<<Disclaimer: Verify this information before applying it to your situation.>> Hello All, This is a bit long, but the possibility of confusion between the symptoms of CD and hypoglycaemia rang bells with a lot of people. There's also confusion about hypoglycaemia itself, so perhaps this will help - very simply, if you are hypoglycaemic, there is a tendency for your blood sugar to drop below an optimum level, causing certain - often highly unpleasant - physical and mental symptoms, e.g. an sort of 'emptiness' in the stomach unlike true hunger but giving the sufferer nevertheless a feeling of an urgent need to eat, a sense of inner unstable-ness and trembling, sweating, faintness, brain-fog, sudden debilitating loss of energy, impairment of vision, palpitations, etc. Some or all of these symptoms may be present, plus others depending in the individual. At the same time, there is often an instinctive urge to grab something sweet to eat. Which is perverse in a way, because anything with sugar in it ultimately has the opposite effect, and beware - many doctors are not aware of this! The trouble is that although the ingestion of sugar gives a sudden, much-needed boost to the system, the hypoglycaemic's sugar-regulating mechanism is out of kelter, and its reaction is to over-produce insulin in order to counteract the sudden surge of sugar. Which in turn then produces another low, so making matters worse in the long run, not better. The best thing when you sense at attack - or 'crash' as it's commonly known - coming on is some sort of protein like nuts, sunflower seeds, hard cheese, raw vegetable etc., which I'd advise any hypoglycaemic to carry with him\her wherever - just in case. The real no-no's for the hypoglycaemic are sugar - regarded as a virtual poison by the serious hypo community - alcohol (sorry!), caffeine, and starches. (All or some of which - apart from sugar which should be permanently outlawed - can be re-introduced once you've stabilized). Most of those who replied, and who suffered from those symptoms felt there could well be something in the hypoglycaemia theory; some thought it more likely to be dairy products; one felt that perhaps those people were not managing to eliminate all gluten from their diets. But 90% of those who replied agreed there was 'something else', but what it was nobody *knew*. One asked, 'How would you find out if it's hypoglycaemia?' It's a good question because the medical profession has hardly covered itself with glory on this one either. 'Do you have to keep checking your blood-sugar levels?' My own answer is that if you cut out all the things which are likely to exacerbate hypo, and the symptoms disappear, then you can be fairly certain that that's what you had! I think your best guide is yourself. And if your symptoms disappear when you change your diet, does it matter what name you give to the condition you've just got rid of?? I'd urge anybody whose symptoms persist for what seems an unreasonable period after going GF to go on a hypoglycaemia diet. Even if there's no improvement, you will at least have eliminated that avenue. (One respondent made a plea for the use of digestive enzymes in the treatment of hypoglycaemia). This is a selection from the replies - 1. You hit the nail right on the head. I am on GF diet four years. When I started, the symptoms not disappearing quickly as I hoped. Than I learned about Candida Albicans and stop consuming any sugar. I went through the hell, but after 5 weeks I experienced "candida die off" Since that the symptoms slowly, but steady disappeared. I don't consume any more processed sugar and in my age 67, I feel as good as I could. 2. I always suspected that refined sugars might make symoptoms worse, though I thought it may be because they were feeding harmful flora of bacteria or candida. 3. I have both Hypoglycemia and Celiac. I had cut out all the sugars and gluten and still had fuzzy days. Then someone told me that coffein creates a similar reaction as sugar - the insulin output seems to go up as well as the adrenaline output with coffin. I stopped coffein and I am doing better now. 4. I have been gluten free for exactly one year and my symptoms are still there. I still battle fatigue, weakness and exhaustion 5. .....the excess sugar can aggravate the imbalance of intestinal flora as well as the hypoglycemia. I'm sure your observation will prove useful to many. 6. I.....will start on cutting down on sugar. I am sure it would make me feel better. 7. You may be on the right track to explore other reasons why some people don't get well for a long time. I can't help but wonder, though, if they are getting gluten regularly in some insidious way such as medicines or vitamins or ?. 8. I've been feeling extremely tired for a long time although there's no obvious reason for this: I stick to my diet, eat healthy, get enough exercise, am generally a happy person. It's just that I'm often so exhausted it makes me wander if I'll ever feel dynamic again. 9. I actually have eliminated most processed sugars without complete success, but that doesn't mean your suggestion won't work for many. 10. I too have recovered quite well since being on a gluten free diet, but do feel tired, listless, etc, etc from time to time. of course this could be due to any number of things, but i would like to investigate the hypoglycaemia theory 11. I really think you may be very right.i have had blood work done and all was well including diabetes. i do feel very tired in the day, 12. The majority of my specifically GI symptoms went away after a month or so on the diet, but the other problems, fatigue, brain fog, and nausea continued. I went back to the GI who did a blood test and (for other reasons) did a second biopsy, and both showed no signs of gluten. 13. I have the very same symptoms you speak of. I have been caught many times while out of the house without any food. I shall not do this anymore. 14. Hypoglycemia as been with me since l983. (This person then goes on to talk about depression, severe in this case, associated with hypo - another symptom that seems common to both conditions). 15. There is a stage of Type 2 diabetes that involves hypoglycemia. There is also a separate condition of permanent, recurring hypoglycemia that is solved by diet. 16. I suffer from it myself sometimes as well as my 13 year old. She is on a GF diet also but always seems to be so hungry - It's pretty clear that the symptoms which may be hypoglycaemia are experienced by a lot of GF people. Sugar is a pretty constant factor, and it's unquestionable that in Western society - the US in particular - there is an unhealthy consumption of sugar, most of it processed so that any goodness in it has been removed. My own view, for what it's worth, is that as sugar in any form as an item in itself is quite unnecessary - the body extracting all the sugar it needs from a diet of fresh, natural food - it's best avoided, particularly by people such as ourselves whose digestive systems are already weakened by CD. Finally, for anybody's who's seriously interested in this, I suggest they go to this excellent Dutch site - http://lightning.prohosting.com/~hypoglyc/ - it has links to many other hypoglycaemia sites, the best of which, I believe, is the HAI - Hypoglycemia Association Inc. - site in the US - http://www.fred.net/slowup/hai.html On both of these sites there's vast amount of info, diets, etc. Both are non-commercial, and maintained by people who either suffer from hypoglycamia or who have done so in the past. Treat with caution sites funded by drug companies, or their philanthropic- sounding spin-offs - with the best will in the world, there has to be a second agenda. I hope this has all been of some use. Jeff in London, UK