Monday, October 27, 2008
Reactive Hypoglycemia--An Experiment?
Reactive hypoglycemia is a condition which is characterized by unusually low blood sugar that occurs one to four hours following a meal. The symptoms are the typical ones for low blood sugar--shakiness, light-headedness, weakness, confusion, anxiety, depression, hunger, pounding heartbeat and sweating.
Progressive development of insulin resistance is often the cause of reactive hypoglycemia. When the pancreas becomes insulin resistant, it is unable to release the proper amount of insulin in response to the stimulus of carbohydrates and proteins. Sometimes the pancreas will overshoot its estimate of the amount of insulin needed to store ingested carbs and proteins. The excess insulin produces hypoglycemia and its associated symptoms. A more detailed explanation of the process can be found in my original post called Reactive Hypoglycemia. (Be sure to read the comments section.)
Reactive hypoglycemia can be diagnosed with a glucose tolerance test. If the test is positive, the patient will typically be advised to eat every 2-3 hours to relieve the symptoms. Although freqent ingestion of food does keep blood sugar from falling too low, it will not provide a long-term resolution of the underlying problem.
One of my readers, Alex, who blogs at Low Carb New England, entered the discussion on the original post with the story of how he has been dealing with reactive hypoglycemia since he was a teenager. Over the years he has systematically tried many different approaches and has taken careful note of what result each personal experiment has produced. To summarize briefly, Alex initially tried eating less sugar and eating frequent meals, but eventually he gained nearly 100 pounds. Next he investigated low-carb eating. By using the Atkins diet, he lost weight and many of his symptoms improved considerably. In an effort to reduce the remaining symptoms, Alex tried eliminating artificial sweeteners and caffeine, and this helped somewhat. He also tried extremely low-carb and even no-carb eating, which didn't help.
Eventually Alex realized that he needed to limit his protein intake to the amount recommended by Drs. Mike and Mary Dan Eades in The Protein Power Lifeplan. (Remember, eating protein also causes insulin release, and thus can contribute to insulin resistance.) Again, his symptoms improved, but were not entirely gone. The final piece of the puzzle seemed to arrive when he read my first comment under the Reactive Hypoglycemia post and decided to try waiting 5-6 hours between meals to allow his insulin levels to come back to baseline and give his body a chance to re-establish a normal level of insulin sensitivity.
After a month of using this three-legged stool approach (low-carb/moderate-protein/5-6 hours between meals) to dealing with reactive hypoglycemia, Alex has finally experienced relief from the symptoms of reactive hypoglycemia. He gives a much more complete version of the story on his blog in a post called "I'm back!" (For those who don't have access to The Protein Power Lifeplan, another method of calculating one's daily protein need can be found here.)
And now I've reached the main point of this post. If the three-legged stool approach (illustrated in the picture above) has worked for Alex, would it work for anybody else out there who has reactive hypoglycemia? Each leg of the stool is designed to reduce insulin resistance and, one hopes, to restore some degree of insulin sensitivity in muscle, liver, brain and pancreas. If any of my readers is interested in trying to follow this plan for a few weeks or a month, I would be very interested in getting your feedback. If this method actually works, it's possible that a series of anecdotal experiences could convince a low-carb researcher to design a study to see if using the three legs of the stool is an improvement over frequent feeding as a way to treat reactive hypoglycemia. If these informal personal experiments don't work, that's also important information. It's possible that there are other pieces of the puzzle that aren't obvious, or perhaps that the mechanisms of reactive hypoglycemia are different from one individual to the next. If you decide to try this, please be very careful, and please don't do anything that would put your health in danger. That said, if you try it and you have observations you would like to share, please put them into the comments and we shall see where this might lead.