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There is a very intricate dance going on inside you twenty-four hours a day. You probably never stop to think about it, and may not even be aware of it. However, when one of the dancers misses a step, it can throw the whole performance out of whack and affect every part of your body.

Hypoglycemia

Dr. Loretta Lanphier, ND, CN, HHP, CH

There is a very intricate dance going on inside you twenty-four hours a day. You probably never stop to think about it, and may not even be aware of it. However, when one of the dancers misses a step, it can throw the whole performance out of whack and affect every part of your body. I am referring to the process of keeping your blood sugar level within the proper parameters. Many organs of your body are involved, but what you put into your body can have a great impact on this balancing act. 

What is Hypoglycemia?

Hypoglycemia, which literally means “low blood sugar,” is a condition that is characterized by blood glucose levels that are below normal. Because glucose (blood sugar) is the main energy source for the body, hypoglycemia leaves the body in a state of instability at the cellular level and beyond.

 

Normally, the body maintains glucose levels within a specific range through a complex effort of several glands that produce appropriate amounts of the hormones necessary to accomplish the task. These hormones include insulin, glucagon, epinephrine (adrenalin), norepinephrine, and growth hormone. However, if any of these interactions are not operating properly, low blood sugar (hypoglycemia) may occur. Symptoms of hypoglycemia range from minor to extreme, and severe cases can potentially result in coma and death.

 

What Causes Hypoglycemia?

Carbohydrates are the main food source that your body needs to produce glucose. Glucose is manufactured in the liver, and then absorbed into the blood stream to provide fuel to your cells and organs. A hormone called insulin is needed in order for glucose to be absorbed by your cells. Insulin is released by the pancreas, which is located behind your stomach. Insulin acts as a key to unlock your cells and let glucose in, and it also regulates the amount of glucose that your liver puts out. Thus, insulin also helps to keep your blood sugar level from getting too high (hyperglycemia), which can be just as dangerous as hypoglycemia.

 

One way that hypoglycemia occurs is when too much insulin is produced and released into your system. This condition is known as hyperinsulinemia, and when this happens the existing glucose enters your cells, but the excess insulin keeps your liver from releasing more glucose into your bloodstream. The result is hypoglycemia.

 

Insulin also plays a key role in how the liver works to help control blood sugar levels. After eating, your insulin levels normally increase. At this point, the liver takes in excess sugar and stores it in a form called glycogen. This glycogen is broken down by the liver into a form of glucose that the cells can absorb, in a process known as glycogenolysis. The liver releases this newly available glucose into your bloodstream between meals, when your insulin level drops. This is how the body fine-tunes your glucose level to keep it within a narrow range that is necessary for the body to function properly. If your system has too much insulin, the whole process breaks down and hypoglycemia occurs.

 

Another way that hypoglycemia can arise is when the production of glucose is not adequate. Besides the process of glycogenolysis mentioned above, the liver is also normally capable of producing glucose through something called gluconeogenesis. This is primarily accomplished in the liver, but the kidneys are involved as well. If gluconeogenesis is disrupted, it will also contribute to hypoglycemia.

 

As you can see, maintaining proper glucose levels is a delicate maneuver that requires great teamwork within the body, and involves many factors. Researchers still do not fully understand all the complexities, but there are some common conditions that trigger hypoglycemia in most people. There are three major types of hypoglycemia:

• Diabetes-related hypoglycemia:  The majority of hypoglycemia cases are of a type referred to as “drug-induced hypoglycemia,” and result as a complication of diabetes. All diabetes patients are at increased risk for hypoglycemia, but those who must inject insulin in order to control their glucose level (insulin-dependent diabetics) are at a greater risk. Since they must artificially adjust their blood sugar level, the chances are greater for mistakes. In insulin-dependent diabetics, hypoglycemia is also called insulin reaction or insulin shock. Insulin shock can be the result of several different scenarios:

 

ü       Too much insulin:  The patient overmedicates, and injects too much synthetic insulin

ü       Too little food:  Not enough food is eaten to balance the amount of insulin injected

ü       Missed meal:  The patient goes too long without a meal or totally skips one. Insulin-dependent diabetics must follow a strict schedule both for eating and medication.

ü       Exercise:  Overly strenuous physical activity can also trip a hypoglycemic episode in a diabetic.

ü       Alcohol:  Too much alcohol is dangerous for diabetics, and can cause hypoglycemia. Alcohol would best be avoided altogether, but if you choose to drink, be especially careful if you are diabetic.

 

Hypoglycemia in an insulin-dependent diabetic can be severe and life threatening, resulting in convulsions, coma, and even death on rare occasions.

 

• Reactive hypoglycemia:  Also known as “ideopathic hypoglycemia” or “postprandial hypoglycemia,” this type strikes some folks after they eat. Symptoms of reactive hypoglycemia are not usually as severe as they often are in diabetic-related cases, and some researchers believe that reactive hypoglycemia may technically be a precursor of diabetes that indicates a greater susceptibility for future full-blown diabetes. The mechanics behind reactive hypoglycemia are not fully understood, and no single factor has been clearly identified. However, some patterns have been observed:

 

ü       Many folks who experience reactive hypoglycemia have disorders of the liver, pancreas, adrenal glands, or the pituitary gland. These particular conditions are not related to diabetes, so it appears that somehow the delicate balance of blood sugar regulation is disturbed in these patients in a way that is not yet understood.

ü       Children who have inherited certain defects in their digestive system are also prone to hypoglycemia.

ü       Kids who have intolerance to a natural sugar called fructose (found in honey, many fruits, and some vegetables) also have a tendency towards low blood sugar.  

ü       Some children who have negative reactions to aspirin also have a high incidence of hypoglycemia.

ü       Adults and kids who have galactose intolerance, the inability to properly digest a sugar found in milk called galactose, also struggle with reactive hypoglycemia.

 

• Fasting hypoglycemia:  Perhaps the rarest type of hypoglycemia, this can occur in otherwise healthy people who go for long periods without food, and sometimes is experienced by marathon runners as well. Not everyone who fasts or runs a marathon will develop hypoglycemia. In fact, fasting and running marathons can be very good for you, and are not harmful for most people.

 

Why does fasting hypoglycemia, and other types, affect some folks and not others? Researchers think it has to a lot to do with long term lifestyle and diet choices that individuals develop over time. Cell sensitivity can increase as we consistently “program” our bodies with such things as diet, stress levels, exercise patterns, and other habitual behaviors. For example, prolonged periods of eating foods that are high in simple carbohydrates, which is so prevalent in the United States and other Western cultures, may change the way our cells react to the many blood sugar regulators that are at work within us. Simple carbs are quickly absorbed by the body, blood sugar spikes, excess insulin is released, and the blood sugar drops to hypoglycemic levels. Throw in a sedentary lifestyle that is off the stress charts, and we have a formula for disaster. One of the casualties of these unhealthy choices is an extremely high rate of diabetes and hypoglycemia. Diet is a huge factor with many illnesses, and it is critical when it comes to managing hypoglycemia. What we eat and don’t eat can cause hypoglycemia, as well as prevent or control it. Even the amount of food we consume is a factor. Many peoples of poorer cultures have very high amounts of carbohydrates in their diets. They can’t afford the foods that are so common to us such as meat and dairy products (probably to their benefit). But the carbohydrates they do eat are generally of the complex and whole grain variety, and they simply do not eat as much food as we do. Combine this with a lifestyle that is rich in physical labor, and they are often much healthier than we are. Reminds me of the old Chinese proverb: “Westerners dig their own graves with a knife and fork.” Okay, I’ll hop off my soapbox for now and return to the topic at hand…

 

What Are the Symptoms of Hypoglycemia?

As I mentioned above, the symptoms of drug-induced hypoglycemia can be severe and life threatening. They are quite similar to an extreme shock reaction. Common ones may include:

 

• Cold, clammy skin

• Pale skin

• Dilated pupils
• Excessive sweating
• Trembling hands
• Fainting
• Excessive hunger
• Heart palpitations
• Headache
• Depression
• Apprehension or anxiety
• Emotional outbursts
• Suicidal tendencies
• Crying spells
• Mental fogginess
• Double vision or blurred vision
• Seizures (rare)
• Sometimes bizarre emotional behavior can be mistaken for and misdiagnosed as psychological in nature.

 

Reactive hypoglycemics generally experience less intense signs, such as:

 

• Extreme fatigue
• Extreme sleepiness
• Unplanned naps, especially after eating
• Mental cloudiness
• Muscle weakness
• Muscle pain, especially in the neck and shoulder
• Forgetfulness
• Headaches
• More frequent urination
• Skin inflammations
• Ringing in the ears
• Abdominal pain

 

If you suspect that you have hypoglycemia, go to your health care provider and have your blood glucose measured with a simple blood test. It requires fasting for twelve hours before testing, and readings below 50 mg/dl may indicate hypoglycemia. Keep in mind though that “normal” glucose levels will vary from person to person.

 

How Can Hypoglycemia Be Treated?

As we learned earlier, diet is probably the most important factor in preventing or managing hypoglycemia. Eating a diet high in whole grains, vegetables, and some fruits is very beneficial. Be careful of any processed foods, and stay away from simple carbs like white rice, white bread or sugar. Some sweet fruits should be limited, such as citrus and bananas. But eating them in balance should be fine. Tip:  Apples are a wonderful food for hypoglycemics. They are slowly digested, and a steady source of complex carbohydrates.

 

Some folks find that consuming candy or glucose tablets can help stabilize their blood sugar. However, it is better to eat whole foods and get your sugars and carbohydrates that way if possible. It might take a while, but changing your eating habits can help to keep your blood sugar to stay in check for the long term.