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Trembling, fatigue and headaches after meals may indicate that you have postprandial hypoglycemia, more commonly known as reactive hypoglycemia. According to the National Diabetes Information Clearinghouse, a blood glucose level that falls below 70mg/dL will verify this diagnosis. This condition occurs in individuals who do not have diabetes. Other symptoms include sweating, dizziness, anxiety, confusion, weakness and difficulty with speech.


A number of causes may explain the trembling, fatigue and headache symptoms in reactive hypoglycemia. According to Vivian A. Fonseca, M.D., of the Tulane University Health Sciences Center, the condition can occur in individuals who have had gastric bypass surgery due to the swift passage of ingested food into the small intestine. Other possible causes include sensitivity to epinephrine – more commonly known as adrenaline – as well as interference in the secretion of the digestive hormone glucagon.


Trembling, fatigue and headache symptoms typically occur four hours after eating in reactive hypoglycemia. According to the University of Illinois McKinley Health Center, small, frequent meals and snacks accompanied with regular exercise can help prevent reactive hypoglycemia. Since the condition often occurs in obese women, prevention includes maintaining a healthy weight and losing weight if you need to. Balance your meals and snacks to include carbohydrates, proteins and fats. Protein and fat slow carbohydrate digestion, which helps avoid extreme fluctuations in your blood sugar levels. If you have worse symptoms in the morning, consider changing your breakfast to include whole grain cereal, such as oatmeal with fresh fruit and walnuts as a protein/fat selection. Avoid sugary cereals.

Helpful Foods

Certain foods can also help avoid the trembling, fatigue and headache symptoms associated with reactive hypoglycemia. These include whole grain bread, fruits, vegetables, and lean sources of protein, such as chicken, turkey, fish and tofu. The longer digestive process for high fiber foods, such as broccoli, sweet potatoes, oatmeal and bran cereals slows the delivery of glucose and helps you maintain a more stable level of blood sugar.

Foods to Avoid

As a rule, people with reactive hypoglycemia do not do well with sugary carbs such as candy bars, doughnuts, cookies, candies, cakes and muffins. Although these carbohydrates will take care of the trembling, fatigue and headache symptoms in the short term, they cause enormous spikes in blood sugar which can cause rebound reactive hypoglycemia, wherein the symptoms recur a short time later. Avoid sweet snacks and stick to healthier ones such as nuts and yogurt. Individuals who experience reactive hypoglycemia after meals should avoid alcohol and caffeine. Drinks containing caffeine include coffee, tea, soda and chocolate.

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