What could be the cause of my reactive hypoglycemia only after first meal

Does anyone have an idea what could be causing my reactive hypoglycemia? it only happens after my first meal. I started right around when I started antibiotics. Im on the stabilization period with Dr J so I am not on any antibiotics but the hypoglycemia is still there. Is there a chance I have an insulinoma? Or is it lyme just attacking the pancreas? How do I fix this because it doesn't allow me to be functional at all.

I mentioned it to them yes. His recommendation was to see what happens while im off antibiotics during my stabilization period. He said inflammation of constantly killing can cause this. But im not sure if nothing changes I will call them

Inflammation or adrenal stress can end up causing insulin resistance or damaging your pancreas.

When you say 'reactive hypoglycemia', was low glucose actually measured on a blood test, or do you just feel yucky? Insulin resistance can make you feel like your blood sugar is low when it actually isn't. If that's the case, you could try taking metformin to see if that helps.

Antibiotics like rifampin can stress your adrenals, but if you're having symptoms when not taking antibiotics, it might be worth getting blood tests for homocysteine and 17-hydroxyprogesterone to look for common adrenal issues (ie MTHFR and 21-hydroxylase deficiency). You can get a cortisol test too, but the normal range of cortisol is wide enough that this won't show an abnormality unless the cortisol is very far out of range, so this often isn't a useful diagnostic test.

Ultimately I solved this problem with a combination of hydrocortisone, naltrexone, and valproate.