Northampton Wellness, Associates, LLC

HANDLING YOUR HYPOGLYCEMIA

Q: I have been experiencing a real lack of energy over the last few months. Sometimes I feel fine, but at other times I feel really sleep and lethargic. At those times I often have to fight the urge to close my eyes and take a nap. I may become irritable, depressed, or easily frustrated. Sometimes I get headaches and blurry vision, or may feel dizzy and light-headed. These feelings seem to come on in the late morning or mid-to-late afternoon. What can I do about it?

A: Although there are many possible causes of fatigue, the pattern and timing of your symptoms strongly suggest that you may be experiencing reactive hypoglycemia: low blood sugar. There are several effective remedies for this condition. To understand these, we need to take a look at how our bodies create, store and work with energy.

It all starts with food, which comes in three basic categories: carbohydrates, proteins and fats. Each of these can be broken down into the simple sugar, glucose, which our muscles and organs use as a basic source of energy – it’s the gas that keeps the engine running. If we eat sugar, it’s converted into glucose so quickly that our blood sugar goes up quite sharply to a relatively high level. This explains the “burst” of energy that sugar seems to give us.

Unfortunately, our bodies do not function well on too high a sugar level, so the pancreas responds by secreting a hormone, insulin, which acts in several ways to bring it back down. With a sudden rise in blood sugar, the pancreas can overreact with too much insulin – this brings the sugar level too low, and we may start to feel woozy. Our adrenal glands will respond by putting out stress hormones that stimulate the secretion of a hormone called glucagons. Glucagon tells the liver to break down glycogen (a storage molecule) into glucose to raise the blood sugar again.

This whole process puts a lot of strain on the adrenals and also the pancreas. The adrenal strain makes it harder for our bodies to cope with stress. The strain on the pancreas may predispose to diabetes from a lack of insulin (and decreased responsiveness to insulin) later on.

It’s clear that we can help prevent the whole process by, first of all, avoiding simple sugars in our diet. This especially includes refined sugar, which is broken down into glucose most quickly, but it usually also means avoiding honey, molasses and maple syrup as well. All fruits have natural sugars in them – some folks may need to take other foods that are broken down more slowly along with fruits, so as to lessen the chances of any ill effects.

Protein is one type of food that is broken down more slowly than simple sugar. After eating a protein food, we generally get a gradual rise in blood sugar, and then a gradual decline over several hours. This gives us the energy we need to function well and feel good, without involving the adrenal/stress hormone cycle. Most adults do well by making sure they get a good helping of protein at three meals a day, plus a protein snack every two to four hours (depending on how quickly their hypoglycemic symptoms may appear). Susceptible children may need even more frequent feedings. Good sources of protein are soy products, nuts and seeds, fish and poultry. Dairy and eggs, if tolerated and taken in moderation, are fine for most people. Natural food stores have a high-protein derivative of wheat called seitan. Another useful item is protein powder, for those on the go (make sure it’s sugar-free!). Also, delicious high protein pasta is now widely available.

Complex carbohydrates can also an important part of the diet for those who are hypoglycemic. These release glucose into the blood stream more quickly than proteins, but not as rapidly as simple sugars. What they especially provide is fiber, which has been shown to improve insulin responsiveness, even in advanced cases of diabetes. That’s why white flour and white rice should be avoided in this condition – these refined carbohydrates are lacking in fiber. Whole grains and starchy vegetables are good sources of complex carbohydrates with plenty of fiber, and should be part of every meal, for those who tolerate them. Some people do better without carbohydrates, however. It all depends on you “metabolic type”, which your medical practitioner can help you determine.

Another useful nutrient is chromium. This trace element is essential for proper sugar metabolism – it acts as a cofactor (helper) in several key enzyme reactions. Many hypoglycemics and even diabetics can benefit from supplementing their diets with added chromium. Good food sources include nutritional yeast, whole wheat bread, beets, mushrooms, cheese, clams, and corn oil.

B-complex vitamins, vitamin C, and zinc are essential to helping the adrenal glands function properly, especially under stress. These nutrients are present in a variety of foods, particularly whole grains, seafood, fresh fruits and vegetables. Even with a good diet, however, supplementation in higher doses is often extremely helpful for those with this problem.

Another way to get the adrenals going is through exercise. First thing in the morning is the best time to wake up those glands – they respond to the increased oxygen demand of aerobic exercise. One effective program begins with a glass of juice (remember, no added sugar!) shortly after arising. Then get 10-20 minutes of exercise, followed by a solid breakfast, including all of the nutrients we have discussed. This will really help you get through the day!

We need to bear in mind that there are many possible causes for fatigue, irritability, headaches, or dizziness. It may not all be due to hypoglycemia, although it is often a factor along with other possible causes. A real key to the diagnosis is the pattern of the symptoms, usually coming 2 to 4 hours after meals.

If we want to confirm the diagnosis, a Glucose-Insulin Tolerance Test can be done. For this test, you would fast for 8 hours (this is easiest overnight), and then a blood sugar level is drawn. Then you drink a special preparation which contains a measured amount of sugar. Hourly blood sugar levels are then drawn over the next 6 hours. In hypoglycemics, we see one of several confirmatory patterns – all of which feature a drop in sugar well below normal at some point in the 6 hours. These results can help us fine-tune the therapy. But it is so much easier just to try the diet and supplement program. If you have hypoglycemia, you will feel better within a week or two, most of the time. For this reason, the Glucose-Insulin Tolerance Test is rarely, if ever, needed.

Food or environmental sensitivities may also cause these symptoms with or without accompanying hypoglycemia. This problem appears to be quite prevalent nowadays, resulting in a wide range of ill effects, sometimes severe. The offending agent can usually be identified after a thorough investigation (see our food allergy article for more information).

Other possible causes of your symptoms, such as anemia, thyroid, or neurological diseases can be ruled out with the help of your physician. However, your success in overcoming this problem is mostly dependent on your own efforts in effecting lifestyle changes. It may be hard to change at first, but it’s easier to stick with your program once you see how much better it makes you feel!