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Thyroid, Blood Sugar, and Metabolic Syndrome


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This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

According to the American Association of Clinical Endocrinologists, 27 million Americans suffer from thyroid dysfunction – half of whom go undiagnosed. Subclinical hypothyroidism, a condition in which TSH is elevated but free T4 is normal, may affect an additional 24 million Americans. Taken together, more than 50 million Americans are affected by some form of thyroid disorder.

Metabolic syndrome (MetS), also affects 50 million Americans, and insulin resistance, one of the components of metabolic syndrome, affects up to 105 million Americans. That’s 35% of the population.

Metabolic syndrome has become so common that it’s predicted to eventually bankrupt our healthcare system. Both metabolic syndrome and insulin resistance are risk factors for heart disease and diabetes, two of the leading causes of death in the developed world. It’s also closely related with diabesity.

With such a high prevalence of both thyroid dysfunction and metabolic syndrome, you might suspect there’s a connection between the two. And you’d be right.

Studies show an increased frequency of thyroid disorders in diabetics, and a higher prevalence of obesity and metabolic syndrome in people with thyroid disorders.

That’s because healthy thyroid function depends on keeping your blood sugar in a normal range, and keeping your blood sugar in a normal range depends on healthy thyroid function.

Thyroid, Blood Sugar, and Metabolic Syndrome

Metabolic syndrome is defined as a group of metabolic risk factors appearing together, including:

Metabolic syndrome is caused by chronic hyperglycemia (high blood sugar). Chronic hyperglycemia is caused by eating too many carbohydrates. Therefore, metabolic syndrome could more simply be called “excess carbohydrate disease”. In fact, some researchers have gone as far as defining metabolic syndrome as “those physiologic markers that respond to reduction in dietary carbohydrate.”

When you eat too many carbs, the pancreas secretes insulin to move excess glucose from the blood into the cells where glucose is used to produce energy. But over time, the cells lose the ability to respond to insulin. It’s as if insulin is knocking on the door, but the cells can’t hear it. The pancreas responds by pumping out even more insulin (knocking louder) in an effort to get glucose into the cells, and this eventually causes insulin resistance.

Studies have shown that the repeated insulin surges common in insulin resistance increase the destruction of the thyroid gland in people with autoimmune thyroid disease. As the thyroid gland is destroyed, thyroid hormone production falls.

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How Low Blood Sugar Affects the Thyroid

But just as high blood sugar can weaken thyroid function, chronically low blood sugar can also cause problems.

Your body is genetically programmed to recognize low blood sugar as a threat to survival. Severe or prolonged hypoglycemia can cause seizures, coma, and death. When your blood sugar levels drop below normal, your adrenal glands respond by secreting a hormone called cortisol. Cortisol then tells the liver to produce more glucose, bringing blood sugar levels back to normal.

The problem is that cortisol (along with epinephrine) is also a sympathetic nervous system hormone involved in the “flight or fight” response.

This response includes an increase in heart rate and lung action and an increase in blood flow to skeletal muscles to help us defend against or flee from danger. Cortisol’s role is to increase the amount of glucose available to the brain, enhance tissue repair, and curb functions – like digestion, growth and reproduction – that are nonessential or even detrimental in a fight or flight situation.

Unfortunately for hypoglycemics, repeated cortisol release caused by episodes of low blood sugar suppresses pituitary function. And as I showed in a previous article, without proper pituitary function, your thyroid can’t function properly.

Together, hyperglycemia and hypoglycemia are referred to as dysglycemia. Dysglycemia weakens and inflames the gut, lungs and brain, imbalances hormone levels, exhausts the adrenal glands, disrupts detoxification pathways, and impairs overall metabolism. Each of these effects significantly weakens thyroid function. As long as you have dysglycemia, whatever you do to fix your thyroid isn’t going to work.

How Low Thyroid Function Affects Blood Sugar

We’ve seen now how both high and low blood sugar cause thyroid dysfunction. On the other hand, low thyroid function can cause dysglycemia and metabolic syndrome through a variety of mechanisms:

  • it slows the rate of glucose uptake by cells;
  • it decreases rate of glucose absorption in the gut;
  • it slows response of insulin to elevated blood sugar; and,
  • it slows the clearance of insulin from the blood.

These mechanisms present clinically as hypoglycemia. When you’re hypothyroid, your cells aren’t very sensitive to glucose. So although you may have normal levels of glucose in your blood, you’ll have the symptoms of hypoglycemia (fatigue, headache, hunger, irritability, etc.). And since your cells aren’t getting the glucose they need, your adrenals will release cortisol to increase the amount of glucose available to them. This causes a chronic stress response, as I described above, that suppresses thyroid function.

How to Keep Your Blood Sugar in a Healthy Range

It’s important to understand that whether you have high or low blood sugar, you probably have some degree of insulin resistance. I described how high blood sugar causes insulin resistance above. But insulin resistance can also cause low blood sugar. This condition, called reactive hypoglycemia, occurs when the body secretes excess insulin in response to a high carbohydrate meal – causing blood sugar levels to drop below normal.

In either case, the solution is to make sure your blood sugar stays within a healthy range. There are two targets to consider. The first is fasting blood glucose, which is a measure of your blood sugar first thing in the morning before eating or drinking anything. I define the normal range for fasting blood glucose as 75 – 95 mg/dL. Although 100 is often considered the cutoff for normal, studies have shown that fasting blood sugar levels in the mid-90s were predictive of future diabetes a decade later. And although 80 mg/dL is often defined as the cutoff on the low end, plenty of healthy people have fasting blood sugar in the mid-to-high 70s (especially if they follow a low-carb diet).

The second, and much more important, target is post-prandial blood glucose. This is a measure of your blood sugar 1-2 hours after a meal. Several studies have shown that post-prandial blood glucose is the most accurate predictor of future diabetic complications and is the first marker (before fasting blood glucose and Hb1Ac) to indicate dysglycemia.

Normal post-prandial blood sugar one to two hours after a meal is 120 mg/dL. Most normal people are under 100 mg/dL two hours after a meal.

Now that we know the targets, let’s look at how to meet them. If you’re hypoglycemic, your challenge is to keep your blood sugar above 75 throughout the day. The best way to do this is to eat a low-to-moderate carbohydrate diet (to prevent the blood sugar fluctuations I described above), and to eat frequent, small meals every 2-3 hours (to ensure a continuous supply of energy to the body.

If you’re hyperglycemic, your challenge is to keep your blood sugar below 120 two hours after a meal. The only way you’re going to be able to do this is to restrict carbohydrates. But how low-carb do you need to go? The answer is different for everyone. You figure your own carbohydrate tolerance by buying a blood glucose meter and testing your blood sugar after various meals. If you’ve eaten too many carbs, your blood sugar will remain above 120 mg/dL two hours after your meal.

I highly recommend you pick up a blood glucose meter if you have a thyroid and/or blood sugar problem. It’s the simplest and most cost-effective way to figure out how much carbohydrate is safe for you to eat. There are tons of meters out there, but one that gets a lot of good recommendations is the ReliOn Ultima. It’s pretty cheap, and the test strips are also cheap, which is where the major expense lies.

Finally, if you have poor thyroid function it’s important that you take steps to normalize it. As I’ve described in this article, the cycle works in both directions. Dysglycemia can depress thyroid function, but thyroid disorders can cause dysglycemia and predispose you to insulin resistance and metabolic syndrome.

Maintaining healthy blood sugar is not only critical for thyroid health, it’s essential for overall health. Sadly, half of Americans has or is at risk of having diabetes, with one-third diabetics unaware that they have it. 

There are many causes of high blood sugar. One of the most significant but least-known is nutrient deficiency. Several vitamins and minerals are required for proper blood sugar regulation, and the majority of Americans don’t get enough of several of these micronutrients

This is where smart supplementation can play a role—and it’s why I created the Adapt Naturals Core Plus bundle. It’s a daily stack of 5 products designed to restore optimal nutrient levels so your body can function as it was intended to, and you can feel and perform your best. 

From metabolism-boosting vitamins and minerals like vitamin B12, folate, magnesium, and vitamin D, to phytonutrients like bioflavonoids, carotenoids, and beta-glucans, Core Plus has you covered.

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  1. I never dx of hypoglycemia or diabetes. .but have had gastric bypass 4 yrs ago now within 2 yrs i hv passed out face forward blood sugar drops in 30 at one episode i couldnt see nothg but blackness out of my vision im so tired of this to where i just sit and sit afraid to go anywhere or have company afraid i will pass out again

    • I am 1 yr. post op sleeve and have frequent episodes of low blood sugar with horrible symptoms. Debilitating and scary. Being followed for hypothyroidism and metabolic syndrome. Hope to figure out something soon.

    • i had gastric 5 yrs ago same issue severe blood sugar drops & then go into seizures. doc. said even though i have hypothroidism & nodules i am fine, but this is getting scary. had 2 be put on anti seizure meds. just 2 stop the seizues.

    • Hi, I don’t know if this will help anyone but I thought I’d let you know what I was going through. I was diagnosed several years ago with Type 2 diabetes but got to the point where I was too tired to even cry. My Dr took the thyroid test further out to test T3 and T4. There it was. Hashimotos disease. On Nature… Now and better.

  2. So glad I found this page, I think this is exactly what’s wrong with me. I’ve been getting attacks of low blood sugar for a while now, it’s become more frequent, usually a few times a week, sometimes even twice in one day. I find it very scary and sometimes it happens when I’m driving so I have to get to a shop and buy something to eat and wait till I’m ok to drive home. It’s always either around lunchtime or a few hours after lunch so it definitely a few hours after eating, I’m starting to notice a pattern that it usually happens when my last meal contained carbs like bread or cereal etc. I’ve been to the doctors and have a blood test book for a few days time, I just wondered in the meantime what sort of thing should I be eating when I get an attack? At first I would go and buy something sugary like a cake or chocolate bar, but then decided it’s probably not the best thing so if it was near lunchtime I’d wait until I had my meal and that would settle it down, but I sometimes find it then happens again a few hours later. I sometimes buy snacks like graze as they contain things like nuts, raisins and a little bit of chocolate as I thought that might be handy to have on me for if it happens. What would you recommend? Should I completely cut out the bread and cereal? I’m veggie so my options are a bit limited without it.

    • Olivia. What you need to do is avoid triggering insulin. Sugar, grains, are the most likely to do this. Fiber and fats (as in seeds and nuts) are less likely to trigger high insulin levels. Insulin is what is causing the low blood sugar episodes. Search for the glycemic index. It will tell you which foods are less likely to trigger a high insulin/low blood sugar response. Stray away from high scoring foods on the glycemic index. Chocolate would be a good choice if it was sugar free. Artificial sweeteners should also be avoided. Stevia is a good choice for a sweetener. I especially like to take dehydrated okra as a snack in the car if I will miss lunch otherwise.

      • Thank you, that’s really helpful. I also stay away from artificial sweetener, poisonous stuff! I usually use xylitol, I think it is low GI. I will have a look at the glycemic index. I do eat a lot of bread, mainly brown but I think that is my worst trigger so I need to try and get rid of that

      • I am 8 years post op RNY Dx with hypothyroidism 20 years ago and felt with very occasional sugar lows very seldomly, I suggest you Go buy glucose tabs in the diabetic section near the pharmacy section fairly cheap! I usually take two when start to feel symptoms but feel I need more than those so I drink cola or orange juice. It’s said milk brings bs levels up and stabilizes but after gp i am in able to tolerate milk!
        I have all the symptoms of hypoglycemia, shaking sweating lightheaded irritability and fatigue thank god I get symptoms and when I check my bs it is usually 65 or lower very scary
        I have glucose tabs located everywhere and also carry a bottle of cola with Bc with the tabs and Coke it jacks my sugar up to about 110 and I also have hypothyroidism. Lately more glycemic issues and just found out my thyroid level is 0.065 compared to few months ago of 8.59 big change and I’m having a lot of different symptoms all related to hupothyroidism
        It sucks!
        Good luck!

  3. I never do this, but my Doctor always says “I don’t know” to all of the weird symptoms I have. I realize the symptoms are linked because one systems affects the others. So here goes..I’m a celiac and follow a strict diet, I’m hypoglycemic-I don’t eat carbs except in the form of fruits and veggies, ei. no GF bread, pasta, etc. I suffer from malabsorption of some kind, having 4-7 BMs a day-usually type 5 and 6 on the poop scale. I eat frequently but cannot seem to maintain a consistent BS level. The mornings are definitely the hardest, my BS drops while I’m sleeping and its quite difficult to wake up in the morning but if I have a snack before bed I cannot sleep because I get a burst of energy. I’m curious what else I could do to help myself-homeopathic, supplements, etc. Any suggestion?

    • Stef: Apparently hypoglycemia can be one of the complications of celiac disease. There is a discussion here in the ehealth forum: http://ehealthforum.com/health/celiac-blood-sugar-t150825.html.
      As a diabetic, I would suggest be sure you have enough good fats and lots of fiber, and you might try eating less frequently–if you can get the energy to last for a longer period. Inulin and glucomannan are fiber supplements that might help you get some staying power out of your meals.

    • NO, you should not cut out bread and cereal. You should add eggs and protein which last longer in your body. sugar comes and will go out of your body very quickly, and that is why this is happening. Keep what you are doing, add another meal, and then with EVERY meal, add some protein. I think you said you don’t eat meat…might change that to adding eggs if possible (which are not baby chickens as people think), or fish?

    • I am Celiac also. I am going to a naturopath doctor who had a degree in biochemistry. She is going to help me with methylation and hpa axis. I have asthma triggered by hypoglycemia. In the meantime I am taking small mints, sweet potatoes, and occasional potatoes. Lots of fruit also. I have to wake up and eat and go back to bed. You cannot solve this in your own. It is too complicated. You need a good naturopath doctor. Otherwise like Chris says, you’ll end up with a prescription for hormones and xanax, which is what the last doctor tried to do. Needless to say, I never went back!

      • I got frustrated with the conventional “hormones and xanax” route. I went to a naturopath to help with methylation..it hurt me more than conventional medicine. Nearly 2 years later it still affects me.

  4. Hello everyone.

    I’m eating around 900kcal a day, and my fasting is around 3.9.

    The problem is when i eat anything, even 30g carbs from vegetables, i’m going up to 7.8, then going down again in around an hour. I don’t know what to do!

    Thanks 🙂

    BTW i’m a 23 year old female with no other known health issues

    • Hi Emma: You must be in Canada? Sounds like a high insulin problem. Search for “the glycemic index” and make sure you are eating at the very lower end of that scale. You do need to find a holistic doctor who can check that there isn’t some medical problem with your pancreas–to be shooting out excess insulin. As far as diet, you need to absolutely stay away from processed foods, sugars and grains, and sodas==especially diet sodas. All of these trigger insulin which could keep your blood sugar too low. Stress can be another factor. High insulin can lead to poor health over the long run, so you do need to find out what is happening here.

  5. I have suffered from low blood sugar episodes my whole life. If I google it online it says I have either diabetes or liver disease. As far as I know I don’t have either lol. I started working out in Jan 5-6 days a week and it’s been tough to manage the blood sugar especially since I cut my calories to 1500 a day. I usually only have problems in the mornings. Sometimes it doesn’t matter what I eat for breakfast, I can’t seem to get my sugar levels up and I have a hard time getting through my workout. Eating a banana will get me half way through my workout. I bought some glucose tabs and I will pop 2 or 3 of those and that helps sometimes. I just wish I could solve the mystery of why it happens and how to prevent it. I feel like my weight loss is hampered when my sugar levels drop because my body goes into panic mode.

    • Rachel: The foods that you mention are all glucose or glucose forming–foods that would trigger insulin surges. Insulin is a fat storage hormone, other than being the hormone that lowers blood glucose. So the more glucose forming foods you eat, the more you trigger insulin, the fatter you get, and the lower your blood sugar goes. So you need to target the high insulin levels and get them under control. Your food should be high fiber vegetables–add high fiber antioxidant fruits (berries) after you get your insulin under control. Eat good fats and protein as well as leafy greens, and a wide variety of vegetables, including cruciferous vegetables==every day. According to Alan Christianson, author of the Adrenal Reset Diet, a high protein breakfast sets your insulin levels for the day. Probably a true hypoglycemic should use fiber supplements such as inulin or glucomannan. Avoid sugar and grains like the plague–they are your poison. If you can find someone to check your insulin and adrenal levels, it will tell you what worked and what didn’t. You probably need to get your adrenals and pancreatic function checked. Panic mode is your adrenals kicking in. And that event can cause another blood sugar spike, and more insulin to get it down. cortisol spikes blood sugar, just like sugar and grains drive up blood glucose, so you want to keep it at an even keel. I hope this helps.

      • Yesterday I bought a glucose tester. My glucose 2 hrs after lunch was 96. This morning when I first woke up it was 50 which according to what I looked up is low. I had a slight headache which was probably from low blood sugar. Instead of having coffee first, I made a smoothie with greek yogurt, banana, cinnamon, protein powder and some vitamin water lol (I had run out of milk and needed some liquid) It was pretty disgusting but I managed to get the whole thing down in between sipping coffee. I then swam 22 laps (50 meters = 1 lap) at the public pool. My levels felt low after the pool so I got an egg, bacon and cheese burrito (which I never do, but thought the protein/carb mix would do me some good) I started my period today and my blood sugar always goes haywire right before, but regardless I’ve always had to be careful of what I eat in the am. I am going to be careful of what I eat before bed and what I eat in the am as well as drinking water with cinnamon extract to see if this helps.

        • Rachel. I see what you mean. glucose meter readings. Yes In the US, 50 is quite low. I think normal is around 75 to 85. As a diabetic I rarely see mine below 100. On insulin I have had readings of 45 — that is ready to lose consciousness at that level. Dont drive! An egg, bacon and cheese burrito for breakfast everyday should stablize your insulin at a better level.

  6. I’m curios to see if any other women have issues with hypothyroidism, luteal phase defect, and a slightly elevated prolactin level. Almost off of the women on my mothers side have issues with hypoglycemia and a lot of her brothers and sisters have hypothyroidism (one brother has hashis). My obgyn just prescribed me prometrium to help my luteal phase defect but I question whether we should be treating my progesterone levels or thyroid first. I know the three are all connected. I also had labs done that showed elevated DHEA (230) but lower end testosterone. My prolactin was only at 27 so I don’t want to pursue an MRI at the moment as I know hypothyroid can cause slightly elevated prolactin. If anyone has any insight I would greatly appreciate it!

    • Elevated prolactin is one of the classic symptoms of hypothyroidism along with fertility issues.

      • When I had my progesterone checked 7DPo it was 8.5. TSH was 3.1 and free T4 was high and free T3 was low. Since the progesterone my free T3 and T4 are perfect and TSH is at 1.5 so pretty much perfect numbers I assume. Only bad thing is that I feel good during luteal phase but horrible the other two times of the month. Hair is now falling out in large amounts.. Not sure where to go from here.

        • Have you looked into Polycystic ovarian syndrome? That’s What this Sounds like to me.

  7. How do I find out what my “magic number” is for my carb daily intake? Below 50, or above 50? Or?

    • 50 what? I would say you want carbohydrate intake of about 50%, but no sugars, grains, refined foods–those should be 0%
      Your carbs should be high fiber fruits and vegetables –brightly colored which means they contain lots of antioxidants. Lots of leafy greens.

  8. I am hypothyroid with latest test result of 1.9 for TSH which is very normal. But My sugar levels post meal are 70 which should be around 120 which is very rare. I also have sleeping issues with a very bad gut. Currently on Thyronom 125mcg. Can someone please help me with why my sugar levels are so low and having digestion, bloating and sleeping issues.

    • Have you had your progesterone levels checked? It’s not uncommon to find women (myself included) with hypothyroidism as well as low progesterone. (You want to check 7 days after ovulation btw). Now I’m trying to figure out which came first.. The hypothyroidism or the low progesterone. Best of luck!

      • I have lupus and high blood glucose levels. I no longer have insurance but when I last did my Dr mentioned low progesterone. I am beyond depressed all the time and have no energy but racing thoughts. I heard that low progesterone can lend to depression and low energy as well as the other two. Have you found this? What do you do for progesterone?

        • I take a bio identical progesterone (not prometrium- I go to a compounding pharmacy and they make their own) on days 14-28 of my cycle at night time. Find a dr in your area who specializes in bio identical hormones. (I had to travel 4 hours to find a good dr). You want a dr that will test your levels 7 days after ovulation. Then prescribe as necessary based on those numbers. You also want a dr that will recheck your levels every 2-3 months to make sure you’re staying at a normal level and not getting too high as too high of progesterone is just as bad as being too low. The racing thoughts could be related to anxiety or something else (I’m not a dr just someone who had a long journey to get my health back) and anxiety can can also be caused by low progesterone. I have very high estrogen, and while I don’t buy into all of the estrogen dominance hype I do think there is something there when you don’t have a healthy balance of estrogen to progesterone. As high serotonin has been linked to the cause of social anxiety and estrogen is a precursor to serotonin if I’m
          Not mistaken. Sorry for the overload of information! Just find a good dr and before you book the appt and waste money ask questions and make sure they are testing correctly and are knowledgable in the field. 🙂 best of luck (while you search for a dr learn how to check for ovulation so you know what day you need to get the labs drawn) also I would stay away from synthetic hormone- bio identical hormones are really so much safer and overall a better option for your body if it’s necessary to take something.

    • Aubrey. Digestive problems. You probably are not eating right—you need high fiber fruits and vegetables, good fats, and protein–especially at breakfast. Breakfast sets your insulin levels for the day. You need a high protein breakfast. Low blood sugar is high insulin. High insulin is from refined carbs, sugars and grains. And also from cortisol –stress. The stress of low blood sugar can trigger cortisol, which triggers sugar made by the liver (gluconeogenesis) and more insulin. Blood sugar problems and thyroid can work together. Fix one, you may fix both.

      • Very true but as an athlete I have a specific diet ( my mother is a dietician) I don’t eat simple carbs except during exercise. All 5 meals are 3oz protein, 20-30g carbs (usually oatmeal or organic wheat toast), and a handful of fat. My mother, aunts, and grandmother all have the same issues. Non diabetic hypoglycemia, but all have also tested for low progesterone and eventually hypothyroid. Due to the unbalanced hormones they all also have pre cancerous cells in the uterus. 0.o I have skimped on my fiber the last week though so i thank you for the reminder!

        • Aubrey. if you are doing o.k. on that diet, fine.
          If it aint broke don’t fix it.” But if you want to optimize, You could (should) swap out some of the grains for antixidant fruits (berries) and leafy greens and other vegetables such as avacado, beet, beans, etc.

          Oat meal and wheat toast are simple carbohydrates.

          • Oatmeal and whole wheat toast are complex carbohydrates. A simple carb would be white toast, white rice, fig newtons, sugary cereal or drink etc. I eat beets and spinach every day actually. For whatever reason fruit doesn’t keep my blood sugar stable very long so I only eat it on occasion.

            • Actually only whole grains –those that are intact as collected from plants –are complex carbohydrates. Whole wheat toast -made from whole wheat flour, which contains gluten, and oatmeal – made from processed oats – do not contain the grain fiber and are rapidly turned to glucose in the blood stream. Diabetics are advised not to eat processed grains.

          • Oatmeal and wheat toast are complex carbohydrates!!!!!!
            Fructose is a simple sugar!!!

  9. To Alalia,

    I have the same condition. I have seen so many doctors, including endocrinologists. They all say that it is rare and abnormal, but the bottom line is that it is not well researched enough for them to be able to treat it. They sent me to a nutritionist who gave me recommendations based on what they do for diabetics, but it backfired. They encouraged more starches because they said that slow carbs wouldn’t stress my system, and my sugar never went over 100, but it would be low all the time. I was dizzy and lightheaded, and I would pass out without warning maybe three times a week. I kept with it because I had done various low carb diets before and, while I initially felt great, eventually all the side effects would creep in. I would get stressed and jittery, lose a lot of weight, have trouble sleeping, my digestion would go to hell, even my hair would start falling out! So, even though I felt terrible all the time, I was reluctant to go back to low carb because I figured that I had already tried it and it didn’t work. This whole time, I was avoiding fruits because they made my sugar go up, and the endocrinologist told me that was very bad. But, then one day I ate an apple and checked my sugar. It went up, but it also stayed up and didn’t crash the way they said it would. So, I did another experiment even though at that point I was really tired of experimenting. I cut the starches and replaced it with fruits for carbs, like apples, bananas, even the forbidden dried fruits. Slowly, but surely, I came back. At first, I still had to eat every couple of hours, but in a few weeks I became a normal person again. The dizziness and lightheadedness is gone, and I can even go four or five hours without eating and actually get to the point where I feel hungry instead of just force feeding myself all the time so that I don’t pass out. I haven’t lost too much weight because I avoid fasting too much, and I hope that the side effects I had from low carb won’t kick in again, but if they do, they are still preferable to what I dealt with before. I almost lost my job because I kept passing out at work and having to go home. I was terrified to even leave the house. I finally feel like a normal person again. I don’t know why this works, but I theorize that the problem is not carbs per se, but glucose specifically, and fructose heavy fruits don’t effect your insulin the same way because they need to be slowly processed by your liver, and in between meals the liver lets out a steady stream so you don’t crash.

    • Susie: As a diabetic, I have had hypoglycemia but it was because I took too much insulin. That effect was: shakes, panic, sort of a stupid feeling, and suddenly losing consciousness–once falling into my plate at a Thanksgiving dinner (embarrassing). My solution was to get off insulin. Intermittent fasting is one way to lower insulin, but that might not be a good idea for a hypoglycemic. Susie’s solution of “slow carbs” reminds me of using fiber: glucomannan and inulin. And some dried fruits such as dates or figs have good carbohydrates and lots of fiber–that should work better than heavy doses of glucoses. Im finding more and more, the m.d.s do not have the answer. After all you go to a doctor to diagnose and manage a disease–they don’t know a thing about health.

      • Really not true about doctors. Cardiologists and Endocrinologists know a lot about nutrition, as well as metabolic issues. It is unbelievable that people think so little of highly educated physicians…amazing. Of course, there are a few bad apples, but I would never trust some “health coach” with a faux degree from some online school. If one doesn’t know human anatomy, physiology, and biochemistry, literally, I think a good doctor or a science-based (at least a BS in the physical sciences, preferably a MS) nutritionist/dietitian is the only way to go.

        • Im glad you have found an M.D. to serve your needs. I am 73 and still looking a medical practitioner who is not about drugs and surgery.

        • It’s not that they don’t know anything about health, it’s that they don’t want to take the time to sit with you and figure out what the right balance is. Most doctors want to get you in and out quickly to make their $$ and are not interested in actually solving your problem. The body is very complex and what works for one person may not work for another.

        • The big problem is that when faced with something that doesn’t look automatic to fix, some Drs will flat out give up on a patient or won’t take the time to uncover something. That’s why a lot of patients respond by saying they felt like they had to hit rock bottom before their physician would do anything for them.
          Medicine has a problem and it’s a lack of basic problem solving skills. Pattern matching only gets you so far you need to think like a detective truthfully. If someone is coming to you with an issue and they’ve seen several physicians over the last few years then your approach should be more testing and in depth question asking. TALK to your patient as though they were a witness or suspect get the truth from them and get their story straight. That means knowing how people think and making them feel comfortable to give up the hidden information. If you’re good enough at this you can get them to remember things that they didn’t even realize they remembered. This is key to helping some one especially when they appear to have cronic illness. It’s not enough to hold a degree and prestige.

    • Hi Susie, I was very interested in your reply above as I think it may have some bearing on the way I am feeling. I have had IBS for over 20 years. 12 months ago I went on the FODMAP diet and have good results for the IBS, I found that I was intolerant to gluten, fructose and sorbitol. A month ago I woke up with vertigo this lasted 2 days followed by lightheadedness. This comes on after I eat breakfast & goes away after lunch. I have had bloods checked & am hypothyroid and have started on the hormone.I have been avoiding fructose for the last year.
      I am in Ireland and our doctors are not proactive. He does not think there is any link with the diet, I don’t agree. I think I’ll have to try eating that apple!!

      • Gerjoy,

        That does sound similar! Dizziness in between breakfast and lunch sounds like classic reactive hypoglycemia. Maybe now that you are taking thyroid meds and avoiding gluten, your digestion will improve enough for you to tolerate fructose again. My digestion used to be horrible also before I went Paleo, but now it’s almost perfect. And, I also had difficultly absorbing fructose when I was low carb, but that was probably because my thyroid was suppressed. After reintroducing carbs, all my low thyroid symptoms went away. Now, I’m ok with it. I still limit myself when it comes to things with long chain fructans like brassicas, but the simple fructose in fruits is usually ok. Some things, like peaches or cherries, I can only have a little of before it may upset my stomach. But, I’m getting about 200g/ day of carbs exclusively from fresh whole fruit and I have total blood sugar control now. Before, when I was passing out all the time, I was only getting about 100g/day of carbs, but it was all from starches. I thought I was doing the right thing, but I felt horrible. You may still want to avoid long chain fructans, but simple fructose found in fruit might be alright. I would start will lower sugar fruits like berries and then see if you can graduate up to other things. Just avoid starches in the mornings. It will mess up your whole day. I pretty much eat just fruit for breakfast with a cup of tea, and I’m fine. And, make sure you’re eating whole raw fruit so you have all the fiber and enzymes. Juice is off the table. And, honey is tricky. I can get away with small amounts, but I mostly just avoid it because it’s just too much concentrated sugar, so I still crash a bit afterwards. Good luck! And, don’t stop trying until something makes you feel better! I almost gave up and resigned myself to misery so many times, but eventually I found what works for me.

        • Thank you so much Susie for your reply. I am really happy to know what is going on with me – I am 100% certain that it is reactive hypoglycaemia. My doctor is treating me for vertigo, but I didn’t think that was the answer. I tried the fruit yesterday but my IBS didn’t like it. I think I will purchase a glucose meter and see if I can work out what suits me best, I also tried taking a small glucose drink this morning. I think I need to find a professional to work with. As I am only taking the Elthroxine for two weeks I suppose I have to give it time to work. Thanks again

    • I actually have the opposite reaction to fruits.
      They don’t keep my blood sugar up at all. Even as a baby and child, I didn’t like fruit, and it’s probably because of the strong reaction it has on my blood sugar.

      But you are correct, that fructose is processed differently then glucose in the body.

  10. So how does one control their blood sugar if they have chronic hypoglycemia?

    Fasting 59-74
    Postprandial hypoglycemia (below 70) within 30 minutes to 90 minutes. Postprandial blood sugar never gets higher then 100 at any point (checking as much as every 15 minutes.)
    I’ve tried high carb, low carb, ketogenic and no carb.

    Physicians are largely disinterested. Despite my neuroglycopenic symptoms, if I don’t have consistent blood sugar levels under 50 continously they generally see my hypoglycemia as a non-issue.

    Postprandially I typically have 4 hypoglycemia events. Where my blood sugar drops, then raises (cortisol – glucagon), then swiftly drops again followed by a repeated cycle until things slowly level out.

    I no longer attempt to use sugar to recover from hypoglycemia, since it creates more hypoglycemia for me. And Physicians don’t seem to understand that. Most just carte blanche assume I’m lying about everything because to them, it makes no sense.

    After 15 years of neuroglycopenic hypoglycemia (as well as a baby/child/teen not ‘liking’ sugar or fruit) I finally got a fasting insulin test, and it did show elevated insulin levels while hypoglycemic. But then the doctor tried to give me metformin…..
    (CT scan for other purposes did not show an Insulinoma)

    So, how do I lower my elevated insulin levels that persists through hypoglycemia?

    • Alalia. I am not an M.D. just someone with a lot of experience managing blood sugar. This sounds to me like you need a complete endocrine work-up–from an endocrinologist, not a regular doctor. Keep your blood sugar records in a dedicated notebook and take it to your appointment. Note what you’ve been eating. This article describes some of the things the endocrinologist needs to look for. Make a check list and make sure he responds to each of your questions. http://www.med.umich.edu/intmed/endocrinology/patients/Hypoglycemia.htm

      • The basic ways to control insulin levels are: 1, on the Glycemic Index stick to low glycemic foods. 2. no sugar or junk food. and 3. intermittent fasting. this is supposed to “reset” your insulin levels if it is out of control.

        Beyond this you need to eat very high quality food: plenty of proteins, and good fats, fruits and vegetables and fruits selected for nutrient density and fiber. And plenty of exercise.

      • I’ve actually seen a few Endocrinologists. And still there doesn’t seem to be much understanding of what’s happening to me.

        To them, it’s great my blood sugar doesn’t go over 100, and they don’t see hypoglycemia as a problem unless it hits a certain number. That arbitrary number doesn’t stop me from feeling the effects of low brain sugar (neuroglycopenic) at 50s-60s blood sugar. But unless I go under 45, and stay there for a substantial amount of time the Endocrinologists I’ve seen won’t do squat.

        So yes, I do have a normal glucagon response, but I still have high insulin no matter what food I eat. And hypoglycemia symptoms with in the first 30 – 45 minutes, however it can occur as quickly as 10 minutes after eating.

        And it seems like in order for an endocrinologist to treat high insulin-hypoglycemia, is to have also a poor glucagon response.

        • There are several posts on hypoglycemia here that concern me very much. Its high insulin levels that are so dangerous. If there is no dietary response to a low glycemic, moderate fat, and high fiber diet, then there is something wrong and it will affect the quality of your life. I would say just keep looking for an endocrinologist who will make the effort to deal with a broad spectrum issue.

          • I completely agree.

            Where I keep meeting resistance is that they (Dr’s) honestly believe that diet can and will always control insulin and if you have high insulin it’s only because the patient is not being honest with their food intake.

            With the very very very very very remote possibly of an Insulinoma, but it’s so rare that they refuse to even try testing it!

            Even though there are at least 20 different (rare) reasons for endogenous hypoglycemia beyond insulin resistance.

            Maybe they think if you have something rare, you would have been diagnosed with it already???

    • Hi I was diagnosed with hypoglycemia when I was about 13 but had been passing out almost daily for years. Anyway I also suffer from seemingly chronic low blood sugar attacks and sugar does not help it only makes it way worse about 30 to 50 minutes later. I have never had any tests besides the oral glucose tolerance test when I was diagnosed. Its becoming very hard to maintain my blood sugar levels. On waking I’m between 40 and 60 and the severe nausea irritability rage fits weakness are so bad I find it almost to hard to eat. I would like to know who to see about this my family doctor after my last severe attack told me in his opinion hypoglycemia is not real what the heck is he talking about. Sorry I live in a small town and our doctors are rejects from big city’s the last time I went in a new doc did a thyroid test of some sort which showed nothing and that was that he was no longer concerned and sent me home saying to eat right and see a nutritionist which I’ve done several times and it doesn’t help so if anyone knows what is my next step

      • Justin. Low blood sugar is really high insulin. I recognize what you are talking about because it is exactly what happens when a diabetic takes too much insulin.
        First. you have to clean up your diet and get off processed grains and sugars of all kinds. search and find The Glycemic Index. Then plan your meals from the lowest glycemic values you can find. Include lots of leafy greens. If you are not vegetarian, include eggs, fish, and meats. As close to free range and organic as you can find. Secondly, when you eat include healthy fats. A salad for lunch for example can have an olive oil dressing. Include fats with everything you eat. this slows insulin spikes.
        Third. You may need a fiber supplement, until you get used to including lots of fiber in your meals. Inulin or glucomannan work You can add them to smoothies, or anything liquid.
        Finally, never use sugar or glucose to combat a hypoglycemic episode–you are going to pass out. Use something sweet with fiber. Figs. Dates. Just a few should do it. I hope this helps. I can’t think of anything worse than facing constant hypoglycemia. I took insulin once before going out to a Thanksgiving dinner. The dinner was delayed, and finally when we did eat I passed out face first in my loaded plate! I hope this hasn’t happened to you. its too much insulin. And you do need to get things checked out because it could be something like a pancreatic tumor–but usually its just too much sugar, and grain products that turn to sugar.

      • Justin, I feel awful for you, after reading about your suffering. Forty years ago, I suffered tremendously like yourself, with gut problems, low sugar, and the waking “severe nausea irritability rage fits weakness are so bad I find it almost to hard to eat.” My nerves jangled always, so I couldn’t get restorative sleep to ease the constant irritation. Finally, I found a very high dose natural B supplement at a health food store. It cost $50 for 30 capsules, at a time when my take-home was $250/month (it was 1975). It settled my nerves and gut immediately, so I continued paying for it. Later, I found an understanding doctor who gave me injections of 1000 mcg of liquid B12 each week, and I felt on top of the world. Unfortunately, he retired shortly after this and I could not find another doctor with the same holistic outlook. I dealt with the low blood sugar and the host of related problems by reading health books and upped my supplements when I could afford to. Nutritional yeast drink (Pep-up) helped.

        I am now type 2 diabetic and low-thyroid, taking T3 prescribed by a naturopath, after a GP refused due to “normal” TSH result. Also on iodine. T3 worked great initially, but glucose readings are higher now; I read that T3 can be the cause.

        Fortunately, in 2015 we have the internet to research and ask for help, and access to more and cheaper supplements. I only mentioned the B12 injections and Mega-B vitamins for those of you who weren’t aware of their benefits. Of course, one needs to take calcium to balance the high phosphorus content of B vitamins.

        • Of course you should never take high dose vitamins like this without a test to see if you need them. High dose vitamins can create other deficiencies because the nutrients are interdependent. Look at the RDAs and stay within that range. And try to take the full spectrum of oil and water-based vitamins and minerals, if you truly aren’t getting nutrients from food. A nutrient dense diet should make excessive vitamin sujpplements unnecessary.

      • Hey Justin

        I understand completely!

        First, stop using sugar to recover from hypoglycemia. Pick up either powder or chews of an amino acid called L-Glutamine. L-Glutamine is the only amino acid that can cross the blood brain barrier and deliver energy.
        I also carry a granola bar with me everywhere. But not off the shelf, you need to find one under 15g carbohydrates (15g after you subtract fiber). Which is more difficult then it sounds. Anything that claims to be low carb, or high fiber are the best ones to look at.

        I have honestly been looking for help for 15 years with no help(except dietary referrals).

        Do you know if you have high insulin, low glucagon or malabsorbtion (when you eat, food isn’t absorbing correctly into your body for energy or nutrition)?
        (There are over 20 possible causes but most have something to do with, or effect these three possibilities).

  11. Hi, I was diagnosed with Hashimoto’s and have recently started mesuring my blood sugar. It is consistantly too high eventhough I am following a Autoimmune Protocol diet. However what surprises me most is, that my blood sugar seems to rise even when I do not eat at all. For example, yeaterday I has 113 in the morning right after waking up, 98 1 hour after lunch, 124 2 hours after lunch and 199 just before dinner ( which was around 7 hours after lunch and I had not eaten anything). How is that possible? Also my 2 hours after meal reading are always higher than the 1 hour after meal, should it not be the opposite? Thanks a lot!

    • Charlotte: Im looking for the answer to this also, and I think that part of the answer is, that glucose can be manufactured from protein (and fats?) as well as carbohydrate. This is called gluconeogenesis and sometimes “dawn phenomenon”. I am following an intermittent fasting program to “reverse diabetes”. I eat between 10 a.m. and 4 p.m. This seems to be working since my last A1c was 5.4. However my over night blood sugars range between 115 and 170 even though I haven’t eaten since 4 PM the previous day, and I am following a very low carb diet. Also I am in a hyperthyroid episode (since last summer) and face radioactive ablation of my thyroid. I don’t have any symptoms particularly, but I feel it must be related to the high fasting blood sugars.

      • You might try eating some iodine.. some seaweed perhaps. start lightly… Seems hyperthyroidism can be caused by severe iodine deficiency.. whereas the body would normally make T4 and then convert it to T3, it seems severely deficient people will just make T3 as it requires less iodine.. Eat some foods from the ocean.. wild caught shrimp, sardines, etc. etc.

        • True. Iodine deficiency is problematical and taking excessive iodine can cause severe hyperthyroid problems–such as the sometimes fatal thyroid storm.. Best to check iodine levels first before O.D. ing on kelp–if you can find someone to do the tests.

    • I have the same problem with
      Fluctuating glucose levels–it’s running very high. recently,–all of a sudden. I qent to the ER twice, and both times they said I had a virus -but I don’t think so
      My doc will be looking into the thyroid function. I have type 2 diabetes & everything just seems out of whack. I haven’t been able to function normally for 2 weeks now. I’m normally a very active person. I am 70 yrs. old .

  12. Hello, my name is Emily. I am 15 years old. I have had Type 1 Diabetes since February 2nd 2009, I found out I had hypothyroidism four years after. I have often changed the types of insulin I’ve been taking, I started out taking Novalog, and as I got older they switched me to Humalog, and that’s when my Thyroid started acting up. I thing my thyroid is affecting all of my blood sugars, all week they have been in the 500’s, even after taking the correct amounts of insulin, I don’t really have control of it. But does this supposed to make my blood sugars like this frequently?

    • Hi Emily – have you ever used Apidra? I used it for about eight years in an Omnipod system and it was wonderful. Now that I have been forced to switch to an insulin pump because of Medicare (Omnipod is not covered and I am now 65), Apidra has not been tested in the pump I have (t-slim by Tandem) AND I AM NOW USING HUMALOG. As a result of this change, in the last seven weeks, my glucose readings have been terrible and what was probably a subclinical level of hypothyroidism has become very apparent. I am glad I saw your posting. How are you now?

  13. I have Graves Disease and have recently had recurring bouts of severe hypoglycemia – so severe that I have gone to the ER twice in the last three weeks. My endocrinologist suspects that I have Herata’s disease – I have every symptom except sweating. Any advice would be helpful- my hypoglycemia is so severe that it is difficult for me to focus for any extended time period – I would also be interested in advice on how to stabilize my blood sugar. Currently if I don’t eat something every 25 minutes or so I become moderately hypoglycemic. I carry honey with me at all times – I am considering getting a holster for it to make accessibility even easier – and things get very dicey if I don’t remember to take it every help hour or so.
    Any input would be deeply appreciated!

  14. Hello everyone,
    I found this site because I am having horrible heart palpitations after eating mostly after dinner/supper. I have Reactive Hypoglycemia and I’m Hypothyroid along with several food allergies/intolerances, Aspergers Syndrome, and ADHD. 🙁 I’m loaded with issues. 🙁 I’ve been suffering since I turned 30 and am now turning 37. I suffer during the middle of my period most with my lows and a few days before I get the period I suffer from the highs. I get low blood sugar on a daily basis so I think when I eat my supper after working chasing kids around for 5-6 hours–I’m not at a good blood sugar level. 🙁 I am currently on Levothyroxine 25mcgs daily and I am also on Bupropion XR 150mgs once daily. I take a chewable Vitamin C at night with my supper to keep the immune system strong as I can. Cardiology tried to put me on Atenolol 12.5mgs a day for the palpitations but like everything else I reacted horribly to it and went off it immediately because of the dizziness/chest tightness/chest pain and shortness of breath. Recently at my endocrinology Dr she found out I am Vitamin D deficient and I started on D2 end of January for 3 months 50,000units once a week. I also had lower potassium levels too. Yesterday my non-english speaking heart care dr said i’m to try Metoprolol XR 12.5mgs a day, well it is from the same family of medicines as Atenolol so no, I most likely won’t take it. Seen enough of the ER lately ugh. I am wondering what it is I can do about the heart palpitations because before I was diagnosed with the Hypothyroidism I got them and then they went away for quite some time once I got on the medicine, but have since returned and seem to hit even if I eat a lower amount of food or lower carb food. I’m ready to scream…what do I do? Please help me!! 🙁 My doctor even agrees with the cardiologist that I should take the Metoprolol and she is well aware I had reaction to the Atenolol and states my symptoms were not a reaction. They are of no help to me whatsoever right now. I need another opinion but looking on here first as I have read all the other comments and alot of them I can relate to! Thank you to anyone who can help me!! 🙂

    • Hi Robin,

      I don’t have any experience with those medicines, but am pretty sure I have some sort of reactive hypoglycemia like you, but the ER doctor’s will not look passed the anxiety it causes.

      I find it odd your doctor told to to supplement D2 instead of D3, since most studies and Vitamin D proponents almost whole-heartedly point at the importance of making sure it’s the D3 variety, taken with a source of fat so it’s soluble. Have you looked into this?

      • William,
        I don’t have a clue about vitamin D and I doubt my endocrinologist does either. I asked her if I could go off it because I have been getting quite sick from it after it is in my system for several hours. I would rather take the otc one that’s only 1000 units a day. I wasn’t told anything about fat or anything cuz shes very short with my visits with her and I get more confused every time.

        • If you feel nauseated after taking D then obviously it’s too much to take. My naturopath has told me that vitamin D overdose shows up as nausea. I think it’s best for you to take a high quality D3 supplement (try pure pharma or even bluebonnet (it’s the brands name) drops. I would take 5000-8000 IU a day.

          • Also D3 is a fat soluble vitamin, so you should take it with the meal that has the most fats. Also if you take D3, you need to take K2-to keep calcium soluable and not backing up in blood vessels. Recently, Dr. Mercola’s articles suggest that if you only take one vitamin supplement, it should be D3.

    • Have you tried natural armour thyroid medicine. I hate chemical medications that doctors are so eager to prescribe. No promises but I have done much better on the natural. And I will tell you now, it will be hard to find a doc that is willing to prescribe it. You would need to do your own research on armour, and decide, but there are a lot less side effects on armour and it is natural not cooked up in a chemical lab. I would agree with you on not wanting to take another medicine in the same group. Remember doctors are only working with books and drug companies, we are the only ones who know when a medicines doesn’t feel right. Hope you find your answers

      • Thanks for all your responses! I am currently on D3 2000 units a day by my own choice. I am not on any heart medicines of any kind. I’m only on the Levothyroxine as I was before but my appointment is upcoming in June. I will try to see if she will agree to Armour but she’s so strong-willed/hard-headed that I’m sure she won’t. It’ll be up to me. I am going to bring up all the palpitation issues and explain each reasoning I feel it’s due to the Hypoglycemia/Hypothyroidism. She loves to just cut all my appointments short like 5 mins and that’s all she ever gives me. She is always late to my appointments too. Not keeping her if she does this one more time to me. Have had it with her rudeness. I need care not her ignorance.

        • Update: June 22nd, 2015 I was told i now have LOW CALCIUM on top of Vitamin D deficiency which has since improved. I chew a Viactiv now a day with D3 and K in it. Is this a sign of Hashimotos? Should I be worried now? I tried to ask her about Hashimotos and she’s pretty sure she feels I don’t have it. Why am I falling apart then?! 🙁 Someone please help me! 🙁 I’m ready to throw in the towel and stay miserable.

          • Low Calcium could make you feel really bad and nervous, and it would take a while to rebuild if you’ve had low D3 and K2—and a useless endocrinologist. Give it some time. Eat well. And look for a new doctor.

    • I had Graves’ disease and had my thyroid removed so now I am hypothyroid. The one thing that helped me with the palpitations was calcium/magnesium it did wonders and still does for me. Hope this helps

  15. If you could help, I would be eternally greatful!!
    I am hyperthyroidism and hypoglycemic; I know but I am also a Libra, off balance!! hehe
    Problem is that all weight loss is to curb appetite, my problem is I don’t get hungry at all. I have to remind myself to eat.
    I was diagnosed at 12 and am now 47, trying to find a way to get an appetite back to lose weight.
    When I ate 6-7 small meals a day I was extremly skinny and couldn’t gain a pound. Now it seems I have no appetite and can’t lose a pound.
    Please help me find a way to get an appetite back so I can lose some weight.
    Thank you!!

    • I was diagnosed with hyperthyroidism may 6 2014 I was in hospital with thyroid storm. I never knew I had any thyroid issues until my both ankle swelled up and heart rate 180 I was so scared I didn’t know what was wrong with me. In hospital for 4 days. Being 41 I always was healthy. But now I’m on thyroid medication. My thyroid is regulated now with meds. 5mg a day. I’m pre diabetes and I also got hypoglycemia. I have to ad more protein to my diet. And go from there. I know how you feel. I go see my endocrinologist every 3 months. Do you go see a endocrinologist? Good luck

  16. I notice my sugar levels drop when I am getting ready to start my period. I have a week of my blood sugar running low or having reactive hypoglycemia. It makes my body and insides feel awful. My doctor recommended a hysterectomy but I do not feel that is the answer. I have heard DGL can help stabilize the blood sugar but to be careful. I have thyroid nodules but blood work is always excellent. I do not eat or drink anything that has caffeine or carbs. I have learned to balance this all out. I has been trial and error. When I do have months where I am not having a period I feel so much better. I have also tried bio-identical hormone creams and they did not help me it just regulated my period. Does anyone have any insight as to what to do during this week to keep my sugar regulated? I even thought about asking my doctor to put me on steroids during this week. Thank you! Very frustrated. Oh and I have gained like 60 lbs in 6 months.

    • I have the same problem, Mo. My blood sugars are terrible about a week before I get my period. My moods are swinging everywhere and I put on 32 pounds in 6 months last year (2014). I had a complete work up done and I would’ve bet money my thyroid was low but TSH and free T4 were normal. My doctor couldn’t explain my symptoms and she was content to leave everything as is. She’s no longer my doctor. I feel like I’ve completely out of sync with my body. (It’s unreliable at best. I was dieting on a low glycemic diabetic diet and I had a Greek yogurt and my sugar went down to 54!). Any insight would be wonderful!

      • The same thing happened to me. Dairy makes your insulin go up, so even if you aren’t consuming any carbs (besides the lactose naturally found in it, although yoghurt has less), you will still have an insulin surge that will drive your sugar below starting level. The same thing happens when you eat lean protein without carbs because protein also makes insulin go up. Insulin isn’t just dependent on glucose. So, after you eat insulinogenic foods without carbs, your blood sugar drops and then your liver has to kick in with gluconeogenesis, which is when you get that adrenaline rush that basically feels like a panic attack. It’s your body pushing stored glucose from your liver into your bloodstream to make up the deficit. I have had so much frustration trying to figure out how to eat with reactive hypogylcemia. I stick with fatty meats and vege and fill in the rest with a moderate amount of carb because if I go too low carb, I lose too much weight and my thyroid gets underactive with all the accompanying side effects, the worst of which is constipation and bad digestion since your thyroid helps with the production of digestion enzymes. It’s been over ten years, and I’m still trying to find a happy medium. The key is to have just enough carbs to where you don’t suppress your metabolism, but not so much that you anger your pancreas (sorry that didn’t sound very scientific, but that’s how it feels).

        • Suzz
          Thank you for that information and I had no idea about the dairy or the gluconeogenesis (new word in my vocabulary)! Yes Hypoglycemia is very hard to understand and manage. I hope something comes out that can help us all who are struggling so badly.

          • you all need to look at adrenal function too along with gut pathogens, like parasites, bacteria – heal leaky gut. the autoimmune paleo seems to be working for many, i just started one month ago. my adrenals are flat lined cortisol. if cortisol is low, then blood sugar is affected. look into a saliva adrenal test. not covered under insurance. most things that help are not covered…

    • @Mo, I have the same problems but not cyclical as I had a Hysterectomy & dbl oopherectomy due to endometriosis nearly 8 years ago. I just turned 38 &can say with great certainty a Hysterectomy can predispose you to further complications (hormone imbalances, mood swings, hot flashes, weight gain, night sweats etc, etc….) unless there is something medically necessary to do such a major surgery I would think long & hard & personally I would run. Any surgery taking away natural processes of a female body is life altering in many ways. Most Dr’s don’t tell you the details they just gloss over everything, they don’t have to live with this decision on a daily basis &get paid no matter what. Its not like a pill you can quite if it doesn’t work, it’s permanent.

      • C.S. Thank you very much for your information. I spoke to my Internal Med NP and she was going to talk to her partners and get back with me…that was 2 weeks ago. She agreed that a hysterectomy was not the right thing to do. She wants to send me back to the endocrinologist who I have already seen who has no idea what to do with me.

        • the short sightedness of the medical profession is criminal and beyond ignorant. i’m blown away that because you have blood sugar issues before your period, you doctor suggests just ripping out the “offending” organ without looking at hormones, including adrenal function, gut health, and yes blood sugar.

    • I meant to leave a comment for you but I accidentally posted on someone else’s question (no idea how to delete it) I would suggest going back on a bio identical progesterone. Progesterone helps stabilize the blood sugar. Have your dr test your progesterone 7 days after ovulation. I have very similar issues and was recently diagnosed with hypothyroidism as well as a luteal phase defect.

  17. My son (21 years old) has Down syndrome and has asthma. He was diagnose with Flu A on Dec. 22nd. He was put on tamiflu, along with breathing treatments every 4 hours around the clock for 48 hours (albuterol and Pulmicort), 4 puffs of Symbicort 2x a day. The next day, the dr. add 3 teaspoons of Prednisolone 2x a day for 3 days and then tapered to 1 teaspoon a day for 3 days. He developed thrush and we took him to an Urgent Care center. They took a chest X-ray and CBC and diagnosed pneumonia in both lungs plus his blood sugar was 211. We were sent to the hospital and spent 5 days getting oxygen, breathing treatments along with blood sugar testing. They diagnosed him as diabetic and began insulin, Metformin. We are now home, his blood sugar last night was 88 and we were told to give him 10 units of Lantis. This morning his sugar was 71. Called the Dr. and he said if blood sugar remained below 200 throughout the day, we should not give the Lantis or the Metformin. The dr. that followed him in the hospital was not an Endocrinologist. We have an appt to see an Endocrinologist on Jan. 13th. Could the stress of the flu along with the breathing treatments and steroids (liquid and inhaled) have caused his blood sugar spikes?

    • Yes. His blood glucose level was likely increased due to the oral steroid doses and his inflammatory response from the influenza. He is quite unlikely to be diabetic. It is common to test blood glucose levels of people on steroid doses. However, labeling him as “diabetic” was premature to say the least. Ask for a blood test called a hemoglobin A1C to be done. This is a test that will tell you how his blood glucose levels have been doing for the last four months. If it’s high, he’s diabetic. If not, it was just the illness and medications that caused the spike.

      This happened to my ex-mother-in-law every time she would get sick and go into the hospital and I’m a Registered Nurse, so I would just spout off her last hemoglobin A1C to them and they would leave her alone about it.

      Good luck!

    • as well as candida. after antibiotics, we wipe out the good bacteria of the gut, which is 80% immune function. this sets the stage of candida overgrowth and dysbiosis and leaky gut. taking more drugs (and vaccines cause harm to the gut) will only make your son more ill. heal his gut. start with probiotics- – get off gluten and dairy and processed sugar. eat whole foods and all carbs with a healthy fat or protein. start there and see how he responds.

  18. Chris,

    how would you proceed for someone who eats ultra low carb, moderate protein (.8g/lb lean mass) and still has a fasting blood glucose of 105-110? If carbs aren’t doing it, and protein isn’t doing it, what could be going on?

    • Chris,
      Your next step should be investigating your postprandial sugar levels and see if they fall into a better range. That would be a good clue for direction and these would be needed to get the best picture of your current situation.

  19. P.S.

    If you were interested in my ALCAT results, here is the list of my food intolerances:

    SEVERE: Artichoke, flaxseed, salmon, whey

    MODERATE: Brazil nut, halibut, hazelnut, honey, pork, venison, gluten/gliadin

    MILD: Acorn squash, almond, bison, black pepper, bok choy, brewer’s yeast, broccoli, carrot, cashew, catfish, chickpea, coconut, coffee, cumin, fava bean, garlic, honeydew melon, hops, jalapeño pepper, lamb, lentil, macadamia, mahi mahi, millet, mung bean, mustard, orange, paprika, parsley, pine nut, quinoa, raspberry, safflower, sardine, shrimp, snapper, squid, tapioca, tomato, turmeric, turnip, veal.

  20. Hi Chris, I couldn’t help but notice your response to someone who had an ALCAT blood test. To clarify: It is NOT an allergy test, but an intolerance indicator (“intolerant” and “allergic” are not equivalent).

    I had numerous allergy tests that came back negative, but the ALCAT was able to pin down quite a few foods that were giving me trouble and that would have taken me a very long time to source out with an elimination diet, due to my extremely diverse and unroutine palate (I’m a multicultural gastronome). Even though a gluten rast came back negative, the ALCAT uncovered I was moderately intolerant of gluten/gliadin. Also, I had no reaction to casein but I am severely intolerant of whey… I was also shooting myself in the foot every day by taking flax oil, of which I am also severely intolerant. The list goes on.

    After being on levothyroxin 88 mcg and supplements for years with no real improvement, since I changed my diet according to my ALCAT results, at month three I first noticed that my goiter shrank significantly, my triglycerides went down from 265 to just a bit above normal range while eating more eggs and red meat, oddly, my HDL is now 59 (from 39) and my vitamin D is finally in normal range.

    What is most important as that the chronic fatigue is gone, and so is the mind-numbing brain fog. I wanted to jump in front of a bus before all this, I felt so defeated. And now – while I can’t say I am 100% like I was before the downward spiral into hyperthyroidism began – I feel quite functional, mostly normal, and not just barely “getting by” anymore. 🙂

    Yes, my endo was skeptical when I told her about it, and she wants to look into the ALCAT to research just how accurate it might be. Perhaps the results are merely anecdotal, but something was certainly removed from my diet that was causing me harm, and it was something that was also listed among my intolerances from the ALCAT.