Hypoglycemia:Want to know why?

Hypoglycemia, which means low blood sugar, is the diagnosis given when blood sugars dip more than would be expected in normal daily life.

We all know how it feels to have gone too long without eating, feeling depleted and in need of food to continue being effective. Low blood sugar when you haven’t eaten for many hours is normal. But some people experience it more frequently and more intensely than that.

Those blood sugar dips can trigger unpleasant symptoms, including:

• hunger

• nausea

• tiredness

• weakness

• dizziness

• shakiness

• difficulty thinking or concentrating

• irritability

• sweating

• fast or irregular heartbeat

• pallor

These symptoms soon get better when you eat something and blood sugar levels rise back to normal again. But don’t be misled into thinking that people with hypoglycemia should be consuming more sugars: high sugar foods tend to make it worse in the long run, while healthy foods help stabilize it. For some people, frequent episodes of hypoglycemia are the first warning sign that a person is moving in the direction of type 2 diabetes.

People who have a tendency to hypoglycemic events are often told to eat smaller meals more often, to prevent blood sugars becoming low and triggering those symptoms. That’s a good management strategy, especially if they are healthy meals, but what about addressing the root cause of the problem? We naturopathic doctors like to look more deeply and ask: Why is this person’s blood sugar level dipping abnormally low so often?

Hypoglycemic symptoms occur because your cells aren’t getting the glucose they need for fuel, which can be due to various problems:

• poor digestion and absorption of foods: blood sugars are low and can’t feed the cells, due to general nutrient depletion

• impaired transport of glucose from our bloodstream into our cells: blood sugars are actually high because the blood can’t get that sugar into the cells, and the cells remain hungry (as happens in diabetics)

• blood sugar levels are falling faster than normal, triggering primal drivers to seek more food before they too low

What can cause these problems?

Poor pancreatic function, in one of two ways:

The pancreas produces digestive enzymes to release nutrients from our food, so the GI tract can absorb them. If this production is low, your nutrient intake will be suboptimal, no matter how good your diet is. So your sugars will be low, along with everything else. The pancreas also makes insulin that enables the glucose in our bloodstream to enter and fuel our cells. If you don’t make enough insulin, the glucose absorbed from your food can’t provide your cells with the fuel they need.

The cells are not responding to insulin’s signals to let glucose in. This is called insulin resistance. Although there may be lots of insulin and lots of glucose circulating in the blood, there isn’t enough getting into those hungry cells. This overproduction of insulin, in an attempt to overwhelm the cells’ resistance, is hard work for the pancreas. In the long run it may reduce pancreatic efficiency, compounding the problem.

Gastro-intestinal absorption is compromised. If the GI tract is not healthy, it can’t absorb nutrients from foods well. Celiac disease is the best-known cause of this, and can lead to severe malnutrition in some cases, but it can also be almost silent. Other problems can also compromise GI absorption, such as inflammation due to food sensitivities, or infections by parasites, bacteria or yeasts. This may not be enough to overtly cause hypoglycemia, but it can be a contributing factor.

Yeasts consuming sugars from your food. Yeasts such as Candida Albicans and Candida Parapsilosus are avid sugar consumers. An overgrowth of these in our GI tract depletes our sugars at a faster rate than normal so we seek out more sugar to compensate, which then feeds them even more! The more they eat, the more their colony grows, so the more hypoglycemia they trigger: a vicious cycle. Healthy foods, including complex carbohydrates, allow for a slow release of the glucose that sustains you, without providing a feast for the bad guys.

The western diet, high in simple carbohydrate foods (think white sugar and white flour), feeds yeast. It also works the pancreas harder than in our ancestors’ days, and there are few medications in western medicine aimed at helping the pancreas itself. Metformin, the first drug given to people with Type 2 diabetes, is known to work on managing sugar levels via the liver and digestive tract, but isn’t thought to work via the pancreas.

When the pancreas is damaged, or too overworked to make enough insulin anymore, western medicine gives insulin injections. This is a life-saver for a type 1 diabetic who can’t make insulin at all, and it tops up insulin levels when the pancreas is struggling. But very little is aimed at finding and addressing the cause of the problem: why insulin production is down, or why the body needs more to get by.

Naturopathic doctors have a variety of tools to help support pancreatic function and gastro-intestinal health, as well as always encouraging you to eat nutrient-dense, low-glycemic foods.

If you are experiencing periods of hypoglycemia, we suggest that you avoid sugar in foods and drinks, and eat frequent small healthy meals to manage it. In the meantime find yourself someone who can help you ask the questions of “Why is this happening in me just now?” and “What do I do about it?”

Curious about the connections? Check out these links:

* Blood Sugar Blues: Are you Insulin Resistant?

** Oh Sugar! Glycemic Index and Glycemic Load