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| Please note that I am not a medical expert. The information on these pages is merely from my research and experience. |
Hypoglycemia (HG) is a condition characterized by periodic lows in the blood sugar level that cause a variety of symptoms including nervousness, shakiness, brain clouds, fatigue, depression, and irritability. This condition is also referred to as Low Blood Sugar (LBS).
The general cause of these symptoms in hypoglycemics is not eating often enough, or eating too much sugar/carbohydrates. Eating too much sugar/carbohydrates causes a high blood sugar level which then results in the pancreas overreacting and secreting too much insulin in its attempt to lower the blood sugar. The result is a very low blood sugar level.
The most common treatment for hypoglycemia is by diet.
Genetics
HG is often hereditary. So if you have a relative with diabetes or hypoglycemia, this might help confirm that your syptoms are a result of hypoglycemia.
Age
I've noticed that the majority of people develop HG during their mid-twenties. In my personal experience, I know that I've always had HG to some degree and couldn't go too long between meals. It was in my mid-twenties that the symptoms became bad enough that I had to change my diet to handle them.
Generally, my diet is a less strict version of the Krimmel diet -- high protein and low simple carbohydrates and starches.
The theory is to eat foods that will take longer for your body to process into sugar. This prevents you from getting too much sugar at one time which causes your body to overreact to the high sugar level and then try to eliminate too much sugar from the blood. Also, foods with protein provide a more consistent level of sugar over a longer period of time since they take longer to process into sugar.
These guidelines will probably sound impossible at first. I currently follow them all, including no sweets! Back when I started my research, I would never have believed that I could cut out sweets entirely. But over a three year period, I made gradual adjustments to my diet and eventually arrived at the point where I can say that I don't want to eat sweets because I prefer feeling good. I find that for me, it is easier to say that I don't eat any sweets than to eat one now and then, and keep overdoing it. (Like a snowball effect.)
I would recommend starting out by revising your diet gradually. I have broken it down into five "steps." Start with a couple of the steps and gradually add another one as you see results and are able to appreciate the improvements that they are making. I've tried to list the easier and more important ones first. You don't necessarily have to do them in order.
You may need to work on each step for a couple of months until you feel comfortable with it and ready to tackle another one. Everyone is different.
They're not easy. It's a big change. You'll just have to see which ones you can fit into your life.
Eat Regularly
Eat smaller meals, more often - Eat a snack or meal about every three hours. Ideally, you want to eat at the same times every day.
Aim for 6 to 8 grams of protein and low carbohydrate in each snack/meal.
Eat just before bed and first thing in the morning - A snack before bed will help you to sleep restfully and to feel better in the morning. Eat first thing when you get up in the morning to bring your blood sugar back up. I've heard that some people feel so terrible when they wake up in the morning that they keep a small glass of juice on the night table to drink in the morning.
Carry snacks with you - It's important to always have an appropriate snack with you wherever you go. You can't depend on hosts and restaurants to have appropriate food at the appropriate time. A bottle of water is also good to carry with you.
Avoid Preservatives
Specifically MSG (monosodium glutamate) and sodium nitrate which are used in many dried or frozen foods including:
Chinese restaurant food (ask for no MSG)
Doritos
Chex Snack Mix
some processed meats such as lunch meat and sausage
Campbells' chicken noodle soup
Banquet frozen chicken pieces
Stove Top Stuffing
dry vegetable dip mix
McCormick dry gravy mix
Boullion cubes - chicken or beef broth (HerbOx is a brand that is safe.)
Slim Jims
Manchuran noodle soup (like Oodles of Noodles, which I haven't checked)
some Hamburger or Chicken Helper kits
Reduce Simple Carbohydrates and Starches
Simple carbohydrates and Starches
Simple carbohydrates are sugars -- sucrose (table sugar), and fructose (fruit sugar). Starches include potatoes, potato products, rice, pasta, corn, corn products, and bread.
Fruit juice should be kept to a minimum or watered down
About 2 ounces is the most you should drink at a time. Fruit is better since it still contains the fruit fiber and therefore takes longer for your body to process into sugar. However, fruit should also be eaten in small amounts and probably with other foods. Also, avoid dried fruit, which is more concentrated sugar.
Reduce/Eliminate Caffine, Alchohol and Smoking
These can really throw off your blood sugar level. You can start out reducing them, and eventually consider eliminating them entirely.
Reduce/Eliminate Sweets
Try to seriously reduce the desserts that you eat. More importantly, don't eat sweets on an empty stomach or when your blood sugar already feels low. Ideally, if you're going to eat sweets, eat them right after a high protein meal, such as a steak. You can start out reducing them and only eating them at safe times, and eventually consider eliminating them entirely.
No matter how hard you try to manage your diet, you're going to make mistakes from time to time. In addition, factors such as stress can also affect your blood sugar level.
To bring your blood sugar back up, drink a small amount of fruit juice (about 2 ounces), eat a little bit of fruit, or eat a glucose tablet. Then you'll need to eat a healthy snack to keep your blood sugar at a comfortable level. This will also work well if your blood sugar gets so low that you feel too nauseous to eat.
Some physicians don't know anything about HG or don't believe that it is a valid condition. You may need to ask for a referral to a dietician for extra help on developing a diet to help manage your blood sugar. You may even want to consider interviewing other physicians to see if you can find one who recognizes that HG is real and will be helpful to you in learning to manage it.
Following is a list of examples of the entrees I've eaten for dinner to keep my blood sugar balanced since it has often been requested. Be sure to eat meals with non-starchy vegetables such as salad, broccoli, and spinach.
Carry decaff tea bags Decaffinated tea and herbal teas are good alternatives to regular tea. It's a good idea to carry decaff tea bags with you if you do drink tea since not all restaurants serve decaff tea.
Fruit for Dessert - After cutting almost all sugar out of my diet, I have come to really enjoy fruit. Fresh fruit is the best, of course, but in the off season and for convenience, I have found that frozen fruit is really good too. Giant sells bags of frozen berries and peaches.
Juice Popsicles - Freeze pure fruit juice (read ingredients carefully) in popsicle molds for a treat.
Smoothies - A fruit only dessert
I find it very difficult to avoid dessert sometimes. As an alternative, a fruit smoothie is a great, no-sugar-added dessert. Just be sure not to overdo the smoothies--they still have fructose (fruit sugar) in them. (see list of recipe books below)
Sodas - Cutting sugar and caffeine out of one's diet rules out all popular soft drinks. For a change from water, I drink flavored seltzer water/club soda. I have found these in the grocery store in flavors including raspberry, lime, lemon, orange and lemon/lime. Make sure you check that they have no sugar, there are similar drinks that have as much sugar as regular sodas. When eating out, I ask for club soda with lemon.
Breakfast Cereal Travel Tip - I have found that Post Grape Nuts have the most protein and least sugar of any cereal (please let me know if you've found something better!) Before traveling, I measure out a bowl of grape nuts into a ziplock bag and the necessary amount of instant dry milk. I make one of these for each day that I will be away. Then each morning, I can just add the required amount of water, and I can have breakfast first thing as usual, and not throw off my schedule.
Travel Snack Tip - It can be especially difficult to eat regular protein rich snacks while traveling. I have found that peanut butter and crackers is a good snack that does not require refrideration. I would carry a jar of peanut butter, crackers (graham crackers, saltines, etc.), a plastic knife, napkins and water in my backpack. You might even find a place to sit at a table and order some milk to go with your snack. I would often just sit on a bench when I needed to eat. (While peanut butter seems to be a good source of protein, nuts unfortunately do not seem to be effective. I have to assume that this is because the stomach is not able to break them down thoroughly enough or maybe quickly enough to use the protein.)
Glucose Tablets - Glucose tablets can be found at the grocery store pharmacy counter. They come in packs of 10 for about $1.50 a pack. Each chewable tablet contains 6 grams of glucose (pure blood sugar). I keep these in my purse, just in case I get stuck somewhere without food at snack time. I also plan to try one of these right before giving my next presentation since I have noticed my symptoms at those times of stress.
Sandwiches - Whenever possible, I use whole wheat bread, rolls and crackers. Another thing that you can do is eat open-faced sandwiches when practical. This reduces the amount of bread (simple carbohydrate) consumed by half.
Yogurt - Store bought yogurt that includes fruit or flavoring contains a lot more sugar than you might expect. Even the vanilla has a good bit of sugar. I prefer to make my own by mixing about a half a cup of plain yogurt with less than a quarter of a cup of fresh or frozen fruit. You can eat it this way, or mixed in a blender. Try fruits such as raspberries, cherries, peaches, or blueberries.
While I am not speaking from any known medical research, nor do I have the backing of any physician on this theory, I have my own personal experience plus that of about a dozen women who have written to me to confirm that there is in fact a relationship between HG and the pill. (Two physicians that I talked to didn't think that the pill would have any relationship to my HG.) In my own experience, I found that about 3-4 months after discontinuing use of the birth control pill, I found that I did not need to eat snacks every three hours and my symptoms overall are much less serious.
As an alternative to the pill, you may want to consider the natural method of birth control, Natural Family Planning (NFP), also known as the Fertility Awarness Method (FAM). This is not simply the rhythm method, but a much more effective method which involves observing fertility signs and daily charting in order to monitor one's monthly reproductive cycle. It is most effective when used by two persons in a committed relationship. An additional benefit of NFP is the empowerment of fully understanding your reproductive cycle throughout the month.
An excellent book on NFP is "Taking Charge of Your Fertility" by Toni Weschler. In addition, courses on FAM/NFP are available through a local Catholic Church Diocese family planning office or a local medical center, or through the Couple to Couple League and are highly recommended in order to fully understand this method. As mentioned before, I am not a medical professional and advise you to properly educate yourself before making any changes to your birth control method.
Snack Ideas - a list you can hang on your refridgerator for inspiration
I have listed the major hypoglycemia web links that I have found in an attempt to help other hypoglycemics find the available information. I hope that you will share wit me any other resources not linked into the pages below.
Frequently Asked Questions about Hypoglycemia
Hypoglycemia Homepage Holland - a wealth of information
Reactive Hypoglycemia Home Page
For the books listed below, I have included a link to each book in the Amazon.com catalog in case you have trouble finding copies of them.
If you would like to order more than one of the listed books through Amazon.com, I recommend that you select the link for the first book, add it to your Shopping Cart at Amazon.com's site, then return to this page and repeat the process for additional items. This will cause all the books to be put on one order and thus reduce the shipping costs per book.
I own both of the low blood sugar books listed below and highly recommend them.
"The Low Blood Sugar Handbook" by Edward and Patricia Krimmel, Franklin Publishers,
ISBN 0-916503-04-6
Order or get more information from Amazon.Com
"The Low Blood Sugar Cookbook: Sugarless Cooking for Everyone" by Patricia Krimmel,
Franklin Publishers, ISBN 0-916503-01-1
I do not follow the diet recommended in this book strictly, but have found several recipes that make great snacks.
Order or get more information from Amazon.Com
Smoothies : 50 Recipes for High-Energy Refreshment
Order or get more information from Amazon.Com
Smoothies : 22 Frosty Fruit Drinks
I have this book and just don't add fruit juice when it's called for. I also really like their advice to freeze the extra smoothie in popsicle molds.
Order or get more information from Amazon.Com
All books purchased through links on this page earn referral fees that help support this web page. (Referral fees do not impact the item's purchase price.)
