Hypoglycemia


	Hypoglycemia

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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | It can lead to... | Recommendations


	Hypoglycemia is a general term used to describe a mixed bag of symptoms that are due to a derangement of glucose metabolism. Under the strict medical definition, hypoglycemia mainly refers to a drop in fasting blood sugar below 50mg% (normal range 70-90mg%). This drop can be associated with differing symptoms depending on the rate at which the blood sugar falls. The causes of functional or reactive hypoglycemia (not absolute or fasting hypoglycemia) can be divided into 3 categories: High sugar / refined carbohydrate diet leading to hyperinsulinism Hypoadrenalism-stress leading to adrenal exhaustion Alimentary or gastric surgery leading to rapid stomach emptying or "dumping syndrome." A Glucose Tolerance Test (ideally lasting 5-6 hours) can confirm a diagnosis, but more alternative doctors are forgoing the inconvenience and shock to the system because symptoms alone are reliable enough. Central nervous system changes, adrenal hormone output and detoxification (what the body tries to do when it is not busy digesting food) also contribute to the overall symptom picture. There are different interpretations given to different patterns seen on glucose tolerance testing. One such system describes three types of curves: Type 1 (Neuroglycopenic) This type results in a rapid rise in blood glucose within the first hour followed by a pronounced or precipitous drop in blood glucose in the second hour. Symptoms of this type of response are rapid mood swings, volatile personality, erratic behavior before and after eating. Possible cause of this response is gastric dumping, too large an insulin response (pancreatic problems) and glucose tolerance factor problems (liver problems). Type 2 (Adrenergic Type) After ingestion of glucose the blood sugar rises for the first three hours followed by a hypoglycemic rebound at 4 to 6 hours. Symptoms associated with this type of response are tiredness 2 hours after eating, allergic responses or food intolerances, and shakiness before meals. When blood sugar falls rapidly, the early symptoms are those brought on by a compensating secretion of adrenalin; these include sweating, weakness, hunger, racing pulse and an "inner trembling". This response can be due to adrenal cortical insufficiency or thyroid deficiency. Type 3 (The Flat Curve Response) In this case the blood glucose does not deviate more than +/- 15% from fasting level through the whole test. Symptoms that may appear are fatigue, apathy or hypotonia (poor muscle tone). These symptoms are due to poor digestion and absorption of nutrients. Patients with hypoglycemia of varying causes appear to show similar personality patterns, suggesting hypoglycemia can cause personality disorders. The term "hypoglycemia" may be better named "carbohydrate intolerance syndrome" and treated accordingly.

Signs, symptoms & indicators of Hypoglycemia:

Symptoms - Allergy

(High) intolerance of sugars

Counter-indicators:

(High) tolerance of sugars

Symptoms - Cardiovascular

Heart racing/palpitations

Symptoms - Food - General

Strong appetite

Hunger is a symptom of hypoglycemia.

Symptoms - Food - Preferences

Afternoon sugar craving

Craving but not/craving and eating wheat

Symptoms - General

Frequent fatigue/fatigue that is relieved by eating

General dizziness

Fatigue that worsens during the day

Poor bodily coordination

Dizziness when standing up

Counter-indicators:

No fatigue relieved by eating

Symptoms - Head - Eyes/Ocular

Seeing visual halos

Vision disturbances

Blurred vision and diplopia (double-vision) are possible symptoms.

Symptoms - Head - Mouth/Oral

Being an incoherent speaker

Symptoms - Metabolic

Adverse/moderate/mild reaction to delayed meals

Inner trembling

Difficulty losing weight

Afternoon headaches

Low stamina

Front-of-head/temple-based headaches

(Occasional) daytime sweating

Counter-indicators:

No reaction to delayed meals

Symptoms - Mind - Emotional

Depression with anxiety

Impatient/hostile disposition

Uncontrolled rage is a possible symptom.

Emotional instability

Symptoms - Mind - General

Periods of confusion/disorientation

Short-term memory failure

Trouble concentrating

Symptoms - Muscular

Tightness across shoulders

Symptoms - Nervous

Numb/tingling/burning extremities

Symptoms - Reproductive - Female Cycle

Carbohydrate craving during cycle

Symptoms - Skin - General

Excess perspiration

Symptoms - Sleep

Unsound sleep

Conditions that suggest Hypoglycemia:

Addictions

Addictions / Addictive Tendencies

A craving for cigarettes and/or drugs is a possible symptom of hypoglycemia.

Allergy

Allergies Indoor

Diet

Sugar Craving

Hormones

Low DHEA Level

Insulin levels may play a significant role in determining how much DHEA is metabolized. Studies have discovered that low levels of DHEA may be related to an excess of insulin. What this suggests is that anyone suffering from hypoglycemia or excess insulin may be prone to converting nutrients to fat due to depressed DHEA levels.

Mental

Depression

Endogenous depression - depression originating from within as opposed to being due to external factors - is a known symptom.

Anxiety

Poor Memory

Temporary forgetfulness is a known symptom of hypoglycemia.

Metabolic

Headaches, Migraine/Tension

Although hypoglycemia may precipitate headache in some diabetic and nondiabetic patients, it is not a universal mechanism responsible for headache in those individuals or in normal fasting subjects.

Tinnitus

Musculo-Skeletal

Restless Leg Syndrome (RLS) / Periodic Limb Moveme

Based on afternoon glucose tolerance testing, many patients with RLS - particularly if they also have spontaneous leg cramps - appear to have hyperinsulinism causing functional ‘hypoglycemia’ during testing. In fact, some patients may have an attack of muscle cramps at the same time as their lowest level of plasma glucose. In an open trial, a group of 350 patients with this type of glucose tolerance curve were placed on a sugar-free, high protein diet along with frequent nibbling and at least one night feeding. The vast majority experienced a prompt remission or, at least, a striking reduction in symptoms. [J Med Assoc 60(5): pp.29-31, 1973]

Muscle Cramps / Twitching

As hypoglycemia progresses a variety of symptoms can occur including muscle twitching. Amongst 300 patients in one study (185 female, 115 male) found to have relative hypoglycemia (a drop of 20% or more below the fasting blood sugar level during a 6-hour glucose tolerance test), 23% had muscular twitching or cramps.

General Weakness

Nervous System

Tremors

Early symptoms of hypoglycemia, such as hand tremors, are similar to those which occur as the result of experiencing a sudden and violent fear.

Organ Health

Counter-indicators:

Diabetes Type II

Skin-Hair-Nails

Night Sweats

Nighttime hypoglycemia may be without symptoms or manifest itself as night sweats, unpleasant dreams or early morning headache.

Risk factors for Hypoglycemia:

Environment / Toxicity

Heavy Metal Toxicity

Heavy metals such as mercury, cadmium, lead and thallium poison the glucose metabolizing catalysts, thus reducing the flow of energy throughout the body. It is interesting to note that the symptoms of heavy metal poisoning are similar to symptoms associated with hypoglycemia i.e. hyperactivity, mood swings, manic depressive behavior, poor concentration and impulsive and unpredictable behavior.

Mercury Toxicity / Amalgam Illness

Hormones

Hypothyroidism

Patients suffering with Wilson's Syndrome, a form of hypothyroidism, occasionally experience intense and previously unfamiliar cravings for sweets. The low body temperature patterns may affect the function of enzymes involved in glucose metabolism that could result in lower blood sugar levels which might contribute to sweet cravings.

Lab Values - Chemistries

Counter-indicators:

(Slightly) elevated fasting glucose

Metabolic

Pyroluria

Symptoms - Food - Intake

(High) refined sugar consumption

Symptoms - Head - Ears

History of tinnitus

Symptoms - Mind - General

Counter-indicators:

Absence of short-term memory loss

Uro-Genital

Consequences of Vasectomy

Hypoglycemia can lead to:

Diet

Sugar Craving

Mental

Schizophrenia

Numerous patients given psychiatric diagnoses have actually turned out to have hypoglycemia, including those classified with depression, bipolar disorder and schizophrenia.

Recommendations for Hypoglycemia:

Amino Acid / Protein

Glutamine

Glutamine plays a vital part in the control of blood sugar. It helps prevent hypoglycemia , since it is easily converted to glucose when blood sugar is low.

Botanical

Stevia (Stevia rebaudiana)

If you must use sweeteners, stevia is an excellent natural alternative to simple sugars and unhealthy chemical alternatives.

Chlorella / Algae Products

Diet

Sugars Avoidance / Reduction

Consuming foods that contain simple sugars makes the problem worse. Avoid sweets other than fresh fruits, if tolerated. In addition, consider avoiding products that only "taste" sweet (artificially sweetened - low calorie). Even though they may contain no sugar, sending signals to your brain that something "sweet" is being consumed may have negative consequences.

Processed Foods Avoidance

Refined carbohydrates are more readily absorbed than unrefined, and should be avoided in those with any glucose intolerance.

Smaller, More Frequent Meals

Frequent small meals are more effective in stabilizing blood sugar levels than large, less frequent ones. Remember to consume something before symptoms appear. Protein snacks that keep well should be stored in locations such that you always have quick access to food. You may find it helpful to store protein bars or nuts in your car, at work, in your pockets or (for women) in your purse.

High/Increased Protein Diet

A diet consisting of higher protein and fat with less refined carbohydrates is a standard recommendation for those with hypoglycemia. Hypoglycemics may find it helpful to start with 100gm of protein or more per day. With increased protein consumption, protein digesting enzymes may need to be supplemented. Hydrochloric acid, which is usually produced by the stomach for the breakdown of food (especially protein) may be needed also.

Grams of carbohydrate can be counted, limiting them to a maximum of 100gm per day. Some persons feel better on 60-100gm of carbohydrates, adjusting up or downward depending on size and degree of physical labor (More if larger and very active). Eating less than 60gm per day may aggravate a return to undesirable symptoms.

Caffeine/Coffee Avoidance

Avoid all soft drinks, coffee, tea, artificial colors and additives.

Alcohol Avoidance

Drinking alcohol can cause blood sugar to drop in some sensitive individuals. Hypoglycemia has been well documented in chronic alcoholics and binge drinkers.

High/Increased Fiber Diet

Soluble fiber delays gastric emptying, slows glucose absorption, and minimizes blood glucose swings.

Coconut

Therapeutic Fasting

In severe cases, additional methods of support besides diet may be needed and perhaps the best of these is fasting. Fasting is a useful, inexpensive and universally available treatment for hypoglycemia. The fast allows the entire system to restore its cellular integrity.

Increased Fruit/Vegetable Consumption

Fruit contains several things that are of benefit, including a sugar (fructose) that does not cause wild glucose swings, trace minerals, and fiber which slows glucose absorption. However, some people find that fruits do make their glucose intolerance worse. Vegetables, especially low starch vegetables like tomatoes, green leafy vegetables, broccoli and carrots are low in carbohydrate and high in nutrients.

Grain-free / Low Starch Diet

As a dietary priciple, simply avoiding grains and foods made from grains should go a long way toward preventing low blood sugar events in those with reactive hypoglycemia

Habits

Aerobic Exercise

Moderate exercise improves glucose metabolism. Those few individuals who find that strenuous or prolonged exercise causes hypoglycemia should take food at the earliest opportunity.

Lab Tests/Rule-Outs

Test Glucose Tolerance

The six hour oral glucose tolerance test is normally used to determine the type and magnitude of the glucose intolerance.

Mineral

Chromium

Chromium status should be optimized for its benefit in carbohydrate disorders (both hypoglycemia and adult-onset diabetes). Studies have shown that chromium supplementation is helpful with hypoglycemia and can improve glucose tolerance test results and increase the number of insulin receptors on red blood cells.

A research team, which included scientists from Georgetown University in Washington, D.C., tested chromium's effects in humans by adding chromium chloride to the diet of 17 men and women, eight of whom had mild glucose intolerance, a condition that precedes diabetes.

During the 14-week study, all participants ate a baseline, chromium-poor diet containing less than 20 micrograms of the metal per day. This is similar to the amount consumed by 25 percent of Americans, Anderson says, noting that the recommended daily allowance ranges from 50 to 200 micrograms.

After four weeks, the researchers divided the volunteers into two groups. One group continued to eat the low-chromium diet, supplemented with daily doses of 200 micrograms of chromium; the other group stayed on the diet but received only placebo pills. Five weeks later, the groups were switched.

In seven of the eight people with glucose intolerance, tests taken an hour after they drank a sugary liquid showed that blood sugar levels rose nearly 50 percent less during chromium supplemention than at the outset of the study or during the unsupplemented baseline diet. In the 11 glucose-tolerant patients, the varying consumption of chromium had no effect on blood glucose levels
, Anderson notes. This selective reduction, he says, indicates "chromium can reverse glucose intolerance."

Glucose-intolerant participants also showed lower circulating levels of insulin and glucagon
-- a pancreas-secreted compound that opposes insulin's action -- during chromium supplementation than at any other point in the study.

Vitamins

Vitamin Niacinamide

KEY

		Weak or unproven link
		Strong or generally accepted link
		Proven definite or direct link
		Weakly counter-indicative
		Strongly counter-indicative
		Very strongly or absolutely counter-indicative
		May do some good
		Likely to help
		Highly recommended

GLOSSARY

Adrenal Insufficiency: Also known as Adrenal Exhaustion or Low Adrenal Function, this is a condition where the adrenal gland is compromised in its production of epinephrine, norepinephrine, cortisol, corticosterone or aldosterone. Symptoms include primarily fatigue, weakness, decreased appetite with ensuing weight loss, as well as nausea, vomiting, abdominal pain, diarrhea or constipation, or increased pigmentation of the skin. Cortical insufficiency (low or no corticosteroids) produces a more serious condition called Addison’s Disease, characterized by extreme weakness, low blood pressure, pigmentation of the skin, shock or even death.

Bipolar Disorder: Also known as manic-depression, this disorder is characterized by alternating periods of extreme moods, usually swinging from being overly elated or irritable (mania) to sad and hopeless (depression) and then back again, with periods of normal mood in between. The frequency of the swings between these two states, and the duration of the mood, varies from person to person.

Carbohydrates: The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.

DHEA: Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.

Diabetes Mellitus: A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Enzymes: Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Fasting Blood Sugar: (FBS): Blood is drawn before breakfast (i.e., after fasting), then the glucose (sugar) in the blood is measured.

Glucose: A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.

Glucose Tolerance Factor: (GTF): A compound containing chromium that aids insulin in regulating blood sugar levels.

Hormones: Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Hypoglycemia: A condition characterized by an abnormally low blood glucose level. Severe hypoglycemia is rare and dangerous. It can be caused by medications such as insulin (diabetics are prone to hypoglycemia), severe physical exhaustion, and some illnesses.

Hypothyroidism: Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.

Hypotonia: Lessened tension; arterial relaxation.

Insulin: A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Metabolism: The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Milligram: (mg): 1/1,000 of a gram by weight.

Nervous System: A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.

Protein: Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Schizophrenia: Any of a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. Schizophrenia is associated with dopamine imbalances in the brain and defects of the frontal lobe and is caused by genetic, other biological, and psychosocial factors.

Stomach: A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Thyroid: Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.