Conventional Thinking Often Results in an Oversimplified Diagnosis of Hypoglycemia

Hypoglycemia means low blood Sugar (the terms "blood glucose" and "blood
sugar" are equivalent). Frequently, I encounter patients who are convinced,
based either on their own interpretation of their symptoms or on the diagnosis
of a physician, that they have a disorder caused by swings in blood sugar
levels.

Their complaints usually include one or more of the following: weakness,
fatigue, headaches, abdominal pain, mental confusion, clouded vision, rapid
heart beat, anxiety, sweating, shaking, and incoordination. These symptoms
typically appear three to four hours after eating, especially when eating has
been delayed or a meal has been skipped. Since these symptoms occur at the
time when one's glucose level is at its lowest, the patient or physician
attributes the problem to low blood sugar—thus the diagnosis of hypoglycemia.

There are two basic types of hypoclycemia: fasting hypoglycemia and
reactive or functional hypoglycemia.

Fasting hypoglycemia is generally due to serious and potentially lifethreatening
disorders such as insulin-secreting tumors or advanced liver
dysfunction. Other causes of fasting hypoglycemia include drugs used for
diabetes, alcohol, advanced renal failure, and hormonal deficits. All these
conditions are relatively rare. In them, blood sugar levels can plummet
dangerously, resulting in profound weakness and even coma and death.
Obviously, individuals with this condition require urgent medical care.

Reactive or functional hypoglycemia is the second type of hypoglycemia
and the common type that is the focus of this chapter. This type of
hypoglycemia results in problematic symptoms, though the blood sugar levels
do not drop to dangerously low levels. The prevalence of this condition is
unknown, largely because there is no widely accepted criteria for its diagnosis.

Some physicians have taken the position that reactive hypoglycemia is very
common and is the cause of innumerable ills. When encountering patients with
symptoms suggestive of reactive hypoglycemia, many of these physicians
advise them to eat frequent meals of high-protein foods. This is usually
effective at reducing or controlling the symptoms.

Are these common symptoms, experienced by many, caused by low blood
sugar? Is a high-protein diet the best way to control this troublesome
condition? My answer to both these questions is an emphatic no.

There is much misinformation that surrounds the issue of hypoglycemia. As
with many other health ailments, health professionals tend to lump patients
with many different medical problems they can't solve into a convenient
diagnosis. I will attempt to help clarify this confusing issue.

Glucose Metabolism—A Finely Tuned Balancing Act

Our brain and body tissues require glucose for survival. Without adequate
glucose circulating throughout our bloodstream and other tissues we would die.
Thus the prevention of hypoglycemia is critical to our survival.

The two major hormones that control our circulating glucose level are
glucagon and insulin. Basically, insulin drives the blood sugar down and
glucagon raises it. Insulin drives the glucose out of the bloodstream and into
the cells. Other hormones secreted to maintain our blood glucose level when
we are not eating include epinephrine, cortisol, and growth hormone. The
prevention of hypoglycemia between meals requires an intact liver and the
appropriate regulatory hormones to control it.

The Glucose Tolerance Test

Reactive hypoglycemia cannot be accurately diagnosed merely by a glucose
tolerance test. First, understand what occurs during a glucose tolerance test:
Before any readings take place, patients must fast for 12 hours. They then
ingest 100 grams of sugar. Every hour afterwards, for five hours, blood is
drawn and the glucose level is monitored.

In the first hour after glucose ingestion, the patient's glucose level is high.
The body takes a bit of time to react to the very large quantity of glucose it has
ingested, but is then stimulated to secrete an unnaturally large amount of
insulin to rapidly lower the exceedingly high level of glucose that has entered
the bloodstream. As insulin is secreted, the glucose level drops. Plasma glucose
concentrations often reach nadirs of less than 50 mg (and sometimes less than
40) in normal people who experience no symptoms. However, when a person's
glucose level drops to 60 mg or less (the lower range of normal) and they start
to experience symptoms, a doctor labels that person hypoglycemic. This is
overly simplistic.

The glucose tolerance test is notoriously unreliable. It is an artificial and
stressful stimulation and it can be expected that many normal people will get
sick from this experience. When a large dose of concentrated sugar (glucose) is
consumed after an overnight fast, we can expect it to produce a sudden surge
in insulin secretion in response to the unnatural stress on the pancreas. This
situation (consuming a large amount of refined sugar) might make many of us
feel ill, but this is not indicative of disease. Consuming such a quantity of
refined carbohydrate is always stressful to our system and should definitely be
avoided.

Other reactions and the release of additional counter-regulatory hormones
also occur to compensate for the insulin surge. Therefore, it is not only the
lowered blood sugar that makes a person feel ill. Besides that, the majority of
patients diagnosed by physicians as having hypoglycemia never had blood
glucose levels below 60 mg on their glucose tolerance tests when they
experienced symptoms.

In general, consuming concentrated sugars is stressful to the system.
Besides generating wide swings in blood sugar, the consumption of sweets can
deplete the body of nutritional reserves needed for optimal immune and
endocrine function. Refined sugar products and other concentrated sweets can
cause excessive fluctuations of insulin and other hormones that can cause
symptoms in healthy people. This does not mean they have hypoglycemia.

A more reliable way for individuals to discern if their symptoms correspond
with low levels of glucose in their blood is to go to the doctor's office or
laboratory at the exact moment when they begin experiencing their symptoms,
and get their blood tested. People usually find that their blood sugar levels are
not unusually low at the time. In fact, it is very rare for them to find that their
blood sugar is low when they are symptomatic.

But what about individuals who feel terribly ill at the same time their blood
sugar is low? Does this mean that their symptoms are caused by low blood
sugar? Not necessarily. They may be caused by other biological processes that
cause discomfort and occur in the system at the same time the blood sugar
drops. Gluconeogenesis is the process by which we maintain our glucose
levels between meals by breaking down stored reserves of rioncarbohydrate
tissues (primarily protein). During gluconeogenesis (which occurs when blood
glucose levels are low), urea and other nitrogenous wastes are dumped into the
bloodstream as the body's tissues are broken down: These products can make
a person feel ill. Therefore, it is not merely low glucose levels that can cause
the ill feeling; there are a number of other factors involved.

Most of the symptoms individuals complain of when they think they have
hypoglycemia would not occur if low blood sugar alone was responsible.
Though weakness, hunger, and sweating are typical symptoms of low blood
sugar, visual disturbance, mental confusion, headaches, and anxiety are not.
These latter symptoms result from decreased activity of the central nervous
system and do not occur simply because of low blood sugar. Headaches and
anxiety, for example, do not occur in "fasting hypoglycemia," such as when a
diabetic is overmedicated by mistake, unless the person also has an autonomic
neuropathy (nerve damage) that blunts the release of epinephrine.

Usually individuals who manifest these complaints when their blood sugar is
low are not accurately described or diagnosed as hypoglycemic, and the
standard treatment that follows is not satisfactory. We must first comprehend
the true nature of these symptoms before we can understand the most
effective way to help the individual who suffers with this problem.

Recurrent Headaches—A Close Relative of Hypoglycemia

Troubling symptoms such as headaches, mental confusion, and anxiety that
accompany a low blood sugar reading have biochemical similarities with the
more common tension or migraine headaches. It is incorrect to believe that low
glucose is the cause, though it may seem that way. Certainly it is easy to see
why people think this, because the headache occurs at the time when the
glucose dips when eating is delayed or a meal is skipped.

Assume you were drinking 12 cups of coffee every day. How would you feel if
you suddenly stopped drinking it? Terrible, right? You would have severe
headaches because when the caffeine is withdrawn the body attempts to
detoxify or remove the buildup of this noxious substance. This is called
withdrawal, or detoxification. Suppose you were addicted to high doses of
heroin. Would you feel better if you tried to quit? Of course not. You would
experience weakness, trembling, abdominal pain, and severe headaches.
Detoxification from most noxious substances results in symptoms much like
those noted by individuals who claim they have hypoglycemia.

If a heavy coffee drinker skips a meal, a severe headache will probably occur.
Heavy coffee drinkers who delay breakfast for a few hours will also experience
mental fatigue, headaches, and confusion. Those who are not addicted to
coffee will generally not suffer when breakfast is delayed. Are the headaches
experienced by caffeine addicts caused by low blood sugar? They occurred only
when the blood sugar was at its lowest point, but clearly these are
manifestations of withdrawal or detoxification that occur because we skip or
delay eating and the body eliminates retained noxious material most effectively
at this time. The body takes the opportunity to accomplish self-cleaning, or
detoxification, when it is not busy digesting and assimilating food and
nutrients.

Likewise, the symptoms of so-called hypoglycemia are most often related to
withdrawal or detoxification. Resolution of this condition is best accomplished
by methods that allow the body to lower its toxic load. To call these symptoms
hypoglycemia shows a gross oversimplification of what is occurring and
illustrates an insufficient understanding of body chemistry.

There are hundreds of other toxins our body may be exposed to on a daily
basis. When we skip a meal, delay eating, or fast, the body almost immediately
begins to detoxify and clean itself of waste. Withdrawal from any one or many
of these non-nutritive substances retained in our tissues can generate a sickly
feeling of weakness, confusion, or headaches.

When patients undergo therapeutic fasts, blood sugar levels below 50 mg per
deciliter are not uncommon. As the fasters' blood sugars dip to low levels, they
may experience weakness and lethargy. Though these patients occasionally
experience headaches, the headaches always resolve with continuation of the
fast. This is the body's way of telling us the elimination of the toxins causing
the symptoms has been completed. Even if the blood sugar levels continue to
fall, the headaches do not recur. This illustrates that these symptoms were not
the result of low blood sugar, but were caused by other processes that were
occurring simultaneously with the lowering of blood glucose.

Those who fast after following low-protein, plant-based diets have less
discomfort and are less likely to have a headache during the early stages of a
fast. This is because withdrawal from proteinaceous or nitrogenous wastes is
the chief culprit that precipitates headaches and sickly feelings.

High-protein diets and medications can control symptoms of so-called
hypoglycemia in the same way continued coffee drinking controls symptoms of
caffeine withdrawal. Individuals with these conditions can completely recover
without resorting to dangerous high-protein diets or medication to control
symptoms. Treatments and high-protein diets give only temporary relief as
they do not address the cause.

Problems with Protein

In the United States and many other industrialized countries, a diet high in
protein is thought to be health promoting. Unfortunately, most people
indoctrinated with this notion in their youth still cling to this outdated and
potentially dangerous misconception. In reality, high-protein diets are linked
with the development of serious diseases including cancer, heart disease,
osteoporosis, rheumatoid arthritis, lupus, renal insufficiency, and kidney
stones.

As human animals we are not biologically adapted to a high-protein diet.
Metabolically there is little difference between humans and the great apes, who
are predominantly vegetarians. Like the ape, we are not adapted to function
optimally on diets that are high in protein and fat. Therefore, we suffer the
consequences of heart attacks, cancer, autoimmune illness, and so on when we
consume a diet ill-adapted to our basic constitution.

The misunderstanding of human protein requirements began 70 years ago
when two scientists published the results of a study that showed that rats fed
vegetable protein grew more slowly than rats fed animal protein. Today, we
have to interpret this information much differently. First of all, we now know
that humans and rats have different protein requirements and that people can
get all the protein they need from plant sources. More important, we now have
found that rats that grow and mature the quickest die earliest. Not only is rapid
growth a poor indicator of the value of a food, but foods that promote rapid
growth in animals and humans are the precise foods that promote premature
aging of our body and even cancer.

With all species the longer an animal takes to reach maturity, the longer it
lives. We know, for example, that women who mature earlier as measured by
their age of puberty have the highest risk of breast cancer. So another reason
to avoid high-protein foods is that they promote premature growth and
maturity.

The average American consumes about 150 grams of protein a day—about
five times the amount actually needed. This excess protein, not to mention the
fat that accompanies it, is extremely damaging. So what does this have to do
with headaches and hypoglycemia? Plenty. Consuming excess protein produces
certain toxins, by-products of animal food digestion, which enter our
bloodstream. These toxins have the ability to cause central nervous system
symptoms, such as mental confusion and headaches. The effects of these
toxins become most noticeable when the digestive tract is not busy digesting
and glucose levels are low. It is under these conditions that nitrogenous wastes
are effectively mobilized.

Since the American diet contains more protein than we need, the liver
attempts to break down the excess and excrete it in the form of urea via the
kidneys. The level of urea is measurable in the blood with a blood test called
BUN, or blood urea nitrogen. Urea is one irritating substance that results from
consuming excess protein. However, there are many other toxic by-products of
protein metabolism besides urea that are not so easily measurable in the
bloodstream: Researchers are finding that many of these other by-products of
protein digestion have a powerful toxic effect on the brain, and can cause
mental fatigue and confusion as their levels rise in the body.

The liver is the major organ of detoxification and it is especially when the
detoxification pathways in the liver are compromised that we see an increased
likelihood that individuals will suffer from the toxic effects of their high-protein
diets. A good way to illustrate the effect excess protein has on cerebral (brain)
function is to look at patients with diseased livers. Patients with advanced
stages of liver failure who cannot adequately metabolize excess dietary
proteins develop a change in mental function, drowsiness, confusion, and
disorientation. They may eventually become markedly confused before lapsing
into a coma. Dietary proteins, especially the ones containing sulfated amino
acids and aromatic amino acids—from the proteins contained in animal
products—must be significantly curtailed in patients with liver disease. This is
the established treatment for this condition. Without restricting animal
proteins, their disease and mental condition will significantly worsen.

A crucial point to keep in mind here is that there are about 14 other toxins
besides urea that are breakdown products of protein metabolism. Even though
urea is the only one we can inexpensively measure in the bloodstream at this
time, the other protein-related toxins are more responsible than urea for the
mentally confused state we see in cirrhotic individuals.

Uric acid and other potentially harmful nitrogenous wastes such as ammonia
increase in our body when we consume excessive protein. Vegetable proteins
generate less ammonia and other harmful wastes and are less acid-forming as
well.

The typical American diet, which is high in protein, especially animal proteins,
results in a high level of retained nitrogenous wastes and metabolic toxins that
have to be either eliminated or stored for future removal. When we give the
body the opportunity, it will attempt to eliminate such toxins. Sometimes
corresponding painful symptoms of mental fatigue, jitters, and headaches will
occur during this detoxification period.

Hypoglycemic persons can recover and no longer need to be addicted to
high-protein diets to control their symptoms. Individuals with a lower level of
retained wastes (especially proteinaceous wastes) in their systems will not
suffer from the symptoms generally regarded as hypoglycemic when their
blood sugar dips. They will recover because their bodies no longer need to
discharge nitrogenous wastes and other retained toxins in between meals.

A Different (and Natural) Solution for Hypoglycemia

So what should you do if you believe you have hypoglycemia?

1. Stop consuming foods that contain refined carbohydrates and simple
sugars. These foods will be absorbed into the body rapidly and force an
excessive insulin response. On the other hand, high-fiber foods slow the
absorption of nutrients and glucose and therefore do not cause an
excessive insulin response.
Especially avoid Sweets other than fresh fruit. Fruit not only contains trace
elements needed for the adequate metabolism of its contents, but also has
its sugars bound in fiber, which causes the sugars to be absorbed into the
bloodstream more slowly.

2. Stop consuming high-protein animal foods. Instead, replace them with
vegetables, fresh fruits, legumes, and unrefined grain products.

3. Avoid all soft drinks, coffee, tea, artificially flavored or colored foods, and
food additives. Avoid alcohol and caffeinated beverages as they
exaggerate hypoglycemia and result in withdrawal symptoms exacerbated
during the low blood sugar nadir.

4. Consume some food every two or three hours during the first few weeks
to minimize symptoms while your body is suffering from "withdrawal" from
your previously rich diet.

5. If necessary, eat a small amount of high-protein plant foods such as beans
or nuts and seeds with each meal for the first month or so when you
eliminate animal proteins from your diet to minimize the initial withdrawal
symptoms from an animal-protein-based diet.

After conforming to the above guidelines, people find they can return to a
wholesome plant-based diet with no further symptoms of so-called
hypoglycemia. With time, more than 95 percent of patients with these
complaints never have another symptom. If, after a reasonable amount of
time, one still gets uncomfortable symptoms before the next meal, he or she
should consider a fast to permanently resolve the condition. Fasting quickly and
predictably resolves symptoms of hypoglycemia because it so effectively allows
the body to lower the level of retained toxins, which can cause tissue irritation.

Occasionally individuals will have unusually severe symptoms of
hypoglycemia. Sometimes they will feel so bad that they arc unable to function
or live a normal life. The approach described here has enabled my patients to
recover when all other methods had failed them.

Samantha, a woman in her early thirties, had such severe hypoglycemic
symptoms that she was forced to quit her job. She had seen multiple
physicians and had undergone numerous tests. Her fasting glucose level ranged
from the forties to 70. She eventually became so weak that she was admitted
to the hospital for further evaluation. During her hospitalization, her doctors
could find nothing seriously wrong with her except for unexplained
hypoglycemic symptoms. Though still so weak she could barely walk,
Samantha was discharged from the hospital with instructions to remain on a.
high-protein diet.

When Samantha first came to see me she was eating eggs, beef, turkey,
ham, and cheese every two hours all day and most of the night. She
accompanied each meal with a glass of milk. She could not walk for even two
blocks. She was physically disabled, forced to quit her nursing job, and too
debilitated to seek any other line of work.

At the start, I maintained Samantha's eating schedule of every two hours but
substituted plant protein for animal protein. Gradually, over the next eight
weeks, we eliminated all animal protein. Instead, Samantha ate tofu, beans,
lentils, chick peas, lima beans, and pumpkin and sunflower seeds, and
increased her intake of green vegetables. Over the next few months we made
gradual dietary adjustments so that her symptoms would not worsen. Her
illness was so severe that I thought she would need to undergo a prolonged
fast to completely recover. I was wrong. She made steady progress. The
severe incapacitating symptoms slowly resolved, and she soon reported that
she had a good energy level. She was able to walk 30 blocks without a problem
and has had no further symptoms: She is now back to work, living a normal
life.

You, too, can forever rid yourself from troublesome symptoms, merely by
adopting the best nutritional program, one that is more appropriately designed
for your natural genetic tendencies: a plant-centered, natural-food diet.