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. Most 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 to too high of levels, you could possibly die. Now that is serious stuff…But if is too low, it may cause severe enough symptoms that we might think we might be…..Okay, a little dramatic, but you get my point.
How does the body regulate blood sugar?
Your body works very hard to keep your blood sugar at the appropriate level. When you eat a meal, your body is designed to break it down and turn it into glucose. When the body detects glucose in the bloodstream, it signals a hormone called insulin to create openings in our cell membrane to which allow glucose to be brought into the cell. From there, it is converted by the mitochondria into something special called ATP which is the “energy currency” of the body.
Any meal generates a rise in blood glucose. If the meal is well balanced, meaning that it contains the appropriate amount of protein, carbohydrates and fats, it causes a slow release of blood sugar and a modest release of insulin. If the meal is too high in carbohydrates, the blood sugar will spike and cause too much insulin to be released. This tends to drop the blood sugar level well below the pre-meal value. This then signals the need for more glucose, creating more sugar cravings and perpetuating the cycle.
The body also releases stored sugars in keep up with our metabolic needs and as a response to any perceived threat which can also affect the cycle.
What is Reactive Hypoglycemia?
Reactive hypoglycemia (or alimentary hypoglycemia) is low blood sugar that occurs after a meal, usually one to three hours after eating. It is different than Clinical Hypoglycemia in that it is usually caused by the body reacting to something, usually diet or stress. Hypoglycemia is defined as a blood glucose level below 65mg/dl, whereas Reactive Hypoglycemia levels are between 66-85mg/dl.
What causes Reactive Hypoglycemia?
Reactive hypoglycemia is usually caused by either not eating often enough or eating a meal too high in carbohydrates. A meal to high in sugars causes an increase in blood glucose and releases a spike in insulin which causes the blood sugar levels to drop below normal fasting levels. If you ignore these hunger pains, it forces the adrenal glands and liver to release stored glucose or breakdown muscle for energy. Unfortunately, repeated constantly over time, may lead to adrenal fatigue and insulin resistance.
Low calorie dieting, eating junk food or eating greater than a 2:1 ratio of carbohydrates to protein in a meal may also lead to low blood sugar levels.
What are the symptoms of Reactive Hypoglycemia?
These may include hunger, weakness, shakiness, sleepiness, lightheartedness, anxiety, confusion, anger, blurry vision, etc. based on the individual.
What’s the problem with long term blood sugar swings?
Eventually, the cells gets pretty tired of dealing with 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.
How can you test?
We look at the fasting glucose marker and an enzyme called LDH. These “24 hour” markers give us a general indication of what is occurring. To get an idea of long term regulation, we rely on Hemoglobin A1C or Ha1C and fasting insulin. There are some issues with Ha1C that may cause it be be skewed such as shorter or longer RBC life, anemias, certain B vitamin deficiencies, etc so we use fasting insulin and 2 hour glucose tolerance testing as our gold standards. We have an article about HA1C if you want to learn more.
How can you prevent low blood sugar?
It is important to consume a diet containing a balanced amount of carbohydrates, fats, and protein help to maintain optimal blood sugar levels. Fats should come from fish, raw nuts and olives, avocado, coconuts, grass fed animal fats, etc. Consuming a meal or snack approximately every 3 hours for those with low blood sugar issues, whether hungry or not, will keep the blood sugar nicely balanced while looking for underlying cause. Just think of blood sugar regulation almost like its own heartbeat, to keep the body well fed. Consider vagus nerve stimulation exercises.