Hi Dr Lam,

On occasion I've noticed that if I don't eat as soon as I wake up my blood sugar begins to drop after about an hour. The severity and 'earliness' of the drop seems dependent on how much food I had just before bed and the amount of time spent awake in the night.

Does this sound normal (as far as hypoglycemia is concerned)?

I would have hoped that reactive hypoglycemia would not be triggered by an overnight fast and would only be problematic a few hours after a food stimulus.

If the hypogylcemia is severve enough, can it initiate a response to carb containing supplements such as fiber (cellulose powder) or slippery elm on an empty stomach?

I stick to a hypoglycemic diet throughout the day and am on a basic program to help with constipation and digestion that includes digestive enzymes, slippery elm, milk thistle, cellulose powder and probiotics. This has helped my constipation and liver ache although perhaps my new found 'emptiness' is making me more sensitive to a hypoglycemic reaction.

Many thanks,