Thursday, May 1, 2014

What is Hypoglycemia?


What is hypoglycemia?
 

Hypoglycemia simply means - Low blood sugar.  Many people mistakenly believe that if they eat something sweet and experience symptoms of a 'sugar high' and then crash and have no energy they have 'hypoglycemia'.   There is a common belief among the general population that hypoglycemia is a diagnosis in itself, this is not the case at all.  

If you feel that you MUST eat protein with every meal or you experience symptoms of what may be high blood sugar and then hours later you have an energy crash, this is not 'hypoglycemia' as a diagnosis.  Hypoglycemia means low blood sugar....not a spike in blood sugar and then low blood sugar, it simply means low blood sugar, period.  If your blood sugar spikes high enough to cause symptoms after eating and then you experience symptoms of low blood sugar hours later....this is called insulin resistance, not hypoglycemia.  You consume something sweet and due to insulin resistance the body is unable to get that blood glucose into the cells and you do not feel well or as most clients describe it you have a 'sugar high.'  

The body continues to pump out more and more insulin to drive that 'energy' or glucose into the cells and when it finally succeeds blood sugar levels drop dramatically and you then experience fatigue or other symptoms.  Despite the common idea that  hypoglycemia is a diagnosis in itself....it is not.

According to the Mayo Clinic:

" Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose), your body's main energy source.

Hypoglycemia is commonly associated with the treatment of diabetes. However, a variety of conditions, many of them rare, can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself — it's an indicator of a health problem.

Immediate treatment of hypoglycemia involves quick steps to get your blood sugar level back into a normal range — about 70 to 100 milligrams per deciliter or mg/dL (3.9 to 5.6 millimoles per liter or mmol/L) — either with high-sugar foods or medications. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia." 1

 

Hypoglycemia is not a diagnosis or a disease and in reality it only occurs in response to an actual medical condition or from other extenuating circumstances.   There are cases where people feel unwell when they haven't eaten in 2-3 hours, there are also cases of individuals who do not feel well when first adopting a plant based diet lower in protein.   Neither of these cases is a disease of 'hypoglycemia.'    

 
I have found that clients who state that they have hypoglycemia are simply trying to express that in general, they don't feel well.  Doctors don't have any diagnosis or label to give them for their suffering and therefore they often adopt this umbrella of 'hypoglycemia' to express their distress. 

 
There are three basic reasons individuals believe they have 'Hypoglycemia':

1.     Individuals with a high metabolism due to high activity levels or simply due to genetics.

 

2.     Individuals who have an accumulation of amino acids in the basement membrane between the capillaries and the cells which leads to feeling ill when protein consumption is not maintained at a high level.  This situation is easily remedied and if not corrected health problems will eventually surface later in life.

 

3.     Individuals who actually have insulin resistance.

 
The Mayo Clinic details the causes associated with hypoglycemia:

·       Medications

·       Excessive Alcohol consumption

·       Severe hepatitis

·       Anorexia Nervosa which depletes the body's glycogen reserves diminishing its ability to perform gluconeogenesis in order to maintain normal blood sugar levels when carbohydrate consumption or food consumption in general is low.

·       Kidney disorders

·       Gastric bypass surgery patients  are at risk

·       Insulinoma

·       nesidioblastosis

·       Endocrine disorders of the adrenal glands or Pituitary gland

 

Many of my clients have told me they have been diagnosed with hypoglycemia by their doctor.  When I asked if their doctor ordered a blood glucose test to determine if in fact they did have low blood sugar levels, none of them had.  A few clients who claimed to have 'hypoglycemia' were actually suffering from insulin resistance or pre-diabetes.  It is unfortunate that so many people are unaware of why they feel this way. The internet is littered with bogus articles touting 'diets for hypoglycemia' and a host of other false information about hypoglycemia as if it were a diagnosis that needs treatment in itself.

 

Are you REALLY experiencing symptoms of Hypoglycemia?

Please take note of the symptoms of hypoglycemia below...as most people who think they are experiencing hypoglycemia are not.

·        Confusion, abnormal behavior or both, such as the inability to complete routine tasks

·        Visual disturbances, such as double vision and blurred vision

·        Seizures, though uncommon

·        Loss of consciousness, though uncommon

 

Hypoglycemia may also cause these other signs and symptoms:

·        Heart palpitations

·        Shakiness

·        Anxiety

·        Sweating

·        Hunger

·        Tingling sensation around the mouth

 

If you are merely feeling hunger and fatigue and nothing else, this really isn't a true hypoglycemic situation.  If in fact you are experiencing a true episode of hypoglycemia, if it is not rectified it can have real, serious consequences such as loss of consciousness. 

If you feel you need to eat protein with every meal in order to feel well....you are NOT well!

 


The first thing to consider in an individual who feels they need protein with every meal and who feels unwell when they consume a diet 'lower in protein' it has nothing to do with low blood sugar.    It is an accumulation of excess amino acids in the basement membrane of the capillaries which prevents adequate oxygenation of cells and also inhibits wastes from exiting the cells.  As soon as protein consumption drops and these excess amino acids begin to clear from the system the individual does not feel well.  Symptoms may include: fatigue, feeling groggy, foggy headed, difficulty concentrating, weakness....the symptoms vary widely from person to person. 

Some people term this, "detox."  I personally don't like the current idea of 'Detoxing' as it is widely used as an excuse for everything one experiences when making a dietary change and it also causes some people to suffer needlessly and then give up on the diet because the 'detox' symptoms never resolved.  Well they didn't resolve because it wasn't 'detox' in the first place.

In this case however, the symptoms will resolve as the body gets rid of the excess amino acid accumulation and normalizes.  If the symptoms do not resolve there is probably another contributing factor and you should consult a knowledgeable practitioner who will not merely try to push 'protein' foods on you but you will truly get to the bottom of your issues.

"The Wendt doctrine, a result of thirty years of research by a family of German physician researchers, connects excess protein consumption to some forms of chronic degenerative disease. The Wendts were able to prove with electron microscope pictures, that excess protein clogs the basement membrane, which is a filtering membrane located between capillaries and cells. This membrane helps regulate the flow of nutrients and waste products between capillaries, cells, and fluid in the tissues they penetrate. The more excess protein there is in the diet, the more protein is lodged in the basement membrane. This makes it more difficult for proteins, other nutrients, including oxygen, to enter the cells and for waste to exit. Eventually, the basement membrane becomes so clogged with excess protein that the cells on the inside of the capillary walls begin to store and secrete the excess protein in insoluble forms that accumulate on the inside of the capillaries and arteriole walls, causing atherosclerosis, hypertension, and what the Wendts term capillarogenic tissue degeneration. This system-wide condition produces cellular malnutrition. The Wendts found that this whole process could be reversed by stopping the intake of all animal protein for one to three months and by eating a low protein diet." 2

 Unfortunately individuals who are more prone to experiencing this feel terrible when their protein consumption drops.  They believe somehow that they 'need' more protein in their diet for energy.  Interestingly protein is the last place the body goes for energy but that is another discussion for another day.

 
 What do I do if I suspect this as the cause of feeling unwell?

 
This is something that needs expert attention as it can take some knowledge to help you unravel your individual situation without enduring uncomfortable symptoms and fatigue.  I would be happy to consult with you and help you understand your particular situation.

 

I have to eat protein with every meal or I get a 'Sugar high'.......
Photo by DraikJack
 

You do not have 'hypoglycemia, you actually have insulin resistance or pre-diabetes.  Any individual whose body CANNOT tolerate healthy whole foods that fuel the body with its optimal source of fuel, as stated by the Mayo Clinic above....blood glucose, you have a problem, this is not normal!


The problem in this case is an accumulation of intramyocellular lipids which lead to insulin resistance.  Individuals who are predisposed to diabetes generally have fewer mitochondria in the cell which leads to the accumulation of these lipids in the muscle cells resulting in insulin resistance.

This mechanism has been known for a long time, A research study published in Diabetes in 1999 concluded:  " These results indicate that increased IMCL represents an early abnormality in the pathogenesis of insulin resistance and suggest that increased IMCL may contribute to the defective glucose uptake in skeletal muscle in insulin-resistant subjects."

Researchers at Pennington Biomedical Research Center in Baton Rouge found that a high fat diet of about 50% of calories from fat caused significantly more intra-myocellular lipid accumulation. 

In 2012 researchers still implicate IMCL accumulation with insulin resistance but we have come even farther in our understanding of impaired lipid metabolism and insulin resistance. 3

You don't need to avoid carbohydrates, you need to get to the root of the problem.  Your body was designed to have blood glucose [blood sugar] if you don't have blood sugar....you DIE!  Blood sugar is NOT a villain, it is your body's primary source of fuel.

I am not going to go into all the details about insulin resistance and diabetes in this post because we are talking about hypoglycemia.  If you are experiencing the above symptoms you may want to look into insulin resistance or pre-diabetes....if you aren't diagnosed yet you are well on your way.

Herbs that may help with Balancing blood sugar levels:

·       Nopal cactus
·       Cinnamon4

·       Licorice

These are a few options for assisting those with a tendency toward type II diabetes.  These herbs will not prevent or treat insulin resistance or diabetes, they merely assist in blood sugar balance along with a healthy diet, exercise in those predisposed to blood sugar imbalances.

***Warning:  These herbs do not control diabetes or insulin resistance and without dietary changes and other interventions these herbs will NOT cure your situation so please do not use them as a sole form of treatment.  They can be used to as a compliment but without dietary change your condition will not change.

Sometimes it is merely a fast metabolism

There are those rare individuals, who have been blessed with a fast metabolism!  These individuals truly do feel unwell if they haven't eaten in 2-3 hours.  They begin to feel fatigue, cannot think clearly and may have true symptoms of low blood sugar.

This is probably more rare than the other reasons people believe they have 'hypoglycemia' but I have seen it and there are people who really do have a need to eat every 2-3 hours.

What can I do if I have a fast metabolism?

Well that is an easy fix....EAT!  Consider yourself lucky and eat every 2-3 hours.  As long as you are maintaining a healthy weight eat as much and as often as you need to.  There are a few things to consider though if you truly are struggling with more severe symptoms of hypoglycemia if you haven't eaten in a few hours.

There is the possibility of Type I diabetes as well in this case so if you are experiencing significant symptoms it is important to seek medical attention.

There are a couple warning signs though to watch out for and those are the symptoms of hyperthyroidism.  You may be perfectly healthy and simply have a high metabolism and that is wonderful but it is always a good idea to make sure you do not have any signs or symptoms of a disease that may need the expertise of a health practitioner.  If you notice these symptoms are similar to those of hypoglycemia.

Hyperthyroidism

·        Sudden weight loss, even when your appetite and the amount and type of food you eat remain the same or even increase

·        Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute — irregular heartbeat (arrhythmia) or pounding of your heart (palpitations)

·        Increased appetite

·        Nervousness, anxiety and irritability

·        Tremor — usually a fine trembling in your hands and fingers

·        Sweating

·        Changes in menstrual patterns

·        Increased sensitivity to heat

·        Changes in bowel patterns, especially more frequent bowel movements

·        An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck

·        Fatigue, muscle weakness

·        Difficulty sleeping

·        Skin thinning

·        Fine, brittle hair

If you are not experiencing any of these symptoms but merely have the signs of hypoglycemia when you don't eat often...by all means....just EAT and enjoy it for those of us who can only dream of having your problem.

It is important to realize that hypoglycemia is not a diagnosis in itself and if you are not feeling well and have to micromanage your macronutrients in order to avoid feeling unwell it is important to find a practitioner who can help you regain your health rather than try to manipulate the diet to simply avoid triggering symptoms of an underlying problem.

 

 

References:

1. http://www.mayoclinic.org/diseases-conditions/hypoglycemia/basics/definition/con-20021103  [accessed 4/30/14]

2. http://www.creationsmagazine.com/articles/C108/Cousens.html

3.  http://www.cell.com/cell/abstract/S0092-8674(12)00217-6

4. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2362.2006.01629.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false

http://japha.org/article.aspx?articleid=1034161

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