~Hypoglycemia

~Hypoglycemia
Reprinted with permission of Life Extension®. Hypoglycemia literally means "low blood sugar" and is often mistaken for a disease when it is actually a symptom. Ingested carbohydrates (sugars and starches) trigger a release of the hormone insulin from the pancreas. Insulin helps the body turn sugars into energy and stored fats. In some people, the amount of insulin released is too high for the amount of carbohydrates ingested, resulting in too much sugar being burned up too quickly. A net loss of blood sugar results. In hypoglycemia attacks, there is too much insulin and not enough blood sugar, causing fatigue, weakness, loss of consciousness, and even death.

There are three general types of hypoglycemia. Two of them are rare organic forms involving the pancreas. The third and most common form is called functional hypoglycemia (FH) and is usually caused by an inadequate diet too high in sugar and refined carbohydrates. Hypoglycemia may be better described as carbohydrate intolerance: the body is unable to absorb certain carbohydrate loads effectively without adverse consequences. Different people react differently to ingested sugars and starches, with some individuals having a higher tolerance level than others.

Although predisposition to FH may be an inherited condition and is most often due to dietary factors, it can also be found in people with such disorders as schizophrenia, alcoholism, drug addiction, juvenile delinquency, hyperactivity, diabetes, and obesity. In some people, severe FH can contribute to other illnesses such as epilepsy, allergies, asthma, ulcers, arthritis, impotence, and mental disorders.

SYMPTOMS

The symptoms of hypoglycemia include:
  • Fatigue, dizziness, shakiness, and faintness
  • Irritability and depression
  • Weakness or cramps in feet or legs
  • Numbness or tingling in the hands, feet, or face
  • Ringing in the ears
  • Swollen feet or legs
  • Tightness in chest
  • Frequent heart pounding or palpitations
  • Anxiety, nightmares, and panic attacks
  • Night sweats
  • Constant hunger
  • Headaches and migraines
  • Impaired memory and concentration
  • Blurring of vision
  • Nasal congestion
  • Abdominal cramps, loose stools, or diarrhea
Functional hypoglycemia may be subclinical, meaning that symptoms are subtle, episodic, and difficult to diagnose. Patients may have a low but acceptable blood sugar level that does not drop until the last hours of a prolonged test. Glucose tolerance tests often miss the lowest blood sugar levels that had triggered acute symptoms. Severe regular attacks of hypoglycemia may have diabetes as the underlying cause. If symptoms persist, see your doctor.

Hypoglycemia and Diabetes

Hypoglycemia can also be a common complication of diabetes. Diabetes occurs when the body cannot use glucose for fuel either because the pancreas is not able to make enough insulin or the insulin that is available is not effective. As a result, glucose builds up in the blood instead of getting into body cells. The aim of treatment in diabetes is to lower high blood sugar levels. To do this, people with diabetes may use insulin or oral drugs, depending on the type of diabetes they have or the severity of their condition. (Refer to the Diabetes protocol for further information.) Using these medications may lower their blood sugar too much, making them hypoglycemic.

Hypoglycemia and Diet

A perfectly regulated diet can help to control hypoglycemia. Usually a regimen high in protein, unrefined carbohydrates (which are slow to be absorbed, such as whole-grain products and vegetables), and moderate fats is recommended. Heavily sugared foods should be avoided, and foods high in natural sugars should be restricted. Alcohol, caffeine, tobacco, and other stimulants should be avoided, because they are capable of precipitating an attack. Small meals taken often during the day are recommended to control the amount of carbohydrates entering the system.

Short-term treatment focuses on raising the blood sugar level without delay. Any substance containing simple sugars, such as fruit juice, soft drinks, or candy--if taken at the onset of a hypoglycemic episode--will help to raise blood sugar quickly and ease the severity of the attack. Sugar combined with a protein source, such as a glass of milk or a piece of cheese, will help slow the absorption of glucose into the system, avoiding the "seesaw" effect caused by rapidly changing blood sugar levels.

Nutritional Supplementation
  • Vitamin B6
  • Chromium
  • Cysteine
  • Glutamine
Vitamin B6. Hypoglycemia may damage brain cells. When hippocampal brain-cell cultures are deprived of glucose, a massive release of lactate dehydrogenase (LDH) occurs, which is an indicator of neuronal death. The addition of the vitamin B6 metabolite pyridoxal 5-phosphate has been shown to inhibit the LDH release. When pyridoxal 5-phosphate is given before glucose deprivation, a more potent inhibitory effect on LDH release has been observed. Scientists have suggested that pyridoxal 5-phosphate protects neurons from glucose deprivation-induced damage. These scientists recommend that pyridoxal 5-phosphate be used prophylactically to protect against brain-cell death induced by metabolic disorders such as hypoglycemia (Geng et al. 1997).

Chromium. Another possible cause of low blood sugar is the inability to release glycogen (stored sugar in the liver), secondary to vitamin B6 and chromium deficiency. Some hypoglycemics are helped by the daily administration of 100-250 mg of pyridoxal 5-phosphate and 200 mcg of chromium. Chromium is a mineral found in brewer's yeast, whole-grain breads and cereals, molasses, cheese, lean meats, and dietary supplements.

Cysteine. Too much insulin in the blood can be partially neutralized by taking the amino acid cysteine along with vitamin B1 and vitamin C. Hypoglycemics should start in the first week with once-a-day doses of 500 mg of cysteine along with 250 mg of vitamin B1 and 1500 mg of vitamin C. This dose should be administered 2 times a day during the second week and 3 times a day by the third week. The objective is to prevent hypoglycemic attacks by neutralizing excess insulin. Every hypoglycemic is slightly different, so the dosage ranges will vary from person to person (Pearson et al. 1982).

Glutamine. Glutamine plays a vital part in the control of blood sugar. It helps prevent hypoglycemia, because it is easily converted to glucose when blood sugar is low. Glutamine can enter the Krebs cycle and serve as a noncarbohydrate source of energy for the body. In fact, this is the main way it usually contributes to the production of energy. However, if the blood sugar is low, glutamine is readily catabolized (broken down) in the liver and used to create more glucose. Together with alanine, glycine, serine, and threonine, glutamine is an important "gluconeogenic" (glucose-rebuilding) amino acid, in fact the primary one. Providing abundant glutamine through diet and supplementation means that less muscle tissue (if any) will be broken down to provide glucose.

This production of glucose from glutamine takes place mainly in the liver. Recently, however, it has been discovered that the kidneys can contribute as much as 25% to whole-body glucose production, a phenomenon that occurs only during hypoglycemia (Stumvoll et al. 1999). Actually this is not surprising, because the kidneys are especially equipped to process glutamine owing to its importance in the detoxification of ammonia.

Glucose has recently been shown to be synthesized in the small intestines through the breakdown of glutamine in a fasting or diabetic state. Under these conditions, the small intestine contributes 20-25% of whole-body endogenous glucose production (Mithieux 2001; Croset et al. 2001).

For more information, contact the Hypoglycemia Association, Inc. (HAI), Box 165, Ashton, MD 20861-0165; (202) 544-4044.



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