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Reactive hypoglycemia

Some gifted children experience a reactive hypoglycemia — a need for body fuel — that causes them stress. They usually function well until mid- or late-morning. Then, suddenly, they are emotionally over-reactive, irritable, and experience intense stress. Once they have eaten, their functioning and stress levels are fine again for several hours.

A Parent’s Guide to Gifted Children
Webb, et al

You can’t imagine my relief at reading this dry bit of prose. Excitedly, I typed it into an e-mail for my husband. I believe the subject line was, “So we weren’t making it up!”

Your average kid, like your average adult, can get cranky when hungry. This isn’t what we’re talking about here. When our son was about three years old, he started to exhibit a pattern that we couldn’t find in any child-rearing manual. He’d be fine, perfectly fine. He was a charming, funny little guy, rather unusual and very sensitive, but that in itself wasn’t distressing, given his parentage.

But without warning, he would start to change into a different child. He would become oppositional, irrational. He’d say crazy things. Most of all, he’d refuse to eat. Pretty soon we figured out food was the key.

Every morning, if I hadn’t fed him his after-breakfast meal, he went insane.

We had one kid; we had one major problem. It wasn’t so hard to take care of: I fed him before the problem came on. It caused us the most trouble on unusual days: weekends, when we were traveling, family get-togethers. We’d forget that we’d had a timechange, or we’d get sidetracked chatting with someone, and suddenly our little boy would have turned into a monster. Eventually we had to teach his teachers about the problem, and it usually took only one episode for them actually to believe me. That boy has to eat.

But I wasn’t reading “A Parent’s Guide” because of my son. It was my daughter who’d driven me to typing that dreaded word, “Gifted,” into Google. With one kid, we were willing to say that he was just a little different. With the second, we had to admit something was going on.

The thing is, of all the troubles we had with our daughter, reactive hypoglycemia wasn’t one! I was happy to see it mentioned because other people had always thought we were so strange when we asked if their kids went insane when they were hungry. Not just a little cranky, mind you, but bonkers, complete with a change of personality and adoption of conspiracy theories. (As you might guess, a four-year-old’s conspiracy theories always start…and end…with his parents.)

Our son has always been very thin — 90th percentile in height, 10th in weight. Our daughter has always been right down the middle. In comparison to her brother, I thought of her as a little plump. And I chalked her resistance to reactive hypoglycemia up to that — she didn’t need as much fuel.

I was wrong, but it took eight years to come out. All of a sudden, sometime last year, we started to notice that many of her fits were preceded with hunger. We started to notice that if we let her get hungry, she’d become so irrational she couldn’t eat. I started to give in to whims like ramen for breakfast only because I knew if I could get her started eating, I might be able to continue the eating into something healthy.

As with all things juvenile, there is no one-to-one correlation here. Not all kids deemed “gifted” have reactive hypoglycemia. And I’m sure there are some kids who aren’t thinkies* like my kids who have this problem.

*I just saw someone refer to that term today and I love it. My kids are thinkies! It’s the intensity of their thinking that makes them who they are. I think I may adopt that term permanently.

What made an impression on me, those four incredibly short, unbelievably long years ago when I read that paragraph, was that we weren’t alone. There were other people who wouldn’t look at me like I was the crazy one for saying that my kids went completely insane when they were hungry. There were people out there who would say, “Oh, yeah, that. We always carry peanut butter pretzels with us, and if he starts to go off we just start stuffing them in.”

I don’t think it’s at all necessary to label kids. But finding a general area where you can locate your unusual kids is incredibly comforting. Not one other parent of a thinkie has been able to chart a course for me. But occasionally, they’ve thrown me a very welcome lifeline and called out, “I’ve been there, too!”

Reactive hypoglycemia: Just the words were enough.

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Posted in Parenting, Psychology.


59 Responses

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  1. anonymous says

    This is absolutely ridiculous to blame a child’s giftedness on reactive hypoglycemia(postprandial hypoglycemia). Unless you have had tests run by a pediatric endocrinologist who specializes in diabetes the symptoms you are seeing are most likely caused by a diet too high in carbohydrates. There is no research to back-up the claim that reactive hypoglycemia is a gifted trait.This is one of those gifted urban legends/myths.

    • Suki says

      I believe the confusion here is with terminology: “reactive hypoglycemia” is not a diagnosis of what’s happening the body, but a description of the results of whatever is happening in the body. I have no problem acknowledging that the cause of the problem may not be known, but to say that the problem isn’t real is to negate the experiences of many, many parents (see below). It would be great if someone studied this. Until then, however, parents of kids who have this problem know that there’s a cure: they need to eat more – and more often – than other kids. Period. It would be lovely to have more hard research, but since we don’t, we can still use these words to explain an unusual characteristic of our kids and help other parents learn how to control it. And yes, I agree that protein is better. But if your child has turned into a screaming maniac and the only thing you can get in is a few crackers, then that’s what you do! Sometimes, as Becca says below, the “wrong” food will pave the way for the right one.

      • anonymous says

        Webb has called it Reactive Hypoglycemia which is a real medical condition..there is no confusion in terminology. Do you honestly believe that gifted kids have different dietary requirements ? The very notion is absurd. Most kids-of all IQ’s – require snacks during the day especially if they have a diet that is high in carbohydrates which leads to unstable blood sugar levels ..it is biology 101. If your child has blood sugar issues you need to be under the care of a specialist. If your child is turning into a screaming maniac because of lack of food I strongly urge you to seek medical advice .Reactive hypoglycemia is a blood sugar disorder that needs to be monitored. It is a symptom of a much larger underlying cause and to ignore it is putting your child’s life at risk.

        • Suki says

          I’ve not seen anyone seriously suggest that all or even most gifted children have different dietary needs. But for whatever reason, this subject rings true with a lot of parents of these kids (and other kids who have similar problems). And my point was that it’s important and helpful for this information to be widely available. But you’re right: I should stop listening to the licensed pediatrician who has known my children since they were babies, as well as people who have spent their lives researching this subject, and instead follow the advice of someone who posts anonymously to blogs. Thanks for the advice! 😉

          But seriously, thanks for offering another viewpoint. I appreciate it.

        • SI2K says

          We have a highly gifted daughter with Asperger’s who fits this profile exactly. She’s over the 99th percentile for height (off the chart) with very little body fat, also. Just because science hasn’t looked at this in-depth (funding for research on gifted kids isn’t politically popular – how can it be when people experiencing it are browbeaten for even using the word?) – this doesn’t mean it doesn’t exist and that people aren’t experiencing it. We also have diabetes in a paternal great grandfather and I had gestational diabetes myself, during her pregnancy, which is interesting. But it’s not diabetes. She’s been tested bc of the family link. My son also doesn’t have this although equally gifted but without Asperger’s syndrome. If the gifted community is seeing this as a pattern, then that’s the definition of something that should lead to further inquiry. It’s not like science is done for the millennium and has gone home. Anecdotes are part of the process.

          Thanks for the post. I also print these descriptions out and give them to teachers. My daughter nearly developed an eating disorder bc they were punishing her for sneaking out of class to eat her snacks throughout the day. One big give away when she was little was she’d get down on all fours and crawl around confused.

          • Suki says

            How awful that your daughter was punished for trying to feed herself! Different children have different nutritional needs, it goes without saying. I hope that you are able to educate them, or if not, are able to find her another school. Good luck with that. And yes, I’m not holding my breath about good research being done, but as more families get exposed to this knowledge, at least they can see if a dietary change helps their children. If not, no harm done.

    • Jennifer says

      I don’t think that this article suggested “blaming giftedness on reactive hypoglycemia”. And while gifted children may not have different dietary needs than typical children, there is actually research that suggests that gifted children, along with children on the other end of the neuro-atypical spectrum do have different executive functioning abilities. Executive functioning can include a lot of things, including regulating behavior and modulating emotions. It would seem to be that some children may be more sensitive to dropping blood sugar than others and if they have difficulties with executive functioning, they experience “Hulk-like” behaviors when hungry. And while I agree that a high sugar, high carbohydrate diet does not regulate blood sugar levels as effectively as a more protein and carb balanced diet, some children are oral motor sensitive or picky eaters, limiting their food preferences, in a sense, continuing the vicious cycle. In any case, thank you for this article. I found it helps validate the mother’s intuition I’ve always had about my son’s hunger and behavior!!

    • Linda Marzucco says

      I’m wondering if he has worms

  2. anonymous says

    in addition Webb is a psychologist and as such does not have the medical background nor the licence to diagnose postprandial hypoglycemia

  3. Becca Jones says

    Thank you! I grew up in a family of 7 kids, and my mom and many of my siblings and I (all gifted) were what you describe. But I had forgotten! And you reminded me of what was going on with my own six gifted kids. Lifeline indeed!

    My husband tells people “sometimes kids need ice cream first when they’re falling apart. It primes the pump for real food, and THEN you can start talking.” And now I see we’re not alone in thinking that….

    • Suki says

      Hey, sometimes *I* need ice cream first. Who am I to deny to my kids what I know works with me? (Actually, these days it’s pure dark chocolate, but the concept is the same!) Good luck!

  4. Micki Howell says

    I have reactive hypoglycemia, and have been diagnosed with ADHD and Asperger’s. I have to consider the glycemic index or glycemic load of my foods. Breakfast of oats (oatmeal, or Cheerios) with some milk and fruit and protein (meat or eggs) are a must. Oats or quinoa pasta are staples. I try to avoid wheat, potatoes, and rice. I hope these dietary suggestions help with your cherubs!

  5. Suki says

    Your diet sounds somewhat like mine, though I require yogurt first thing as well! I think part of parenting is teaching kids to learn to get along with their own biology — I wrote about this some time ago at http://blog.sukiwessling.com/?p=70 . Our 12 yo finally “gets” having a good breakfast, though leftover Thai food is more his style than granola and yogurt. But the 8 yo has a long way to go before she understands the connections between what goes in and what comes out in her behavior.

  6. et says

    We went through all the therapies you described in order to find an answer, and eventually meds that made the behaviors worse. We stopped everything after another psychiatrist said the medicine was making her worse; we changed her doctor, changed her diet, added certain nutritional supplements, and changed the counselor that she was also working with to one of the experts that is experienced with profoundly gifted children & 2es, and she improved. She carries glucose tablets, and it works really fast. It makes it possible for her to wait fifteen or twenty minutes_ at least until we can get her real food. It is easy for people to say this is voodoo, but they have not been what we have been through; our kid is a real outlier, but we feel real hopeful right now with the calm.

    • Suki says

      The long path you took is familiar — I’m glad to hear that you have a happy ending. Too many families don’t ask for second opinions or do their own research (though I think that number — I hope! — is going down rapidly). The way I see it, the voodoo argument is meritless. Even if what you’re doing is just a placebo, it’s a placebo that works and doesn’t hurt. It’s so hard to tease out one aspect from the complexity of a single person — when you have a breakthrough like this, it’s a reminder that it’s always worth continuing to search. Good luck!

  7. Lynn says

    Today is my first day even knowing the term “reactive hypoglycemia,” and after reading a few things online (including this one) I am 100% certain my daughter has it. How do I get her tested?

    • Suki says

      Hi Lynn, Unfortunately, if you went to a doctor and used the term, they’d tell you it’s not a medical condition. This is something that psychologists and therapists who work with gifted kids have noticed, though it hasn’t been clinically tested. I and lots of other parents can tell you that it is real, however. The common “treatments” for the condition include: high-protein breakfast, mid-morning snack *before* the child feels hungry, and Omega-3 fish oil supplements (ones that are formulated for kids). Another big problem is getting caregiver buy-in on this. I had to give my son’s teachers in K and 1/2 big lectures about making sure he ate a snack mid-morning. They didn’t take it seriously, but if he didn’t, he’d crash and have a horrible day! In any case, try out those suggestions and see if you can stabilize things.

    • Terri says

      I am on this merry-go-round with my son. I have kept a “foods log for the last 3 years. That is the best way to get a clear picture. My son is 7. It didn’t take long to see patterns in food and behavior. My son is on a high protein diet most of the time. In addition to all you have read, I am finding a link between growth spurts needing to change is food schedule. My son is”throwing Ketones” thru this all. We have seen a pediatric endocrinologist who assured me his “levels” are within the norm, however, when his ketone levels spike he is a totally different child. I also finding any form corn syrup literally gives him “brain fog.” We are taking him to a pediatric nutritionist who is helping. I am so glad to have found this blog. I feel a lot less alone!

      • Suki says

        Yes, growth spurts can bring out all sorts of, ahem, interesting behaviors! I was talking to a mom recently who told me that her worrying child has spikes of anxiety right before growth spurts. We see lots of regressive behaviors in our house, often involving becoming very picky about food – right when they really need to eat! I’m glad the blog is helpful.

        • Terri says

          Have you heard of Ketones affecting children this way? We started down this path due to the foul breathe he gets. At 1st we thought the breathe and the behavior was allergy driven. The allergy meds seemed to make it worse so we started looking at everything. We found Ketone were def. the cause of the breathe. We started out with simple urine strips. When we kept getting positive results, we contacted a pediatric endocrynologist. He kept thinking we were getting false positives and suggested we take a blood sample reading much like diabetic, only it measure Ketones. The blood test show he is throwing them too. The doctor was at a loss whick didn’t make us feel any better. He simply said my son was not diabetic which I knew however, could not explain why he was throwing ketones. My son does not throw them all the time we have found out, but when he does… the behavior is so unlike my usual son.

          • Suki says

            No, I haven’t heard of that. Thanks for the information!

    • Kathryn Iadevais says

      My daughters neurologist found it on her eeg. Her brain waves were slowing down like she was sleeping after she ate. She is being seen by neurologist for seizures and behaviors. Endocrinologist confirmed it through bloodwork. I also was tested by endocrinologist using 3hour blood glucose test. 5 blood tests in three hours after dri nking high glucose drink. My daughter has oppositional controlling behaviors. Still trying to figure out diet

  8. Bronwyn says

    I am sooooo excited to find this. First we thought we has a food sensitivity issue and we tried the Feingold Diet. As we explored the FG diet and saw significant improvement we also discovered that “oatmeal is magic”. By following FG, we had by default, eliminated allmost all processed foods and sugar, and added fish oil / omega 3 supplements. As time has passed, we have found that indeed she needs to eat almost every 2 hours for her normal “thinky” self to shine through. Now that she is 6.5, she verbalizes that she is feeling tired just 2 or 3 hours after breakfast so we get some warning as the drop begins. Thanks so much for posting

    • Suki says

      I’m glad you found it, too! It can be a long process to figure out what helps and what hurts when you’re trying to work in diet issues. It looks like you have hit the big offenders. I’m impressed that you could eliminate almost all sugar. I admit that it would be hard for us to do that, given my own love of a fine piece of chocolate!

      • Bronwyn says

        Well, all sugar…that has been tough. We have found that she seems to be ok with a bit of real cane sugar. We have a stash of organic lolipops made from cane sugar, real fruit flavors and no artificial colors that we dole out or trade for any offending candy received. Making sure that breakfast is sugar free is REALLY important and makes the old addage “breakfast is the most important meal of the day” really ring true….oy made the mistake of pancakes with real maple syrup on a week day, this morning….big mistake…what was I thinking? I blame it on having a newborn in the house. 😉

        • Suki says

          Personally, I think that the rule of moderation in anything is worth considering. We couldn’t do a no-sugar diet and be happy, nor could we do an only-whole-grains diet and be happy. (Well, I could, except when it comes to that occasional cookie that I treasure!) We are doing as much as we can to have healthy diets, but we’re also relaxed enough to enjoy yummy food and the amazing treasury of tastes we explore through cooking.

  9. Bronwyn says

    Suki! I just had the most remarkable conversation with my father about himself and all of his five brothers. They are ALL like this! My grandfather was apparently like this too. They were all, as children, like this, skinny as a rail. And my dad in particular (IQ 160ish and two other brothers are easily in the same range) has to eat plenty of protein and fat to stay stable. Even now, my Dad describes it as ” just running out of gas”. He will be thinking along in his normal “thinky” way, and suddenly he just feel tired but not hungry, and its hard to think. I have actually seen him like this, and it is like he is in a fog and easily irritated. So…. make of that what you will. It seems to run in the family.

    (Side note, all of the brothers have had to cut sugar as they have aged to correct high cholesterol and lower their blood pressure as they aged)

    • Suki says

      Yes, I think a lot of families have learned to deal with it without really noticing that they do things differently than other people. It really amazed me when I found out that other people have kids who don’t have meltdowns when they’re hungry! As to altering your diet as you age, I think this is one of the reasons Americans don’t really know how to eat: we don’t really think about eating as fulfilling our bodies’ changing needs. Right now, I let my skinny kids have as much fat as they want, but I point out that *I* am not eating potato chips, nor will they be able to do so once their metabolism slows down. OK, I admit I sneak one from them occasionally, but if I ate them as often as I want them, I’d be joining the multitudes of Americans on the road to obesity!

  10. Alaska mom says

    Any books or other publications I can reference to help me figure out if this is what my gifted almost 9-yr-old is experiencing? Her moods swings are drastic, sudden, sometimes even violent. Do other parents recommend going to a pediatrician? Straight to a dietician instead? Or pursue the counseling route that I’ve been trying, if someone would return my calls? I’m losing my patience. I can’t even give my daughter a small cookie with half a cup of unsweetened almond milk an hour after dinner, without her having a fit 45 minutes to an hour later.

    • Suki says

      That sounds like a difficult situation! Reports on talking with pediatricians about these issues vary widely depending on the pediatrician. A very traditional one will tell you that food has no effect on behavior. But if you have a good one, it’s worth talking about it and seeing if s/he has any ideas. Sometimes the process of talking about what you’re seeing helps you figure out approaches, even if the person you’re talking to doesn’t have much to offer. Definitely try to find an experienced therapist – an occupational therapist who has worked with similar kids could be a good choice, too. What I found helped a lot was keeping a journal of what was going on. See if you can track the problems and how they relate to sleep, diet, activity. It may be that your daughter would have evening meltdowns in any case, or perhaps the days that you’re tempted to give her a cookie are days that have already been problematic in other ways and you’re seeing the culmination of those problems at the end of the day? But definitely, having someone to help you dissect the problem will be very helpful.

  11. Alaska mom says

    Thank you for the quick reply. My daughter craves fruit, she’s always eating/wanting fruit and I try to serve it with protein or complex carb if at all possible. She seems to need/want to eat every 2 hours. She really doesn’t consume many sugars or processed foods…now that I recall, I mentioned this to the pediatrician, the pediatrician said she can control her behavior since the school isn’t reporting any behavior problems, so it’s a matter of self-control. I will try fewer sugars and more complex carbs & protein for a few weeks and hope to see some improvement.

    • Suki says

      Well, I’m sorry to say that an MD doesn’t know what he’s saying, but if he read any modern brain research he would know that the part of the brain that controls impulses isn’t fully developed until people are in their twenties. So to ask a 9-year-old simply to “control her impulses” is both medically unsound and inconsiderate to the parent! Yes, all children need to learn to control impulses, but the more we study how the brain works, the more we learn that impulses are born of something. Sometimes they are born of something that needs to be curbed, but often they come from real needs and the child is just trying to fulfill that need in some way. Another thing that a pediatrician should know is that kids who can control behaviors in school can’t necessarily control them at home. I remember the day that our pediatrician explained this to me. He said, “The people I work with think I’m the coolest guy, but sometimes my family thinks I’m horrible! When I’m out of the house, I have to control my impulses, but at home, I’m more relaxed and more likely to let people know how I’m really feeling.” This is a successful adult explaining a very real thing that all of us know: We are not as in control of ourselves at home as we are in public. So why should I child be as in control of her impulses at home as at school? Makes no sense to me. I do think you’ll benefit from working with someone who listens to you and helps you figure out what will work well for your daughter. Her eating patterns – although unconventional – are actually very healthy. Some people are “grazers,” and as long as they get the right nutrition spread out through the day, that’s fine.

  12. Jessica Cangemi says

    My sons glucose without fasting, sick, and on steriods was a 57 (which would have raised his levels to be much higher). Very low. We have an appointment with an endocrinologist in a couple weeks. This is a very serious issue. Anything under 45 is a medical emergency. My son has to eat every couple hours. We have to force him to eat. When I can see an outburst coming on, his gets orange juice immediately. I suggest everyone to either have their doctor test their child or get a glucose monitoring device. Sweating, pale, clammy, unusual behavior, headaches, wetting the bed, urinating often, highs and lows are all some symptoms.

    • Suki says

      I’m sorry to hear this! That’s all great advice. I hope you find out what’s going on – hang in there. – Suki

  13. Vicky says

    Sounds more like fasting hypoglycemia than reactive – and both are legitimate medical terms btw but usually seen by doctors as a symptom than a disease, since they’re usually caused by an underlying disorder.

  14. Jumi says

    My husband is a physician AND a reactive hypoglycemic who happens to be gifted. We also have three gifted reactive hypoglycemic kids. Though carbs (like ice cream or other high GI/carbs) will do the trick in terms of calming a hypoglycemic episode, carbs will actually set the stage for another episode later by destabilizing blood sugar levels. So, they should be avoided at all cost! Stephanie Kenrose writes about this on her reactive hypoglycemia blog, and we find this is true for us as well. So, EVERYONE in the family is on a high protein (meats, dairy, beans), good fats (nuts), whole foods (veggies/fruits), low simple carb/GI diet. And I can’t tell you how helpful it has been in preventing blood sugar crashes!

    • Suki says

      Yes, stuffing protein into our kids is always a chore, but we make sure to do it, especially in the mornings. Every once in a while I forget, and I pay the price! Thanks for your input.

  15. lori says

    Oh my goodness. my daughter was just diagnosed hypoglycemic. Thinking back I should have known, given the dense family history….but it was a word tossed around, not something we were educated on. I myself am hypoglycemic, however I didn’t start digging until my daughter showed symptoms. And it certainly affects us differently. I didn’t see symptoms in my daughter because she was previously home schooled and she just ate whenever she wanted….now she was having to wait 3 hours in between meals at school. I just wanted to say thank you so much for this, it was like you were talking about my baby girl. quirky, sensitive and funny…..and then in the next second, a child I didn’t recognize. the road to education is a long one and I didn’t ever do it for myself but I am doing it for her!

  16. Amanda says

    Thanks for posting! You are a great advocate for your children. Take it from me, you saved them a life of frustration. I came across your post after going down a google rabbit hole by searching why coffee makes me tired. I am 25 and in graduate school. I was recently diagnosed with ADHD. I was identified as “gifted” in elementary school. My family would always joke that my big brain made me eat! I was extremely irritable (still am) when I was hungry. My dad could relate because he has diabetes.To appease me, as a child, my family let me eat whatever I wanted. This persisted through out middle and high school. I managed to graduate from college without much trouble but I could never really concentrate and I gained 60lbs! I am not one to medicate, so I was always hesitant to seek any diagnosis. I got over that because it is unbearable to not be able to concentrate in graduate school. I am now taking Adderall for my ADHD after Ritalin made me dizzy. Reactive hypoglycemia also really makes sense and explains many of my unresolved symptoms and perhaps my sensitivity to stimulants. I wish my parents had access to this information when I was younger.

  17. Serendipity says

    Hi, I think it’s great you wrote about this. I’m in the process of being diagnosed with aspergers at the moment and I also get irrationally cranky when I’m hungry to the point of not eating. The doctor is also having me tested for reactive hypoglucemia. Thanks for letting me know there are others with the same mixture of symptoms. They say hypoglucemia is caused in some by insane amounts of stress, and believe me, having aspergers is pretty stressful in today’s society where it is misunderstood and seen as an illness.

    • Suki says

      Thanks for writing. Yes, it’s tough to hear a diagnosis, but hopefully it will help you find the information you need. I’m glad I could help!

  18. Judy says

    I found out that I have reactive hypoglycemia at 50 after finding neuropathy. The mood swings, the horrible side effects since I was born. It finally has a name. I am a writer and poet. I think gifted people are more prone to disorders like this. I am having my genome mapped soon and look forward to some major answers.

  19. V says

    I am reading this in tears. My 8 year old son has turned into a child I didn’t know over the last few months (since learning to pick the lock on the pantry, incidentally) and my husband and I have been at a loss as to what was happening. The yelling and punishments and withdrawal from family life, the angry violent outbursts followed by a sudden depression so deep that I heard my child wish himself dead. From an 8 year old! I became aware that it was something related to diet about 5 weeks ago, and I should have thought of that before because blood sugar problems, including Type I diabetes is in my family, and I had hypoglycemia episodes frequently myself before changing my diet. But I never realized what an effect it could have on behavior because my symptoms were more physical. My first thought was gluten because he ate a half loaf of bread one evening that resulted in the worst outburst he’d had to date. The pieces finally clicked this week after I discovered he had not eaten a bite of the lunch I’d given him, but instead had eaten cookies and candy that a classmate gave him. This discovery directly followed an incident with him that took 10 years off my life. I was ready to seek mental help because I was seriously scared he was going to kill himself. We immediately modified his diet, and explained to him what was happening. He expressed relief that there was a reason because he was blaming himself. I let his teachers know what I suspected and they immediately expressed relief also because he had suddenly been very difficult in school and they were at a loss to explain. We went to the dr yesterday, and thank God, he respects me and took me seriously. We’re doing a 5 hour GTT Tuesday, but even if it doesn’t show what’s going on, I have seen such a difference in the last couple of days that I am positive that unstable blood sugar is his problem and we are sticking to our diet modifications. Incidentally, I tested gifted as a child, and he is potentially higher in intelligence than I am. Very much a “thinker”.

    • Suki says

      Hi V, thanks for writing. You are going through a rough time! I would suggest three dietary changes that have shown to help with behavioral issues. Given your situation, it doesn’t make sense to wait because none of these will hurt him:
      1) Omega-3 is so helpful for so many kids. You should start him immediately. People debate about which brand is the best, but I’d say, with a kid in crisis, let him take any brand he likes. My kids hate the flavored ones so we’ve settled on Pure Formulas, which they swallow whole.
      2) There is a lot of new research coming out linking behavioral issues with iron deficiency. I have a forthcoming article about this in the 2e Newsletter. Have his iron tested, and make sure they break out ferritin levels, which they don’t usually do. Kids who get ADHD diagnoses seem prone to low ferritin levels, and ferritin is what helps the brain regulate serotonin levels. If his ferritin is low, choose an easily digestible supplement. Again, we use Pure Formulas, but only because it was recommended and doesn’t give my daughter an upset stomach. If she could swallow bigger pills, I might want to go for one of the “real food” based supplements, but they taste awful and are large.
      3) I have been reading recently about emerging evidence that gut bacteria actually play a huge role in behavior. This was very interesting to me because our daughter’s greatest difficulties happened when she was taking an antibiotic for a congenital urinary system disorder. There are new and very expensive ways to diagnose and treat gut bacteria imbalances, but the easy thing you can you is either have him eat lots of live culture yogurts, pickles, and sauerkraut or have him take a probiotic. One of the most interesting papers I read about this showed that kids with gut bacteria imbalances actually seek out the foods that are worst for them. I also see that behavior and it’s very frustrating.
      Good luck – love that little boy!

      • V says

        Update: I feel like I’m getting my child back, day by day. We got our official diagnosis yesterday and his results showed what I thought they would. The GTT was tough! He crashed badly and had very obvious physical symptoms for the first time. The lab actually released us after the 4th hour because he was in bad shape and they had the numbers they needed. Thank you for the info. I will investigate the iron levels more thoroughly. I bought him a chewable gel cap omega 3, but he said it was nasty, and I can’t convince him to swallow it whole yet. Luckily, he loves fish, so we’ve been doing wild caught salmon.

        • Suki says

          I’m glad to hear things are going better. My kids won’t chew fish pills, either. For the younger one, I get the little tiny chewables but she swallows them whole. It’s great that he loves fish – that helps. Canned oily fish like anchovies are convenient to have around. We get cans of salmon or trout and make “tuna” salad from them. Also, in Asian stores they often have dried fish snacks that are nice and crunchy for kids who like fish taste.

  20. Sharon says

    I just finished reading a book on misdiagnosis of gifted children and came upon the term ‘reactive hypoglycemia’. I ended up on this website after googling the term. Whether or not there is an official medical diagnosis, this phenomenon is TRUE. My 8-yr old, very intelligent son has been this way for years- irrational, defiant, oppositional, over emotional- seemingly out of the blue and for no reason. He has been assessed for ADHD because of it, but the diagnosis never really seemed to fit him. I have researched food allergies, candida, mood disorders, etc. to try to understand my kid and help him. After recently reading some books on diets and the book on gifted kids, I feel certan his behavior was horrible mainly when he was hungry. He would be so hungry that food didn’t sound good to him. This makes no sense, I know, but every time he has been like this the rotten behavior disappears within several minutes of eating. He then becomes this lovely, smart kid again. I know everyone gets irritable when they are hungry, but he has been sent home from school and summer camp for horrible behavior. My other son does not have these same issues. By the way, my medical doctor has turned down my requests to test his blood sugar levels, blood panel for allergies, etc. because she says behavior problems have nothing to do with that! So everything I have researched has been on my own. Shouldn’t be that way.

    • Suki says

      Hi Sharon, What you describe is something that is TRUE, regardless of whether it’s an accepted medical diagnosis. I’m glad you found the book and have started to work on helping your son through this. It’s too bad your doctor is so behind in her education – time to find a new one? Though I would agree with her about doing a blood sugar test – that’s only necessary if he’s showing signs of diabetes or similar – she should be responsive to you as a parent and respectful of your concern for your son. Furthermore, any pediatrician these days should be reading all the new research on the links between diet and behavior. Ask around your community to see if you can find someone who’s a bit more proactive about allergy testing, just in case there’s something else you’re missing.

      But as to the reactive hypoglycemia, you’re absolutely right that once a child starts into reactive mode, the last thing they want to do is eat. When my son was little, before we knew that there was even a word for it, we had to do something we called “priming the pump.” He would be insane and screaming and we’d shove a little piece of bread or cracker in his mouth, something that dissolves in saliva so he couldn’t choke on it, and watch the miracle happen. As soon as his taste buds registered food, he would suddenly realize how hungry he was and start eating. The problem was, we were feeding him the way you would feed a typical child, expecting him to go pretty long periods between eating, and expecting that if he was hungry he’d eat. But if we let him go too long (which we sometimes did and schools always did), he’d get past the point of being able to feed himself.

      It’s important that you talk with your son’s teacher and explain the situation. Let the teacher know that your son needs regular snacks, and let her know the time of morning that you have noticed he has the dips in his behavior. I hope the teacher is receptive. My daughter’s kindergarten teacher refused to let her get more food from her lunchbox after she ate the tiny snack that she was allowed. The teacher said that it would “send a message to the other kids that they could eat lunch whenever they wanted.” Well, yes, it would send that message, and that message is a healthy one! Children are all different, but none of them functions well on an empty stomach. If your son is to succeed in his classroom, he needs support. Often if you put it in those terms – “I would like to get your support in helping my son succeed in the classroom” – it’s much more helpful than anything the teacher might hear as critical, e.g. “You’re not letting my son eat when he’s hungry!”

      Good luck!
      Suki

      • Karen says

        I know this post is several years ago, but I would REALLY like to contact you for info and types because we are on this path with my 6 year old!

        • Suki says

          Hi Karen,
          I don’t have any more recent information than this, but there has likely been more study of it since I wrote this piece. I think the key is just to keep working on diet and frequency of eating. 6-year-olds can be tough when it comes to diet changes. I recommend that you make sure that food goes in before you talk about any sort of planning, scheduling, trips out of the house, etc. I had a lot of success with an approach that started with a calm declaration of what was going to happen: “OK, first we’re going to eat a snack, and then we’ll talk about what else we’re going to do.” Or in the case of a kid needing to get out the door each morning for school, make a morning schedule that includes eating before something the child does willingly, and announce them in that order: “OK, breakfast and then you get to scooter on the driveway for 3 minutes before we jump in the car.” This does mean planning in more time to get out of the house, but it’s worth it in the end. Also, if the child is in school or classes during the day, talking to teachers about frequent snacking is important. A lot of times they will just brush you off, so refer to it as a “medical necessity” in order to get their attention! Good luck!

  21. A says

    Thank you for sharing your experiences. They ring so true with us and we have managed the issue in our now 7yo son for over 5 years following a watershed meltdown in his carseat when as a last resort we gave him the entire tub of dried fruit we kept in the car for snacks – he finished it all and immediately gave us a beaming smile oblivious to the parental horror we had been through before we found the solution! Both he and our daughter now have a morning window of opportunity for breakfast before their behaviour becomes unmanageable. Unfortunately our daughter is a picky eater and your blog has made me think her love of just pasta may be destabilising her blood sugar – time to find the GI cookbook again… And by the way to the lady who dealt so bravely with her son who talked of wanting to die – we have been there too. Parenting these children can be the hardest thing in the world but who is better equipped to do it? BIG hugs to all of you sharing this journey! WHY is it still taboo???

    • Suki says

      I have no idea why the general medical establishment doesn’t accept it – perhaps an abiding suspicion that we are all hysterical parents? I know exactly what you mean about kids who crave simple carbs – it’s a constant battle and you have to figure out the level of commitment your family has. Some remove all simple carbs from the diet, period. Others set up a barter system – “eat some protein and I’ll let you have that pasta”. I don’t think there’s any one answer – you have to figure out what works in your family with your children. Good luck!

  22. Kay Grieve says

    Oh my gosh just stumbled upon this while researching hypoglycemia in my 8 yr old daughter. I know I found it much later than the original posting but this fits my gifted daughter perfectly! The relief I feel is immense and to know it wasn’t just me out there is incredible thank you so much for that.

    • Suki says

      I’m glad to help! I hope you find a diet that works for her.

  23. Laurie says

    I have a 6.5 year old daughter, who I believe has reactive hypoglycemia. She is extremely smart, very thin, and has the appetite of a linebacker. We never really exposed our kids to high-sugar items, so it was fairly easy to pinpoint high sugar as triggering violent and oppositional behavior. She was always a good kid, but give her a cupcake, or a few cookies, it was like a scene out of poltergeist. Once the “fit” was over, the glazed over eyes would disappear, and she would be sweet as can be, and sometimes not remember the “fit.” We brought it up to her pediatrician who said that there is no such thing as a sugar sensitivity, so he dismissed it and said to just “let her run off the sugar.” Still not convinced that was right, I took her to a naturopathic doctor, who told us that she probably runs as a very high adrenaline level, and once adding high quantities of sugar with no protein or fiber to help slow down the absorption, her body just couldn’t process it. Made perfect sense to me. Until she started having similar (non-violent but just as scary) meltdowns if she got too hungry. Just before she hits the breaking point, I notice her pupils get dilated and her eyes get glassy. If she ever hits the point of being so hungry she refuses to eat, we find that just putting food in front of her while she is freaking out, and then walking away, within minutes she begins shoveling the food in, and then we can have a rational conversation again. I also noticed that a small glass of orange juice can reverse it long enough to get her to eat as well. Stumbled upon reactive hypoglycemia and I am fairly confident that is what is going on with her. Next step is taking her to an endochronologist so I can be sure that the school is supportive of her having extra snacks throughout the day. Thanks for sharing your stories everyone. Nice to know that we aren’t alone!

  24. connie says

    You are so right !!!!!!! OMG my son is Aspergers and if he doesnt have his iron liquid every 2nd day and food every hour he melts down bad, i also give him multivitamins and minerals! I thought he was just acting out but when we visited my mum in QLD she said try feeding him each hour and as soon as he wakes up OMG it changed our lives. I dont know if there is a mecical term for it or not? I started my son on Iron Liquid because he was addicted to any thing cold and wouldnt eat anything buy ice, icypoles, andy thing frozen as soon as he was given Iron Liquid he was OK.

Continuing the Discussion

  1. A parent’s view from the psychiatrist’s couch – Avant Parenting linked to this post on July 20, 2012

    […] say that he always throws fabulous tantrums in the mid-morning. Everyone should have “reactive hypoglycemia” on the tips of their tongues. But not one practitioner ever mentioned it to […]

  2. Fish oil: More than just memory – Avant Parenting linked to this post on November 5, 2012

    […] Reactive hypoglycemia […]

  3. A behavioral diet toolkit – Avant Parenting linked to this post on August 31, 2013

    […] fast-metabolizing kids who seem to go up and then crash mid-morning. I wrote an article on reactive hypoglycemia, and another on the effects of omega-3. There’s no reason not to start your child on fish […]



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