I am 58 years old, and have been recently diagnosed with hypoglycemia, as well as hypothyroidism. I have struggled with my weight since I was three months old. I have never been able to lose weight, until recently, after reading Dr. Bernstein’s book, which really should be a best seller. It has radically improved the quality of my life. However, I am still uncertain what to eat, when I “crash”. Can you tell me? My crashes are equal to being in a coma-like state. They are very severe.

I am glad you have found some relief with the dietary changes. Since it sounds as if you are still having some radical drops in blood sugar, perhaps some refinements are called for.

The type of hypoglycemia you describe is sometimes associated with what we might call a “sputtering pancreas,” one which is on it’s way to developing frank type 2 diabetes. The lows are cause by the body occasionally releasing too much insulin, well after eating — instead of right when you eat when it’s needed. In addition to not overdoing the carbohydrate at any one meal (as I’m sure you’ve picked up from Dr. Bernstein), I would also recommend eating smaller, more frequent meals, distributing some carbohydrate, protein, and a bit of fat at each one. Some people find it helpful to follow a guideline of not going more than three or four hours without having a little something to eat. Choosing lower glycemic index (more slowly digested) carbohydrate foods may also be helpful in putting a safety net under your blood sugars. The Glycemic Index will explain a bit more and provides a good list of such foods.

I’d also recommend checking your blood sugar both fasting in the morning and an hour or two after eating occasionally. Any fasting value greater than 126 mg/dl [7 mmol/L] or any after meal value greater than 140 mg/dl [7.8 mmol/L] would be of concern, relative to the development of diabetes, and should be discussed with your health care provider.

BB

[Editor’s comment: It’s not clear what the basis is for your diagnosis of hypoglycemia. If you have not been evaluated by an endocrinologist for the combination of uncontrolled hypoglycemic symptoms and hypothyroidism, you should be. Ask your present physician for a referral.

WWQ]