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

Instead of reliance on gels, has she considered the full-blown carbo-loading regimen (with depletion phase) of Ron Hill?

She’s pretty thin. Probably doesn’t have a lot of muscle mass to hold all of those carbs.

I wonder how many people even know what that is these days.

Believe it or not people have run marathons without energy drinks and gels.

She also may want to pay special attention to the glycemic index of the carbs consumed in the loading phase.

You know Hill was a prolific racer. So he had prolific experimentation on himself.

But you don’t know the size of her liver and brain. :)

Fueling is not necessary. I ran my one and only marathon (a 2:19) with no fuel or water.

Indeed - haven't people run 2:07 with only water.

Typically, younger and thinner athletic folks' muscles at a cellular level are more receptive to insulin than older, heavier people. For most people who have hypoglycemia, nutritionists will advise weight loss, regular exercise and dietary changes that replace simple carbs with complex, fiber-rich carbs, as well as including protein and healthy fats with carbs to slow down the rate at which sugars get into the bloodstream.

It is good that McColgan is working with nutritionist who has elite distance athletes as clients. She'll clearly have to experiment with different fueling and refueling strategies, maybe taking carbs toward the end of a race or literally as soon as the race ends in order to avoid an insulin-induced blood sugar crash. I hope she can figure it out.

Simple:

twizzlers

I’m far from elite and don’t use gels or whatever for marathons. I carry them as a fail safe but strictly use water or whatever electrolyte drink is on course. It can be done. But I’m not eilish with a full staff monitoring me. I’m sure whatever the bone heads here can think of, her coaches have tried.

Yes, we get it that it's possible to run a marathon well without gels or replacement drinks - or anything at all for that matter. Personally, I ran my best marathon with maybe one quick chug of a few ounces of drink, which I could have done without.

However, the question is, can you compete with the very best using that strategy? What do the current top marathoners do for fueling? Does Kipchoge, for instance, go without any fuel during his marathons? I was under the impression he takes in some fluids and fuel.

It's easy to say "hey, Steve Jones (or Salazar, or whoever) didn't need gels or replacement drinks". Fair enough. But they ran 2:08. Improvements in many areas have allowed today's elites to run faster than that (even before the shoes became a big thing). Perhaps fueling and staying better-hydrated is part of the reason?

The point is, I'm sure McColgan could run a good marathon while abstaining from all caloric intake, but would it be good enough? If it costs her even a minute or two, that's going to be huge at that level of competition.

Lots of people know how to treat this but we're free loaders on a free message board that she isn't even asking on.

She should talk to a real life endocrinologist. It could be as simple as regulating her insulin.

Has anyone won a major marathon in the last 25 years without an energy drink or gel?

I doubt it.

If you are a woman, that's relevant. If you are a man, please consider the McColgan is likely aiming higher than the female equivalent of 2:19.

Good point, and yes I totally realize that she is far above my level and has a goal that is definitely much faster than the female equivalent to a male running a 2:19. I never even broke 16 in the 5k in college. I was in no way shape or form comparing our abilities and saying they are similar. However, I do not think fueling is completely necessary. I don't believe I would have run faster if I had taken in any fluids or fuel. It's how I trained, I was comfortable with it, and my stomach gets easily upset when I tried doing anything. Noticed no difference on longs runs/workouts. That's all I was saying. Hope she figures it out.