% of your calories from protein) also seems to benefit people with hypoglycemia. Until you are in better control, no alcohol either.

I would suggest you call your doctor and tell him/her that you don't understand the diet and you need nutritional counseling. In the meantime, if you feel faint, eat a slice or two of cheese, lunchmeat or a hot dog without the bun. Contrary to the diabetic who needs sugar when his blood sugar is low, a hypoglycemic needs protein. If you ate something sweet, your blood sugar would go up, but would drop sharply again within two hours because you produce too much insulin.

The diet your husband should follow is a high protein, low carbohydrate and bland, lactose-free diet in six small feedings. Your husband needs help in putting this all together. He should see a dietitian to individualize his diet to consider his food preferences.

To get him started, your husband should avoid all concentrated sweets such as cakes, pies, cookies, ice cream, candy and carbonated beverages. These foods trigger his hypoglycemia. He also needs six small meals per day to spread out the carbohydrate and calorie content of his diet.

His diet should have good sources of protein (beef, pork, veal, lamb, chicken, turkey, fish or eggs) at each meal. Breakfast should include peanut butter, cheese or an egg. At noon, a two-ounce meat sandwich would be good. At supper, a three or four ounce portion of meat is recommended. The carbohydrate foods at each meal are limited to one piece of bread or potato, one piece of fruit and a vegetable. The in-between meal snacks are light. Snacks of cheese and crackers or fruit and cheese would be all right. The snacks help prevent the possibility of low blood sugar.

In regard to the hyperacidity, you didn't state if your husband has an ulcer. Foods that stimulate the excess secretion of acid are alcohol, caffeine, chocolate, pepper, cayenne, chili powder and curry. These foods should be omitted from the diet of a person with an ulcer. He should also eat six small meals per day. This should be evaluated by a doctor and not by the person himself.

Your husband's hyperacidity and intolerance to lactose in milk limit the amount of milk he should drink to less than 2 cups per day. Any milk he does drink can be treated with lactase enzyme. Lactase is the enzyme necessary to break down lactose in milk. There is an over-the-counter product called Lactaid which when added to milk converts the lactose to glucose and galactose, which he should be able to tolerate. People with ulcers should not drink more than two glasses of milk per day. This is a big change from years ago when we had them drinking lots of milk and cream.

A diet that would supply the necessary daily nutrients is based on the Food Guide Pyramid. If an adult eats two to three meat servings, two milk servings, two to four fruits, three to five vegetable servings, six to eleven bread servings and use fats, oils and sweets sparingly by choosing a variety of food choices, he/she should be able to meet their Recommended Dietary Allowance (RDA).