Diet for Hypoglycaemia (blood sugar imbalance)
by Sue Kira, Naturopath & Clinical Nutritionist
What is hypoglycaemia/Dysglycaemia/Blood sugar imbalance
– Causes of hypoglycaemia
– Signs, symptoms and diagnosis of non-diabetic hypoglycaemia
Case study: mood, energy, health and hypoglycaemia
What is Hypoglycaemia/Dysglycaemia/Blood sugar imbalance?
Hypoglycaemia (aka Dysglycaemia and Blood sugar imbalance) occurs when the sugar levels in your blood drop too low to give your body and brain cells enough energy to function properly.
It occurs with diabetes, however, in this article we refer to non-diabetic hypoglycaemia. For many, hypoglycaemia can be an ongoing problem with the potential to lead to diabetes.
There are two types of non-diabetic hypoglycaemia. The first is fasting hypoglycaemia which can occur if someone goes without food for eight hours or more. The second is reactive hypoglycaemia which usually occurs about two to four hours after a meal.
Causes of Hypoglycaemia
Some of the factors that can cause hypoglycaemia are:
- dietary influences
- alcohol
- over exercising, or exercising on an empty stomach
- eating disorders
- disease of the liver, kidneys or pancreas
- metabolic and/or digestive system issues
- certain medicines
- pre-diabetes
- stomach surgery
- excessive amounts of insulin in the blood
Signs, symptoms and diagnosis of non-diabetic hypoglycaemia
Most people have felt the symptoms of low blood sugar when very hungry or have exercised too much without proper nutrition beforehand, which is easy to correct and not normally an issue.
For many, hypoglycaemia can be an ongoing problem with the potential to lead to diabetes. But prior to that happening, many people suffer from various other indicators of blood sugar imbalances.
The signs and symptoms of non-diabetic hypoglycaemia vary depending on how low blood sugar levels drop. These include:
- shakiness and trembling of hands and sometimes the whole body
- a feeling of needing to eat something sweet immediately (often confused with a sugar craving)
- dizziness or lightheaded
- fatigue
- headache
- blurred vision
- feelings of anxiety or confusion
- fast heartbeat
- an inability to focus
- a feeling that you will ‘black-out’ or faint.
- sweating more than usual
- fainting
- seizures
To diagnose non-diabetic hypoglycaemia, a doctor would normally check your symptoms, overall health and may organise blood tests to test for sugar levels. There are also more detailed tests which involve fasting and observing symptoms in a controlled situation such as a hospital or a pathology collection centre, where blood sugar levels are tested after consuming glucose.
Doctors normally prescribe snacking and eating smaller meals more often across the day.
Diet and Hypoglycaemia
When blood sugars drop, that’s a call to eat. Most tend to rush and eat or drink something sweet for a sugar hit or spike, then the body settles for a while until the next sugar drop.
A better approach is to initially eat something sweet like a piece of fruit, immediately followed by something more substantial such as protein with vegetables or salad, to break the sugar spike cycle.
For example, if you have cereal or a banana for breakfast, you are more likely to have a blood sugar ‘attack’ in a couple of hours, whereas a more substantial breakfast, containing protein, will sustain you for much longer and not necessarily cause the drop that you would get from a carbohydrate/sugar type breakfast.
A blood sugar spike, caused by eating carbohydrates, first initiates the call from the pancreas to secrete insulin. Often, too much insulin is secreted to quickly lower the elevated blood sugar. When the blood sugar levels drop too low, the adrenal glands kick in and secrete cortisol, a stress response hormone, which starts to break down muscle to convert to sugar and bring blood sugar up to a normal level again.
This yo-yo effect can be very harmful to the body and after a while can lead to conditions such as diabetes, pancreas issues, adrenal exhaustion, anxiety, behavioural problems, hormonal imbalances (especially exacerbation of PMS symptoms), weight gain, and eating disorders.
When someone has hypoglycaemia, they are commonly told to eat small meals more often as larger meals are thought to stimulate too much insulin. But I found it depends on what was eaten previously.
For example, when I stayed at hotels and ate ‘continental breakfasts’ of juice, cereal, and toast, followed by tea or coffee, within three hours I’d have a ‘Hypo’ attack and felt like I was falling apart at the seams, sweating, shaking and weak. So I would eat fruit and get back on track for a while before another attack (unless I quickly had an early lunch). But if I ate breakfast at 7am with eggs, tomato, spinach and mushrooms and no toast, then I would be fine till 2pm and not at all shaky when I felt hungry for lunch.
In the first meal, even though the grain bread was gluten free and high in fibre, and the cereal was also gluten free and full of healthy grains and dried fruit, the meal was high in sugar. Consequently, the spike in my blood sugar created a flood of insulin that subsequently plummeted my blood sugar levels.
As a result of my experiences, I have shared a different way of eating with many of my clients (such as the egg breaky option) and all have had good results. The spacing of meals is an option and will work, but it limits your freedom because you must rely on eating and snacking throughout the day. Instead, you can eat when you are truly ready, after your body has had a rest and fully digested your last meal.
Non-diabetic hypoglycaemia is not about the timing of foods, it’s more about the type and quality of foods eaten.
For those who are affected by hypoglycaemia, it’s better to avoid many of the carbohydrates. The body can run very efficiently on fats for calories, rather than carbs. Eating quality foods doesn’t upset blood glucose levels and you can feel more stable all day, rather than the ups and downs of a carb based diet.
You might think you should have carbohydrates to balance your diet with the fats and proteins. Not a problem – there are carbohydrates in a diet for hypoglycaemia.
You see, there are two types of carbohydrates. One is stimulating and the other is non-stimulating. Stimulating foods can spike your blood sugar and stimulate your nervous system. Examples are sugary foods, breads, pastas and other products made from grains and sugar. Some fruits can also be stimulating such as mangos and grapes due to their high natural sugar content.
Non-stimulating carbohydrates (the goodies) don’t spike your blood sugar or stimulate the nervous system. These include most vegetables, salads, nuts, seeds, and fruits like berries, pawpaw/papaya, lemons and limes.
The idea is to eliminate foods considered detrimental and include foods that support your body. For this reason, all foods in a hypoglycaemia diet should be gluten and dairy-free.
Gluten comes from grain foods and grains are the types of carbs that have the potential to stimulate blood sugar levels to spike and then drop. Because of their fibre content, the spike from grains is not as fast as that of sugar carbs, but it still happens. Gluten and dairy products also contain proteins that are difficult to digest, and proteins are needed to help stabilise blood sugar levels.
Certain nutrients are also helpful to stabilise blood sugar levels; the most important is chromium. Other helpful nutrients are zinc and B vitamins (especially B6) . Foods that contain lots of fibre, especially the soluble type, can help to stabilise blood sugars. Cinnamon is a spice regarded for its ability to stop sugar cravings and helps to balance blood glucose levels.
Good sources of Chromium include:
Meat, broccoli, mushrooms, green beans, nutritional yeast, beef, chicken, calves’ liver, eggs, fish, sea-food, corn, potatoes and fresh vegetables. Licorice tea is also high in chromium.
Good sources of soluble fibre include:
Fruits, vegetables, seed husks, flaxseed, psyllium, dried beans, lentils, peas, soy milk and soy products as well as quinoa (pron kin-waa), chia seeds, buckwheat and amaranth.
Good sources of zinc include:
Beef (has more zinc than many other foods), oysters, spinach, shrimp, kidney beans, flax seeds, pumpkin seeds (pepitas) and watermelon seeds.
Good sources of B6 include:
Rice bran, pistachio nuts, tuna, liver, turkey, beef, chicken, fish in general, sunflower seeds, pork, prunes, bananas, avocados and spinach.
Meals in a diet for hypoglycaemia should not spike your blood sugars in the first place and are rich in the nutrients that support good blood sugar balance.
If you balance proteins with non-stimulating carbs and good quality fats and avoid sugars and other stimulating carbohydrates, you can avoid the ‘sugar crash’ symptoms. Those around you will be happier because you won’t be ‘biting their head off’, throwing something or ‘falling to pieces’. A bonus is that your job and relationships are more secure. ?
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Case study: mood, energy, health and hypoglycaemia
Client name and identifying information changed
When Cathy first came to me she thought she had ‘manic depression’ (bipolar disorder). This was initially self-diagnosed, then she visited her doctor who agreed with her and wanted to trial her on some medication. She was reluctant to do this and wanted to see if diet could help, which is why she came to me.
Her symptoms were massive mood swings, especially just before her period but also during ovulation. She said that she felt like she had PMS all month, but it was much worse at those times.
Cathy’s husband told her that unless her moods changed he was not going to hang around for much longer. She told me that sometimes she would be super aggressive to him and have ‘adult tantrums’. Other times she was so sad and depressed that she couldn’t function at work and her boss was almost over it.
She was sick on and off, with one flu after the other, catching everything that was ‘going around’ and any wounds she had took ages to heal. Cathy also suffered from many headaches and joint pains and her eye sight was failing. In short, she was a mess.
Although some of her symptoms looked like bipolar disorder, that diagnosis didn’t feel right to me. When I asked about her diet, I discovered that she had ‘massive sugar cravings’ (her words). Cathy had one slice of toast for breakfast (with honey) as she wasn’t hungry in the mornings, then by the time she got to work she was ‘starving’ and had a muffin and coffee. She also ‘lived off’ lollies and chocolates for snacks at work.
Lunch was a salad sandwich, which was two slices of white bread with limp lettuce, cucumber slices and tomato, which she considered healthy. Afternoon tea was a chocolate bar and coffee and dinner was normally a pasta dish with vegetables and small amount of meat, followed by several glasses of red wine to help her to relax after a stressful day at work.
Some days her diet was better, but when premenstrual her sugar cravings were enormous and she practically lived off chocolate.
I discussed the affects her diet would be having on her body and blood sugar balance. I then started Cathy on a grain free (gluten free), dairy free, sugar free diet and told her to avoid alcohol, chocolate and coffee as these would have had a huge impact on her erratic moods.
She was reluctant to give up chocolate, so we made a deal to follow my recommendations for two weeks to see if the diet helped, and if so, then I would give her some dairy and sugar free chocolate options. But first I wanted to give her body a clean break to see if that helped with her cravings.
I suspected that Cathy might also have a candida overgrowth to deal with, but the diet was the first thing to trial, and if that didn’t help then we would look at checking her bowel for bacterial imbalances.
After only two weeks on the diet for hypoglycaemia Cathy was a new woman. No headaches, no pains, no mood swings, no PMS symptoms (and she had just ovulated). Her husband was so amazed that he booked a holiday for the two of them to rekindle their relationship.
Cathy responded amazingly to the diet changes and was convinced the foods she previously ate were responsible for her massive mood swings. She didn’t even ask me about the chocolate recipes.
Thank goodness she didn’t need any medications. I prescribed some good probiotics to ensure her gut health would be fine and I knew that the foods in her new diet would ensure her gut remained healthy. I’m sure her boss was also happy.