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Hypoglycemia: How low blood sugar can affect our life

Hypoglycemia is a condition caused by the body's inability to use sugar effectively, causing low blood sugar. Hypo means low and glycemia means sugar.

Hypoglycemia is the opposite of diabetes, which is a condition marked by high blood sugar and known also as hyperglycemia.

Dr. Seale Harris was the first to discover hypoglycemia in 1924. It was known then by the name hyperinsulinism, due to the belief that it was caused by too much insulin in the blood. The excessive insulin burned more sugar than was necessary and caused the blood sugar level to drop dramatically to below normal levels.

What is Hypoglycemia?

Blamed on "the sugar-laden American diet", hypoglycemia is estimated by some physicians to affect over 20 million people in the United States. The major symptoms of this condition are mental confusion, low energy, and emotional instability that is often accompanied by neurotic or psychotic behavior. According to some experts, a hypoglycemic individual may experience more marital and family conflicts, have more accidents, and even commit suicide during an episode of low blood sugar. It can make an individual afflicted by hypoglycemia very miserable and seriously impact their personal and social life.

A Controversial Condition

Even though hypoglycemia seems to seriously affect many lives, it is surrounded by controversy in the medical establishment. The American Medical Association is among those who insist that hypoglycemia is nearly a nonexistent condition. They believe it to be a popular status disorder, or the "in" disease of the jet-set attributable to too much stress and heavy drinking. Still others believe that it is a carbohydrate metabolism disorder that can be avoided or easily controlled. Many also believe it to be the invention of self-diagnosing health faddists and hypochondriacs. Physicians who do not believe in hypoglycemia generally do not talk about it and pretend it will go away if they don't discuss it. However, many renowned physicians consider hypoglycemia to be one of the most prevalent ailments in modern society. Some healthcare providers even consider hypoglycemia to be a serious disease contributing to heart disease and cancer.

Some physicians feel that functional hypoglycemia is a common problem but usually due to other causes such as excess sugar in the diet, food allergies, emotional stress, weak adrenal gland function, thyroid problems, vitamin and mineral deficiencies, etc. They feel that if the focus is put on these causes and they are corrected, that the hypoglycemia will go away. So why keep the term hypoglycemia? Hypoglycemia has to be suspected and diagnosed before its causes can be further investigated.

Healthcare providers also differ in how they define hypoglycemia. Some believe that it is the opposite of diabetes (too much sugar in the blood). Others believe it is caused by low blood sugar and curable by consuming more of the easily available sugar. Other experts view the underlying causes of hypoglycemia as so complex and different on an individual basis that it is nearly impossible to find a common treatment.

Diagnostic procedures are equally debated. In the opinion of some experts, the five or six-hour glucose tolerance test is a reliable and conclusive way to diagnose hypoglycemia. Other experts feel this test is not only unreliable but also harmful. Another expert believes that in some individuals it is not how low the blood sugar level goes, but the speed at which it drops that causes symptoms.

Regardless of the experts differing opinions on the causes of hypoglycemia, most agree on the treatment. A commonly prescribed diet for hypoglycemia is the "Seale Harris" diet, which is a high protein, low carbohydrate diet.

How Diet Has Changed

Carbohydrates, fats and proteins, in varying proportions, are the three basic nutrients obtained through foods. Our basic diet throughout history has changed. Mankind started with a diet that was high in protein because we were hunters and fishermen. Then the diets changed to natural complex carbohydrate foods, such as grains, seeds, nuts, vegetables, fruits and dairy products, with a little meat and fish -- and then to a diet that includes some meat and large amounts of concentrated carbohydrates such as sugar and refined flour. Excess consumption of protein and refined carbohydrates has overloaded our metabolisms and is a major contributor to disease.

The Effect of Sugar in Our Diet

Our body uses sugar as the fuel to obtain heat and energy. Sugar is needed for all muscle actions, especially for our nerves and brain. When we eat sugar in the form of natural carbohydrates such as grains, vegetables, potatoes, fruits, bread and beans, our blood and tissues usually contain only the amount of sugar needed for normal function. These complex carbohydrates are changed into glucose, which is absorbed slowly through the wall of the small intestine and then carried to the liver where it is converted into glycogen and stored.

When our body needs sugar, the glycogen is reconverted into a glucose and transported by the blood to the areas of the body where it's needed. When we eat food with refined, white, commercially produced sugar, it is absorbed almost instantaneously through the membranes of the mouth and stomach, causing a sudden rush of glucose into the bloodstream causing a large strain on the pancreas, liver, adrenals and other endocrine glands.

Occasional ingestion of excess sugar can be handled by the pancreas. The pancreas destroys the excess sugar by releasing insulin into the bloodstream. However, excess sugar in the diet on a regular basis strains and may damage our body's sugar-regulating organs, causing them to function abnormally, which may be a major contributing factor to the development of hypoglycemia. The excessive insulin not only brings the sugar level down, but it lowers the sugar level much too fast and far below normal. When this happens it may be responsible for unpleasant symptoms and personality changes. The heart and muscle action are weakened and the brain and nerve activity are deranged. An individual's energy and endurance level is lowered and emotional stability is lost. At this point, a hypoglycemic will crave a quick pick-up. If they choose sweets, caffeine or alcohol, the blood sugar level will go up, but it will raise the sugar level too high and the pancreas is again forced to overreact and counteract this by over-producing insulin, creating a vicious cycle for the hypoglycemic. While their sugar level is high, they are hyperactive, energetic and happy for a short time. But then they become totally exhausted, confused and "bonkers" a short time later when they again experience the rapid drop in blood sugar level.

Other Factors That Contribute to Hypoglycemia

The malfunction of the sugar level regulating organs may be caused by factors such as emotional and physical stresses, allergies, alcohol, caffeine, smoking, nutritional deficiencies, overeating, and drugs. Imbalances in secretions of hormones from the pituitary and thyroid may also be responsible.

Studies have shown that caffeinated coffee drastically lowers a hypoglycemic's blood sugar level. Coffee has a stimulating effect on the adrenal glands that, in turn, encourages the liver to release more sugar into the blood. Combining coffee and sugar is especially harmful. Sugar enters the bloodstream quickly and directly. Coffee adds to the total sugar level by acting through the adrenals, brain and liver. Cola drinks are also harmful due to the combination of caffeine and sugar.

Alcohol can also induce hypoglycemia. Almost all alcoholics are hypoglycemic. A hypoglycemic can become an alcoholic when they get caught in the vicious cycle of drinking to improve their sense of well-being and to feel symptom free from low blood sugar. The uncomfortable symptoms experienced with a "morning after" hangover displays all the classic symptoms of hypoglycemia. Low blood sugar can become a chronic condition because alcohol reduces the output of glucose by the liver which may exaggerate low blood sugar. When an alcoholic stops drinking, he usually substitutes sweets because they are able to achieve the same "high".

Emotional stress can cause hypoglycemia and is characterized by a "flat glucose-tolerance curve". Flat curve hypoglycemia has a devastating effect on a person's life. When an individual finds no challenge and no sense of accomplishment in pursuing their unpleasant, unrewarding, and inescapable duties, their body responds to the situation with feelings of aimlessness, disinterest, and a loss of zest for life. They lack motivation, are bored, experience constant fatigue and feel half alive. These symptoms are experienced when the adrenals and pancreas are weak and do not work in coordination with each other. This creates a chronic low-grade cerebral starvation. Flat-curve hypoglycemia is not dramatic or extreme. However, if left untreated it may develop into a more serious case of hypoglycemia or into diabetes. It can be treated with lifestyle changes, dietary therapy and psychological counseling. Individuals with this condition often go undiagnosed because they don't feel sick and don't seek treatment.

Hypoglycemia may aggravate or initiate allergies and allergies may cause hypoglycemia. When an individual is exposed to allergens they may experience a significant drop in blood sugar levels. Allergic reactions to food or non-food allergens like perfume, auto exhaust, pesticides, chemical odors and food additives trigger the body's defensive mechanisms and cause the blood sugar levels to drop.

Smoking has also been shown to cause a rapid rise in blood sugar with just as rapid a drop shortly after the cigarette is put out. Nicotine has been identified as the culprit. A smoker must totally stop in order to return their blood levels to normal and eliminate their symptoms.

Premenstrual Syndrome (PMS) Similarities

The symptoms of PMS and hypoglycemia have some similar symptoms such as headache, irritability, increased appetite, carbohydrate cravings, anxiety, fatigue, depression, crying spells, difficulty in concentration, mental confusion, cravings for sweets, and lack of coordination. Women who suspect they have PMS may also have tests to rule out hypoglycemia. PMS researchers are looking into whether some PMS symptoms may actually be caused by abnormalities in carbohydrate metabolism. Some researchers have found that insulin receptors are doubled in concentration during the first half of the menstrual cycle among women with PMS. This could result in impaired glucose tolerance during the second half of the menstrual cycle, when PMS symptoms typically appear. Salt and sugar binges may exacerbate the hypoglycemic effect. Dieting to offset the fluid retention and bloating associated with PMS may make the problem even worse.

The Effect of Progesterone and Estrogen on Blood Sugar Levels

Several studies have evaluated how hypoglycemia is affected by estrogen and progesterone (ERT and HRT) therapy. Dr. Ray Peat has found that ERT tends to depress blood sugar levels.

Dr. John R. Lee, in Natural Progesterone: The Multiple Roles of a Remarkable Hormone states that he has found that estrogen predisposes one to blood sugar imbalances whereas progesterone enhances blood sugar control.

How The Thyroid Gland Affects Hypoglycemia

The action of the thyroid gland on hypoglycemia is subtle and often overlooked in the treatment of this condition, states Dr. Broda O. Barnes in Hope For Hypoglycemia. He explains that a lack of thyroid is accompanied by a sluggish liver. Since a sluggish liver is the most common cause of hypoglycemia, it seems logical that the hypothyroid patient is highly susceptible to low blood sugar. Dr. Barnes reports good results from treating functional hypoglycemia patients with thyroid therapy. He found that individuals treated with thyroid therapy could eat foods which they had avoided for years and most of the other symptoms of hypoglycemia and hypothyroidism also disappeared.

Functional and Organic Hypoglycemia

Functional hypoglycemia, also referred to as hyperinsulinism, is caused by an overactive or oversensitized pancreas and is believed to account for most of the cases of low blood sugar. Organic hypoglycemia is caused by tumors in the insulin-producing area of the pancreas, and when the insulin producing area of the pancreas is enlarged. It may also be caused by a defective liver, a diseased or malfunctioning pituitary or adrenal glands. Organic hypoglycemia accounts for about one percent of all cases of low blood sugar.

How Do I Know If I Have Hypoglycemia

Consult the list of symptoms on this page and check the symptoms that you experience on a regular, recurring basis. These symptoms may go away at times or change in character, then they will soon reappear. You may have just a few of the listed symptoms or most of them. This varies on an individual basis. If you feel that your symptoms may be related to hypoglycemia, make notes of the symptoms that you experience and talk to your healthcare provider. They will probably ask you about your living and eating habits, have you describe your symptoms and perform a clinical examination. If they feel your symptoms may be related to hypoglycemia they will probably administer the five or six-hour glucose tolerance test (GTT), which at the present time, is the most reliable test for this condition.

The checklist

The glucose tolerance test is commonly given in the morning since the patient is advised to go without food for several hours before the test. The first blood test is taken to determine the fasting blood sugar level and then you are given a glucose solution to drink. At hourly intervals after drinking the glucose solution, blood samples are taken and measured for its blood sugar level. A healthy individual will have a slight rise in the level of sugar and then the sugar level will fall back to the fasting level before the test. In the diabetic, the level rises much higher than normal and very slowly goes down, not reaching the fasting level for six or more hours. In hypoglycemics the natural rise will be followed by a rapid drop below the normal fasting range. The lower and the faster it drops, the more severe the hypoglycemia. The GTT alone is not conclusive. It should always be used in combination with the other diagnostic procedures (clinical exam, history and symptoms).

Diet

A diet with excessive salt intake has been found to contribute to hypoglycemia. Salt causes a loss of blood potassium that leads to a drop in blood sugar. Potassium is necessary to correct sugar metabolism abnormalities. Excessive salt intake causes potassium losses, which results in a drop in the blood sugar level. The low blood sugar level triggers the onset of stress, causing a lot of potassium to be lost in the urine and for sodium, as well as water, to be retained in the system. An excessive desire for salt by hypoglycemics can signal possible adrenal failure. Malfunctioning adrenals allow abnormal salt excretion, encouraging heavier salt consumption. A hypoglycemic should use a moderate amount of salt, as the adrenal glands do need some salt for normal functioning.

Nutritional deficiencies can aggravate almost any ailment. There are several specific nutrients that are involved in sugar metabolism. Deficiencies or excesses of these nutrients can cause the organs involved with sugar metabolism to breakdown or malfunction. Please see the vitamin article in this newsletter to read about the effect vitamin B and C, pantothenic acid, magnesium, potassium, and B6 have on hypoglycemia.

The proper hypoglycemia diet appears to be very controversial. The Seale Harris diet, developed in the 1920's, has been the most prescribed diet over the years. This diet is a high protein, low-carbohydrate diet found in clinical experience to control the symptoms of low blood sugar.

Paavo Airola, M.D. has developed a nutritional program that is a low protein, high natural carbohydrate diet. Dr. Airola felt that the conventional diets, while able to control the symptoms, were so harmful to an individual's general health that they actually created even more serious disorders and diseases than those they were attempting to cure. His nutritional and biological approach to the treatment of hypoglycemia through diet, specific vitamins and supplements and herbs, is not offered as a cure, but rather as a supportive means of assisting your body's own inherent healing forces by eliminating the underlying causes of disease and thus creating the most favorable conditions for the body's healing power to bring about the actual cure. In other words, the proposed diet and other natural therapies are aimed at helping your body to heal itself.

In more recent years, Robert Atkins The New Diet Revolution and Barry Sears The Zone have demonstrated the importance of proteins and fats in the diet to control hypoglycemia.

In Summary

Every individual's response to specific foods, vitamins, and other treatments is extremely different, depending on the individual's specific condition, including: individual nutritional requirements, age, health stature, inherited weaknesses, ability to assimilate nutrients, emotional health, the level of environmental stresses, etc. These individual variances combined with differing opinions in the medical establishment as to the exact cause, and proper treatment for hypoglycemia leaves a confusing situation for an individual who suffers from the symptoms of low blood sugar. We generally know our own bodies, so listen to what it tells you and search out appropriate care by a healthcare provider that is willing to find the answers that are specifically tailored to help you get off the low blood sugar roller coaster.

Vitamin and Mineral Supplements Most Helpful For Hypoglycemia

Vitamin B-complex

Vitamin B-complex, known as anti-stress vitamins that aid in sugar metabolism and helps to normalize sugar levels. It also helps normal liver functions which assists in carbohydrate metabolism.

Vitamin B6

Vitamin B6 helps build up adrenals. It also helps in sugar metabolism by regulating the balance between sodium and potassium.

Vitamin B12

Vitamin B 12 helps the liver regenerate.

Vitamin C

Helps normalize sugar metabolism and increases the body's tolerance to carbohydrates and sugar. It improves the adrenal hormonal output and is a potent detoxifier.

Magnesium

Should be taken with calcium. It's involved in sugar metabolism and energy production.

Pantothenic Acid

The deficiency of pantothenic acid is associated with rapid drops in sugar levels. It stimulates the adrenal glands and increases production of adrenal hormones.

Potassium

Potassium is important in sugar metabolism. A drop in blood sugar may be caused by low levels of blood potassium.

Q. What is the impact of hormone replacement therapy on hypoglycemia?

A. In articles about hypoglycemia written by Dr. Ray Peat, he points out that blood sugar is depressed in women in an estrogen dominated state. For example, women with PMS who show strong signs of estrogen dominance, and women with hysterectomies who are given Estrogen Replacement Therapy (ERT), may have hypoglycemic effect because of the impact of estrogen dominance. Dr. Peat also points out that the hormones progesterone, testosterone and thyroid all have the capacity to normalize low blood sugar. Some of the symptoms that are attributed to problem with imbalances in sex hormones and in thyroid can possibly be attributed to the impact on the blood glucose level. The side effects from some replacement therapies could also be due to the hormonal impact on blood glucose.

Publisher's Notes

Constance Kindschi Hegerfeld Executive Vice President Women's Health Connection

The Holiday's are fast approaching -- in fact, by the time you receive this newsletter, Thanksgiving will be past. Many of us wonder why we have such a difficult time coping with the Holiday Season. Of course, it is often the stress on our body from so many changes in routine and diet.

Hypoglycemia is a very timely topic for the holiday season, especially since we as a society tend to do only two things wrong at this time of year --MORE and MANY!

MORE stress from preparing for festivities

Too MANY parties to attend

MORE stress from coping with relatives

Too MANY shopping trips

eating MORE food

eating MANY of the wrong foods

eating MORE sweets

drinking too MANY alcoholic drinks

drinking MORE coffee specialty drinks

eating too MANY sweets with coffee or alcohol

While we recognize that not all healthcare providers believe in hypoglycemia, certainly many believe that changes in blood sugar levels can be caused by excess sugar or alcohol, and stress. Hopefully, regardless of what they call blood sugar level changes, your healthcare provider will take the time to listen to you and help you search for an end to the blood sugar roller coaster.

I would like to wish each of you a happy and healthy holiday season. Hopefully, by having an awareness level of hypoglycemia and how different foods, sweets, caffeine and alcohol affect your blood sugar level, you can make good health choices during the month of December. Elimination or moderation of the factors mentioned in How Sweet It Is, are good health choices for everyone -- not just those with known blood sugar problems.

This article was written by Women's Health Connection Editor, Laud Lee. The information is written and compiled from The New Diet Revolution by Robert Atkins, The Zone by Barry Sears, Dr. Wright's Book of Nutritional Therapy, by Jonathan V. Wright, M.D., Hope For Hypoglycemia by Broda O. Barnes, M.D., Ph.D. and Hypoglycemia: A Better Approach by Dr. Paavo Airola.

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By Lauri Lee

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