10 January 2009

Reactive Hypoglycemia, Dehydration and Headache

It’s 2009 and I've been gluten-free for two years now. When I started this journey, I thought that discovering my gluten intolerance and other food allergies (or intolerances) would solve my headache problem. Unfortunately, they were only a piece of the puzzle, albeit an important piece. I am convinced that the undiscovered gluten intolerance lead to malabsorption of important nutrients, including the magnesium and B2 that my neurologist wanted me to take to prevent migraine. Now that I am gluten-free, my body seems to actually use the magnesium instead of flushing it through my system. Not to mention the fact that avoiding gluten can save me from osteoporosis, cancers and a number of other serious conditions.

But my headaches persist. Not as bad as before though. In the meantime I have discovered a couple other things that seem to contribute heavily to my propensity for getting headaches. Dehydration and low blood sugar episodes. I have always known that skipping meals or not drinking enough water were sure to bring on a headache, so I didn't skip meals and I thought I was drinking enough water. Here’s the thing: it seems I need more water than the average person to keep from getting a headache. The standard 8 glasses a day are not enough, especially on days when I practice Naginata. I seem to have to rediscover this every so often. When we were on vacation in Phoenix last Fall I needed 10-12 glasses of water a day because it was so dry there. Upon reflection, I think I need that much water no matter where I am. 

The second important discovery is about low blood sugar. For years I have noticed that I seem to get episodes of lightheadedness, shakiness, sweating, etc. midmorning. I noticed it got better when I stopped drinking regular coffee. Then I started getting them again. I noticed I got them after eating a breakfast that was high in refined flours or sugars. So I stopped eating waffles for breakfast. Then I stopped putting jam on my toast. Then I switched to whole grains and that seemed to take care of it. Going gluten-free kind of threw me for awhile. Most gluten-free grains are high on the glycemic index so the episodes came back when I ate things like gluten-free waffles, or toast for breakfast. So I switched to eating gluten-free oatmeal or buckwheat cereal. Everything was great for awhile. Then I started to have sugar crashes in the evening during Naginata practice. It seemed that the more I tried to avoid carbohydrates, the worse it got. Frustrated, I mentioned it to my doctor and she suggested I talk to a nutritionist. She said I might have reactive hypoglycemia. The nutritionist took one look at my food diary and said I wasn't eating enough, especially carbohydrates! I was very surprised by this, but thought it wouldn't hurt to follow her advice for a week and see what happened. She recommended that I eat 30-45 grams of carbohydrates per meal and 15-20 grams per snack. She gave me a diet plan that had me eating a mid-morning and mid-afternoon snack (which I was already doing). She also told me to forget about the glycemic index for now and concentrate on getting enough carbs each day, especially on days when I exercised a lot. She said I wasn't giving my body enough energy to work out and that was why I was crashing. Also, the Weight Watcher points level I was following was not enough calories for me. She recommended I add 200 calories a day to my diet.

At first I was afraid that I would gain weight. I had been trying to lose weight without success before. The amazing thing is that the new plan is actually helping me to lose weight again and I am not hungry all the time. The sugar crashes are gone as well. I got a blood sugar measuring kit to test my levels and as long as I eat protein with my carbs and fat and as long as I stay away from fruit juices and highly refined things (like GF waffles...at least in the morning) I seem to stay pretty level all day. 

The bonus was that my headaches went away as well. I had an entire week headache free the first week that was on the new eating plan. I think I may be on to something. These two issues are two important pieces in the puzzle. And I no longer have to feel guilty for eating corn or rice, both of which my body seems to like. Who knew?

Karen, herself


aftershave balm said...
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Brandis Danielson said...
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Karen said...

Hi Brandis,

Thanks so much for your comment. I hope that going gluten free helps you, but you should know that it is best to be tested first. After just a few weeks gluten-free, the conventional blood test for Celiac will come back negative. If you really want to know you should test first.

I too was always borderline anemic and that was one clue that I had gluten intolerance. My doctors always thought it was due to my cycles, but the anemia persisted after a hysterectomy and there was no other cause for it.

Since going gluten-free, I have noticed that certain aches and pains have gone away as well as the gastrointestinal issues I had.

Good luck

Karen, herself

Alison said...

Hi Karen,

I discovered your blog last Fall when I was considering going gluten-free. I've had migraines for over 20 years and have many symptoms of celiac/gluten intolerance. I felt such a sense of relief to connect with someone else who has a similar situation. SO glad to see you writing in your blog again -- it is a lifeline for someone like me who feels alone in her struggle for a pain-free, healthy life.

Would you be comfortable posting the name of the center that did your food testing? I've been trying to determine my own food allergies/intolerances through an elimination diet and have been unsuccessful. I'd like to see if something similar to your center exists on the East Coast, and knowing more about the center would help me in my research.

Many thanks,

Karen said...

Hi Alison,

I did my testing at the Meridian Clinic in Renton, WA. It is associated with the Tahoma Clinic, also in Renton.

I am sorry to hear you have been unsuccessful with elimination diets on your own, but not really surprised. I had similar problems. The issue for me was that I didn't realize that I could react to something up to 3 days after eating it! After my test results came back it was clear why it was so hard. I was reacting to so many things.

Today I have been able to reintroduce many of the foods that I was previously sensitive to. Now I find that headache triggers are easier to find and unfortunately, chocolate is among them. Even though I did not test allergic to it. I find that eating chocolate when the weather is changing a lot is a recipe for a headache. Also, rebound is a big issue with me.

Anyway, thanks for reading and for your comments. Hope this helps.


mrsteetime said...

Karen: I stumbled upon your blog yesterday when searching on "Food Sensitivities" and "headache/migraine".

I've read through the entire blog and came away with alot of useful information....Thank you!

I have also read "Heal your Headache" and thought it was a great book. I didn't think I had food sensitivities until I read the book.

Unfortunately, I've let my good eating habits slip and will need to go back and use the elimination diet in Heal your Headache again. (I had worcestershire sauce in a marinade yesterday and within minutes had a scorching headache and extreme sinus congestion).

I do have a question for you. I eat tons of salad but have reactions to commercially prepared salad dressing. Do you have any recipes for salad dressing that are "purer" than the bottled stuff?



David and Jen said...

Thanks so much for this post. I was dx hypoglycemic 8 years ago. I have recently begun GF/CF free diet with amazing results for about day 10-14. Then started crashing again recently. I was looking for the missing link and it is the fact that a lot of the GF flours have high GI's and I was relying on things like waffles for breakfast. Now I will be watching what GF carbs in ingest + fruit!
regarding the last poster, I absolutely love plain olive oil & red wine vinegar on my salad with a little sea salt and fresh ground pepper. I also find that adding onion to every salad increases the flavor and sweetness tremendously! Enjoy!

mercymorning said...

Thank you for this blog post! I recently started a gluten-free diet and began having worse episodes of low blood sugar (dizziness, shakiness, tingling, etc). Your post began my research into what foods have a high glycemic index (my instincts were often wrong!). I'm hoping that a little knowledge and extra planning will eliminate any more episodes of low blood sugar.

Jonna said...

Hi Karen
Thank you for this post - I feel like I could have written it myself. I've been struggling with all of the same issues for the past 2 years. Your experience is reassuring because I've come to all of the same conclusions this past week myself. I've increased the amount of complex carbs (gluten-free) throughout the day and I'm sure to have protein or fat with each meal or snack. I exercise early in the AM and found that having a bedtime snack (like a Larabar) and a smoothie (banana, protein powder, almond butter) in the AM about 30 min before the workout gives me much more energy and prevents any crashes during or after the workout.

Sigrid Macdonald said...

Karen, thx so much for your post. I sufer from severe hypoglycemia caused by stomach surgery and I fear I have a gluten intolerance (my sis does and in many ways I feel much worse on my hypo diet because of all the whole grains, or maybe the migraine trigger foods like nuts and cheese). Also I only eat 70-80 grams of carb a day, mainly in nuts and whole wheat bread or rye crackers. When I add carbs (cereal, muffins, fruit) I feel better at first but then I carsh and feel terible (sleepy, shaky, irritable, nightmares). I'm eating 12 food (mainly huge quantities of meat - ugh) and have vitamin deficiencies, etc. Can you post your diet? I'd KILL to eat 30 g of carb per meal!! I'm so hungry and deprived -- have no energy and a daily headache on this diet but when I go off wheat and try rice crackers, my sugar crashes. Any advice re what to eat would be super. Nutrionists and dieticians have not helped me. Thanks! Sigrid

Karen said...

To Sigrid,

Thanks so much for your comment.

My nutritionist suggested that I try for 30g of carbs at meals and to bump it up to 45g before a workout. As long as I have 2-3 oz. of good protein with it and a little high quality fat (olive oil, organic butter, canola oil, etc.) and some green vegetables, I seem to be ok.

I have been reading Diana Schwarzbein's "The Schwarzbein Principle" and her other books about fixing your metabolism. Her recommendations for someone of my level of activity and with hypoglycemia (not from diabetes) tracks with what the nutritionist said, so that is what I am trying.

The important thing is not to eat any sugar, aspartame, cut way back or eliminate caffeine and alcohol and all man-made carbs (bread, crackers, pasta). You can have whole grain rice cakes and bread, pasta once in a awhile, but try not to overdo it. I use the wild rice and brown rice cakes and I am now putting a full tablespoon of unsweetened peanut butter or full fat cream cheese on them for a snack.

I have GF oatmeal (made from rolled oats on the stovetop, not instant) or amaranth or even polenta for breakfast. The trick is to have 1/3 to 2/3 of a cup of the cereal, add some butter and cream (not milk) and then have an egg or some regular cottage cheese or meat with it.

Lunches are either a salad with meat or cheese or fish plus whole grain or roasted potato or legumes and green vegetables.

I count fruit as a carb and have peanut butter or cheese with it. Never eat a carb without a protein and fat and never eat a protein without a good carb. Drink mostly water and exercise some but not too much each day and get a good night's sleep.

That's the crux of the book and it seems to work. Only problem is that you could gain weight at first until your metabolism fixes itself. Then you should start to lose fat weight.

Most of this I was doing, but I was skimping on the protein and fat to keep my calories down and this is where I went wrong. It left me hungry all the time and snacking on GF crackers and cookies and eating fruit by itself. Then I got into trouble when I exercised. Now I am not having carb cravings and not crashing. Also not losing much weight, but I am determined to hang in there.

Good luck.


John said...
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brdudeon said...

Interesting blog.

I'm currently struggling to find the cause of my almost 8 year old son's headaches.

We just returned from the Optometrist to eliminate vision as a possibility as a matter of fact.

Your blog caught my eye because I've been trying to pinpoint what I think are multiple factors including dehydration, blood sugar and something else that I think is allergy related.

I'm going to read back thru your blog to see what you have to say about your gluten journey. I'm not sure if that is or is not his issue, but I do think it is food related.

Good luck.

Sigrid Macdonald said...

Oh my goodness, Karen, I just saw your long response to my post from two years ago now! So sorry. Thank you for taking the time to write out your detailed diet. I'm so glad that you've found relief.

I continue to have a daily headache that drives me wild. Finally, despite the difficulty that going GF is for me as a hypoglycemic, I am trying the program. I am on my fourth day. My goal is to do 30 days gluten-free and to reevaluate at the end. Right now I'm starving.

I would give anything to be able to add more carbs. By removing 100% whole wheat and rye crackers from my diet, I have eliminated about 20 to 30 g of carbs per day. The last nutritionist that I saw said she suspected the low-carb business was causing my headaches, but I feel really sleepy and anxious when I add ANY carbohydrates. I think right now I'm at about 40 or 50 g/ carb a day. I'm hoping to see some relief from eliminating gluten; if not, I will take an even bigger leap by trying to add some carbohydrates. Will also try to locate the book by the author you suggested.

Thanks again for taking the time to reply to my post in such detail. My apologies for the two-year delay :-) Sigrid

PS I am eating the Blue Diamond rice crackers with almond or with pecan. I only have one at a time and each one is about the size of two quarters. It's not very filling!