u/HotPaleontologist838

I am a 33-year-old man, 1.83 m and around 90 kg. I train regularly with weights and normally aim to live an active, healthy lifestyle. Over the last two months, I experienced three main episodes that were interpreted as reactive hypoglycaemia / hyperinsulinaemia-related episodes.

I have had reassuring medical investigations. I had a full cardiac evaluation, including heart ultrasound/triplex, and I was seen by two cardiologists. Everything was normal. I also had blood tests and hormone tests. The main abnormal findings were high B12, high ferritin, low B9/folate, and white blood cells close to the lower reference limit on some tests. I am now taking folic acid/B9, magnesium malate, vitamin C, and a B-complex/multivitamin.

Before quitting, I was vaping heavily, with an estimated nicotine exposure of around 150–200 mg nicotine per day. I also consumed a very high amount of caffeine, around 10 teaspoons of instant coffee per day.

Timeline of the Hypoglycaemia Episodes

The first major episode happened on 27 March. During this episode, I experienced shaking/trembling, palpitations, dizziness, and a strong feeling that something was wrong. Emergency services/112 came, but I was medically cleared. My temperature and blood pressure were normal.

Before this first episode, several stressors had happened close together: I had trained legs, my wife had recently recovered from a strong gastroenteritis, I had an athletic massage the day before, and I was still doing intermittent fasting. That evening I ate two plain chicken wraps, which felt insufficient, but I avoided eating more because I was trying to lose weight.

After the episode, I did not recover immediately. It took around 7–10 days before I felt about 90% recovered.

The second episode happened on 12 April. The symptoms were again similar: shaking, palpitations, dizziness and intense physical alarm, while my general vital signs such as temperature and blood pressure remained normal. Around this date, I massively reduced caffeine intake from about 10 teaspoons of instant coffee per day to about 1 teaspoon per day.

Again, recovery was not immediate. After this episode, it also took several days, roughly 7–10 days, to feel close to normal again.

The third reactive hypoglycaemia-type episode happened on 20 April. It again involved shaking/trembling, palpitations and dizziness, without abnormal temperature or blood pressure. On this same date, I stopped vaping/nicotine completely, cold turkey.

After this third episode, I again needed around 7–10 days to feel around 90% recovered.

Nicotine Withdrawal Timeline

From 20 April, I stopped vaping completely after heavy daily use, estimated at around 150–200 mg nicotine per day.

In the first 1–3 days after stopping nicotine, I had shaking in my hands and body. On day two, I also experienced a short but very intense feeling of deep depression for about one hour.

After the first few days, the most intense emotional crash passed, but the shaking/trembling continued for about 14 days. During this period, magnesium and theanine helped me sleep well.

At this stage, I do not have the classic ongoing withdrawal symptoms such as irritability, concentration problems, strong hunger, strange sleep, or constipation. My sleep is generally good.

Current Diet and Insulin Stabilisation

After these episodes, I changed my diet to stabilise my blood sugar and insulin response. I now eat 4–5 meals per day, usually protein-rich, combined with either fats, fibre, or controlled carbohydrates to reduce glucose and insulin spikes.

My current diet is based on regular meals, protein, controlled carbohydrates, and enough fat to avoid large blood sugar swings. I believe this has helped me greatly improve the insulin-related instability.

My Libre/CGM readings have generally been reassuring, with values such as around 7.1 mmol/L after food and around 5.4 mmol/L several hours after eating, which are not hypoglycaemic. I am no longer mainly worried that my recent symptoms are true hypoglycaemia.

Current Main Issue: Digestive/Gut Sensitivity

My current problem feels mainly gastrointestinal rather than hypoglycaemic.

Recently, I had a digestive setback after eating a lot of fibre: many nuts, salad, and several apples. I went to the toilet five times in one day, with normal but large/soft stools, not diarrhoea. After that, I felt weak and depleted. I recovered after about a week.

Later, I had another digestive setback after eating pre-fried potatoes from the fridge and heavier mixed meals, including pizza, nuggets, salad, nuts, eggs, and other foods. I suspect that pre-fried potatoes may be a trigger for me, because I had a similar stomach issue in February after eating pre-fried potatoes that had been stored for more than two days.

My current symptoms feel mostly digestive: delayed digestion, food or water feeling like it “sits” in the stomach, cold hands, weakness, fatigue, internal tension, and reduced appetite during flare-ups. My stools are usually normal, and I do not think this is diarrhoea or true hypoglycaemia.

Overall Interpretation

My current interpretation is that I am generally healthy, but my body temporarily lost resilience because several major changes happened close together:

three reactive hypoglycaemia / hyperinsulinaemia-type episodes on 27 March, 12 April, and 20 April;

symptoms during these episodes: shaking, palpitations, dizziness and strong physical alarm;

normal temperature and blood pressure during the episodes;

emergency/medical evaluation on 27 March, with no dangerous findings;

slow recovery after each episode, taking around 7–10 days to feel about 90% recovered;

very heavy previous nicotine/vape exposure, estimated around 150–200 mg nicotine per day;

complete nicotine/vape cessation from 20 April;

massive caffeine reduction from around 10 teaspoons of instant coffee per day to 1 teaspoon per day from 12 April;

early nicotine withdrawal with shaking, temporary emotional crash, and around 14 days of tremor-like symptoms;

major diet changes to stabilise insulin;

increased protein, fat, fibre, and meal frequency;

digestive setbacks from fibre overload and possibly specific trigger foods.

I want to recover my normal life: to train 4–5 times per week, eat around 2500 kcal on average, tolerate normal meals again, and eventually be able to have occasional foods or even two glasses of wine per month without feeling fragile or afraid.

At the moment, I feel medically reassured but physically vulnerable. My goal is not only to avoid symptoms, but to rebuild metabolic, digestive, and nervous-system resilience after quitting heavy vaping, reducing caffeine, and stabilising insulin.