Q:Can you tell me more about hypoglycemia? Why, when blood sugar drops, does blood pressure rise accordingly? I gave up on doctors. One said it’s “just your age”; another blamed me for “causing it” by monitoring my blood pressure regularly. I’ve tri

A:As allergy specialist Jonathan Brostoff puts it, what petrol is to a car, glucose is to the body an energy-rich fuel that keeps every part of the body alive and powers our muscles. The transport for glucose is blood, from which it is absorbed into cells when necessary.

This level of sugar in the blood is maintained at a delicate balance by several hormones; insulin, the one we’re most familiar with, is the policeman, called into play when blood sugar is too high. It drives sugar out of the blood and tucks it into body cells. This is why diabetics, who have inadequate insulin, must take injections of it and avoid high sugary meals that would suddenly push up blood-sugar levels.

If the insulin level gets excessive, you get low blood sugar, or hypoglycemia. Even if you’re healthy, you’ve probably had a taste of this syndrome whenever you’ve had a rich, sugary meal, downed with lot of wine. The sudden blast of insulin your body produces to cope with sugar overload sends down your blood sugar. You end up feeling tired, faint, confused, and possibly even moody because your brain cells especially require glucose to work properly.

In true hypoglycemia, there are three varieties. The first and most severe results from “insulinoma”, an insulin producing tumour of the pancreas or liver. This situation, while potentially life-threatening, is very rare, occurring (as medicine gauges it) in four out of every 1 million person years (whatever that means). If the tumour can be removed, such patients usually recover (The New England Journal of Medicine, 27 April 1995).

The next type, or diabetic (or “factitious”) hypoglycemia, occurs if a diabetic jabs himself with too much insulin, causing his blood sugar levels to fall too low.

The third, and most common type, is “reactive” hypoglycemia, a metabolic problem causing the body to see-saw to too-low blood-sugar levels after meals, particularly those containing lots of starchy or sugary food. People who tend to suffer from this will feel weak, faint, have rapid heart beats or palpitations, or even vertigo. Because the brain relies so much on glucose, in its absence you tend to suffer from behavioural problems as well. These can include anxiety and panic attacks, mood swings, irritability, insomnia, even mental disturbances and disorders like hysteria, or hypochondria. If you tend toward migraines, epilepsy or allergies, hypoglycemia can bring on the conditions.

The biggest problem with this third category is that medicine doesn’t believe it exists. In a recent review article on the subject under the column “Medical Progress”, Dr F J Service, an endocrinologist at the august US institution the Mayo Clinic, wrote: “There is no convincing scientific evidence that supports the diagnoses however long in use of functional hypoglycemia, early diabetes hypoglycemia, and alimentary (food) hypogycemia” (New Eng J of Med, April 27, 1995). Hence why your doctor palmed you off with the you’ll-just-have-to-learn-to-live-with-it line. That tends to be the favourite dismissal of anything that doctors don’t know how to treat. Because many doctors don’t have the tools to prove the existence of this disorder, they prefer to say that patients suffering from vague symptoms after eating are really suffering from something else Dr Service, dubs this, for want of a better term, “idiopathic postprandial syndrome” (translation: “after-eating syndrome of unknown origin”).

Doctors mainly pooh-pooh hypoglycemia because it appears to relate to nutrition and food allergy, two areas they tend to know very little about. According to nutritional expert Dr Stephen Davies and Dr Brostoff, the most common cause of reactive hypoglycemia is eating refined carbohydrates white bread and pasta, commercial baked goods and the like and sugar. These sorts of meals, which are so popular in the West, can send your insulin levels soaring. If you are overweight, you can suffer from the condition frequently, as your body cells, which are accustomed to dealing with high glucose levels, react more readily to insulin.

Dr Brostoff and others believe that one major cause of hyperactivity in children is hypoglycemia, possibly caused by food sensitivity. The current theory, he says, is that food allergy makes the insulin-producing cells in the pancreas themselves hyperactive. This may be why hyperactive children often crave junk foods.

Other causes include an unbalanced thyroid (both underactive and overactive can wreak havoc with your blood sugar); stress; too much alcohol, smoking or caffeine; and certain drugs, such as metronidazole (used to treat gut parasites and trichomoniasis. Still other causes of the condition include an unbalanced internal ecology, whether from candida albicans overgrowth; or vitamin or mineral deficiencies-magnesium, potassium, manganese, zinc, chromium and the B vitamin complex, particularly B6-or food allergies or intolerance.

Dr Brostoff says that a major complication of tests for hypoglycemia has to do with the fact that glucose used in the standard test for hypoglycemia is dextrose, which is derived from corn, a common food allergen, particularly in North America. If you are intolerant of corn, you will react to the test, and your blood glucose will fall, leading to a diagnosis of hypoglycemia, when the problem is food allergy.

Oftentimes, a food allergy will cause all the symptoms of hypoglycemia; as soon as you cut out the offending food, your symptoms disappear.

For clues as to how a fellow reader cured her own case of hypoglycemia, and some other alternative suggestions, please read on.

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Written by What Doctors Don't Tell You

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