<<Disclaimer: Verify this information before applying it to your situation.>>

Here is a summary of what I received back in response to my
questions/concerns.

I had written that I was concerned of the 'conflict' of the CD diet to
Krimmels diet - I should say that I am concerned that I will have nothing
left to eat once I combine my food allergies, CD diet and a hypo diet!!  I
was lucky enough to get a response from the Krimmels!!  I included that in
the summary.  Please note that since the original book was written Ed was
diagnosed with CD so the next version of the book will address this!

*************

Symptoms of food allergies often mimic reactive hypoglycemia; the key
difference is the timing: reactive hypo symptoms usually occur 2 to 4 hours
after eating; food allergies can occur any time after eating.  Food
allergies can contribute to hypoglycemia.

I recommend a "caveman" diet www.alternate-health.com/pulse.html

<<What might you suggest to get past the darkness of the AM?>>

Leftovers from dinner - meat/fish, veggies, nuts, seeds .


There is a grain (though botanically speaking it isn't related to 'real'
grains, it's a seed) that doesn't have gluten in it and has a high
protein content. It is called quinoa, it grows in the Andes, and most
healthfood stores have it. (And there are also places where you can
order it online.) It is very easy and quick to prepare: One part quinoa
to two parts water, bring to the boil and let it boil for five minutes,
then let it sit (with a lid on) for ten more minutes and it's done! One
word of warning: You have to rinse it very thoroughly before cooking
because the seeds are covered in a little layer of saponine (natural
insect repellent) and like the name suggests it tastes like soap. So if
you don't wash the quinoa well it will taste a little bitter. Put it in
a bowl of water, stir it with a fork and pour water away. Repeat till
water runs (fairly) clear and doesn't foam anymore.You can use it pretty
much in the same way you would use rice.

I also occasionally leave grains etc. out alltogether. I just have meat and
vegetables and salads etc. That works very well, actually. :)

A couple of reasons why hypo may be worse is that you're not eating
enough carbs and bottoming out sooner.  Need to eat the snack about 30
mins before symptoms occur.  If I ate as often as Krimmels' suggest
would set mine off as only need to eat a snack about 3 hours after a
meal.  The second is that your body hasn't adjusted to the new
requirements.  Found out at work that automatically produce insulin at
meal times even when don't eat then.  About 30 mins after a scheduled
meal time sugar levels noticeably dropped.  Try eating a snack before
you go to sleep and not sleep more than 8 hours--especially if have
night sweats/chills or nightmares.  Any longer makes it harder to keep
sugar levels up.  During pms got to point where just try to keep it from
dropping lower instead of trying to get it up.  If yours is worse then
might try taking magnesium and B6 which help the liver to get rid of
excess estrogen which makes hypo worse. there is probably a wealth of
information at http://www.lowcarb.org

I've had to make some significant adaptations to the Krimmel diet. I guess
what I'm saying is that I've really had to narrow the list down to what I
know I can eat. I've done this thru trial of various foods.

You already know from other sources what you can't eat. I did too. So I
took the Krimmel list and subtracted from it those things I couldn't eat
and that then became the list of foods I could eat. This resulted in a
pretty short list which includes broccoli, zuccini, cauliflower, beef,
chicken,mozzarella cheese (it breaks down much more slowly than other
dairy) and Ryvita crackers (no wheat or sugar) and almonds and pecans. I
also occassionally eat popcorn and sometimes half an apple with cheese.
What Krimmel doesn't spend much time on is the importance of balancing
each food intake with protein, complex carbs and monounsaturated fat
(ie: chicken, broccoli, olive oil) which is important so that your body
absorbs food properly. For example, I can't eat Yogurt any time it has
too much sugar in it for me.

I have a gastrointestinal problem that was casued by an operation. I tend to
absorb glucose too quickly and the enteric nervous system that controls  the
intestinal tract doesn't function properly. So I have to take meds. before I
eat. I might also note that the adrenals play a role in the immune system and
resistance to allergies. This may be a clue for you that you have a
disfunctional adrenal system. Also it's (adrenals) the emission of excess
epinepherine that causes most of the hypo symptoms you describe. Sweating,
shakes, heart palpitations, anxiety and hunger are symptoms common to excess
epinepherine.


As you appear to have a gastrointestinal problem also you may find
information from the International Foundation for Functional Gastrointestinal
Disorders. They've done significant research in theunderlying causes of
gastrointestinal problems many of which are nervoussystem related. Especially
the Enteric Nervous System which is sort of a second brain which work on it's
own to control the intestinal tract while it communicates with the brain.
http://www.iffgd.org

I have Krimmels book, but I also did some research on the glycemic
index, which his book does not incorporate to any great extent. He had
some good info, but some of it was a little extreme. I've sort of
combined the two. I stick to low glycemic carbs, such as brown rice
products and steamed veggies, and avoid refined starches and sugars and
other high glycemic carbs.  I can tell a real difference in how I feel.
This is a good resourcefor the glycemic index
<http://www.mendosa.com/gi.htm>. I am a cyclist, so carb intake is
critical to my endurance. Another site I have used to
trackcarbohydrates, calories, etc is <http://www.dietsite.com/>.  I kept
a diet diary using that web site for a couple of weeks and found I was
too low in carbs and way too high in fat, though I eat pretty reasonably
(or so I thought).

I would also suggest you talk to your Dr. about symptoms. All my tests were
normal, but I had been on the high carb diet for 2 weeks when they did the
blood sugar test. My Dr. told me to stick to the diet-he believed that was
the problem-and I am back to normal now except that I have to be careful to
eat according to how much I am training. I do have to eat more often during
the day-but I do feel a lot better. I've been on the GF diet for 20 years and
did have to make an effort to start eating more GF breads, crackers and
pastas. But it has been worth it.

Many celiacs are also diabetic or hypoglycemic.  We do well on a low carb
diet.There are many books out there, including Atkins, Dr Bernstein [who
writes on Type2 Diabetes, McCollough has a great cookbook.

Have you had a 6 hour glucose tolerance test?  You may be classified as
PREdiabetic.  There are several websites which help  I am on
[log in to unmask],


I am seeing an endocrinologist now for this problem since my GI thinks
theepisodes are a forerunner to diabetes.  He gave me a glucose monitor
tocheck the sugar levels when I have an episode and see if the blood
sugarreadings are below 30 or 40.  However, he has seen people with very
lowreadings and no symptoms at all.  He also found a nodule on my thyroid, so
we are addressing that issue first.

There is some information at the Mayo Oasis site.  Also the Joslin
DiabeticClinic in NY advised not to eat any simple carbohydrates without
a balanceof protein and some fat.  That has seemed to help.  My last
problem was when I had orange juice (alone) and went for a bike ride----
led to a scarey episode and I decided to get some medical assistance
with this thing.  Balancing the meals seemed to help.  If you eat simple
CHOs alone, you may be putting out too much insulin which will bring the
blood sugar level down suddenly and the symptoms occur.  It happens very
suddenly, but as long as you carry some sugar, juice, etc. with you it
resolves very fast.

Are you sure you don't have diabetes?  I have T-1 diabetes along with DH and
CD and I have a lot of Hypos or low blood sugars especially when I overdo it
like mowing the yard yesterday.  I used to have a neighbor that had the, low
blood sugar, type of diabetes.  She had to drink juice at certain times of
day or whenever she felt it coming on.  Some times this a precursor to T-1
diabetes.

Another thing that interested me about your story is the panic attacks.
I always been extremely shy and actually dropped out of high school and
joined the USAF because of having to give speeches in English.  Now I am
retired but the problem still persists.  My doctors have been letting me
treatmyself.  I started out with Prozac, then Paxil, Buspar and now
Zoloft.  Mytrouble is that my hands shake now especially if I have to
write somethingit is almost illegible.  The Zoloft seems to be working
better than anythingso far and I don't have that 'hung over' feeling
like when I took Paxil.  I think I emailed you once before but I can't
remember what medication you are taking?  I go through Asheville a lot
when I go to visit my dad in Madisonville, TN which is just below
Knoxville.  NC is a very beautiful state!  What I use a lot or most of
the time for hypo attacks is GlucoseTablets available at Wal-Mart $4.37
for a bottle of 50 and they are in the section with diabetic supplies.


I follow a program called Carbohydrate Addict's Diet.  It works quite nicely
in controlling insulin ups and downs.  I find it is very easy to follow in
conjunction with the Celiac diet.

When I was on this list a year or so ago, on a number of occasions I posted
concerning the similarities between the symptoms of hypo and of  coeliac
disease - which is an intolerance to gluten found primarily in wheat, rye and
barley (plus one or two other rarer grains) - and the difficulties there can
be in sorting out one from the other. Though my hypo is now well and truly a
thing of the past - fingers crossed at least - I am coeliac, and once a
coeliac, always a coeliac. And for reasons I don't think anybody's clear
about, hypo sufferers are often coeliac. And here's the rub - as so many of
the prime symptoms such as panic attacks, brain fog, shakiness, bowel
problems etc. are very similar for each, you could actually be treating the
wrong one. And what's good for the hypo is often bad for the coeliac and vice
versa. So unless you're sure what you've got, in the process of treating one,
you could actually be making the other worse.

I would urge any hypo whose hypo symptoms persist even on a strict hypo diet,
to go on a month or two's gluten-free diet. The good thing about coeliac
disease - if 'good thing' is the right phrase - is that although it's
incurable, a gluten-free diet completely eradicates the symptoms and the
problem. So if a couple of months on a GF diet removes or eases the 'hypo'
symptoms, you know that at least part, and maybe all, of what you've got is
gluten intolerance. And it's far more common that was once supposed. In the
US particularly it was thought of as a primarily European disease, but it's
becoming clear that that's not the case. There are huge numbers now in the US
who are coeliac, but as with hypo, few doctors know as much about it as they
should. So it's often mis-diagnosed.

I was diagnosed with hypoglycemia after the birth of my first son.  I had
been diagnosed with celiac diases a few years prior to that.  I have beentold
that hypoglycemia is also in some connected to celiac disease (one of the
associated other problems).  I went to a few dieticians who understood
hypoglycemia but did not have a clear handle on the celiac disease.  I am
also lactose-intolerant but use lactaid caplets with great success.  The
dieticians really wanted to push soy products and seemed to harp on the hypo
and lactose problems.

I heard from the dieticians, if you feel like your glucose level is dropping
just grab a few crackers or 'whatever is around'.  I tried to explain that
'just grabbing a few crackers' is not as easy as it sounds (unless you carry
a purse the size of a small grocery store).

The best diagnosis is a 5-hour glucose tolerance test with insulin levels
being monitored.  My endocrinologist had to send the blood samples out to
special lab, but he said that without knowing the insulin levels as well as
the glucose levels he could not make an accurate diagnosis.  My insulin
levels dropped to as low as 51 (which I understand is dangerously low).

I have had to learn to control the sudden drops in glucose levels.  I
havenot tried any 'diet' per se.  Mostly trial and error.  I get to know
thewarning signs before the levels drops.  I have had to learn to snack
throughout the day.  The worst thing to do when your levels drop is to
grabsomething high in sugar are carbs.  The payoff is a quick relief but
thenyou are setting yourself up for another drop because your insulin
levels get too high and start eating up all of the glucose.

The trick is to balance carbs with protein and fat so as to digest the carbs
slower, thereby not spiking your insulin levels.  I have found that trial and
error are the best answer.  So few people understand celiac disease it is
hard for them to advise.  I was lucky my endocrinologist was intrigued with
the hypo celiac combination, he admittedly wanted to learn more about celiac
disease.

I've had no hypo symptoms whatever now for over a year. I didn't do
anything very spectacular really. I did cut out ALL sugar completely,
and I followed the HAI diet pretty strictly. The other thing I did - and
when I used to raise this subject on the list in those days I was often
roundly, evenabusively attacked for it - was to look into my whole
lifestyle, particularly as far as stress was concerned. I was convinced
that a lot of hypo was a result of psychological imbalances. And I'm
sure the elimination of the stress I was under in those days was one of
the biggest contributory factors.


The Krimmel diet is helping me. I've been on it quite strictly for 3 months
now. I'm stuck at about the 3rd week recommendations because I don't seem
able to tolerate the higher carbs in fruits, grains & other starchy foods.
It's boring, but I feel MUCH better.

Perhaps if you're not vegetarian, you could go heavy on the meats & low-carb
veggies. How about nuts?

Don't have much experience w/ panic disorder you described. Stay tuned to
this group & hopefully help will come.

I have severe reactive Hypoglycemia and CD. I am living basically with
the Atkins diet.  He is much in tune with Hypoglycemia and gives also
great advice on how to substitute real sugar, that is what we are
reacting to. Cut back on the carbs, start maybe with 40 g/day three days
and then slowly up by 20 g/day, till you feel it is too much. I am
eating between 20 and 40, can't tolerate more. Eat lots of protein,
eggs, meat, fish, forgot which vegetables, cut back on potatoes, chips,
baked stuff, fruit. Many fruit have lots of sugar.

It takes only threee days to get it normalized, that is the good news.

I used to have hypoglycemia, but I have not had symptoms for years.   How I
resolved the problem may not be scientific, but it worked for me.  If you're
desperate and have good will power, try it.  It is not unhealthy not
dangerous.

1. Eliminate all sweets and sugars.  No candy, candy bars, sodas.  Pastries,
cookies, etc.

2. Eat a healthy breakfast which includes some sort of protein, like eggs,
yogurt.  GF bread is fine, fruit.

3. Don't skip meals, eat complex carbohydrates like rice, vegetables, fruit.

4. Between meals, have bits of cheese or nuts for snacks, not sweet stuff.


It takes awhile for your body to readjust itself, but you will find that
aftereither a few days or a few weeks, that you will start feeling better.  I
don'tknow how long it takes, but now I don't have to be so strict and can
cheat oncein a while with no adverse effects.


In the beginning you should be avoiding all sugars (including fruits
andjuices) and highly starchy foods( pasta, breads, rice, beans,
potatoes,corn,etc.), caffeine, nicotine and alcohol.  Fruits are high in
natural sugars and the highly starchy foods convert to too much glucose
for hypoglycemics to handle.

2 to 4 cups of one or more of these vegetables should be eaten for lunch
& dinner along with protein and some fat:asparagus, broccoli,
cauliflower, green or yellow string beans, peas with edible pod, eggplant


You can eat as much as you desire of the following, but not in place of, the
above vegetables:  alfalfa sprouts, bamboo shoots, beet greens, rawcabbage,
celery, chives, collards, cucumber, dandelion green, endive,escarole, fennel,
kale, kohlrabi, lettuce, mung bean sprouts, mushroomes,okra, olives, onions,
parsley, peppers, dill pickles, pimentos, radishes,swiss chard, spinach,
tomatoes, turnips, turnips greens, watercress,zucchini.

 Also you need to eat snacks between meals, as soon as you get up and
justbefore going to bed.  Plain yogurt is good for the night and morning
snacks.  Whenever you eat, you should always eat a combination of
protein,carbs and fat.

After you get stable, then you can try gradually adding a small quantity of
avoided foods back into your diet to see which ones and how much you can
tolerate. The above is just a thumbnail sketch of what you need to know and
do to stabilize your blood sugar.


Sally Hackett,  Raleigh NC