Eilish McColgan has ‘rebound hypoglycaemia’ and won't run London Marathon until 2023 as a result. How can she treat it?

Improving her insulin sensitivity will be key. When eating meals, eating veggies first, then fats and carbs last will help long term. Some fasted training before breakfast too.

Anyone suffering from rebound / reactive hypoglycemia, would recommend the suggestions on managing the condition on this page https://www.instagram.com/glucosegoddess/

In 10 years, I didn't find a single nutritionist/doctor who understood/could explain what I was experiencing. Told me it was in my head, I wasn't eating enough... I knew neither were true but still couldn't work out the problem. So pleased Eilish has spoken out about her issue.

I'm sensitive to the fact that most of what we do in athletics hasn't been proven with scientific certainty, but you're just egregiously misstating my claim here. The question isn't whether carbs are important; the question is whether it's necessary to take carbs during the race AND carboload in advance. To my knowledge, research on carb intake has never focused on whether athletes have previously carb loaded (which very few athletes do, according to accepted protocols). It has been shown, however, that carb loading has no effect on race performance for athletes who take exogenous carbohydrates during exercise, and it has also been shown that carb loading allows for glycogen stores that should, at least in theory, be far in excess of what's necessary to run an elite marathon. Also, high level carb intake during races for elites is a relatively new phenomenon. Most elites use fluids and no gels, and it has been observed that most elites consume only a small fraction of the fluid in their personal bottles. Finally, when blood sugar readings have been taken from elite athletes after marathons, it is typical for those readings to be abnormally high, not low.

As for the fact that elites like Kipchoge are big carb consumers during races? That makes perfect sense. If your stomach can tolerate it, why not take extra as an insurance policy. I don't believe anyone is suggesting that extra carbohydrate is BAD. Elites (and average joes) do a lot of things that might help but are unlikely to hurt. If your livelihood depends on your performance, why take a chance? On the other hand, if there's a very good reason you can't take carbs, then it's worth considering whether that inability is going to present an insurmountable handicap. I submit that it's unlikely to do so.

So, yes, there's a ton we don't know, but it seems likely that for the marathon at least, carbs are not a huge problem. Ignoring carbs entirely could certainly be disastrous, but there are multiple ways to get to the finish line with plenty left in the tank. It would be a totally different story, I expect, if we were talking about bicycle racing or long course triathlon.

This is just silly. A CGM isn't an a training intervention; it's a measurement tool used to acquire evidence. I agree that there's no particular reason for most athletes to use a CGM, but if a particular athlete has a demonstrated inability to manage blood sugar during prolonged exercise, it would be idiotic not to get more data.

I have this; solution for me is complex carb gels and fluids (CarbBoom, Gu Roctane, Hammer drinks). Also skip simple carbs pre race.

This is called reactive hypoglycemia. To fix: less
carb esp simple carb. I am a doc for this foundation and a runner. More
protein and fat. Creates stable blood sugar.
https://hypoglycemia.org/
a blog i wrote years ago on the use of continuous glucose
monitors to sort it out.
https://hypoglycemia.org/libre-liberation/
Dr Mark Cucuzzella

Yes, I used to have bouts of hypoglycemia. As I got older, it got worse. It's apparently hereditary in my family.

A donut in the morning would result in a major crash in 2-3 hours. Even sugar in my coffee would cause problems. Interestingly, when I checked my BG, it would be in the low-normal range, not clinically low, but the symptoms would be severe... dizziness, mood swings, brain fog, loss of appetite, performance declines, and fatigue.

I "cured" it by starting my day with MCT oil. Healthy oils stabilize blood sugar levels. As a bonus, these reduced swings in blood sugar also reduce cravings for sweets. Paradoxically, adding high calorie oils to my diet resulted in fewer calories from carbs so I didn't gain any weight.

I would bet that she has eliminated most oils in her diet. Carbs can lead to spikes and then crashes... rebound hypoglycemia.

Anyway, my suggestion would be to take a tablespoon of MCT oil in the morning. She can add it to her morning coffee and blend it. It's surprisingly good.

MCT oil is a specific C-8 medium chain triglyceride found in coconut oil.

I can provide more details if desired.

She has an eating disorder which complicates things. The way to treat her condition is to admit her problem and start treatment for it. I don't doubt that she has reactive hypoglycemia, but that's a symptom of the actual cause of her problems, not the actual problem. Anyone that cannot see she has an ED is blind and just enabling her.

I am curious, does everyone underweight by reference to the BMI ranges have an eating disorder regardless of the reason they are underweight?

I am also curious as to whether anyone overweight defined by the BMI ranges also has an eating disorder and if not why?

I do not get why people think their experience as hobby joggers is in any way relevant for Eilish McColgan.

No BMI normal range(18.5-25) is only supposed to cover 95% of the population, assuming a heathy lifestyle.

i.e if everyone was healthy 2.5% of people would still be over/under the normal range.

taller people tend to have lower Bmis, as do women. So I wouldn’t be surprised if Eilish has a bmi of around 17. In some people this can still be considered healthy for the aforementioned characteristics.

Reading this thread again, I think that if I personally was having this problem, I would look into fueling like the Tour de France riders. Some of them are taking a ketone drink. It's not the same as zero carbs; it's something called ketone esters.

I don't remember the details since I only briefly looked into it. The science (and lack of it) was interesting, but, IIRC, it was about $30/serving. Since I'm not a pro and not rich, that's outside my price point as a workout supplement. If I were looking for the edge at the pro world class level, then I'd definitely look into it.

Bodies respond differently to extreme endurance exercise so why not test a ketone ester on some long runs?

Since some posters here are search engine challenged, here is the one I heard about during the TdF. It's not as expensive as I thought, but it's still $22/serving. There are other brands.

thefeed.com

TdeltaS Ketone Ester Delta H

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I will not offer my opinion on whether Eilish should run without nutrition or not, as I am aware that my experience as a sub hobbyjogger wont matter at all. In the article she even states that her mum (also an elite runner) used to run without much intake of nutrition and water. She is aware of the possibilities my fellow hobby joggers!

I wouldn’t read to much into her withdrawal from London, I was 99% sure it would be the case but wasn’t sure what the reason would be.

She has just come off 3 championships back to back and performed really well in 2 of them after a bout of covid before worlds. There is no way she would have been able to prepare in the little time left to get the long runs and marathon specific work in to perform over the last 6 miles of the marathon.

Smart call and it will be good to see her in April next year with a proper build up.