Hi folks, this is my first post here. I have started a methylation protocol, and I am getting hypoglycemia in the afternoon and at night (60-70 mg/dL). At first I thought it was hypokalemia, increased my potassium intake, but eventually ended up throwing up in the ER. I have been getting some great improvements from methylation, but the low blood sugar is really a drag. The background I am in my early 30s and I have had minor symptoms of chronic fatigue or fibromyalgia my whole life. Allergies, brain fog, muscle knots/pain, repetitive strain injury, eyestrain, skinny, difficulty building muscle, unrefreshing sleep, upper airway resistance syndrome, cold hands/feet, constant thirst. MTHFR 677 +/-, MTRR A664A +/-, bad BHMT. Luckily, I have been able to have a decent career, and I can lift weights and run. But my quality of life is not great. My protocol Based on the @Freddd protocol. Methylation: methylcobalamin 1000mcg-1500mcg, adenosylcobalamin 1000-1500mcg, methylfolate 400mcg, l-carnitine fumarate 250-500mg, Seeking Health B Minus complex 1-2 / day Vitamins: C, D, E, K, nicotinamide riboside, NADH (discontinued), spirulina Minerals: Thorne pic-min complex, magnesium 200-300mg, calcium Other: Phospholipids, R-ALA, milk thistle, fish oil, lysine, gynostemma, ashwaganda Diet: Mostly meat, whey protein, olive oil, fruit, and sometime small amounts of rice. The story Going on the methylation protocol has resulted in either consistent or temporary improvement in most of my symptoms. Sleep is more restful, eyestrain is nearly gone, muscle knots improved, increase in strength, increase in energy some days, decrease in allergies some days. From day 3 of the methylation onwards, when I added methylfolate, I’ve experienced startup symptoms involving lightheadedness. I believed that this was hypokalemia that @Freddd talks about, so I increased my potassium intake. My muscle knots miraculously released I was still dealing with startup symptoms (beating heart, clammy hands, tunnel vision), so I increased my dosage of potassium, decreased the dosage on my protocol, and used diluted electrolyte supplements in water. I ended up throwing up in the ER, likely due to excessive potassium (because I had the reaction right after chugging a lot of potassium). I lost 5 lbs. Having difficulty recovering, and experiencing reactive hypoglycemia on most days and nights. I eventually figured this out with a finger prick device. My blood sugar has been as low as 57 mg/dL. The feelings of hypoglycemia feel exactly the same as my startup symptoms. This leads me to believe that I had hypoglycemia that entire time. I can’t rule out hypokalemia, but my dosage of potassium should have made me get better if that was the main problem (instead of making me throw up). And I have direct proof of the hypoglycemia. According to my reading, getting hypoglycemia from methylation doesn’t make any sense. If anything, methylation should be making blood sugar control better. I have never had hypoglycemia before (maybe once a year in retrospect), and normally I can eat any amount of carbs or sugary drinks. What is going on? Clearly the methylation has changed something in my glucose / insulin / glucagon metabolism. Had some good days where I had a lot of energy and was bounding around. My body felt accelerated by 20% doing everything. I was also lifting weights as usual, before I recognized the hypoglycemia. I have been trying a bunch of different dietary or supplement changes to address the hypoglycemia, and I’ve had some days without it. I am doing the obvious stuff, like not eating carbs by themselves, reducing whey protein, and eating multiple small meals. I still get blood swings every couple hours, or sometimes, even more often. The ER visit didn’t help anything, but I’m pretty sure that I was was getting the hypoglycemia as a startup symptom prior to the ER, and then tried to “fix” hypoglycemia with high dose potassium. I have tried increasing my fat intake, olive oil, MCT oil and butyrate, but no noticeable difference. Chromium 100mcg was already in my trace minerals. Next I am trying: more soluble fiber (previously at <5g), glucomannan, uncooked corn starch, and l-alanine. Questions (No need to attempt to answer all of them.) Any theories about what might be happening? Anyone else dealt with hypoglycemia in the context of methylation? I see a few mentions from searching, but they are sparse. Any other ideas for treating the hypoglycemia? Is it more likely that I am dealing insulin resistance or insulin sensitivity? I am holding my methylation at 1000mcg methylcobalamin, 400mcg methylfolate, and B-complex. I am afraid to go higher because last time I increased the methylfolate, the hypoglycemia regressed. Any changes to the protocol that might help? My methylation results have been great so far other than this and hopefully I can get back on track soon. Thanks!