Do you have Reactive Hypoglycemia? Do you ever experience symptoms like brain fog, fatigue, headaches, anxiety or even increased hunger within a few hours after eating a meal? In Thyroid Thursday #89, Dr. Eric Balcavage continues the discussion of why reactive hypoglycemia occurs in the body and more about insulin resistance!
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We’re back for another edition of Thyroid Thursday, and today is part two in our Reactive Hypoglycemia Series. If you remember from the last video, we talked about reactive hypoglycemia being the condition where your blood sugar drops a bit too low in the one to four hours post-eating. When that happens, you can get number of symptoms, anxiety and irritability. You can get brain fog, lightheadedness, confusion, blurred vision, fatigue, weakness, sweating, headaches, heart palpitations, cravings to eat, and have disrupted sleep. Blood glucose dysregulation is a major reason for disrupted sleep.
So, what’s going on?
As I said in the last video, when you eat, food comes into the GI tract. You break it down into micronutrients, minerals, amino acids, glucose and fatty acids. What should happen is, that as your blood sugar rises, insulin should rise with it. This initial rise in insulin is called the First Phase Insulin Response. We’re going to talk more about the First Phase Insulin Response in more detail in the next video. As glucose rises, insulin should rise with it. Then, as glucose starts to drop, insulin should start to drop and it should bring us back to our baseline. If, however, glucose drops a bit too low, it can result in slow blood glucose symptoms.
What causes this state to occur?
Well, one of the things that can occur is that you have too much insulin, or you’re too insulin sensitive. The primary reason for that is an increased level of something called GLP-1, which is an enzyme in the GI tract, and that enzyme is what triggers the first phase insulin response and makes us more insulin sensitive. We’ll talk more about that in the next video. If you’re a type 2 diabetic already and you’re taking insulin, it can be caused by taking too much insulin. It could also happen to somebody whose type 1 diabetic.
A second reason is your GI tract, especially the stomach, empties way too fast. If you’re one of those people who eats and they have to go to the bathroom right away, then you’re probably getting excessive GLP-1 that’s increasing that insulin response, and increasing insulin sensitivity, and that can cause the drop in blood sugar rapidly.
A third cause is inflammation. Chronic low-grade inflammation is a chronic problem for many people. If you have low-grade chronic inflammation, it can trigger changes in GI function, GI motility and cause the blood sugar to drop, as well.
A fourth reason is decreased production of what we call the counter regulatory enzymes or hormones. What happens is, as the blood sugar starts to drop, these counter regulatory hormones, (the things we talked about last time; glucagon, cortisol, adrenaline, and growth factor) should actually kick in and bring our blood sugar back to a normal optimal level. However, if we’re not getting good production of glucagon, cortisol, adrenaline or growth hormone, then we don’t have this counter regulatory measure working well. Your blood sugar will drop too low, and with sluggish production of regulatory hormones, the blood glucose is not restored quickly and symptoms ensue.
The primary reason for reduced production of regulatory hormones is hypothyroidism. It can be glandular hypothyroidism, where the gland’s not putting out enough thyroid hormone, resulting in reduced thyroid hormone to the cells and tissues. Or, you could have cellular hypothyroidism. Which means there is reduced thyroid hormone in the specific cells or tissues that are making these counter regulatory hormones. Without appropriate counter regulatory hormones, and you’re going to have this reactive hypoglycemic state.
The last reason could be nutrient deficiencies. You could have carnitine, vitamin C, or amino acids deficiency, which I commonly see in people who have hypothyroidism. One reason for amino acid deficiency is reduced stomach acid production for proper protein digestion. Iron deficiency can also be caused by low stomach acid and result in this reactive hypoglycemic state.
The question you may be asking yourself is, “Okay, so what do I do about it?”
This is one of those things that I don’t think you take lightly. I think you should reach out to a functional medicine practitioner like myself, and get some help and some guidance on this because really what we need to do is identify the underlying cause. Yeah, you can eat like every two hours, which is what a lot of people recommend. People are often told to eat small frequent meals to regulate their blood sugar, but that’s a recipe for problems down the line. What we really want to do is help you identify the mechanism that’s creating this problem, and the reason you can’t regulate glucose as well as you should.
Hopefully this video helps. Stay tuned for part three in the Reactive Hypoglycemic Series.
