Hypoglycemia can lead to a myriad of symptoms, ranging from small annoyances of mild hunger, a bit of brain fog, and tiredness, to major life disturbances such as passing out, fear of being alone, nighttime heart palpitations, and not being able to drive for fear of overwhelming symptoms.
What's worse, fasting might be very difficult if you are experiencing blood sugar crashes or reactive hypoglycemia.
In this post I discuss:
Symptoms of hypoglycemia
Why conventional medicine and nutritional treatments typically don't help
Why we should support adrenal health
Steps to treat and reverse this sometimes debilitating issue!
Hypoglycemia is a true diagnosis, but I believe metabolic inflexibility is at the root cause of hypoglycemia. In most cases of hypoglycemia, your body is not able to process carbohydrates very well and is inefficient at fat burning. When blood sugar starts to fall, signals are sent to the brain to make you eat more carbohydrates and more sugar, because you're so used to constantly burning glucose for fuel from carbohydrates.
We have been taught that our brain requires glucose in order to function, but that is not true. It can run perfectly fine on ketones. The problem is a lot of people are not very efficient at burning fats. If your body is not used to burning fat efficiently as a fuel, you can have a hard time as your blood sugar starts to fall.
It can be difficult to diagnose hypoglycemia, and a lot of people never really get an official diagnosis, but, if you have a lot of the symptoms, chances are you probably have some degree of hypoglycemia.
Do any of these sound familiar?
You get shaky if you don’t eat every couple of hours.
You are always carrying snacks to ward off intense hunger.
You don’t feel well if you aren’t eating carbs frequently.
You have a family history of type 2 diabetes or prediabetes.
You feel dizzy and anxious when you don’t eat frequently.
You never allow yourself to become hungry, so that you don’t get angry and cranky.
These were just some of the symptoms that I faced before I realized I was dealing with mild hypoglycemia. I would also become tired and fatigued after meals. That can be another symptom, as your blood sugar skyrockets, and then falls. What follows is your body releasing a ton of insulin to allow all that glucose into the cells. Because it's released a lot of insulin, the sugar is then out of the bloodstream. Sometimes what follows is a crash in blood sugar, in response to all the insulin. A crash for most people is when your blood sugar falls below 70. This is where symptoms come into play and you feel terrible. Then your body craves glucose and the cycle starts all over again. It can go on, again and again, day after day.
You are chained to eating carbs all day every day, and sometimes even at night.
Don't get too wrapped up in numbers. It's hard to diagnose going off glucose readings alone because people don't normally know their baseline blood sugar. I personally would go more off symptoms, as some people may feel fine at a level of 60 or 70, simply because they're good at fat burning and ketone production is taking over.
Others may feel hypoglycemic at a glucose level of 100 because their blood sugar reading is typically running high at 150-160.
There's a really wide variance of impact with hypoglycemia. Some people can have minor hypoglycemia with mild symptoms and others can have major life-altering symptoms, such as not trusting themselves to take care of a small child or a baby or even to drive.
If you think this could be something you are struggling with, the next question is:
Where do you go from here?
If you think you have issues with hypoglycemia, I recommend getting your fasting insulin level checked. Not all doctors will do this for you voluntarily. You will likely have to ask for it, but it's not an expensive test. If your results are above 5-6 for fasting insulin, you likely have at least some degree of insulin resistance. I've seen people come back at 12, 20, 25 or 30. That is very severe insulin resistance. But if yours is between 2-6, those are good healthy levels.
If you have high insulin all the time and your body's demanding energy all the time, you're going to want to eat all the time. This means your body is really inefficient at utilizing the blood sugar and the blood glucose.
There's no medication for hypoglycemia because it's a blood glucose metabolic issue. So how do you fix falling blood sugar?
There is no pill you can pop. Hypoglycemia is controlled by diet and blood sugar balance. This can be frustrating for medical professionals, especially those conventionally trained, because they can't just give you a script for a pill. Lifestyle needs to be addressed. You have to get to the base root cause of it, and this is why a lot of times it's never addressed correctly.
Unfortunately, even if you are sent to a traditionally-trained dietitian, they will likely instruct you to eat some sort of complex carbohydrate and protein every couple of hours to keep your blood sugar up. While this sounds good in theory, it ultimately feeds the problem and makes it worse, because you're constantly increasing glucose, followed by a rise in insulin. You're not teaching your body to burn fat. This treatment accentuates the problem and is pretty terrible advice, in my opinion.
After checking your insulin levels, the next tip I would give you is to start down the path of actual healing by adding more fat to your diet. When we stop stimulating so much insulin production by decreasing intake of carbohydrates and increasing fat, this will start to bring our insulin levels down. Our bodies stop demanding constant energy, as fat is a slower burning fuel.
You can teach your body how to be more efficient at fat burning. I suggest you slowly start adding more fat to your meals, focusing on the healthful fats of coconut, avocado, and olives or their oils. Butter, tallow, lard, eggs, full-fat dairy, and ghee, which is clarified butter, are great options. You can also start adding in some fattier meats to your diet.
A lot of times we think we need to eat chicken breast and salad to lose weight, but we actually need more natural fats, and adequate protein. Eating chicken with the skin, a higher fat beef, and even bacon are going to help you become more of a fat burner. You want to do this slowly over time, as your body gets better at burning fat. This will naturally help you go longer periods without eating. After that, you'll be able to start fasting longer, and going longer periods of time without food. You will recover from hypoglycemia and start to burn your stored body fat instead of demanding constant carbohydrates.
It is a process and it takes some transition time, but hypoglycemia doesn't have to be a life-altering issue forever.
I want you to think of a fire and how it's really great to start it with something like newspaper and kindling. But... if you don't have logs there to keep that fire burning low and slow, the fire will dwindle. And the fire is going to require more and more kindling to keep it from going out. The newspaper and the kindling is like carbohydrates that burns really quick, because it's really easy to burn. Whereas fat is like a log. This is the low and slow burn that you need to take you from meal to meal. That's why it's so important to have fat at your meals.
Fat is key for reversing hypoglycemia.
We can’t discuss healing hypoglycemia without talking about adrenal support. The whole reason why your body starts to send out signals is because your brain is requiring more energy. If the energy isn't coming in quickly enough, the adrenals start to freak out.
If your blood sugar is starting to plummet and if you're not a good fat burner, your adrenals start to tank and get stressed. Then they are going to increase cortisol in your body, which will tell your body to release more glycogen and increase blood sugar. And this can wear your adrenals out over time. By becoming a more efficient fat burner, your adrenals will be less stressed out.
Another thing that might happen, if you have really severe hypoglycemia, you may wake up in the middle of the night with heart palpitations or labored breathing. Again, treating the adrenals and learning to burn fat as fuel is important because it's the low blood sugar that is waking you up. The glycogen that is stored in your body is being depleted and the adrenals are stepping up to increase the blood sugar, as well as, increase adrenaline.
What you'll likely be told is to eat right before you go to bed and right when you get up. And then if you wake up in that state, you should eat a snack, and pretty soon people are eating 15 times a day. They're eating in the middle of the night and then they're gaining weight because their adrenals are tanked and they are super frustrated!
So again, we need to work on metabolic flexibility and increase natural fat intake. Fat is your best friend if you think you have hypoglycemia because you're going to use that fat as slow-burning fuel. You can also try wearing a continuous glucose monitor (CGM) and seeing what your blood sugar is doing. It shouldn't really switch more than maybe 40 points or so after you eat. By wearing a CGM, you can work on your diet and check into why you're having such major swings in your blood sugar. A CGM can really help you to see what foods are causing you issues.
I want you to know that if you've been dealing with this for a long time, you can reverse it. Your body is not broken.
When you start transitioning and adding more fat, you might not be able to take the carbohydrates down too low at first. It will likely need to be a slow transition. If you're eating 300-400 grams of carbohydrate right now and you're on a low fat, moderate protein diet, you want to increase your fat slowly. Try cutting carbohydrates by 100 over a week or two and see how you feel. I always say try to go at least below 100 g total carb daily, but if you're having severe issues, try taking it slowly down to 50, and then keeping it around 50-100 g total. It is important to give yourself a couple of weeks to a month to transition.
Just know that your body is not broken, you can heal this, there is definitely hope for you! If you want to learn more about hypoglycemia and balancing blood sugars, I encourage you to listen to the companion podcast episode for this blog post. Click HERE to listen now!
Pass this episode along if you know somebody who's suffering from hypoglycemia, reactive hypoglycemia, or insulin resistance.
If you are ready to start healing your body, I can help you get started and even reverse insulin resistance. You can work with me in a couple of different ways, the first being my membership program, click HERE to learn more. If you are looking for one-on-one nutrition coaching, click HERE to inquire.
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