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Hypoglycemia
  Hypoglycemia
 Signs, symptoms, indicators
 Conditions that suggest it
 Contributing risk factors
 It can lead to...
 It could instead be...
 Treatment 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. This is a common condition of an abnormally low level of sugar in the blood. Sugar levels frequently change throughout the day and may be normal sometimes and abnormal at others.

Causes & Development


The causes of functional or reactive hypoglycemia (not absolute or fasting hypoglycemia) can be divided into 3 categories:
  1. High sugar / refined carbohydrate diet leading to hyperinsulinism
  2. Hypoadrenalism-stress leading to adrenal exhaustion
  3. Alimentary or gastric surgery leading to rapid stomach emptying or "dumping syndrome."
Two factors can lead to sugar overload: An over-consumption of sugar and a problem with sugar metabolism. Over-consumption of sugar begins at an early age - just check out the sugar levels in the most popular children's cereals. You will find that many contain almost 50% of their calories as sugar. And sugar is addictive -- and difficult to combat because sugar is added to almost every packaged food sold today.

Signs & Symptoms
Symptoms include weakness, shakiness, excess hunger, anxiety, outbursts, faintness, headaches, passing out, delirium, coma, hallucinations, excess sweating, the appearance of intoxication, marked personality changes, irritability, negativism, mood swings, depression, crying spells, and a panorama of similar mental symptoms.

Diagnosis & Tests
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.

Treatment & Prevention
The term "hypoglycemia" may be better named "carbohydrate intolerance syndrome" and treated accordingly.

Complications
Patients with hypoglycemia of varying causes appear to show similar personality patterns, suggesting hypoglycemia can cause personality disorders.





SpacerSigns, symptoms & indicators of Hypoglycemia:
TopleftSpacerTopright
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Symptoms - AllergyIcon  (High) intolerance of sugars

Counter-indicators:
Icon  (High) tolerance of sugars

Symptoms - Cardiovascular

Icon  Heart racing/palpitations

Symptoms - Food - General

Icon  Strong appetite
SpacerWhy Hunger is a symptom of hypoglycemia.

Symptoms - Food - Preferences

Icon  Afternoon coffee/sugar craving
Icon  Sugar/sweet craving
Icon  Craving and/craving but not eating wheat

Symptoms - General

Icon  Frequent fatigue/fatigue that is relieved by eating
Icon  General dizziness
Icon  Fatigue that worsens during the day
Icon  Poor bodily coordination
Icon  Dizziness when standing up

Symptoms - Head - Eyes/Ocular

Icon  Vision disturbances
SpacerWhy Blurred vision and diplopia (double-vision) are possible symptoms.

Symptoms - Head - Mouth/Oral

Icon  Incoherent speech

Symptoms - Metabolic

Icon  Adverse reaction to delayed meals
Icon  Inner trembling
Icon  Difficulty losing weight
Icon  Afternoon headaches
Icon  Low energy/stamina
Icon  Front-of-head/temple-based headaches

Symptoms - Mind - Emotional

Icon  Depression with anxiety
Icon  Impatient/hostile disposition
SpacerWhy Uncontrolled rage is a possible symptom.

Icon  Emotional instability

Symptoms - Mind - General

Icon  Occasional/frequent confusion/disorientation
Icon  Having trouble concentrating

Symptoms - Muscular

Icon  Tightness across shoulders

Symptoms - Nervous

Icon  Numb/tingling/burning extremities

Symptoms - Reproductive - Female Cycle

Icon  Carbohydrate craving during cycle

Symptoms - Skin - General

Icon  Excess perspiration

Symptoms - Sleep

Icon  Unsound sleep
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SpacerConditions that suggest Hypoglycemia:
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AllergyIcon  Indoor Allergies

Hormones

Icon  Low DHEA Level
SpacerWhy 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

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

Icon  Anxiety
Icon  Poor Memory
SpacerWhy Temporary forgetfulness is a known symptom of hypoglycemia.

Metabolic

Icon  Addictions / Addictive Tendencies
SpacerWhy A craving for cigarettes and/or drugs is a possible symptom of hypoglycemia.

Icon  Migraine/Tension Headaches
Icon  Tinnitus

Musculo-Skeletal

Icon  Restless Leg Syndrome
SpacerWhy 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]

Icon  Muscle Cramps / Twitching
SpacerWhy 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.

Icon  General Weakness

Nervous System

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

Skin-Hair-Nails

Icon  Excessive Sweating
Icon  Night Sweats
SpacerWhy Nighttime hypoglycemia may be without symptoms or manifest itself as night sweats, unpleasant dreams or early morning headache.

Symptoms - Glandular

Icon  Hypoglycemia (confirmed)
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SpacerRisk factors for Hypoglycemia:
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Environment / ToxicityIcon  Heavy Metal Toxicity
SpacerWhy 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.

Icon  Mercury Toxicity (Amalgam Illness)
SpacerWhy 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.

Hormones

Icon  Hypothyroidism
SpacerWhy 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.

Symptoms - Food - Intake

Icon  (High) refined sugar consumption

Symptoms - Head - Ears

Icon  History of tinnitus

Uro-Genital

Icon  Consequences of Vasectomy
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SpacerHypoglycemia can lead to:
TopleftSpacerTopright
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MetabolicIcon  Migraine/Tension Headaches
Spacer
BotleftSpacerBotright

SpacerHypoglycemia could instead be:
TopleftSpacerTopright
Spacer
MentalIcon  Schizophrenia
SpacerWhy Numerous patients given psychiatric diagnoses have actually turned out to have hypoglycemia, including those classified with depression, manic-depressive disorder, and schizophrenia.
Spacer
BotleftSpacerBotright

SpacerRecommendations and treatments for Hypoglycemia:
TopleftSpacerTopright
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ActionIcon  Book Reading
SpacerWhy For additional reading from a sufferer's perspective, you could read the book The Low Blood Sugar Handbook: You Don't Have to Suffer... by Edward A. Krimmel, Patricia T. Krimmel. It is not a dry technical book, but one that you should enjoy while helping you resolve the problem.

Botanical

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

Icon  Chlorella

Diet

Icon  Sugars Avoidance / Reduction
SpacerWhy 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.

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

Icon  Smaller, More Frequent Meals
SpacerWhy 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.

Icon  High/Increased Protein Diet
SpacerWhy A diet consisting of higher protein and fat with less refined carbohydrates is a standard recommendation for those with hypoglycemia.

Icon  Caffeine/Coffee Avoidance
SpacerWhy Avoid all soft drinks, coffee, tea, artificial colors and additives.

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

Icon  High/Increased Fiber Diet
SpacerWhy Soluble fiber delays gastric emptying, slows glucose absorption, and minimizes blood glucose swings.

Icon  Coconut
Icon  Therapeutic Fasting
SpacerWhy 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.

Icon  Increased Fruit/Vegetable Consumption
SpacerWhy 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.

Habits

Icon  Aerobic Exercise
SpacerWhy 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

Icon  Glucose Tolerance Test
SpacerWhy The six hour oral glucose tolerance test is normally used to determine the type and magnitude of the glucose intolerance.

Mineral

Icon  Chromium
SpacerWhy Chromium status should be optimized for its benefit in carbohydrate disorders (both hypoglycemia and adult-onset diabetes).

Vitamins

Icon  Vitamin Niacinamide
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KEY
PlusSpacerWeak or unproven link
PlusSpacerStrong or generally accepted link
PlusSpacerProven definite or direct link
MinusSpacerStrongly counter-indicative
TickSpacerMay do some good
TickSpacerLikely to help
TickSpacerHighly recommended



GLOSSARY

Adrenal (Adrenal Gland, Adrenal Glands, Adrenals)
The adrenal glands sit on top of each kidney and consist of an outer cortex and an inner medulla. Of the 50 or so hormones the adrenals make, only cortisone and adrenaline are recognized by most people. Some of these hormones must be produced to preserve life, while others help resist stress. Other hormones from the adrenals control normal energy output (along with the thyroid) and govern the breakdown of stored energy into quick energy sources. The medulla produces epinephrine and norepinephrine, which are specifically designed to help the body deal with stressful situations. The adrenals control the body's potassium/sodium balance, which is vital for energy production. They also produce sex hormones in minute amounts, which is important for later years when the gonads drop or cease their production.

Adrenal Insufficiency (Adrenal Exhaustion, Low Adrenal Function)
A condition in which 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.

Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.

Bipolar Disorder (Manic Depression, Manic-Depression, Manic-Depressive)
A 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 (Carbohydrate)
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.

Central Nervous System (CNS)
A collective term for the brain, spinal cord, their nerves, and the sensory end organs. More broadly, this can even include the
neurotransmitting hormones instigated by the CNS that control the chemical nervous system, the endocrine glands.

Chromium
Chromium is a mineral that becomes a part of the glucose tolerance factor (GTF). Chromium aids in insulin utilization and blood sugar control. By controlling blood sugar, chromium helps prevent the damage caused by glucose, which is called glycation. Chromium helps maintain normal cholesterol levels and improves high-density lipoprotein levels. Chromium is also important in building muscle and reducing obesity.

Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.

Cramp (Cramping, Cramps)
A sudden, involuntary, painful muscular contraction.

Crave (Craving, Cravings)
To have a strong desire for; to feel the need for.

DHEA (DHEA-S)
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 (Diabetes, Diabetic, Diabetics)
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.

Dietary Fiber (Insoluble Fiber, Insoluble Fibers, Soluble Fiber, Soluble Fibers)
There are two types of dietary fiber - soluble and insoluble. Insoluble fiber acts like a sponge; it absorbs water and moves solid waste out of the intestines. It is found mainly in whole grains and on the outside of seeds, fruits, and legumes. Soluble fiber is found in fruits, vegetables, seeds, brown rice, barley, oats and oat bran. It forms a gel when mixed with liquid producing a softer stool. It also prevents and reduces the absorption of certain substances from the intestines into the bloodstream.

Endogenous
From within the body, either a native function or the product of the extended colony. Normal flora in the colon are considered endogenous.

Enzymes (Enzyme)
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.

Fructose
A simple sugar which occurs naturally in fruit or honey.

Gastric
Of, relating to, or associated with the stomach.

Gastric Dumping (Gastric Dumping Syndrome)
Unusually rapid transit of food through the stomach: the stomach releases its contents too quickly, resulting in adverse pH balance of the intestines.

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.

Hallucination (Hallucinations)
A false or distorted perception of objects or events, including sensations of sight, sound, taste, smell or touch, typically accompanied by a powerful belief in their reality.

Hormones (Hormone)
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 (Hypothyroid)
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.

Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.

Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
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. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.

Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.

Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.

Protein (Proteins)
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.

Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).

Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating 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. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.

Trace Element (Trace Elements, Trace Mineral, Trace Minerals)
A mineral or element that is essential, in small amounts, for good health. Nutritionists prefer to call minerals either minerals or trace minerals depending on the amount needed by the body, while analytical chemists prefer to call minerals 'trace elements'.




Last updated: Jan 03, 2010


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