Does anyone have flushing and low blood sugar after eating?
I have been doing Keto for 12+ months and have put my type 2 diabetes into remission (hba1c, and fasting insulin now in non diabetic ranges). I have had issues with facial flushing for a while now and have had extensive tests for Cushing’s and hormones before starting Keto but I have started testing my blood sugar when I flush and I have noticed I have blood sugar in the late 4 mmols approx 30 mins after eating (possible reactive hypoglycemia). I see an endocrinologist and he does try his best and likes the results I have had with bloods and weightloss but he really doesn’t seem to understand what I am doing with Keto (20 total grams carbs) or IF. Does anyone else have this issue and how did you counter act the hyperinsulinemic spike? Do you do extended fasts? Carbs a little higher? I am kind of at a loss as it is a very uncomfortable flushed red, hot face, a temp spike and my extremities get super cold plus sometimes a sore stomach).
Flushing after eating
Well that doesn’t sound like much fun @Ketoteak. Are you finding that you’re getting the temp spikes and flushing after every meal? Have you tried eliminating foods to see if you can find the trigger?
Most meals, sometimes when I haven’t eaten as well although it is better most of the time if I don’t eat.
I have been doing an autoimmune protocol sort of Keto a most of the time, so I have eliminated many things like coffee etc and introduce them back.to check reactions. I orginally thought it might be an allergy as well as I can’t certain things. I can’t eat wheat even if I wanted to after a bad reaction with a painful rash after a cheat day 7 months in. Food allergy testing came up with nada and I was told it was just an intolerance to wheat. So frustrating!
I’m assuming if you’ve been tested for Cushing’s you’ve also been tested for Graves (Hyperthyroidism). It used to happen to me when I had a good dose of sugar, in particular if I had a mug of hot chocolate or heavy starchy carbs, but largely stopped when I went Keto. I have alcohol intolerance so have a pretty horrible adverse reaction when I drink, but given this is happening to you during most meals, I’m assuming alcohol is not the cause for you. 
Kava, sulfates and sodium nitrates can also be problematic for some people. Maybe try cutting these out of your diet to see how it goes?
I have Hashimoto’s but haven’t been tested for Grave’s. I have asked before (and I have heard of people that have had both) but my Endo didn’t think it was necessary at the time (which annoys me). Thanks for the reply - I think I might have to push him to test for Grave’s.
I found this thread in a search and was wondering if you’ve found an answer about the facial flushing. I have a facial flushing reaction to coconut oil. I’ve been ketogenic for 4 months now but spent the last 6 weeks traveling and depending on cheese, cream, and avocado for my fat content. I’m home now and including coconut oil again and have bright facial flushes within minutes of having it.
Have you discovered anything about your causes yet?
Yes I sort of have an answer. I have found out that my insulin was back up to 20 (insulin resistant) when it had previously gotten it down to 9 (non insulin resistant). I was having reactive hypoglycemia because my carbs were low and my insulin was bringing it down too low after eating.
My endocrinologist has been testing me for Cushing’s for the last 3 years which the flushing was one of the symptoms. He was in the middle of testing for different hormones again but I was sure it wasn’t that. I started writing down symptoms of when it was happening and I realised it was after eating. I started checking my blood sugars when I was flushing and each time I flushed it was approx 15 mins after eating and my sugars were in the 3’ s and 4’s.
My Endo wanted me to go to hospital it it went under 3.5. He said they would give me glucose so I was like nope not doing that so I have had to eat a bit more often to stop it going so low that I felt sick, tired or/and cold.
I still have the low sugar at the moment but don’t feel sick. I recently found out I am pregnant and being diabetic (ex) I need to keep them low now anyway. One good thing being pregnant and Keto no morning sickness (when last time I was sick from the start until week 23).
MCT oil has made me flush previously. Also coffee and tea.
Thanks for replying.
Thanks, Kate fir the reply, and congratulations. Wonderful news. I have laid off the coconut oil but tried again tonight and was much better. I am wondering if it had something to do with jet lag too, now.
Take care and excellent re no morning sickness. I needed to do that…32 years ago 
Dreadful morning sickness. Ended up in hospital at 8 months. Soooo long ago
Hi,
I just started keto about a week ago, and I have noticed extreme flushing in my face, neck and chest towards the end of the day and it lasts for hours. Is this something to be expected as I am starting out, or is it something that may not pass unless I make a change? It is really the only negative symptom I have experienced so far in transitioning to keto.
I experience flushing, fast-paced heart beat and temp spike nearly every time I drink alcohol, even after just a couple sips of wine. I also experience this when I am too surprised or have an “overstimulation” of an excited/stressful emotion, its almost like my body goes to shock and reacts. So this is something I am experienced with and sorta used to, but the flushing I have experienced the past few days has made my cheeks extremely hot and toes/fingers cold, pretty much to the point of pain/discomfort.
I’m going to see if this passes, and log what I have eaten when it happens. Maybe I’ll notice a pattern, but I’m not really familiar with the science behind all of this, so I appreciate the post and advice anyone has to offer.
Thank you,
Paige
Mine turned out to be reactive hypoglycemia. My blood sugar was going really low 15 - 30 mins after eating and was producing a stress sort of reaction raising my blood sugar back up. For me it was happening for a few years but more so early in this pregnancy (before I knew I was pregnant).
It also pushes up my blood pressure which has helped me avoid some of the things in my last pregnancy
Coconut oil and MCT oil can sometimes cause newbies a flush.
In regards to your reaction to alcohol it could spike your insulin because of sugar/carb content or if you are like my mother she gets a reaction from some of the preservatives in things like red wine. However the joint pain/cold could also be explained by Raynaud’s phenomenon which I have had myself from my Autoimmune disease.
Best thing to do is to keep a food log and use a blood glucose monitor when it happens. This is how I pinned down what was happening with me. My endocrinologist was doing all these tests and it was me that figured it out!
This has been happening to me for years, but only on low-carb, and is quite different from the hot flashes I occasionally get. It always happens right after eating, or sometimes late in the day if I’m feeling really hungry. No-one ever seems to know what this is, so thank you for that answer! I don’t test my sugar, only ketones; however I was starting to suspect an insulin connection which is why I just searched this question again and found your thread. I will be buying some glucose strips tomorrow!! This makes so much sense. Thank you!
So if it is reactive hypoglycemia, how do you handle it?
What changes can or need to be made to stop the reaction?
Lowered my insulin levels. It has been the only thing that has done it. Whenever I start to feel sick I know my Insulin levels are up again.
A late response, but I found this thread through Google, so maybe others will too.
This can definitely be a reactive hypoglycemia low blood sugar thing, as the OP said, but a lot of times when we start keto, we switch to eating a lot more foods that are high in histamine or are histamine releasers (cured meats, cheeses, vinegar, dark chocolate, avocados, etc.) so a low-histamine diet may be something to try for a couple of weeks, especially if it comes with other symptoms of histamine intolerance.
Paige’s description of flushing after alcohol sounded familiar. Red wine, in particular, is high in histamine, but anything fermented will get ya. People with MTHFR mutations often aren’t as good as clearing histamine.
So just something to check. Histamine intolerance can cause the heart palpitations too.
I have been on keto for 3 days and having the facial flushing, and it first happened when I used coconut oil!
It’s happening after I eat a high fat meal, so relieved other people have this
Me too! I’m having terrible redness and facial flushing. After a high fat meal, higher the fat worse the flush and heat. I noticed when I was feeling hot in the face that my blood sugar had dropped into the 50-60s…I hope it passes soon
Check your blood sugar…!!! When this happens to me my blood sugar is dipping below 60 and into the 50s. I think I have insulin intolerance from PCOS and I’ve read my body is still making excess insulin but there is nothing for it to really work on since the carbs are not there, so blood sugar drops and the body is in panic mode kinda.