Reactive hypoglycemia is a controversial subject. Many people consider themselves to be suffering from hypoglycemia but do not meet all of its criteria.
For example, they regularly go through moments of fatigue, low energy, and nervousness, but their blood sugar remains completely normal. Thus, in these cases, the doctor cannot conclude that there is hypoglycemia.
To find out more, discover all the information in this article.
What is hypoglycemia?
| Remark. This sheet concerns so-called reactive (or reactive) hypoglycemia, which can affect people without diabetes. For more information on diabetes-related hypoglycemia, see our Diabetes fact sheet. |
From a medical point of view, the following 3 criteria must be met in an individual to be able to say that he has reactive hypoglycemia:
- sudden drops in energy accompanied by nervousness, tremors, hunger pangs,, or other symptoms;
- blood glucose, or “sugar” level, of less than 3.5 millimoles per liter (mmol/l) at the time the symptoms occur;
- the disappearance of discomfort after taking sugar, such as candy or fruit juice.
These criteria were established in the 1930s by an American surgeon who was interested in disorders of the pancreas, Dr. Allen Whipple. They are also called Whipple’s triad.
Reactive hypoglycemia is a controversial subject. Many people consider themselves to be suffering from hypoglycemia but do not meet all of its criteria.
For example, they regularly go through moments of fatigue, low energy, and nervousness, but their blood sugar remains completely normal. Thus, in these cases, the doctor cannot conclude that there is hypoglycemia.
There is no clear explanation of the origin of these “pseudo-hypoglycemias”. A state of panic or excessive stress could be the cause. In addition, some people’s bodies may react more strongly to a drop in blood sugar.
In medicine, “true” hypoglycemia – which meets the 3 criteria listed above – is usually diagnosed in people with glucose intolerance (a preliminary stage to diabetes), diabetes, or another disease of the pancreas. Stomach surgery can also cause hypoglycemia, but this is quite rare.
That said, whether it is true hypoglycemia or “pseudo-hypoglycemia”, the symptoms are controlled and prevented in the same way, thanks in particular to various changes in eating habits.
A better understanding of blood sugar
Glucose provides the organs with their main source of energy. It comes from the digestion of sugars in food. They are called carbohydrates, carbohydrates, or carbohydrates. Desserts, fruits, and cereal products (rice, pasta, and bread) are full of them.
A normal fasting blood sugar level (that is to say after 8 hours without eating), for a non-diabetic person, is between 3.5 mmol/l and 7.0 mmol/l. After a meal, it can go up to 7.8 mmol/l. Between meals, the body must ensure that there is enough glucose circulating in the blood to provide a source of energy to the organs.
It is the liver that provides this glucose, either by synthesizing it, or by releasing the glucose that it stores in the form of glycogen. Muscles also contain glycogen, but this cannot be used to restore blood sugar levels that are too low.
Blood sugar is controlled by several hormones. Insulin secreted after a meal lowers blood sugar, while glucagon, growth hormone, adrenaline, and cortisol raise it. All of these hormones are finely tuned so that circulating glucose levels are relatively constant, even when fasting.
Who is affected by hypoglycemia?
People who suffer from hypoglycemia are usually women in their 20s or 30s. Since this condition is not considered a disease, there are no reliable statistics on the number of people affected.
Consequences of hypoglycemia
Most of the time, reactive hypoglycemia is mild and fades spontaneously or after ingesting foods that provide glucose to the body. There are then no serious consequences.
How to diagnose hypoglycemia?
Once the situation that triggers the symptoms is discovered, the doctor may ask the patient to measure their blood sugar before and after a symptomatic period.
People who have a blood glucose meter (glucose meter) available to them can use it. Otherwise, blood sugar levels are taken using a blotting paper test (Glucoval), available in some private laboratories.
If the blood sugar is abnormal, the doctor performs a complete checkup to find the cause. When the doctor suspects that the person has glucose intolerance or diabetes, further blood sugar testing is done.
Symptoms of reactive hypoglycemia most often appear 3 to 4 hours after a meal.
See the list of all symptoms here.
Symptoms of hypoglycemia
Symptoms of reactive hypoglycemia most often appear 3 to 4 hours after a meal:
- a sudden drop in energy;
- nervousness, irritability, and tremors;
- paleness of the face;
- sweats;
- a headache ;
- heart palpitation;
- an imperious hunger;
- a state of weakness;
- dizziness, drowsiness;
- an inability to concentrate and incoherent speech.
When the crisis occurs at night, it can cause:
- insomnia;
- night sweats;
- nightmares ;
- fatigue, irritability, and confusion upon waking.
Risk factors for hypoglycemia
- Alcohol inhibits the mechanisms that release glucose from the liver. It may cause hypoglycemia in fasting subjects suffering from undernourishment;
- prolonged and excessively intense physical activity.
In order to prevent hypoglycemia, there are basic preventive measures that you can apply on a daily basis.
Discover them in detail here.
How to prevent hypoglycemia?
Why warn?
Reactive hypoglycemia and “pseudo-hypoglycemia” can be linked to several factors that are sometimes difficult to determine. Nevertheless, many people’s symptoms can be prevented by adopting a balanced lifestyle based on a varied and healthy diet, good stress management, and regular physical exercise.
These measures have, of course, the great advantage of improving overall health.
Basic preventive measures
A healthy diet
Diet is the most important element in preventing hypoglycemia attacks.
Physical activity
Exercise regularly, but in moderation, avoiding violent and intense exercise. Exercise improves the functioning of hormones that control blood sugar.
See our Physical Fitness file.
Good stress management
Learn how to manage your stress, that is to say, to find the origin of it and to find solutions to feel more in control (reorganize your schedules, plan meals for the week, etc…). Regularly practicing certain forms of relaxation, such as relaxation exercises (deep breathing, progressive muscle relaxation, etc.), also helps to relieve stress.
We sometimes notice that hypoglycemic attacks tend to become rarer or disappear completely during the holidays.
See our file Stress and anxiety.
The majority of hypoglycemia is treated by a reorganization of the diet. Consulting a nutritionist may be helpful.
Hypoglycaemia caused by other diseases is generally resolved by treating the causes: by removal of the tumor in the case of insulinoma, by a change in medication, etc.
For more information, see this article.
How to treat hypoglycemia?
In case of symptoms of hypoglycemia, it may be useful to consult a doctor in order to obtain a check-up.
Hypoglycaemia caused by other diseases is generally resolved by treating the causes: by removal of the tumor in the case of insulinoma (tumor of the pancreas), by a change in medication, etc.
The majority of hypoglycemia is treated by a reorganization of the diet. Consulting a nutritionist may be helpful.
Food: the basis of treatment
The goal is to stabilize blood sugar. This prevents sudden drops in energy. Here are some recommendations:
- eat 3 meals a day at regular times;
- have a snack between meals;
- limit the consumption of foods rich in concentrated or “fast” sugars: store-bought cakes and biscuits, ice cream, jams, dried fruit (alone), etc. ;
- eat enough dietary fiber (25 g to 38 g per day);
- avoid drinking alcohol on an empty stomach. A glass of alcohol while eating is usually well tolerated;
- limit coffee and other beverages that contain caffeine because they lower blood sugar.
What to do in the event of a hypoglycemic crisis?
- In case of pseudo-hypoglycemia: sit down, then eat a source of sugar, for example, a fruit, a piece of bread, or a homemade muffin;
- in the event of true hypoglycemia, which meets the 3 criteria stated at the beginning of the sheet: sit down, then eat a source of concentrated sugar, for example, a fruit juice or a candy;
- in any case, it is good to have a protein snack about twenty minutes later, such as a piece of cheese or some nuts.
To treat hypoglycemia, some complementary approaches can be effective for a more natural treatment.
More information is in the article below.
Complementary Approaches for Hypoglycemia
Some naturopathic sources mention that various vitamin and mineral supplements help control the symptoms of low blood sugar. Zinc, magnesium, B vitamins, and vitamin C are most often cited. Note that, according to our research on PubMed, no clinical studies have evaluated their effectiveness in controlling hypoglycemia.
The American naturopath JE Pizzorno recommends, for his part, the daily intake of a multivitamin and mineral1 supplement. According to him, in some cases, reactive hypoglycemia can be associated with various health problems, such as depression, premenstrual syndrome, and migraine1.
Moreover, in the work of authors entitled Vaincre l’hypoglycémie, it is emphasized that hypoglycemic people must first and foremost make sure to have a balanced diet.
Image Credit: Image by xb100 on Freepik
