This is great, I'm sorry cause I know this isn't a good thing to have but I love reading everyones experiences.

Did you guys think that you were always hypo? I remember in my childhood having symptoms. I also get symptoms from fasting, I can go about 16 hours without food then I get bad heart palpitations.

The thing I hate the very most about hypo is that I get really grouchy and irrational. Driving is the worst because I want everyone to get out of my way. That's what inspired me to try to find ways to treat myself. Its really confusing to me that I eat lowcarb and still get hypo before lc I ate something sugary every few hours so I didn't get hypo symptoms that often. Although constantly craving sugar would be a symptom too.

That's interesting what you said about adrenal function and hypo Woo. How does that work? There is something wrong with my pituitary that caused my hypothyroidism. Could it be the cause of hypoglycemia somehow too?

Yea I think that is called an insulinoma; fatal hypoglycemia is caused by insulinoma or a diabetic being overmedicated.
I thought "common hypoglycemia" from eating too many carbs or having a mild adrenal insufficiency (from stress or genetics) which is like 99% of most hypoglycemics isn't really fatal.

I get unstable blood sugar on low carb, but, they're not that bad.
Most of the time when I get it now it's comparatively mild, and it's because I ate too many carbs, caffeine, didn't sleep well, or overexercised... things like that. The lower I keep my carbs, and the less I eat, the more stable my blood sugar is.

However, I have to stay above a certain minimum of carbs in order to keep my overall energy up. If I keep carbs too low my blood sugar is solid as a rock, but unfortunately, my energy is always a bit too low.
My theory is in addition to a tendency to hyperinsulinemia and IR, I may have a mild adrenal insufficiency as well. So, even though ketosis eliminates the prospect of unstable sugar, the overall sugar level is too low most of the time, since ketosis puts a lot of demand on my body to make sugar (which it can't do well).

Best for me is low, but not too low carbohydrate (above ketosis is fine), small, frequent meals, and overall lower calories.

Hypoglycemia is made up of two parts:
The actual low blood sugar level (relatively asymptomatic, but, after experiencing it enough you can tell signs)
The sympathetic nervous system adaptation to rapidly dropping sugar (these are what the hypoglycemic symptoms are made up of).

Sympathetic nervous system is what makes you shake, sweat, hot & cold sensations, feel extremely emotional and irritated ("on guard"). Most people claim themselves hypoglycemics based on experiencing this; however this is not accurate way to self-diagnose since the relationship is not absolute. Some people experience hypoglycemic "feelings" because of a changing blood sugar level (that never goes into the true hypoglyemic range), or, for reasons totally unrelated to blood sugar (like anxiety).

Also, low sugar isn't the major catalyst for the magnitude of experiencing the sympathetic nervous system response. The symptoms are caused not really by the sugar being low, but primarily by the steepness of the decline; the faster and harder you start to crash the more your "fight or flight" sympathetic nervous system kicks into gear to "save your life".

The absolute low blood sugar has symptoms as well, but they are much more mild. They are mostly on cognitive functioning. This is the reason for the dizziness. When I am really low you become "zombie-like"; your brain stops working, it feels almost like living death. It's like you'll be looking at something and you won't understand it. You'll say something and it will come out wrong. You will try to move a certain way and you'll fumble. You'll write a word and it will look like gibberish. There are mild physical symptoms too, like you'll feel tingling and numbness in extremities are caused by too low sugar. They are hard to spot because, well, how can you be aware that you are not aware? Plus, since hypoglycemia is usually coupled with that adrenaline surge (mentioned previously), which in of itself makes it hard to relax and focus. It's very easy to not notice these subtle signs of low sugar so most people associate "feeling hypoglycemic" with the shaking and sweating.

Yea that's like me... but even on the carbs I eat now (which according to fit day is 60-80 most days) I can experience hypoglycemic symptoms often. I suspect I could do more to control it better, but, at this level the problem isn't that bad (episodes are always very mild).

Ok, gotcha. There's "plunging blood sugar" and there is low blood sugar. Maybe a hyperinsulin response leads to that nervous system response. Or a release of adrenaline. I know my nephew had it happen and it triggered a huge panic attack for him. Then I remember a time when my Dad described how he felt like he sort of blacked out once and yet was still walkign and functioning. I bet those were examples of the Plunge and the Hypo.

I used to feel nauseous when I was having a plunge.

I actually drifted to lower carb before I even knew about 'low carb' to keep my blood sugar balanced. I now do pretty well, but I don't get hungry, and frequently I'll forget to eat until I'm shaking and can tell I'm getting irrational. Then I'm all "Oh, I was going to have lunch 4 hours ago...)".

It's interesting how many people do better with small frequent meals. I'm exactly the opposite. It's as though If I don't eat enough at one time, then I stay hungry, and my blood sugar keeps dropping. I do best on 3 solid meals, plus a snack or two.

I have a huge problem with AS. My body hates it worse than real sugar. We hate sugar too. I can use tiny bits of splenda, and a little bit of honey. Both sugar and AS make me completely irrational and ossilate my blood sugar up and down, it sometimes won't balance until I get a nights sleep.

It's been a long time since I've passed out, but mostly that's because I've had friends or roommates or the DH around, and they've all come to notice low blood sugar symptoms. I still carry emergency candy in my purse, plus nuts or seeds.

I think things are better now, but they'd be a lot better if I could learn to eat on a regular schedule. I don't have a 9-5 job, so my life doesn't lend itself well to eating on the clock.

I'm currently experimenting with upping my carbs again to see if a higher carb level will trigger a more normal hunger reaction. All this bottoming out can't be a good idea, although I never get the manic highs and extremely fast drops I used to have, so that's an improvement.

This is making me think about my sister. I am a type 1 diabetic....have been for 25 years. Iswitched from injections to an insulin pump 10 years ago. I have a sister that lives overseas. She gets shaky and has what she calls, "Sinking Spells." She eats carbs throughout the day and night. She frets about her weight, but keeps telling me that she can't go on low carb because of these "spells." Several years ago I checked her blood sugar--a fasting. I can't remember exactly what it was, but I think it was like 130. I told her then that I thought she should talk with her doctor. She gave me a big song and dance rationalization--like she always does. I'm the "baby" sister, what can I possibly know. Keep in mind that this is the same person who used to give me speeches about how much harder it was for her to lose weight than me. I listened...blah, blah, blah. Finally I said, "Get over yourself. I have a metabolic disease. I have to pump insulin. It ain't easy for me, either."

Anyway, I say all of this because I do worry about her. Is she in a state that is a precurser to diabetes? She just knew she was having thyroid problems and was baffled when tests show normal thyroid function. My dad has developed Type 2. She eats often and feels bad. Her weight distribution is not like mine or my dad's, visceral or however you spell it. She has a smaller waist and the saddle bag things going. But, she is heavier than she has ever been and feels really badly toward herself. She lives in Asia where she is surrounded by very tiny body types.

I doubt she will ever listen to my opinions, but I do try to understand her experience. Reading this thread helps me empathize.
Sara<><

My endo did think my Hypoglycemic episodes were a pre-cursor to Diabetes. I was really worried, because my Mom who is 66 years old just got diagnosed as Type 1 diabetic. We've been looking into the pump for her too. She's really conscientious about taking her BS and Insulin, but I do worry about some of her Low BS episodes. At first she was really aware of when they started dropping. If her sugar got down to 80, she was shaking and could feel it. I read that the more kow blood sugar episodes you have, the less you are aware of them. And that's what has happened to her lately...she'll get down to 60 or 70 and not feel the symptoms as well. It's pretty scary.

And I have difficulties now getting my Mom to do anything other than the ADA's recommended diet of about 40 carbs a meal. I've tried to get her to try Atkins for Diabetes or Bernstein, but she is afraid to deviate from her Dr's advice.

In perusing this thread, I'm wondering if Dr. Lutz's Life Without Bread would be the program to follow. He recommends a maximum of 72 grams of carbs a day. This should allow enough glucose to prevent low blood sugar.

The hyperinsulinemia precipitates plunging, and, it is the plunge itself that activates the sympathetic nervous system. Our bodies have evolved to see "suddenly dropping sugar" and associate that with hunting animals and running for our lives .
As far as it knows, there is only one time sugar drops abnormally quick, and that's when you're doing something pretty dangerous, and you need a bit of mojo to get you through it.
This is why when our body responds to rapidly dropping sugar it comes along with these annoying and inconvenient "unnecessary extras" that make you feel like you're going to die. This is what your body thinks, so, it makes you FEEL it in a real way to get you to respond to your environment as such.
So, excessive SNS activity happens only when sugar changes fast, and, not necessarily when sugar is absolutely in the hypoglycemic range.

There is another complication to the puzzle. Our bodies don't understand that we can have hyperglycemia. So, the body operates with an assumption that all blood sugar levels will never exceed normal. That's why it responds the same way to suddenly dropping sugar no matter what the level is, and it can't tell the difference between "a sudden drop to normal" and "a sudden drop below normal".
A hyperglycemic diabetic may "feel hypoglycemic" if his sugar drops suddenly, even though he is still absolutely hyperglycemic. Someone who is chronically mildly hypoglycemic may not feel any SNS symptoms at all, if the hypoglycemia is chronic and stable... like me when I eat too low carb or when I am not eating much food.

Ironically I feel hypoglycemic much more often when eating more food, because my sugar is less stable (due to the food-induced changes in insulin & thus sugar level). Although, I would wager that the amount of time I spend being absolutely hypoglycemic is far less than it is when I am under eating... in that state I feel mildly low most of the time but the actual sugar level is solid as a rock.


I agree Nancy, that sounds just like a plunge and a (rather severe) absolute hypo. "There but not there", your brain just doesn't work right.

Although panic attacks can cause hypoglycemic symptoms (the SNS response is the same for both), but sometimes, the plunge can also cause panic attacks.
It's hard to tell which comes first without actually determining a root cause (like, conclusively determining whether anxiety was prevoked, or, determining if sugar ever became relatively hypoglycemic).

Remember, body wants you to feel in danger because it thinks rapidly dropping sugar = dangerous situation is an absolute, solid relationship.
The SNS response to hypo can result in panic attacks, because the body is telling you to be afraid when there's nothing to logically be afraid of. Result? "OH MY GOD THIS ROOM IS OVERWHELMING" type thoughts run through your brain.

The other day I was carrying something very heavy, while walking very fast, plus, I had not eaten much all day. This sudden activity on empty stomach caused my sugar to do a sharp downturn. Suddenly I was overcome with extreme emotionality and wanted to cry, I was right in the street too so this was very inappropriate and irrational. This was before I experienced any other symptoms. I knew it was hypoglycemia because I started getting the cognitive symptoms (I became very dizzy, confused and was afraid I would faint, they were very strong). I was actually really worried I might drop off right in the street.
Once I got to my destination, finally, the other symptoms kicked in - I was shaking uncontrollably, sweating, felt very hot (I am always cold), etc. I started chewing gum frantically to try to help my body fix things, and eventually I was back to normal (although feeling like I had just been in a boxing match, which seems to happen whenever I get a pretty bad hypo like that).

In fact, I have kind of learned to tell that I am getting low based on the sudden emergence of irrational emotional thoughts. I'll be like "Wait... this doesn't make sense I should feel this way. I probably am gonna get whomped with a hypo in like 3 seconds".

Yes, that is another common symptom.

This might be why CRON works so well. It keeps blood sugar a lot more stable.

Yea...
We really don't talk about hypoglycemia much around here, but it's such a common problem for those of us with this carb tolerance issue.

I did not know what hypo was until starting atkins.
Starting atkins, I was amazed that all these problems I had went away over night (like my acne and pcos symptoms). I was finally not hungry for the first time ever, and miraculously, I could tolerate not being with food for long periods of time. Reading the Atkins website for information, one of the symptoms of carb intolerance was "being really irritable and shaky when food was delayed". Then this provided the segway for me to learn what hypoglycemia was. I realized I had it when I read the symptoms and description of it.

I had my self diagnosis it verified in september by testing at home after 50g glucose challenge. Then my doctor confirmed it by officially diagnosing me as reactive hypoglycemic.

I never understood until then why for me "hunger" was about panic and emotionality and shaking, feeling too weak to function. Even as a kid I remember these episodes. I can remember numerous times crying out of "my hunger" and begging my mom to get me something to eat, in the rare moments when I was islanded from food. I seriously didn't realize that hunger wasn't supposed to feel like that. My family joked at my expense about how "I never knew what it felt like to be hungry and that's why I couldn't tolerate it" (since I was fat ). If only they knew what that felt like.

My hypoglycemia is a big reason I developed a food obsession. I was irrationally hungry all day long, and, I was irrationally afraid "of becoming hungry". So I just kinda ate and ate all the time to try to satiate myself and prevent "hunger".

I can experience hypoglycemia which is like a "dramatic plunge" in the food restricted or fasted state very rarely. It has happened only if its induced by excessive activities that put too much stress on my body's ability to make sugar. Ketosis or fasting, however, does put me in a chronic, stable, mildly hypoglycemic state. Every time I've had my fasting blood sugar taken it has been mildly hypoglycemic. Although, since sticking to LC, my fasting blood sugar continues to improve and recent values measure as low normal.


What I hate most about it is how I always have to be afraid how I will feel after eating something. Even low carb food. I mean normal people don't have to worry about these things. Fear of hypoglycemia is probably what I hate most, more than actually experiencing it. This is a big reason I ate the way I used to. I hate hate hate feeling that way.


If you restrict energy (calories) now, you can be expected to experience the actual symptoms of hypoglycemia more often than if you ate unrestricted.

Like, if before you were like me and on a "see food diet", every time you got that first inkling from your body, you probably unthinkingly grabbed a candy or something. It's just natural to eat when you start to get hungry, before you even logically recognize yourself as hungry. But, now that we watch our intake, we are less likely to "listen" when our bodies urge us to grab something. We are DEFINITELY likely to heistiate when our bodies say "gimmie a fruit" like mine always did . So as a result, we experience hypo symptoms more often because we restrict carbs and energy when our bodies want us to eat these things to keep sugar up.

It's a fine line between eating to keep sugar up and eating to mess it up.

Also there is a myth that hypo is ALL about hyperinsulinemia, it's not true. Adrenal insufficiencies are big players too; hyperinsulinemia just makes it worse. More insulin stresses the body's need to make adrenal hormones to maintain homeostasis in blood sugar. If you have, say, addison's disease or mild CAH or some other condition, your body lacks enzymes to make glucocorticoids well. This means your body simply can't make that much sugar and struggles to keep levels up. Eating carbs makes this so much worse for your body, but, eating none at all (fasting/ketosis) isn't a lot better either. The idea is to eat "just enough" carbs to relieve the pressure from your body (non-ketosis). But, don't eat so much that your insulin is so high and your adrenals can't keep up (and then you get the reactive hypos).


I can't say for sure since I don't know your particular case, nawchem. But I can say if you tend to be hypoglycemic when fasting too, and not just reactive type, that some kind of adrenal insufficiency might be playing a role there. There are lots of reasons your body's adrenals dont' do what they're supposed to. The pituitary orchestrates things, so, if there's a problem with it it could be affecting other things.

Out of curiosity, do you tend to be hypotensive? Do you have PCOS or PCOS-like symptoms?

Hypoglycemia does precede diabetes often times. Since hypo is a symptom, and the cause is not the same for all cases, not all types of hypoglycemia are indicative of insulin resistance & hyperinsulinemia. Most of the time, though, it is. Crappy diet and inactivity is common. Genetic enzymatic deficiencies & adrenal tumors are rare.

Fasting hyperglycemia is a huge indicator of diabetes. If your sis is getting readings like that in the fasting state she should see a doctor. At the very least she needs to get on a low carb diet asap. Diabetes, once you have it, the damage is permanent. All you can do is advise her. You can't make her take responsibility for herself. I hope she listens to you but if she doesn't, you should know you tried to help.

Dear Itsthewoo:

Thanks for your replies to this thread. I went to the endo a few days ago and she seemed to just look blank when I tried to explain to her my displeasure at surging and falling blood sugars. She kept saying 'all these readings are fine'. I kept trying to tell her that sharply rising or falling 50 pts is extremely unpleasant - even though an absolute reading of 120 or 70 is ok if you get there gradually.
I really hate both the 'ride' up and the 'ride' down. I have been trying to control my surges with lc diet, metformin and Byetta, but I think I also need something else like quick acting insulin for the highs. The lows I will have to just live with - for now.

I've always thought of my hypoglycemic condition as a potential rollercoaster. The more sugar/carb in a meal, the higher I go with more potential for a fall. It's basic common sense when what goes up must come down. I like rollercoasters, but not in my bloodstream thank you very much. I tend to feel extreme irritability if I go below 40 carb, even for a long period. I feel my best when I'm hovering under 70 carbs a day. Over that, and it's welcome to Crave City.

It's amazing what a fine line you tread when you want to keep level.

Also, what I have for breakfast will have a deciding factor whether I have a hypoglycemic event during the rest of the day.