Adrenal Fatigue and Hypoglycemia Symptoms – Part 1
One of the classic signs of Adrenal Fatigue are hypoglycemia symptoms. Traditionally hypoglycemia is a medical term for a state produced by a lower than normal level of blood sugar.
Unfortunately, no single glucose value alone satisfactorily gauges all people because many variables are involved. While there are no disagreements as to the normal range of blood sugar (90-110 mg/dl), debate continues as to what degree of hypoglycemia warrants medical evaluation and treatment, or can cause harm.
Throughout the 24-hour cycle of a day, blood plasma glucose levels of healthy people are generally maintained between 72 and 144 mg/dL (4-8 mmol/L) while 60 or 70 mg/dL (3.3 or 3.9 mmol/L) is commonly cited as the lower limit of normal glucose.
Many healthy people can occasionally have glucose levels in the hypoglycemic range without hypoglycemia symptoms of disease. This makes hypoglycemia a difficult clinical state to establish in the first place. The problem is further compounded in those with Adrenal Fatigue.
In Adrenal Fatigue, the hypoglycemia symptoms experienced is more often than not sub-clinical. This means that the person has clinical hypoglycemia symptoms even though the blood plasma level is invariably above 60-70 mg/dl. Their fasting serum blood sugar and glucose tolerance tests are usually normal. Conventional doctors not aware of the adrenal influence will miss this.
The diagram below shows how Adrenal Fatigue contributes to hypoglycemia symptoms. Compared to a normal person or even one with compromised insulin control, those with Adrenal Fatigue tend to have hypoglycemia symptoms even though the serum blood sugar may be within the normal range. This is clinically evident. After a meal, those with advanced Adrenal Fatigue tend to have a faster dip in serum blood sugar below the Hypoglycemic Symptoms Threshold (HSL) level compared to normal. This triggers symptoms of hypoglycemia such as irritability and fatigue. The more advanced the Adrenal Fatigue, the more the blood sugar curve is shifted towards the left. As a result, the time between completion of a meal to the onset of hypoglycemia symptoms is shortened.
Sugar and Adrenal Fatigue
For this reason, it is common for those with Stage 3 and beyond Adrenal Fatigue to require sugar replenishment every 2-3 hours. A small snack usually suffices. In fact, as Adrenal Fatigue recovers, this period lengthens. Those with Stage 2 Adrenal Fatigue can go 4-6 hours without food and not have hypoglycemia symptoms and hunger. Many in Stage 1 can skip a meal and have no symptoms at all.
Our body needs a continuous supply of energy to maintain homeostasis throughout the day. Cellular energy demand is met by intake of food, which is then converted into sugar. When this demand is not being met, as in Adrenal Fatigue, the body will turn to existing protein and fat as resources of energy. This pathway is not as efficient but, nevertheless is put on overdrive in order to provide the energy required. Without adequate cortisol levels to elevate blood sugar levels by facilitating the conversion of glycogen, fats, and proteins to new glucose supplies, this increased demand is difficult or impossible to meet. Irregular blood sugar patterns with hypoglycemia are common as the body tries to kick start the process whenever it detects a low blood sugar level. This leads to a variety of symptoms.
Hypoglycemia symptoms include hunger, nausea, headache, rage, lethargy, daydreams, confusion, amnesia, dizziness, fatigue, irritability, anxiety, jittery feelings, adrenaline rush, elevated heart rate, memory loss, and in severe cases, fainting, coma, and seizures.
Key hormones regulating blood sugar in the body include insulin, cortisol, and growth hormone. Conditions associated with Adrenal Fatigue that might also play a part in sugar regulation include Polycystic Ovarian Syndrome, metabolic syndrome, drug effects, adrenal insufficiency, and diabetes. In the absence of other medical reasons, one must consider Adrenal Fatigue as a cause.
Acute hypoglycemia can easily be temporarily reversed by taking 10-20 grams of carbohydrate (3-4 ounces of orange, apple or grape juice). While this can be overcome with a sugar fix consisting of an instant load of sugary drink or food such as coffee or soda, this is a quick solution emergency remedy only. Usually symptoms go away immediately, but return after 1-2 hours. Reactivation and restoration of normal cell function require extra amounts of energy beyond what is normally required for maintenance of normal energy burn. With each hypoglycemic episode, more cells are damaged. Thus, the body reaches a new low with each insult of hypoglycemia. If this happens at the same time as demand for glucose increases, the stage becomes set for an adrenal crisis. With each plunge, the Adrenal Fatigue increases and hypoglycemia worsens. By the end of the day, the person may feel nearly exhausted without having done anything. Low blood sugar times are most likely to occur at around 10:00 a.m., 2:00 p.m., and from 3-4:00 p.m.
© Copyright 2013 Michael Lam, M.D. All Rights Reserved.
Dr. Lam’s Key Question
If someone is hypoglycemic, is it better to balance sugar levels with natural foods, or can it be with substituted meals, like protein shakes?
To battle hypoglycemia – both the use or natural foods or protein shakes may help.
Dear Dr. Lam and Staff,
I would like to thank you for the generous and clear medical information you share on your website. It's safe to say you recently saved my life. I am incredibly grateful. I was and still am in Stage 2-3 Adrenal Fatigue based on a Saliva Test provided for free through a distant doctor friend. However, I have had four recent years of financial hardship which has made the AF worse. I live in a small rural town and felt I had nowhere to turn to for medical advice. After a series of health crashes since the summer and some very bad crashes, similar to what sent me to the ER a year ago. This event wiped me out financially and they had no clue what was going on even though I had extreme low pulse and blood pressure. As I read and researched your site, I realized my CHF-like symptoms were dehydration, low sodium, and hypoglycemia. It had presented itself differently than what I've experienced, and I had gotten to the point that I felt nauseous about eating. So THANK YOU! Amazingly, I have found a naturopath in town that is covered by my health insurance. However, I will continue to turn to you to learn more. Again, thank you for being there during a very dark and scary time when I felt my body was cycling down with no hope of recovery. I am extremely grateful for your open-hearted and generous services.