There is a lot of talk about what happens when our blood sugar gets too high, but what about if it is too low? Blood sugar is the metabolic fuel for our body and is closely regulated. Adults have about one gallon of blood in their bodies and are quite surprised to learn that in that gallon, there is only one teaspoon of sugar! If your blood sugar level were to rise higher than that, you could possibly die. But if is too low, it may cause enough symptoms that we might think we could…..Okay, way overly dramatic, but you get my point.

How does the body regulate blood sugar?

When you eat a meal, it gets converted into glucose. When glucose it detected in the bloodstream, a hormone called insulin is signaled to create openings in the cell membrane to bring in the sugar. From there, it is converted by the mitochondria into something called ATP which is the “energy currency” of the body.

If a meal is well balanced, meaning that it contains the appropriate amount of protein, carbohydrates, fiber, and fat, it causes a slow release of sugar and a modest release of insulin. If the meal is too high in carbohydrates, blood sugar spikes causes too much insulin to be released. This tends to drop the blood sugar level well below the pre-meal value signaling the need for more glucose. This causes sugar cravings and perpetuates the cycle.

If our energy needs exceed the amount supplied through diet, our bodies must access stored sources or creates it from scratch utilizing our muscles, fat, etc.

Eventually, the cells get pretty tired of dealing with cyclical high amounts of sugar and quit responding. This signals the release of even more insulin to try to force the sugar into the cells and may lead to insulin resistance and metabolic syndrome.

What are symptoms of Hypoglycemia?

The biggest clue— Eating a meal makes you feel better.

You might also experience:

• Need to eat frequently
• Fatigue between meals
• Energy crash around 3–4 pm
• Sugar cravings during the day especially in the afternoon and after dinner
• Decreased energy between meals
• Irritability, shakiness, anxiety between meals
• Feel lightheaded if meals are missed
• Agitation, easily upset, nervous
• Poor memory and bouts of mental fatigue
• Mood swings
• Difficulty staying asleep
• Feel unrested after waking
• Blurred vision
• Low blood pressure
• Cold hands and feet
• Muscle cramps/swelling
• Dehydration
• Hair loss and weal nails

Did you know there are different kinds of hypoglycemia?

You would think low blood sugar should be easily controlled with diet, but it turns out it is only one of the possible causes.

Clinical Hypoglycemia

This medical condition is often diagnosed in those with consistent blood glucose levels below 65mg/dl. It is caused by pathological disease or medication such as exogenous insulin.

These folks tend to experience blood sugar issues throughout the entire day and often need to eat frequent high fat/protein meals just to function normally.

Please note that with any type of blood sugar regulation, it is also important to rule out autoimmunity involving the brain, pancreas, or insulin.

Reactive Hypoglycemia

Reactive hypoglycemia is form of low blood sugar that occurs one to four hours after eating. Glucose levels are between 66-85mg/dl (and/or LDH <140).

Low calorie dieting, eating junk food or eating greater than a 2:1 ratio of carbohydrates to protein in a meal may lead to low blood sugar levels. As we mentioned before, if you consume a meal too high in sugar, it causes an increased spike in insulin which causes the blood sugar levels to drop below normal levels. Conversely, if you do not eat, it forces the pancreas and adrenal glands to initiate the release of stored glucose or signal conversion of resources into glucose by the liver.

Dietary changes are usually successful in helping to correct this disorder. If there is an issue with digestion, it may be necessary to support with digestive enzymes and possibly HCL and/or gallbladder support. Supplemental fiber may also help slow down the sugar response.

Functional Hypoglycemia

This form is more complicated than the one above as it can be related to diet or some underlying condition. For example, if someone eats infrequently, they may not be able to build up their sugar (glycogen) reserves. Easy fix.

For others, there may be issues with their pancreas or adrenals limiting the body’s ability to access or manufacture glucose when needed. High amounts of stress can also overwhelm adrenals.

In rare cases, overactive insulin receptors drive too much sugar into the cells. Additional underlying causes may include liver, autoimmunity, mitochondria, infections, chemical burden, brain injury, etc.

Fasting blood glucose are the same as the type above with glucose 66-85 mg/dL and/or LDH<140. These folks also tend to experience blood sugar issues throughout the day and will often have to eat frequent high fat/protein meals to function.’

Nocturnal Hypoglycemia

If sleep is disruptive, this can be a sign of nocturnal hypoglycemia. A protein or fat snack (no carbs) consumed right before bed may help sustain blood sugar throughout the night Otherwise you might be awakened with a jolt of adrenaline as the body attempts to retrieve stored sugar. 

It is also important to eat regularly throughout the day so that you body has the opportunity to store sugar for nighttime use. 

How do you test for low blood sugar?

Functional Blood Chemistry offers data as to how our body is functioning. Blood fasting glucose and an enzyme called LDH are considered “24 hour” markers for general indication of blood sugar levels. Fasting insulin can also be used as a general marker of blood sugar utilization. To determine overall pancreatic involvement, a Glycomark test is recommended,

Many practitioners utilize Hemoglobin A1C or Ha1C as an indication of long-term blood sugar levels. This marker can easy be skewed and may better represent potential oxidative stress. 

For Reactive Hypoglycemia, a 2-hour glucose tolerance testing would be recommended to watch for blood sugar drops related to diet.

How can you best prevent low blood sugar?

Eat frequently enough to prevent drops of blood glucose and allow storage of glucose.

• Avoid missing meals
• Eat snacks if necessary
• Don’t use caffeine or nicotine to suppress appetite
• Don’t eat sweets instead of a meal
• Eat breakfast
• Add protein and fiber to diet
• Avoid overtraining

Have a diet that supports blood sugar lapses

Folks with Pathogenic or Functional Hypoglycemia may fare better on a strict Ketogenic diet.

For all others, it will be important to consume regular meals and snacks consisting of proteins, vegetables, fiber, and fats to help slow down sugar release. Fats should come from fish, raw nuts and olives, avocado, coconut, grass fed animal fats, etc.

Meal timing is important. For some folks to maintain stable blood sugar, they must remember to eat every few hours whether or not they are hungry. A small balanced snack may make the difference in one’s overall health.  It is also important to consume a balanced meal within one hour of waking.

Please Avoid:

• Junk food, sugars or sweets
• Fruit juice
• Fruits without proteins and fats
• High-carbohydrate foods (breads, pasta, rice, etc.)

Please Eat::

• Vegetables that grow above the ground
• Healthy fats
• Moderate amounts of protein

Supplements

A basic multivitamin provides necessary cofactors required to support blood sugar usage. For some, adaptogenic herbs may help the hypothalamus regulate cortisol levels, whereas sea salt and glycyrrhiza may help support cortisol levels. Glandulars may be helpful to support pancreas, liver, adrenals, etc. Other supplements may be necessary based on type and cause of hypoglycemia.

Vagus nerve stimulation exercises can be beneficial as well as stress reduction techniques like meditation.