Low Blood Sugar

Hypoglycemia (low blood sugar) is a condition in which there is an abnormally low level of glucose (sugar) in your blood. Normally your body keeps your blood sugar levels within a narrow range through the coordinated work of several glands and their hormones. But factors such as disease or a poor diet can disrupt the mechanisms that regulate your sugar levels. Too much glucose (hyperglycemia) results in diabetes and too little glucose results in hypoglycemia.

Signs and Symptoms

Because glucose (sugar) is the brain's primary fuel your brain feels the effects of hypoglycemia. The effects include the following.

• Headache
• Excessive sweating
• Blurred vision dizziness
• Trembling incoordination
• Depression anxiety
• Mental confusion irritability
• Heart palpitations
• Slurred speech
• Seizures
• Fatigue
• Irritability
• Coma

What Causes It?

Hypoglycemia can be caused by the following conditions.

• Drugs (such as insulin or alcohol)
• Critical organ failure (kidney heart or liver)
• Hormone deficiencies
• Tumors
• Inherited abnormalities
• Lack of an appropriate diet especially with a critical illness
• With strenuous exercise several hours after eating
• After gastrointestinal surgery

What to Expect at Your Provider's Office

If your symptoms are not severe your health care provider will order a blood test called a glucose tolerance test (GTT). If your levels are only slightly above normal your provider may recommend diet and lifestyle changes. If your symptoms are severe your provider will immediately give you glucose in either an oral or injectable form to bring your blood sugar level back to normal as quickly as possible. Additional tests can determine the cause of your low blood sugar.

Treatment Options

Treatment Plan

Hypoglycemia that results from exercise rarely produces serious symptoms. A glass of orange juice and a piece of bread can correct blood glucose levels within minutes. However for people with underlying disease it is important to treat low blood sugar immediately to avoid long-term serious effects. Glucose levels are raised by receiving glucose orally intravenously or by an injection.

Drug Therapies

Prescription

• Glucose by mouth—if you are awake enough to swallow
• Glucose given intravenously—if you are unable to swallow
• Glucose by injection—you also must be able to eat because the effect of the injection does not last long
• Intravenous mannitol and glucocorticoids—used in severe cases when the glucose level has returned to normal but the patient is in a coma

Over the Counter

N/A

Complementary and Alternative Therapies

Long-term treatment is aimed at the cause of the hypoglycemia but alternative therapies may also be useful in regulating blood sugar in the short term. Nutritional support should be part of treatment.

Nutrition

Small frequent meals that are high in protein and complex carbohydrates are best preferably five or six a day. Cut down on simple carbohydrates including sugar refined foods juices and fruit. Eliminate caffeine alcohol and tobacco.

Vitamins and minerals that are important for regulating glucose levels include the following.

• Chromium picolinate: 100 to 200 mcg three times per day with meals
• Magnesium: 200 mg two to three times per day
• Vanadyl sulfate: 10 to 20 mg per day
• Zinc: 15 to 30 mg per day
• B complex: 50 to 100 mg per day
• Niacinamide: 500 mg per day
• Pyridoxine (B₆): 100 mg per day
• Pantothenic acid (B₅): 250 mg per day
• Vitamin C: 1 000 mg two to three times per day
• Vitamin E: 400 IU per day

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

• Siberian ginseng (Eleuthrococcus senticosus) provides adrenal support. Use tincture 20 drops two times a day or dried extract 100 mg three times a day for two to three weeks with a one week rest before you start taking it again.
• A tincture of equal parts of licorice root (Glycerrhiza glabra) gotu kola (Centella asiatica) Siberian ginseng (Eleuthrococcus senticosus) and ginger root (Zingiber officinale) may be used in combination to strengthen the adrenals and help hypoglycemic symptoms. Take 10 to 15 drops three times a day. Do not take licorice if you have high blood pressure.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Acupuncture

May be beneficial in decreasing stress and increasing coping skills.

Following Up

Any underlying condition that may be causing your hypoglycemia must be aggressively treated so that your episodes do not recur. If you have hypoglycemia when you exercise carry healthy snack food with you when you exercise.

Special Considerations

Do not ignore the signs and symptoms of hypoglycemia. Untreated it can cause irreversible brain damage coma or even death.

Supporting Research

Anderson RA Polansky MM Bryden NA Bhathena SJ Canary JJ. Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. Metabolism. 1987;36:351–355.

Branch WT Jr. Office Practice of Medicine. 3rd ed. Philadelphia Pa: WB Saunders; 1994:574–575.

Fauci AS Braunwald E Isselbacher KJ et al: Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998:2069–2071.

Mowry DB. The Scientific Validation of Herbal Medicine. New Canaan Conn: Keats Publishing; 1986:25.

Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York NY: Pharmaceutical Products Press; 1994:141.

Wilson JD Foster DW. Williams Textbook of Endocrinology. 8th ed. Philadelphia Pa: WB Saunders; 1992:1232–1248.

Wyngaarden JB Smith LH Jr. Cecil Textbook of Medicine. 17th ed. Philadelphia Pa: WB Saunders; 1985:1342–1348.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.