The Ultimate Guide to Hypoglycemia And Natural Treatment

The Hypoglycemia Treatment

Standard hypoglycemia treatment is built on the foundation of managing hypoglycemia-not necessarily reversing it or healing it…until now. Here’s all you need to know about the root causes of hypoglycemia and natural hypoglycemia treatment methods to curb shakiness, low energy and crashes for good.

Hypoglycemia 101

Hypoglycemia, or low blood sugar, is a blood sugar dysfunction that affects approximately at least 1 in 3 people at some point, given that 1 in 3 people have pre-diabetes and about the same amount of people have diabetes*. Although, not all people with hypoglycemia have diabetes and the condition can occur in people without diabetes, as we will discuss further. 

Hypoglycemia is characterized by low energy production and low glucose in the cells..

According to lab blood work, hypoglycemia is diagnosed with a low plasma glucose reading of less than 70 mg/dL.

Severe hypoglycemia presents with a blood glucose reading of less than 40 mg/dL. 

Healthy fasting blood sugars for healthy individuals are 70-85 mg/dL (fasted blood glucose levels). After meals, your blood sugar should rise about 40 mg/dL higher over your fasting levels, only to go back to your fasting levels 2 hours later.

Diagnosis

In conventional medicine, official diagnosis of hypoglycemia is made when individuals meet “Whipple’s Triad”—characterized by these three criteria:

1. Symptoms consistent with hypoglycemia;
2. Low plasma glucose measured with a precise method (meaning not a glucometer), when symptoms are present (below 40 mg/dL) on lab testing;
3. Relief of those symptoms if plasma glucose is raised

If the patient is not symptomatic during testing, practitioners sometimes may recreate the conditions in which hypoglycemia would appear by doing a prolonged supervised fast for an official diagnosis. This is the most reliable test for hypoglycemia in a food-deprived state. 

Q. What if the doc says I am fine, but I still have low blood sugar?

In functional medicine, hypoglycemic episodes and chronic hypoglycemia is not ruled out by this criteria alone. 

For instance, many people who present with “adrenal fatigue” or “HPA Axis” dysfunction (chronic stress) may even have normal blood testing levels on clinical labs, only to regularly experience hypoglycemic “crashes” and signs and symptoms aligned with hypoglycemia.  

Reactive hypoglycemia is another common “phenomenon” in the hypoglycemia presentation—characterized by hypoglycemic episodes if one goes too long between meals, or even “crashes” after meals, as if the body is unable to use the food it was just given. Reactive hypoglycemia is not always recognized in the conventional medicine setting. 

If an individual has ongoing symptoms that are consistent with hypoglycemia (below), but their blood glucose reading is 70 mg/dL, we look first to the overall clinical presentation and less to numbers alone. We seek to rule out other conditions that can also cause these symptoms (such as under-eating, gut pathologies, etc.), but if the problems still remain, then a blood sugar disorder, like hypoglycemia may very well be present. 

Signs & Symptoms

Signs and symptoms of hypoglycemia are diverse and non-specific. They may include:

blurred vision

anxiety

dizziness

light headedness

depression

fainting spells

fatigue

headache

irritability

mood swings

cravings for carbs or sweets

night sweats

constant hunger

swollen feet

confusion

cognitive impairment or behavior changes

weakness in the legs

nervous habits

insomnia

pain in various parts of the body (especially the eyes)

mental disturbances 

a feeling of tightness in the chest

seizure & coma (at lower plasma glucose concentrations)

 

 

Note: Hypoglycemia symptoms may also go unrecognized due to “hypoglycemia unawareness.” Some people may experience symptoms like anxiety, weakness, tremor, perspiration, or palpitations, but shrug them off or think they are related to something else. Many practitioners also fail to recognize that hypoglycemia may be present. 

Causes of Hypoglycemia

Conventional Medicine

The following are recognized explanations for the cause of hypoglycemia in conventional medicine: 

• Drugs & Alcohol
• Critical Illness
• Anorexia & eating disorders
• Cortisol Deficiency or “Adrenal Fatigue” 
• Cell Tumors & Pancreas Dysfunction
• Hyperinsulinism (beta cell disorders, autoimmune hypoglycemia disorder where the body attacks insulin)
• Diabetes & impaired glucose tolerance (unable to control sugar)
• Postprandial syndrome (low blood sugar under 50 mg/dL within 2-4 hours of eating)

Unfortunately, many cases of hypoglycemia can go unrecognized or unexplained because many patients with hypoglycemia won’t necessarily have any of the conventional causes at play.

Root Causes of Hypoglycemia: Functional Medicine

In functional medicine, we always dig deeper, asking: “What is the ROOT cause of imbalance?” 

Unfortunately, the mention of the contribution of modern lifestyle is typically overlooked in conventional medicine. The lifestyle and underlying causes of hypoglycemia (especially postprandial—following meals) are practically identical to the underlying causes of hyperglycemia (high blood sugar), including:

• Sleep deprivation
• Disrupted gut bacteria & gut pathologies
• Recent surgery
• Antibiotic use
• Physical inactivity or over-training (1)
• Nutrient imbalances
• Environmental toxins
• Chronic stress
• Under-eating
• Westernized diet (processed, packaged, vegetable oils, sugars, additives) 

Hypoglycemia Physiology 

Regardless of the root cause of hypoglycemia, it can be super frustrating to feel like your body is “working against you”— no matter how “clean” you eat or how healthy you try to be. 

Why can your body no longer handle glucose, food and balance your blood sugar levels?!

To answer this question, it’s important to understand the physiology of low blood sugar.

How Digestion Should Work

The body is designed to digest and assimilate three primary nutrients: proteins, fats and carbohydrates. 

Proteins and fats can be used for energy, but their conversion to usable forms in the body is NOT immediate; it’s gradual. Carbohydrates, on the other hand are immediate energy and readily digested into sugar. 

Low-glycemic carbohydrates such as many vegetables and beans provide a slow time-release of the sugar they contain in their complex molecules of starch mixed with fiber. The presence of “resistant starch” pre-biotic foods (like cooked and cooled potatoes/sweet potatoes, cooked and cooled white rice, prebiotic supplements, beans, green plantains and bananas) further slows the sugar liberation process.

High-glycemic carbs (foods with higher amounts of sugars, like cooked carrots, parsnips, grains, cereals, several fruits, honey, sweets and refined foods) provide a rapid sugar fix. This results in an immediate, pleasant sense of gratification—sometimes even a mild drowsiness. (i.e. a “sugar high”). 

In response to any sugar or energy (food) in the blood, the body calls upon its insulin reserves, generated by the pancreas, to lower the blood sugar. It especially calls on ALOT of insulin when it seems as though there is more sugar than the body can handle at once. 

Enter: The hypoglycemia dilemma. 

How Hypoglycemia Works

Hypoglycemia (low blood sugar) happens when a person eats food their body’s cells need; but their body is unable to uptake or use the glucose as normal, resulting in an influx of insulin in the blood stream to lower blood sugar, followed by a “crash”—since the person’s blood sugar lowers too much, resulting in all sorts of side effects including: low energy, a “blood sugar rush,” brain fog, poor concentration, memory and mood. 

In addition, low blood sugar triggers an outpouring of counter-regulatory hormones from the adrenals—including adrenaline and cortisol.  These hormones oppose the action of insulin to push blood sugar levels back up. Unfortunately for the hypoglycemic person, these “rescue” hormones are the very same ones that produce the adrenaline rush of a “fight-or-flight” response, resulting in symptoms like palpitations, sweaty palms, nervousness, tremor, waking up in the middle of the night and panic attacks.

Why Hypoglycemia Keeps Happening

Here’s an in-depth understanding of why hypoglycemia keeps happening for you. 

Cortisol Imbalances (Stress Hormone)

Cortisol is a stress hormone that fights every day to balance blood sugar levels, and drives hypoglycemia symptoms if it’s imbalanced. Physiologically, cortisol binds to receptors on the fat cells, liver and pancreas, and increases glucose levels (energy) for muscles to use. When cortisol is imbalanced however—super high, super low or a mix of both—your normal “blood sugar balance” gets confused too. For some people this leads to hypoglycemia, others it can lead to hyperglycemia.

Blood sugar imbalances go hand in hand with cortisol imbalances. When your blood sugar is high, cortisol is high too. When blood sugar is low, cortisol is low.  People with hypoglycemia typically present with cortisol imbalances throughout the day—one moment feeling “fine,” only to have a quick high, followed by a quick low (i.e. a hypoglycemic crash). Since cortisol influences your pancreas and liver in particular (your organs responsible for producing and using your hormones that regulate blood sugar—insulin and glucagon), if your cortisol is out of whack, then so is your blood sugar balance. (2, 3, 4, 5, 6)

Excess Adrenaline (“Fight or Flight” Hormone)
There are four main hormones involved in raising blood sugar levels:

• glucagon (your body’s preferred source);
• cortisol;
• growth hormone (GH); and
• adrenaline (aka epinephrine, norepinephrine)

Our bodies use adrenaline when the others don’t work. One of the roles of adrenaline (fight or flight hormone) is to promote the release of glucose from the locations in the body where it’s stored. Adrenaline also binds to receptors on the heart and heart vessels—and is responsible for producing many hypoglycemia symptoms. 

When the body’s blood sugar level thermostat, decides that your blood sugar is too low and your other hormones aren’t doing their jobs properly, it signals to your adrenal glands to out on the emergency brakes. Adrenaline kicks up for a quick release of blood sugar to your body, resulting in common symptoms of hypoglycemia: You get the shaky, a blood rush to your head, “brain fog”, hunger, and sometimes (if the problem happens overnight) it may even wake you up, your body screaming for food, also known as “nocturnal hypoglycemia” (nighttime hypoglycemia), and consequently, further blood sugar imbalances and more adrenaline the next day—during waking hours—as the body attempts to recover.

If you don’t calm adrenaline down (with food, suppressing the stress), then increased adrenaline causes an increased body demand for MORE glucose so that body can handle stress. It’s a vicious cycle. (2, 7, 8)

Low Serotonin (Feel Good Brain Chemicals)

Your brain requires TONS of energy (70-80% at any time) from the food you eat—derived from proteins, carbs and healthy fats. However, if you have a gut dysfunction (and your body is unable to digest these foods) OR you have nutrient deficiencies, then your brain energy is starved and it cannot create neurotransmitters, like serotonin.

Serotonin helps your body maintain balance, feel satisfied and prevent stress. Without enough serotonin, your brain triggers the release of stress hormones (cortisol), which then drives blood sugar levels quickly up—only to eventually plummet shortly after a meal once the energy-taxing process of digestion begins. 

Low L-Carnitine (Helps Your Cells “Digest” Fats & Proteins) 

Carnitine is an amino acid that can be made by the body and helps transport long chain fatty acids across the inner mitochondrial membrane to be used as a source for ATP synthesis (beta oxidation and “energy”). However, although the body can make l-carnitine, individuals with hypoglycemia may not have the proper nutrients to make it in the first place, including: amino acids lysine and methionine, vitamin C, vitamin B6, iron, and oxygen.

If you don’t have enough l-carnitine for the body to use your own healthy fats for energy when glucose levels drop, then when glucose levels drop, you are left with the inability to convert fats into energy to counteract the balance, resulting in hypoglycemia in some cases. Carnitine deficiency is particularly common during and after pregnancy, and in vegan/vegetarian diets.  

Bad Gut Bacteria

Gut bacteria dictate the health of every function in our body— blood sugar balance included. You have more than 100 trillion gut bacteria living in you—10 times more bacteria than cells in your body. Thus, the healthier these bacteria are, the healthier you are too. When it comes to glucose balance, your gut bacteria are responsible for helping you digest and metabolize everything you eat—particularly carbohydrates and sugars. If your gut bacteria are unhealthy, than this process can dysfunction (9).

Multiple studies have shown the links between elevated pathogenic gut bacteria, decreased healthy gut bacteria and blood sugar imbalances, like diabetes and blood sugar dysfunction (10-14).

For instance, in people with SIBO (small intestinal bacterial overgrowth), when SIBO is eradicated, blood sugar levels, cholesterol and other inflammatory also have been shown to improve (15). In another example: one researcher was able to reverse type 2 diabetes in all of the 250 study participants by doing fecal transplantations on them (swapping out their gut bacteria for someone else’s) (15.1).

Other research shows that IBS (irritable bowel syndrome) is positively correlated with metabolic syndrome (16). To balance blood sugar, researchers have also found that increasing healthy bacteria (probiotics and prebiotics) helps balance blood sugar. A German Diabetes Center clinical study found that taking the probiotic Lactobacillus reuteri promoted optimal glucose and insulin levels in participants (17). Another study found that, after just six weeks of consuming a probiotics, the 64 study participants experienced balanced blood sugar and lessened oxidative stress (18). Given that hypoglycemia is highly correlated with stress, decreasing gut inflammation naturally helps decrease stress. Lastly, in addition to probiotic power, increasing short-chain fatty acids and pre-biotics (fibers that feed healthy bacteria)  has been shown to counterbalance the metabolic deregulation in persons with glucose impairment disorders, including both hypoglycemia and reactive hypoglycemia (18.1) 

Candida & Fungal Overgrowth

On top of bad gut bacteria, fungal or yeast (candida) overgrowth can also cause problems for glucose tolerance and hypoglycemia. Candida albicans—the most common form of candida in the gut—has been shown to increase with glucose elevations (i.e. eating starchy carbs, sugars and blood sugar imbalances) and chronic stress (19, 20). One study in non-diabetic women with candida overgrowth showed a significantly impaired tolerance for glucose (carbs) and poor blood sugar control compared to controls (21).  Another study found that individuals with lower morning cortisol levels (i.e. “adrenal fatigue”) were more likely to have both yeast infections and blood sugar intolerances (20).

There are a variety of ways that Candida impacts blood sugar, but without getting too technical it basically boils down to this: It disrupts organs, systems and hormones, like the pancreas, thyroid, liver, adrenal glands, insulin levels and cortisol, which then disrupts the way the body processes glucose.

Additionally, pathogenic yeast and fungi feed on your glucose, which then brings your blood sugar crashing down. It causes nutritional deficiencies and if certain nutrients are not provided in the body in adequate levels, this contributes to hypoglycemia. 

One of candida’s primary weapons for destroying tissues and acquiring nutrients in the body is through enzymes it produces called Secreted Aspartyl Proteases (SAPs)— candida’s primary mechanism of how it spreads in the body and causes damage.

Researchers have discovered that SAPs enzymes can also cause pre-diabetes, immune system suppression, and high blood pressure. Pre-diabetes conditions include insulin-resistance and hypoglycemia. Insulin attaches to receptors on cells that then activate the absorption of sugar from the blood. These protease enzymes will chop off the receptors on cells causing blood sugar levels to increase, only to quickly fall as the cells are not fed (22, 23).

Candida & Bacteria Die Off

Given the connections between candida/fungi, gut bacteria and blood sugar balance, episodes of hypoglycemia can also arise when you begin to actually treat the candida, treat bacterial infections, and/or support your gut health. This happens as part of a die-off reaction—as pathogenic yeasts and bacteria are “starved” of the fuel source you’ve been feeding it (glucose) or as you target them with anti fungal herbs, medications and/or probiotics and prebiotics. In die off reactions, toxins are released as the Candida or gut bacteria is killed. If too much is killed at one time it can overload the body with toxins and result in a variety of symptoms experienced in hypoglycemia—including shakiness, weakness, and feeling fluttery inside. Additionally, people may experience hypoglycemia when they begin eating a low-carb or ketogenic based diet, particularly if they also had a gut infection or yeast/bacterial overgrowth. Since glucose is the primary fuel source of yeast and bacteria, when you cut this back, your gut bacteria and yeast “fire up”—causing stress to your blood sugar balance. 

Sluggish or Toxic Liver

Your liver is responsible for storing energy (mostly from carbohydrate), called “glycogen” and breaking it down into glucose (sugar) for your cells to use and keep your blood sugar balanced all day long. However, if your liver is sluggish and unable to break down glycogen appropriately OR it is in “overdrive” from adrenaline (and breaks it down TOO fast), this can lead to blood sugar imbalances— “starving” your body and cells from getting the energy they need all day long. Liver malfunctions or sluggishness can happen from a number of reasons including: excess adrenaline or cortisol (stress), low-fat diets, long term low-protein (vegetarian/vegan) diets, bad fat diets (canola oil, packaged processed foods, eating out), environmental toxins, long term birth control or medication use. 

Pancreatic Insufficiency

Pancreatic insufficiency happens when pancreatic functions start to decrease and there are not enough exocrine enzymes released to digest food properly. As a result, the body struggles to absorb a lot of vital nutrients necessary for energy in your cells. This usually occurs due to tissue damage of the pancreas itself, or as a blockage of the ducts that move digestive enzymes into the intestines, and can lead to symptoms like hypoglycemia.

Chromium Deficiency

Supplementation with chromium in individuals with hypoglycemia has been shown to help naturally raise blood glucose levels (24)—suggesting that chromium deficiency may be at play in hypoglycemia. Chromium is a mineral that humans require in trace amounts. Chromium is known to enhance the action of insulin and is directly involved in carbohydrate, fat, and protein metabolism. Foods naturally high in chromium include: green beans, broccoli, nuts, brewer’s yeast, egg yolks, chicken and beef. In one study, eight women with symptoms of hypoglycemia supplemented with 200 mcg of Chromium as chromic chloride for three months. Chromium supplementation alleviated the hypoglycemic symptoms and significantly raised the minimum serum glucose values observed two to four hours following a glucose load. Insulin binding to red blood cells and insulin receptor number also improved significantly during supplementation (24). 

Treatment of Hypoglycemia

The following measures are essential in treating, managing and reversing hypoglycemia:

Address the Root Causes

Hypoglycemia treatment first starts with addressing the root causes of hypoglycemia, and asking: What caused hypoglycemia in the first place? Is it due to a gut pathology? Cortisol imbalances and chronic stress? Under-eating? Poor sleep? Toxic burden? Your diet?

To figure out this answer, lab testing may also be warranted under the guidance of a skilled physician. Some lab tests may include:

• Functional Blood Chemistry Testing
• Stool Testing
• DUTCH Cortisol & Hormone Testing
• SIBO Breath Testing
• Heavy Metal &/or Mold Testing

Consider a free health evaluation to get a functional medicine perspective on your case.

Dietary Management 

While you work with a practitioner to figure out root causes for your hypoglycemia, dietary changes can make a BIG difference in how you feel and your experience. Some dietary changes that are helpful for hypoglycemia management include: 

Eat 5-6 Small Meals Per Day

Since hypoglycemia symptoms and episodes may occur every 2-3 hours in the early recovery stages, more frequent smaller meals and snacks can help your body “ride the waves” of blood sugar imbalances. 

Limit Starchy Carbs, Grains & High Sugar Fruits

Carbs are not the enemy, but during the early recovery stages from hypoglycemia, sometimes too much carbohydrate (glucose) at once can send the body into “overdrive”—initially spiking blood sugar after a meal, only to leave it in hypoglycemic crash within 2-4 hours after a meal. This may happen if your body’s ability to use glucose properly is impaired. If you include carbohydrates in a given meal, choose higher-fiber, slow-digesting carbohydrates (such as vegetables, beans/legumes, low glycemic starchy carbs like beets, winter squash and resistant starchy tubers—cooked and cooled potatoes and sweet potatoes, and low-fructose fruits like berries and citrus). Eat as tolerated, and aim for the least restrictive as possible—incorporating plenty of colorful veggies at the very least with every meal. As stress levels improve, so will your carbohydrate tolerance.  

Eat Protein &/or Fat with Every Meal & Snack

Protein and healthy fats are known as “stability” nutrients. Since they cause less of a sudden glucose spike (blood sugar response) and are slower digesting, they are more likely to stay with you throughout the day. Include both proteins and fats and your primary meals, and include both or one or the other at snacks. 

Time Your Meals Appropriately

Erratic eating patterns that leave your body guessing when its next meal is going to happen can lead to more stress initially. In the early stages of hypoglycemia, set a schedule for your eating and stick to it. Ideal times for meals are in line with your body’s natural circadian rhythms, including: Breakfast-between 6-8 am, Snack-around 10-11 Am., Lunch-between 1-3 p.m., Snack-between 3-5 p.m., Dinner- between 6-8 p.m., Bedtime Snack (protein or fat based)- between 9-11 p.m.

Be Prepared

Failing to prepare can be preparing to fail. Make sure you carry your “essentials” (i.e. meals or snacks) as well as supplements you need during your initial hypoglycemia recovery. With time, your ability to go longer between meals will improve, but in the early stages, sticking to consistency is essential. Get an essentials lunchbox like this

Just Right Exercise

The “Goldilock’s” approach is ideal—not too much and not too little. Just right. While exercise is a “stressor,” it can be a healthy stressor for helping your body establish yin-and-yang (balance) again as well. The key is to: stop the intensity for the time being, and focus more on strengthening (weight training), moderate aerobics (steady state endurance, such as walking, cycling, swimming—without overexertion), flexibility and mobility. 

Yoga, Tai Chi, Qigong 

Yoga is a restorative practice for not only the body, but also the mind, in the recovery from hypoglycemia—and stress. Other forms of restorative movement and meditation (in one) include Tai Chi and Qi Gong. Try them on for size. 

Address Stress

Stress is the “elephant in the room” when it comes to blood sugar imbalances—both mental and physiological. Common sources of stress include: 

• toxic burden (from beauty, cleaning, hygiene and food products)
• lack of sleep
• gut dysfunction
• circadian rhythm dysfunction (shift work, off schedules, weird eating schedules or waking schedules)
• light exposure and screen exposure at night
• long term medication use
• Inappropriate supplement use
• Food intolerances
• Poor quality foods
• Relationship stress/loneliness
• Financial stress
• Overwork
• Overtraining or sedentary lifestyle

Pinpointing your sources of stress are essential in order to address them and counter them. Once you uncover this piece to your puzzle, “addressing stress” is where the fun really begins. Some simple things you can do include:

• Replacing environmental toxic products with organic, additive-free sources
• Getting 7-9 hours of sleep each night & practicing healthy sleep hygiene
• Starting a mindfulness practice (journaling, meditation, yoga)
• Working with a practitioner to figure out the right supplements for you instead of Google searching them
• Eliminating screen time at night
• Refusing to overtrain, as well as start moving if you’ve been sedentary 
• Work with a financial advisor to figure out a budget and get organized
• Take “mandatory” recess breaks, days off and/or vacations from work

Just Breathe

Deep breathing is not only relaxing, but it’s also been scientifically proven to affect the heart, the brain, digestion, the immune system and stress levels (i.e. cortisol and adrenaline). Slow, deep breathing, or “diaphragmatic breathing” (breathing from the diaphragm) reduces oxidative stress, helps normalize insulin and blood sugar levels, and stimulates the parasympathetic reaction — the one that calms us downThe result? Less severe crashes in the case of hypoglycemia. 

Arm Yourself Against Crashes

“Crashes” or hypoglycemic episodes are an inevitable part of the recovery process, but the more you learn your own rhythms, the better able you’ll be able to “arm” yourself against them and be prepared to NOT let them happen. Pay attention to your body’s times of day when it seems to crash—does it happen while you’re sleeping? Mid-morning? Late afternoon? If so, what are the usual habits, foods and routines surrounding those times in the hours leading up to them? Are you eating more carbs in the meal before? Have you been going non-stop all day? Are you on screens late at night? The better awareness you have, the more able you’ll be to “play” with changing things up, and seeing if changes in diet, routine or habits can inhibit stress. In addition, recognition of your “crash” times will also help you know the best times for some of the natural supplement supports beneficial for hypoglycemia recovery. 

Natural Supplement Support

You cannot supplement your way out of hypoglycemia or a stressful lifestyle, but key nutrients and compounds can help bring the imbalanced body back into balance when used appropriately.

See Nutrition & Supplements for hypoglycemia treatment (below) for key insights. 

Nutrition for Hypoglycemia Treatment

Water: Drink half your bodyweight in ounces each day. 

Eat Plenty of Protein: The serving size for protein is: Kids: 2-3 oz., Women: 4-6 oz., Men: 5-8 oz. Use the size and thickness of your hand as a general rule of thumb. Consume the majority of proteins from complete sources, like chicken, beef, bison, fish, wild game, lamb, and eggs. Aim for at least 25-30% of your daily calories from proteins, starting off with 30-40 grams at breakfast. 

Consume Low Glycemic Carbs
The glycemic index is a tool that’s used to indicate how a particular food affects blood sugar (or glucose) levels. The definition of the glycemic index (GI) is “a measure of the blood glucose-raising potential of the carbohydrate content of a food compared to a reference food (generally pure glucose, or sugar).” Foods are assigned a glycemic index/glycemic load number that can be compared to pure glucose, which serves as the benchmark for all other foods.

Foods with a glycemic index (GI) of less than 50, or a low glycemic load (GL) of less than 11 are absorbed slowly.

Gycemic Load takes into account the glycemic index score of a particular carbohydrate but also considers how the carbs in the food affect blood sugar levels when eaten in average portions (not just in 100-gram servings). Many of the fruits and vegetables that are high on the glycemic index scale come in low on the glycemic load scale. Avoid foods for at least 60-90 days with a Glycemic Index above 50, and/or a Glycemic Load Above 10. Some good low GI & GL options include:

Quality Proteins: Meat, fish and poultry

Healthy Fats: Avocado, coconut, olives, nuts and seeds

Legumes (soaked, not canned)

Yogurt (no sugar)

Veggies:

• All green veggies
• Artichokes
• Bamboo
• Baby carrots (1/2 cup or less)
• Cauliflower
• Celery
• Fennel
• Peas
• Peppers
• Onions

• Sauerkraut & pickled veggies
• Cooked & Cooled Boiled Sweet Potato
• New Potatoes (1/2 cup or less)
• Mushrooms
• Pumpkin
• Radishes
• Tomato
• Water Chestnuts
• Yellow Squash

 

Fruits

• Apples
• Apricots, dried
• Berries
• Cherries
• Grapefruit
• Green Tipped Bananas

• Grapes
• Kiwi
• Orange
• Peach
• Pear

 

The following foods are considered “high-GI foods,” which you therefore should try reducing or avoiding:

• Refined grains and flours, including products made with white wheat flour, packaged grain products like most bread, processed breakfast cereals, cookies, cakes, etc.
• Sweetened beverages, such as soda and bottled juices
• Table sugar, honey, molasses, etc. (A small amount of real, raw honey can be a good option in cases of severe blood sugar dips for fast acting sugar)
• Dried fruits, such as raisins, craisins and dates 
• Starchy root vegetables, such as white potatoes, winter squash, etc. These are actually healthy options, but again portion control and pairing them with lower-GI foods is key.
• Also avoid too much caffeine or alcohol
• Empty calories, including packaged goods that are highly processed and salty
• Lots of added sugar in condiments, sauces, etc.
• Fast food and fried foods

Consume Chromium Rich Foods
Chromium is vital in controlling blood sugar levels properly. A deficiency in chromium can be a contributing factor to hypoglycemia. High chromium foods include: brewer’s yeast, pastured eggs, sweet potato, broccoli, grass-fed beef, bananas, tomatoes, green beans, romaine lettuce and grapes.

Consume Carnitine Rich Foods.

Especially grass-fed red meats, wild caught fatty fish, pastured poultry, grass-fed whey and grass-fed dairy. Carnitine is essential for helping your cells “absorb” nutrients and fatty acid optimization (converting foods you eat into fatty acids in your cells so your cells have enough energy all day long).   

Add Sea Salt

Promotes adrenal balance. When the adrenal glands are fatigued, they fail to produce adequate amounts of several hormones, including adrenaline, cortisol and aldosterone. Lack of aldosterone can disrupt the sodium balance at a cellular level, causing a sodium deficiency. Recommendation: Salt food to taste and add a pinch of sea salt to water.

Limit Starchy Carbs

 Starchy carbs, may trigger symptoms more, especially in early on in hypoglycemia recovery. Consume in small amounts (15 grams or less; about 1/2 cup), only as tolerated. Aim to get the majority of your starchy carbs from pre-biotic tubers and soluble fibers like cooked and cooled sweet potatoes, cooked and cooled white rice, winter squash, carrots, green peas, beets, jicama, artichoke, green tipped plantains, cassava, coconut flour based breads or coconut tortillas, and other whole foods. 

Limit Fruits:
Like starchy carbs, fruits may trigger symptoms more in the early stages of hypoglycemia recovery. Incorporate 1-2 servings of fruit per day as tolerated. Fruit is best digested when eaten in small amounts, away from complex meals, and paired with a little bit of healthy fat to stabilize blood sugar. You may also tolerate it with lighter meals, such as incorporated into a smoothie or berries tossed onto a salad. 

Cut Out Grains.

Eliminate grains and gluten containing foods for at least 60-90 days to allow any inflammation in the gut and brain to heal. If grains are desired after 60-90 days, slowly reintroduce one at a time.

Add in Nuts & Seeds.

Great healthy fats to consume with snacks, in a smoothie or tossed into a salad or yogurt. Consume in moderation due to inflammatory properties. Limit to 1 serving of nutbutter (2 tbsp.) or ¼ cup nuts each day.  

Snack as Needed:

Snacks can help keep blood sugar levels stable early on in healing. Base snacks around a protein and/or fat to sustain energy levels, balance blood sugar and curb cravings until the next meal. Snack ideas include:

Protein Snacks

• Bone Broth
• Beef Isolate Protein Powder
• Collagen Protein
• Organic Turkey or Beef Jerky
• Leftover protein
• Deli meat rollups

Fat Snacks

• Grass-fed butter or ghee
• Coconut butter
• Coconut Milk ice cream (no sweetener)
• Grass-fed cheddar or goat cheese (with 1/2 apple or veggies)
• Raw nuts and seeds
• Olives

Recommended Gut & Brain Boosters. Add optional gut health supports including: 1-2 fermented foods/day, digestive enzymes and apple cider vinegar (in water) with meal. Encouraged to support optimal digestion, nutrient absorption and blood sugar balance.

Supplements for Hypoglycemia Treatment

The following supplements may be helpful in managing and reversing hypoglycemia. Keep in mind, you cannot supplement your way out of a poor diet or stressful lifestyle. Focus first on boosting nutrition and lifestyle factors. Work with a skilled practitioner for optimal recommendations customized to you.

• Adrenal Adaptogen (Herbal) Support
• Betaine HCL or Apple Cider Vinegar
• Chromium Chelate 
• Cod Liver Oil
• Colostrum & L-Glutamine       
• Digestive Enzymes
• Magnesium Glycinate
• Methyl B Vitamins
• Prebiotic Fiber (Glucomannan)
• Soil-Based Probiotic
• Zinc

Optional: 

• Gut Support Protocol (treat for Candida, Yeast, SIBO or any other underlying pathologies)
• Vitamin D

About Supplements for Hypoglycemia Treatment

Aceytl L-Carnitine 

Carnitine is an amino acid your body needs to produce energy. Primarily, carnitine is used to transport long-chain fatty acids, your body’s main source of metabolic energy, to the mitochondria in your cells so your body can actually use the energy you eat. Recommendation: Women 250 mg, Men 500 mg with meals 2-3 times per day if initial protocol and lifestyle changes are sub-par. Particularly for vegetarian/vegan based diets and postpartum hypoglycemia.  

Adrenal Adaptogen (Herbal) Support

Adaptogenic herbs provide the adrenals with cortisol balancing support to help support blood sugar balance at the same time. Adaptogens work to counter both high and low cortisol, depending your unique presentation. Avoid formulas with stimulating herbs including licorice or ginseng, unless under the care of a knowledgeable practitioner, for general use. Recommendation: 1 dose, 1-3 times, particularly around times you know when your blood sugar balance is “off.” Look for ashwaganda and sensoril rhodiola. 

Betaine HCL or Apple Cider Vinegar

Aids in the absorption of nutrients by boosting stomach acid. Recommendation: 250-1000 mg of Betaine HCL with meals (do the “HCL Challenge” to figure out your just right amount), or 1 tbsp. Apple cider vinegar in water with meals. If pregnant or taking acid suppressing drugs or corticosteroids, use apple cider vinegar. 

Chromium Chelate
Chromium enhances the action of insulin, which delivers glucose to the cells thereby stabilizing blood sugar, which is key in regulating mood and diminishing cravings. Deficiency due to dietary intake is rare, but diets high in processed foods, sugar, low-fat or poor variety deplete body chromium stores. Even mild deficiencies of chromium can interfere with blood sugar regulation and cause fatigue, anxiety and sugar cravings. Recommendation: 100-300 mcg., 1 time per day with meals.

Cod Liver Oil

Essential fatty acids, including Vitamins A & D for fatty acid absorption, to aid in inflammatory processes, nutrient absorption and energy utilization. Counters common symptoms of hypoglycemia including shakiness, brain fog and poor concentration. Recommendation: 1 tsp., once per day or 1 dose of capsules; fermented cod liver oil or extra virgin olive oil or wild salmon oil. 

Colostrum. The “perfect food” nutrient found in a mother’s milk, as well as cow’s milk.  Colostrum contains proteins, carbohydrates, fats, vitamins, minerals, and proteins that fight off bacteria and viruses, boost the immune system, improve cognitive function and heal intestinal permeability (leaky gut).  Recommendation: 1 dose of tegricel colostrum in water or tablets. 

Digestive Enzymes

Support your pancreas, small intestine, liver and other digestive organs to boost digestion with similar enzymes to those found in your gut. Many people with blood sugar issues and/or gut dysfunction are low in natural digestive enzymes due to a variety of stressors, such as previous antibiotic use, poor quality diet, poor food hygiene practices, low stomach acid and more. Recommendation: 1-2 digestive enzymes with meals. 

L-Glutamine       

Gut lining healing nutrients to support gut integrity, immune function and gut healing for all around digestion and nutrient optimization. Recommendation: 1 serving in water or liquid of choice, 1-2 times per day. 

Magnesium
Magnesium is used by the body’s enzymes to process glucose efficiently, and it has been shown to decrease inflammation, which is one of the primary drivers of insulin resistance.  Also, it is a calming nutrient that helps the body process all manner of imbalances.  This is why magnesium is so essential, especially for those with hypoglycemia. Opt for chelated forms, such as Magnesium Glycinate, for optimal absorption. Recommendation: 1 dose Magnesium Glycinate (200-300 mg), 1 time per day. 

Methyl B Vitamin Complex (including Biotin)
B-Vitamins are essential for countless chemical processes within the body. Amongst these are their role in hormonal balance (adrenal health), digestion, metabolism and blood sugar control. A deficiency of Vitamin B vitamins can result in blood sugar problems. B-vitamins are easily depleted by a number of factors such as stress, poor diet, nutrient deficiencies, alcohol consumption, the contraceptive pill, and other medications. Recommendation: Methylated B Vitamins are best absorbed by the body, particularly for those with underlying methylation issues.

Prebiotic Fiber

High-fiber diets reduce the risk of diabetes and aid in the treatment of blood sugar imbalances. Fiber decreases insulin peaks after meals because it slows absorption of carbs and increases insulin sensitivity. Include both through fiber in the diet and use of supplements, like Glucomannan or Partially Hydrolyzed Guar Gum. Recommendation: 8-13g/day or 2-4 tsp. Per day depending on your food intake of fibers too. Start slow and build up. 

Soil-Based Probiotic. Upwards of 90% of probiotics on shelves do not contain the probiotics they claim. Many formulas are also packed with lactic acid bacteria–the types found naturally in fermented foods (the best sources), and the types that most people typically have more of. Soil based formulas mimic the healthy gut bacteria found in nutrient-rich soil hundreds and thousands of years ago, and are the most shelf-stable of most probiotics in order to ensure you get what you pay for. Recommendation: 1-2 capsules, 1-2 times per day. 

Vitamin D. Vitamin D is an essential fat soluble vitamin for a number of physiological processes including: Promoting calcium absorption in the gut; Maintaining calcium and phosphate levels in the blood; Regulating cell growth, neuromuscular and immune function.

Vitamin D can be obtained from three sources: food, ultraviolet light (sun and UV lamps), and supplements. Supplementation should only be considered if 25(OH) Vitamin D blood levels are below the recommended 35 ng/mL. In addition, PTH (parathyroid hormone levels) should be considered to determine whether or not supplements are appropriate for you. Use the following table as a reference for how to treat and supplement for optimal Vitamin D levels. (Note: EVCLO=extra virgin cod liver oil)

Zinc
A highly important mineral with regard to insulin function. Zinc is necessary for the production of insulin and it also helps it to bind to receptors on the cells. Zinc is also required for stomach acid production and gut lining support; therefore it affects how well food is digested. A deficiency of zinc affects the action of insulin directly and also interferes with proper digestion, creating deficiencies of the other important blood sugar control nutrients as well. Recommendation: Short-term 8-week therapeutic dose of 30 mg/day. 

Overcome Hypoglycemia Today

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Resources

Overtraining

1. Galassetti, Pietro & Mann, Stephnie & Tate, Donna & A. Neill, Ray & Costa, Fernando & Wasserman, David & N. Davis, Stephen. (2001). Effect of antecedent prolonged exercise on subsequent counterregulatory responses to hypoglycemia. American journal of physiology. Endocrinology and metabolism. 280. E908-17. 10.1152/ajpendo.2001.280.6.E908.  

Cortisol & Blood Sugar

2. Tesfaye, N., & Seaquist, E. R. (2010). Neuroendocrine Responses to Hypoglycemia. Annals of the New York Academy of Sciences, 1212, 12–28. http://doi.org/10.1111/j.1749-6632.2010.05820.x

3. Kamba, A., Daimon, M., Murakami, H., Otaka, H., Matsuki, K., Sato, E., … Nakaji, S. (2016). Association between Higher Serum Cortisol Levels and Decreased Insulin Secretion in a General Population. PLoS ONE, 11(11), e0166077. http://doi.org/10.1371/journal.pone.0166077

4. Davis, S. N., Shavers, C., Costa, F., & Mosqueda-Garcia, R. (1996). Role of cortisol in the pathogenesis of deficient counterregulation after antecedent hypoglycemia in normal humans. Journal of Clinical Investigation, 98(3), 680–691.

5. Yamaguchi, Hiroshi. (2015). Reactive Hypoglycemia Associated with Mild Adrenal Dysfunction, So-called Adrenal Fatigue. International Journal of Medical and Pharmaceutical Case Reports. Vol.: 2. Page 27-35. 10.9734/IJMPCR/2015/12994. 

6. Darleen A. Sandoval, , Ling Ping, Anthony Ray Neill, Sachiko Morrey and Stephen N. Davis. (2003). Cortisol Acts Through Central Mechanisms to Blunt Counterregulatory Responses to Hypoglycemia in Conscious Rats. Diabetes. Sep; 52(9): 2198-2204. https://doi.org/10.2337/diabetes.52.9.2198

Adrenaline & Blood Sugar

7.  Ly, T. T., Hewitt, J., Davey, R. J., Lim, E. M., Davis, E. A., & Jones, T. W. (2011). Improving Epinephrine Responses in Hypoglycemia Unawareness With Real-Time Continuous Glucose Monitoring in Adolescents With Type 1 Diabetes. Diabetes Care, 34(1), 50–52. http://doi.org/10.2337/dc10-1042

8. Fredheim, Siri & Foli Andersen, P & Laerkholm, G & Svensson, Jannet & Juhl, Claus & Olsen, Birthe & Pilgaard, Kasper & Johannesen, J. (2018). Adrenaline and cortisol levels are lower during nighttime than daytime hypoglycaemia in children with type 1 diabetes. Acta Paediatrica. 10.1111/apa.14310. 

Gut Bacteria & Blood Sugar

9. Utzschneider, K. M., Kratz, M., Damman, C. J., & Hullarg, M. (2016). Mechanisms Linking the Gut Microbiome and Glucose Metabolism. The Journal of Clinical Endocrinology and Metabolism, 101(4), 1445–1454. http://doi.org/10.1210/jc.2015-4251

10. Alam C, Bittoun E, Bhagwat D, Valkonen S, Saari A, Jaakkola U et al. (2011). Effects of a germ-free environment on gut immune regulation and diabetes progression in non-obese diabetic (NOD) mice. Diabetologia 54: 1398–1406.

11. Kim CH, Park J, Kim M. (2014). Gut microbiota-derived short-chain Fatty acids, T cells, and inflammation. Immune Netw 14: 277–288.

12. Kriegel MA, Sefik E, Hill JA, Wu HJ, Benoist C, Mathis D. (2011). Naturally transmitted segmented filamentous bacteria segregate with diabetes protection in nonobese diabetic mice. Proc Natl Acad Sci USA 108: 11548–11553.

13. Lee AS, Gibson DL, Zhang Y, Sham HP, Vallance BA, Dutz JP. (2010). Gut barrier disruption by an enteric bacterial pathogen accelerates insulitis in NOD mice. Diabetologia 53: 741–748.

14. de Kort S, Keszthelyi D, Masclee AA. (2011). Leaky gut and diabetes mellitus: what is the link? Obes Rev 12: 449–458.

15. Mathur, R., Chua, K. S., Mamelak, M., Morales, W., Barlow, G. M., Thomas, R., … Pimentel, M. (2016). Metabolic Effects of Eradicating Breath Methane using Antibiotics in Prediabetic Subjects with Obesity. Obesity (Silver Spring, Md.), 24(3), 576–582. http://doi.org/10.1002/oby.21385

15.1 Cell Metabolism, Kootte et al.: “Improvement of insulin sensitivity after lean donor feces in metabolic syndrome is driven by baseline intestinal microbiota composition.” http://www.cell.com/cell-metabolism/fulltext/S1550-4131(17)30559-4 , DOI: 10.1016/j.cmet.2017.09.008 

16. Guo, Y., Niu, K., Momma, H., Kobayashi, Y., Chujo, M., Otomo, A., … Nagatomi, R. (2014). Irritable Bowel Syndrome Is Positively Related to Metabolic Syndrome: A Population-Based Cross-Sectional Study. PLoS ONE, 9(11), e112289. http://doi.org/10.1371/journal.pone.0112289

17. Simon, M., Strassburger, K., Nowotny, B., Kolb, H., Nowotny, P., Burkart, V., . . . Roden, M. (2015). Intake of Lactobacillus reuteri Improves Incretin and Insulin Secretion in Glucose-Tolerant Humans: A Proof of Concept. Diabetes Care,38(10), 1827-1834. doi:10.2337/dc14-2690

18. Ejtahed, H. S., Mohtadi-Nia, J., Homayouni-Rad, A., Niafar, M., Asghari-Jafarabadi, M., & Mofid, V. (2012). Probiotic yogurt improves antioxidant status in type 2 diabetic patients. Nutrition,28(5), 539-543. doi:10.1016/j.nut.2011.08.013

18.1 Quercia S, Turroni S, Fiori J, et al. Gut microbiome response to short‐term dietary interventions in reactive hypoglycemia subjects. Diabetes Metab Res Rev. 2017;33:e2927. https://doi.org/10.1002/dmrr.2927

19. Brown, V., Sexton, J. A., & Johnston, M. (2006). A Glucose Sensor in Candida albicans . Eukaryotic Cell, 5(10), 1726–1737. http://doi.org/10.1128/EC.00186-06

20. Donders, Gilbert & Prenen, Hans & Verbeke, Geert & Reybrouck, Reinhilde. (2002). Impaired tolerance for glucose in women with recurrent vaginal candidiasis. American journal of obstetrics and gynecology. 187. 989-93. 10.1067/mob.2002.126285. 

21. Mandal, S. M., Mahata, D., Migliolo, L., Parekh, A., Addy, P. S., Mandal, M., & Basak, A. (2014). Glucose Directly Promotes Antifungal Resistance in the Fungal Pathogen, Candida spp. The Journal of Biological Chemistry, 289(37), 25468–25473. http://doi.org/10.1074/jbc.C114.571778

22. http://jacobsschool.ucsd.edu/news/news_releases/release.sfe?id=744; DeLano, F. A., & Schmid-Schönbein, G. W. (2008). PROTEINASE ACTIVITY AND RECEPTOR CLEAVAGE: MECHANISM FOR INSULIN RESISTANCE IN SPONTANEOUSLY HYPERTENSIVE RAT. Hypertension, 52(2), 415–423. http://doi.org/10.1161/HYPERTENSIONAHA.107.104356

23. DeLano, F. A., Zhang, H., Tran, E. E., Zhang, C., & Schmid-Schönbein, G. W. (2010). A New Hypothesis for Insulin Resistance in Hypertension Due to Receptor Cleavage. Expert Review of Endocrinology & Metabolism, 5(1), 149–158.

24. A. Anderson, Richard & M. Polansky, Marilyn & A. Bryden, Noella & J. Bhathena, Sam & J. Canary, John. (1987). Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. Metabolism: clinical and experimental. 36. 351-5. 10.1016/0026-0495(87)90206-X. ;  https://www.researchgate.net/publication/19612297_Effects_of_supplemental_chromium_on_patients_with_symptoms_of_reactive_hypoglycemia 

 

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