The Truth About Hypoglycemia
I’ve received this question a number of times over the years: “I have episodes of hypoglycemia that make me really tired, foggy, and shaky. My doctor says to drink a glass of orange juice or eat some candy immediately and it works. But what should I do on the Wheat Belly lifestyle?” First of all, let’s put aside hypoglycemia–low blood sugars, generally 70 mg/dl (3.8 mmol/L) or less–that occurs in people with diabetes. In diabetics, it is a matter of making adjustments in insulin or other medications, or avoiding blood sugar drops during exercise, sleep, or prolonged periods of not eating. I’m not talking about this kind of hypoglycemia. I’m also not talking about very rare causes of hypoglycemia, such as insulinoma (a form of pancreatic cancer), binge drinking, antibodies against insulin or the insulin receptor in people with lupus, people who have undergone gastric bypass surgery, or have rare inherited carbohydrate metabolism defects such as glycogen storage diseases. Put all of that aside. I’m talking about the common, everyday form of hypoglycemia that plagues non-diabetic people and is responsible for symptoms such as fatigue, mental “fogginess,” confusion, slurred speech, trembling, rapid heart beat, irritability, and sweating. This form of hypoglycemia–“reactive hypoglycemia”–typically occurs about 90 minutes to 3 hours after eating (varying depending on the composition of the meal and the vigor of your insulin response). The conventional “solution,” as in the question above, is to consume some source of sugar, usually 15 to 25 grams worth. Once you understand why hypoglycemia develops, however, you will understand how knuckleheaded that solution is. Outside of diabetes, some diabetes drugs, and the rare causes of hypoglycemia me Continue reading >>
Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?
In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>
Keto Induction Vs Hypoglycemia
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Resurgam Type 2 (in remission!) Well-Known Member I had what must have been false hypos when I switched to low carb, which I treated with a few grapes, then a sit down for a few minutes until the feeling passed. I think that if I had allowed myself to become anxious and consumed a lot of carbs I'd have been bouncing around like a ping pong ball. The relief did not last all that long, but I was at home so it was not all that dangerous - though I did get lost on my way to bed - I turn out all the lights and walk from the landing to bed in almost total darkness, but we have lived here for decades so it was quite a strange feeling to become disoriented. After a day or so the feeling passed and I went into ketosis, but I did have to persist. I could have dropped the carb count more slowly to allow time for my body to adapt - but I have never been afraid of low carb, and still aren't despite the hypo feeling. The article you have just posted is written by people who haven't got a clue about the symptoms and how RH happens, it is a supposition that everyone has reactive hypoglycaemic and it is normal for those who have episodes of RH is normal. The condition they are describing is post prandial symptoms that are not hypos, there is a condition that is not RH but has the exact symptoms but don't hypo. My condition is real, my symptoms are real, I have a high intolerance to carbs and sugars. I have been in ketosis for well over two years, it is symptom free and since going into ketosis I have not had an episode of Hypoglycaemia. I know I still have the condition because of my last eOGTT (extended or prolonged oral glucose test) and I still went into hypo. Don' Continue reading >>
Insufficient Ketone Body Use Is The Cause Of Ketotic Hypoglycemia In One Of A Pair Of Homozygotic Twins
The Journal of Clinical Endocrinology & Metabolism Insufficient Ketone Body Use Is the Cause of Ketotic Hypoglycemia in One of a Pair of Homozygotic Twins Department for Clinical Science, Intervention and Technology (Clintec), Division of Pediatrics, (C.M., J.A., J.E.), Karolinska University Hospital, Karolinska Institutet, Huddinge SE-141 86 Stockholm, Sweden Address all correspondence and requests for reprints to: Claude Marcus, M.D., Ph.D., Professor of Pediatrics, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden. Search for other works by this author on: Department for Clinical Science, Intervention and Technology (Clintec), Division of Pediatrics, (C.M., J.A., J.E.), Karolinska University Hospital, Karolinska Institutet, Huddinge SE-141 86 Stockholm, Sweden Search for other works by this author on: Department for Clinical Science, Intervention and Technology (Clintec), Division of Pediatrics, (C.M., J.A., J.E.), Karolinska University Hospital, Karolinska Institutet, Huddinge SE-141 86 Stockholm, Sweden Search for other works by this author on: Department of Pediatrics (L.B.), University of Lund, SE-221 84 Lund, Sweden Search for other works by this author on: Department of Womens and Childrens Health (J.G.), Uppsala University, SE-751 05 Uppsala, Sweden Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1 November 2007, Pages 40804084, Claude Marcus, Jenny Alken, Jens Eriksson, Leif Blom, Jan Gustafsson; Insufficient Ketone Body Use Is the Cause of Ketotic Hypoglycemia in One of a Pair of Homozygotic Twins, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1 November 2007, Pages 40804084, Context: Childhood ketotic hypoglycemia (KH) is a disease characterize Continue reading >>
Ketogenic Diet And Hypoglycemia
Grief had me wide awake at 3 a.m. on Saturday, I was trying to figure out which chores I could cram into the 14 hours before I returned to the land of migraine disability. I had admitted defeat with the ketogenic diet. One more meal was all I had left on the diet; dinner would take me back to migraine as usual. Ketogenic Diet and Hypoglycemia: Cause and Effect Frustratingly, even though the ketogenic diet reduced my migraine attack severity and enabled me to be more functional, it also caused hypoglycemia—which is in itself a migraine trigger. Despite a month of various fixes, I couldn’t get it under control. (I’ve actually been wrestling with it for two months. That awful nausea I attributed to dehydration was actually hypoglycemia. The wrung out feeling I woke up with each day was the fallout from hypoglycemia-triggered migraine attacks that came on while I slept.) How I Discovered Hypoglycemia Was the Problem After increasing to 2500 calories to gain some weight back, I woke up each day ravenous and shaky. This seemed odd—how could I be hungrier than when I ate 1700 calories a day? Knowing that a ketogenic diet could cause hypoglycemia, I began researching. Not only did I discover that it was likely I had hypoglycemia, but the nausea and accompanying symptoms of the previous month fit the pattern of reactive hypoglycemia perfectly. Reactive Hypoglycemia Reactive, or postprandial, hypoglycemia occurs two to four hours after eating. It’s usually a crash after eating a meal high in carbohydrates. Although I wasn’t eating many carbohydrates, my blood sugar was so low the rest of the time that I’d crash after my meal each day. It would start two hours after the meal, but I’m so used to ignoring vague physical symptoms that I didn’t notice until they got Continue reading >>
The Ketogenic Diet And Hypoglycemia
I wanted to write a technical post about a question I keep getting regarding the ketogenic diet and hypoglycemia. Even if youre not into the keto diet, I think you may find some useful ideas to makelow blood sugar less invasive in the short term. I recently shot a series of videos about the ketogenic diet and diabetes as part of my daily YouTube vlogging and you can check those out and subscribe here. My general goal in my diabetes management is minimalism. Minimal intervention, treatment and daily impact. The most basic manifestation of this is to aim for the use of less insulin, which can create greater blood sugar stability. This strategyled me to a low carb diet. The need to have athletic performance in addition to the blood sugar stability led me one step further to the keto diet. Using less insulin and eating fewer carbs means that lows do still happen but less frequently and they are easier to handle. Consider driving an empty truck down a hill. Its going to be easier to stop than if its loaded down and has greater momentum. The same concept applies to insulin loads and slowing the drop of blood sugar. Simply lightening the load can simplify control of the vehicle. When a low blood sugar occurs, the treatmentideally involves matching anincrease in BG to the proportionate decrease in order to balance the two out. Therefore all hypo treatments are not created equal, or one treatment does not fit all lows since different methods of raising blood sugar work differently. One of the biggest obstacles to blood sugarstability is over correction of lows. Over correction can result from either the source of the treatment, the quantity of the treatment or a combination both factors. In other words, you dont have to eat the entire pantry to overcorrect and spike. Sometimes Continue reading >>
Can A Ketogenic Diet Cause Hypogycemia And Insulin Resistance?
What are the consequences attached to being on a ketogenic diet long term? Is the Atkins Diet, Keto Diet, Nutritional Ketosis (LCHF) and other diets that restrict carbohydrates safe, or are there unforeseen consequences that might pop up from keeping your carbohydrate level very low? Can a long-term ketogenic diet actually cause insulin resistance and hypoglycemia? I was reading over at Lowcarber forum a couple of days ago, and ran into something interesting in the Atkins' section. Someone over there was asking if a long-term ketogenic diet had the capacity to cause insulin resistance and hypoglycemia. Her concern was due to an interview that Jimmy Moore had with Dr. Keith Berkowitz of the Center for Balanced Health. Now, I'm not completely sure where this interview transcript came from because I only have dial-up and can't listen to Jimmy's podcasts. I'm just assuming that's what this is, a transcript from a podcast. The transcript is definitely an interview Jimmy had with Dr. Berkowitz a little while ago. If you want to read that interview, so you'll understand what I'm talking about in this post, it can be found here; just scroll down to post #8. It's not very long. My Gut Reaction to the Comments Like many low-carb forums, the response to the interview posted over there was frustrating. Dieters who would rather believe in and defend low-carb magic over science or biology tend to ignore what's really going on. In this case, most of the comments were useless. A lot of things that Dr. Atkins wrote in 1972 have not held up to the science, but that doesn't mean that a low-carb diet is not a useful tool to combat obesity and assist you in getting down to a healthier weight. [I reread the interview this morning, November 2016, in order to update this post and found it inte Continue reading >>
[ketotic Hypoglycemia In Children].
Abstract Idiopathic ketotic hypoglycemia is the most frequent cause of hypoglycemia in children between 1 and 5 years of age. The symptoms and signs of hypoglycemia are often overlooked because they mimic signs of other common diseases like psychiatric disorders, migraine, gastro-enterological dysfunction, or visual disturbances. Glycemia and ketone bodies in the urine should be systematically investigated in such cases. Because hypoglycemia is a life-threatening event and can lead to severe neurological sequelae, intravenous administration of glucose is mandatory. These children respond promptly to glucose. Infants with normal growth and psychomotor development, normal physical examination who present with a first episode of symptomatic fasting hypoglycemia and elevated ketonuria, and who improve quickly after intravenous glucose administration, do not need a comprehensive metabolic and endocrine workup. Recurrence of hypoglycemic attacks can be prevented by supplying frequent snacks containing complex carbohydrates, so called "slow sugars", particularly at bed-time. Other causes of ketotic hypoglycemia are briefly presented. Continue reading >>
Help With Hypoglycemia
Im hoping for some insight. I attempted going keto last November (in solidarity with my husband). After 2-3 days I would end up with hypoglycemia in the mornings upon waking. BG would be 45/50/55 and I was shaky, exhausted, nauseated which endedin vomiting for hours in two occasions. So I went to my doc and all his tests were normal, so he sent me to an endocrinologist and all HIS tests were normal. The Endo diagnosed me with reactive hypoglycemia. Now I have two thoughts on this. The first is that RH is basically early T2D. The second is that the Endo isnt very smart since I never have hypos after eating I only have them when waking. I did a round or Whole30 in January. Not one hypo, and I was tracking my BG. I was frequently in the 60s but felt fine. I decided to try keto again as I want all the amazing benefits and nobody can find anything wrong with me. I started in March 1st, and have been pushing the sodium and magnesium. I felt great! Until this morning on day 7, woke up shaky and nauseated. My BG was 50. So I added about. 1/4 sweet potatoe into my breakfast. I know this lifestyle is important to my wellbeing- mainly for cancer resuction. Do I just go slowly? Is it possible my body just doesnt do GNG well? Hmmmm. I am not sure. Hopefully someone with more smarts on this will turn up. The only thing I can thing to suggest is to maybe ease in a little slower if having a bit higher carb stops it? Does the sweet potato help? Maybe smaller and smaller amounts of similar if it does? I also have reactive hypoglycemia. After the hours long test I was well below 50. Before I knew that I would binge on sugar and then crave a triple cheeseburger, it always helped level me. I used to think simply staying away from processed sugar and simple carbs would be enough. I ate high Continue reading >>
Common Concerns About Low-carb Dieting And Hypoglycemia
I magine that you’re a few days into your low-carb diet and when you suddenly you begin to feel “off”. You’re experiencing “brain fog”, light-headedness, weakness, and mood swings. Thoughts race through your mind. I don’t feel right…could I be hypoglycemic? Oh no, my blood sugar is low. Maybe, I should drink some fruit juice… STOP! Hold it right there! There is a better solution, but first, let’s try and figure out what may be the cause. Why am I feeling this way? When I hear someone say that they are hypoglycemic, I often raise an eyebrow. It is possible for some to experience episodes of acute hypoglycemia, or low blood sugar, but that term gets tossed around more than a hot potato. In fact, the medical field uses a variety of values in glycemic control as cut-off points in order to define hypo- or hyperglycemia. The cut-off values aren’t clear-cut. If you have a true underlying medical cause, such as diabetes, or some other condition, then this article isn’t intended for you. This is for the rest of the population, most of whom may not even know what a common fasting blood glucose range is. When one begins The Carb Nite® Solution, Carb Backloading™, or any other low-carb diet, there are some foreign physiological changes that can occur, and it is normal to be concerned or aware of these shifts. The “feeling” that you’re experiencing may indeed be a drop in blood sugar. Even if it’s within the normal range, you may experience the symptoms of hypoglycemia. However, there could be other reasons that you aren’t feeling optimal. Improving metabolic flexibility to use fats for fuel, namely the rate at which fat oxidation adjusts to high fat intake, can vary[2-4]. You could also be experiencing a shift in electrolytes. That being s Continue reading >>
Can A Ketogenic Diet Cause Hypoglycemia Or Low Blood Sugar?
Short Answer: It can but usually only in the first few weeks of keto and usually in only the most insulin resistant. Your Old Diet Before we get into how hypoglycemia is possible with a ketogenic diet, let’s review what happens with your blood sugar levels when you start a ketogenic diet. While you were eating your traditional high-carb Standard American Diet, you were training your body to produce a large amount of insulin with every meal. This insulin was important because the high levels pf blood glucose your diet was producing was toxic to your body so your body had to get that sugar out of the blood stream and into cells where it could be used as fuel or stored as glycogen of triglycerides. Your New Diet Now let’s look at what happens when you start a ketogenic diet. Your body continues to produce the same amount of insulin when you eat which should cause your blood sugar levels to drop so instead, your body begins to pull sugar out of all the nooks and crannies in your body where it stored it. The first reservoir to be tapped is the glycogen stored in your muscles. This stock of sugar is large enough that you can potentially go several weeks with normal blood sugars on keto but eventually those stores run out and that’s when things can get a crazy. Now for most people, by the time the stores of sugar are depleted, your body has already begun making a few of the necessary changes to your metabolism to run on fat and the feeling of being “run down” or what is sometimes called the “Keto Flu” only last a few days. The body makes the transition over to running on stored fat and ketones and you are off to the races but for a few people, especially the really insulin resistant ones, you can start to feel the symptoms of hypoglycemia. Symptoms of Hypoglycemi Continue reading >>
Hypoglycemia And Low-carb
Many people know that low blood sugar or hypoglycemia (HG) is usually associated with persons with type-1 diabetes. Their blood sugars are often very labile –going too high and dropping too low. In this situation HG not only causes severe symptoms that diminish one’s quality of life but can be lethal. One of the benefits of carbohydrate restriction in a person with type-1 is that blood-sugar swings even out with more moderate highs and far less hypoglycemic reactions. One reason why this happens is because we are able to decrease medications including insulin that a person with type-1 diabetes must take. Reactive Hypoglycemia: Lots of People Have It The purpose of this article is to talk about reactive hypoglycemia (RHG), a far more common occurrence. It is often unrecognized and undiagnosed. It is not likely to cause death but is associated with a long list of symptoms that can interfere with everyday life. Symptoms of RHG are often treated with prescription drugs but because it is the result of lifestyle it should be treated with lifestyle changes. Reactive hypoglycemia or low blood sugar is not the opposite of diabetes (high blood sugar). It is the same condition just an earlier phase. When one eats too many carbs, especially simple sugars and starches, glucose is digested and dumps in the blood quickly. The body responds by making insulin to carry glucose into the cells for energy. Any excess glucose is stored as glycogen and when the glycogen store is full, the glucose gets stored as fat in fat cells. There are a number of factors than can lead to diabetes. If a person has a genetic risk for diabetes they are likely to be carbohydrate intolerant to some degree. This means their cells may be resistant to the effects of insulin requiring more and more to be produ Continue reading >>
Ketotic hypoglycemia is a medical term used in two ways: (1) broadly, to refer to any circumstance in which low blood glucose is accompanied by ketosis, and (2) in a much more restrictive way to refer to recurrent episodes of hypoglycemic symptoms with ketosis and, often, vomiting, in young children. The first usage refers to a pair of metabolic states (hypoglycemia plus ketosis) that can have many causes, while the second usage refers to a specific "disease" called ketotic hypoglycemia. Hypoglycemia with ketosis: the broad sense There are hundreds of causes of hypoglycemia. Normally, the defensive, physiological response to a falling blood glucose is reduction of insulin secretion to undetectable levels, and release of glucagon, adrenaline, and other counterregulatory hormones. This shift of hormones initiates glycogenolysis and gluconeogenesis in the liver, and lipolysis in adipose tissue. Lipids are metabolized to triglycerides, in turn to fatty acids, which are transformed in the mitochondria of liver and kidney cells to the ketone bodies— acetoacetate, beta-hydroxybutyrate, and acetone. Ketones can be used by the brain as an alternate fuel when glucose is scarce. A high level of ketones in the blood, ketosis, is thus a normal response to hypoglycemia in healthy people of all ages. The presence or absence of ketosis is therefore an important clue to the cause of hypoglycemia in an individual patient. Absence of ketosis ("nonketotic hypoglycemia") most often indicates excessive insulin as the cause of the hypoglycemia. Less commonly, it may indicate a fatty acid oxidation disorder. Ketotic hypoglycemia in Glycogen storage disease Some of the subtypes of Glycogen storage disease show ketotic hypoglycemia after fasting periods. Especially Glycogen storage Continue reading >>
Will Low-carb Diets Cause Blood Sugar Levels To Drop?
Video of the Day If you're accustomed to eating a very high-carb diet and suddenly switch to a very low-carb diet, you could experience rather dramatic drops in your blood sugar during the first few days or weeks of your transition. This low blood sugar can cause notably uncomfortable side effects and intense cravings. Carbs and Blood Sugar Your body converts consumed carbohydrates into glucose, a type of sugar. When the glucose enters your bloodstream, it leads to an increase in your blood sugar level. The pancreas produces insulin in response to spikes in blood sugar, which helps your body store the sugar for energy. This insulin release subsides when your cells absorb the sugar and your levels stabilize. In a healthy body, the surge of blood sugar and insulin is relatively moderate and keeps you evenly motoring through your day. When you eat lots of carbohydrates, your body's blood sugar remains consistently high and your system constantly pumps out insulin. This chronic elevation of blood sugar and release of insulin causes inflammation, an increase in fat storage and an inability to burn stored fat. Chronically high blood sugar levels increase your risk of disease, including heart disease and type 2 diabetes. You crave carbohydrates regularly for energy, because your body isn't efficient at using stored fat for fuel. How a Low-Carb Diet Impacts Blood Sugar If you regularly consume a large amount of carbohydrates, especially refined ones like white bread and soda, you may experience a notable drop in blood sugar when you drastically reduce your carb intake. In the first week of carb reduction, your body will seek to maintain your high sugar intake. You'll crave carbohydrates and may even feel weak because your body hasn't yet become efficient at burning fat for fuel Continue reading >>
Reactive hypoglycemia is a condition in which the body reacts to a perceived catastrophic drop in blood sugar. I say perceived because during an episode, the blood sugar readings may be in the normal range, but still "feel" like low blood sugar to the person having the reaction. In my experience, hypoglycemia happens to most people when first beginning a low carb, ketogenic diet. It may be especially strong in people who have already developed insulin resistance or pre-diabetes from a chronic excess of carbohydrate intake. There are different types of low blood sugar causes. Transient hypoglycemia normally happens when most people who have been eating a high carb diet drastically reduce carbohydrate intake for the first time. This type happens during the first several weeks of carb reduction because the body has not had time to create the enzymes or metabolic state to burn internal fat stores for fuel. Basically there is a gap in the amount of carbohydrate available for fuel, and the process of accessing fat stores for fuel. The lack of fuel sources results in transient low blood sugar. Reactive hypoglycemia is more of an acute reaction to a very high carb meal. For instance, when a person eats 2 or 3 glazed donuts, there is a huge spike in blood sugar and compensating insulin secretion after such a meal. The large insulin spike drives blood sugar very low several hours after the meal. How Reactive Hypoglycemia Happens Insulin, a hormone, is secreted from the pancreas in response to eating food, especially foods high in carbohydrates. Its main job is to move the sugar your body makes from the food you eat into your cells so that this excess sugar can be broken down for energy or stored. Insulin is a very powerful hormone, and it acts very quickly. The amount of insulin Continue reading >>