Reactive hypoglycemia (RH) may arise from a variety of causes including insulinoma, noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS), post-bariatric surgery hypoglycemia dumping syndrome, insulin autoimmunity and postprandial syndrome (1). Cell mutations have also been documented to result in increased insulin secretion and subsequent hypoglycemia (2,3). Even rarer, congenital enzyme deficiencies can cause RH, such as hereditary fructose intolerance, galactosemia,