Low Carbohydrate Diet for Hypoglycemia
(a.k.a. low blood sugar or pseudohypoglycemia)
by J. C. Waterhouse, Ph.D.

(The following was written for an AOL chat group and is a preliminary version of an article that will appear in the Synergy Health Newsletter, in the fall of 1999. For more information go to: http://members.aol.com/SynergyHN SynergyHN-home page )

First, I should say I am a Ph.D., not an M.D. and I want to stress that the following is for information only and is not medical advice. Consult your physician regarding any changes in your treatment, including diet, especially for anyone with diabetes or gout. However, if your doctor is skeptical, he may not be aware of recent research on the benefits of reducing carbohydrates and excess insulin (like the work of Dr. GM Reaven and others found via MEDLINE or in the book “Healthy for Life” or other books).

Many types of symptoms are helped by a low carbohydrate diet that reduces blood sugar fluctuations. With age and increased stress and illness, one’s ability to regulate blood sugar levels often declines. When blood sugar drops below a certain level (often still within the so-called normal range, Genter & Ipp, 1994, Metabolism 43(1), also see Harrison’s Principles of Internal Medicine, 1997, p. 2082 & 2086, discussion of pseudohypoglycemia), a surge of stress hormones are released to bring the blood sugar levels up. These stress hormones can result in dizziness, anxiety, headaches and sleep disruptions. Fatigue and difficulty concentrating also occur, and there are many other consequences for the bodies various hormones and regulatory systems. For instance, the surges of insulin which occur with carbohydrate consumption cause important amino acids to be driven into the body’s cells, leaving less available for the brain to produce important brain chemicals, like serotonin, that affect mood.

Dr. R. Paul St. Amand finds that many of his fibromyalgia patients have hypoglycemia and benefit from a low carbohydrate diet. The low blood sugar and excess insulin also contributes to weight gain. Insulin is well-known as a fat storage hormone, thus it has effects on metabolism that make it easier to gain weight and harder to burn fat. In my own case, going on Dr. St. Amand's suggested low carbohydrate diet for hypoglycemia helped a great deal (for a description of the diet one can go to: http://members.aol.com/SynergyHN CISRA--SynergyHN Home Page and also to see Dr. St. Amand's paper, go to FIBROMEET or the GUAI-Group site).
However, I have found that to get maximal benefit from the low carbohydrate diet, you need to be cautious that you don't add a large amount of a very allergenic protein. Unfortunately, four of the favorite non-meat proteins can be problematic due to relatively high levels of hypersensitivity and/or allergy: soy, dairy, eggs and peanuts. Fortunately, newer protein sources are being used for protein powders, like rice and bean derived proteins. It turns out I do best with chicken breasts for protein; sunflower seeds or sunflower butter is also relatively well tolerated. Of course, there is a lot of variation in what people react to. Years ago I switched to a low carb. diet that involved a lot of eggs, and within a few weeks, my egg sensitivity had gotten out of hand. I didn't know that this was the problem, I just realized that after a while the diet wasn't helping anymore. If one can't do the various clinical and lab tests for food allergy/sensitivity reactions, one can use the pulse test (greater than 10% pulse increase 30 min. after meal or 2 minutes after placing the food on the tongue), as well as symptom diaries and/or elimination diets to help figure them out (see CISRA--SynergyHN Home Page for more information). If food cravings persist on the low carbohydrate diet, it may be that there are still some foods that you are having an allergy/sensitivity reaction to--common carbohydrate offenders are wheat and corn. Some will do better if they phase these out of their diet, at least temporarily. These reactive foods stimulate the nervous system and stimulate insulin release, so you may go through withdrawal symptoms, like headaches and sleep disturbances for 3-10 days after stopping them.

I also wanted to mention that the time it takes to respond to the low carbohydrate diet varies and if you try it, you may even feel worse for the first few days, and possibly a week or two, as your body adjusts to the change. Dr. St. Amand finds people experience the greatest benefit by the end of the second month on the diet. I found I was feeling considerably better within a few days, though it may take 2 -3 weeks to start feeling better. It reduced dizziness, fatigue, anxiety, cognitive problems and night sweats. It also made it easier to maintain weight or lose it if I chose to do so. I find that the people for which this diet is least appealing are often those who need it most. They tend to be carbohydrate cravers, as I was, and really only feel alive for a short time after filling up on carbohydrates. It is usually the first week or so on the low carbohydrate diet that is the hardest, until you can begin to get off the roller coaster ride of the reactive hypoglycemia.

In some ways, the most difficult part of going on the diet is the psychological adjustment it takes. People are used to relying on carbohydrates to lift their energy. In fact, it almost acts like a drug. But the problem is that soon they crash and need another fix. I was amazed that after a week on the diet, I would begin to find myself typing away at the computer when I hadn’t eaten for 4 or 5 hours, whereas before, I would be feeling shakey with hypoglycemia by then and have trouble functioning at all. Until you adjust to the new diet, which may take 1 week or several, it may be hard. I found that it helped if whenever I finished a meal, I would try to have the next one prepared and ready on the plate in the refrigerator, so I would be less tempted to find a carbohydrate first when meal time came. I also would not have to be preparing food on an empty stomach, which may be harder during the first few days of the new diet. Sometimes planning to watch a humorous video or T.V. program during my meal helped to give me a lift that didn’t come from the carbohydrate as I was used to. If I was eating with other people, I would focus on them and the conversation, instead of the food. In fact, I enjoy social times even more now, because my focus is on being sociable and appreciating the people and the interaction (I often bring my own food to make things simpler). I also find that I don’t mind not having the dessert because I no longer have to struggle with the desire for more and the internal conflicts associated with that inner struggle. I know I am not having it and it is as simple and unconflicted as that. I found I could also use the dessert time to go lie down and rest a bit. The longer I go without the splurging, the less tempted I become until now I am out of the habit of imagining the taste of things whenever I see high carbohydrate foods in commercials or elsewhere. It is that imagined tasting that rouses the craving. On a few occasions, after months on the low carbohydrate diet, I have tasted a tiny amount of a dessert and found it rather disappointing. Most people find that their tastes change and sweets start to be cloying and unappealing after a while on the low carbohydrate diet.

I also have found it interesting that the pattern of my appetite during a meal has changed. As before, I start out hungry and during the first half to 2/3 of the meal, the food tastes good and is satisfying. But toward the last 1/3 of the meal, it stops tasting as good. In fact, by the end, it tastes rather unappealing. If I was feeling sorry for myself and still stuck in my old thinking patterns, I might wish I was eating my old carbohydrates, foods that always left me wanting more and looking forward to the next “fix”. One day I realized how really perfect the situation on my new low carbohydrate diet actually was--in fact this was actually normal. The food should taste great when you are hungry and not very appealing when you are full, toward the end of the meal. When it stops being appealing, you just stop eating. At last I could relate to certain people I knew who were naturally thin and seemed indifferent to having seconds or having dessert, when I would be having inward struggles with myself to avoid overeating. Those of us with a tendency to produce high levels of insulin in response to carbohydrates are thought to have what is called a “thrifty gene”. Our easily sparked insulin gives us a greater drive to eat and conserve calories. This genetic makeup made us less likely to starve during human evolution. However, it makes us less well-adapted to our modern diet of high amounts of concentrated carbohydrates. And with age, the problem worsens, as evidenced by increasing obesity with age and the failure of the low fat approaches usually touted.

In my own case, for convenience, I cook a very large amount of skinless boneless chicken breasts (I prefer organic chicken, but without the fat, even non organic chicken should be O.K. for most). I then store some in the freezer after it is cooked. I use a big covered roasting pan. Lately, I have been cooking 16-18 pounds at 375 degrees for about 2 hours. I use about a tablespoon of olive oil and a lot of salt for seasoning when I have it at meal time, with whatever small amount of carbohydrate (the equivalent of 10 g. carbohydrate from a whole grain food or fruit) and non-starchy vegetable I might have (see St. Amand’s Hypoglycemia paper, FIBROMEET ). I don’t use spices because of my allergies and sensitivities, but others may if they wish to. It is possible to have a much more varied diet than mine if you have fewer food sensitivities than I do.

Part II of this article, including brief book reviews and more on allergies/sensitivities, can be found at: Hypogly2 on books and diets

Disclaimer: This is for information only and is not medical advice. Consult your physician regarding changes in diet, especially if you have any medical condition.