Hungry, shaky, sleepy, anxious, dizzy, confused, nervous, sweaty, irritable, or "hangry". Ever experience any of these symptoms right after starting a workout? These are symptoms of reactive hypoglycemia, or low blood sugar in response to exercise. This is a condition that can occur in under certain circumstances shortly after a susceptible person begins to exercise.
How It Happens
In response to eating carbohydrates our body releases insulin, a hormone that’s main goal is to drive glucose (the main breakdown product of carbohydrates) into cells for storage or use. This process is what returns our blood sugar to normal following a meal - after we eat and digestion has begun, the sugars (glucose) in carbohydrates are released into the bloodstream and insulin's job is to bring those glucose levels down to a 'normal' level.
Additionally, a separate process occurs independent of insulin in working muscles. You see, muscles can uptake and utilize glucose all by themselves, without insulin. Mother Nature created this 'fail safe' system so that our muscles would never be deprived of energy to work.
Now, imagine for a moment what could happen if both of these processes were to occur at their full capacity at the same time. The combined action of insulin lowering blood glucose coupled with voracious muscles that are also pulling glucose from the bloodstream can drop blood sugar levels extremely quickly - this is what's known as reactive, or rebound hypoglycemia. In other words, your blood sugar plummets and is too low. If you’ve ever had this happen, you know how tough it is to keep working out, much less even retain any composure!
Dietary Timing for Hypoglycemia
Historically, it was recommended to avoid carbohydrates before exercise altogether to prevent this phenomenon from happening; however, our viewpoint on this has changed.
In those that have experienced reactive hypoglycemia or are prone to it, the timing and type of carbohydrates before exercise is important. Since both blood glucose and insulin concentrations peak 20-40 minutes after eating a meal/snack, eating carbohydrates within the 10 minutes before starting to exercise or during the warm up is one strategy for treating reactive hypoglycemia. The sugar from the carbs is then released as the working muscles start requiring it, and this keeps insulin (mostly) out of the picture. This is thought to result in a much less precipitous drop in blood sugar.
Also, choosing low glycemic index (GI) carbohydrates, such as a slightly under-ripe banana, may also help. The glycemic index refers to how quickly a food can raise blood sugars. A low glycemic carbohydrate will cause sugars to rise more slowly than high glycemic carbohydrates, resulting in a gradual (versus rapid) rise in blood glucose and therefore insulin levels will also be lower.
If neither of these strategies work for someone who is prone to reactive hypoglycemia, avoiding all carbohydrates within 90 minutes of exercising might be worth a try. At this point, blood sugars should be stable and no longer affected by any changes in insulin levels.
Hypoglycemia Dietary Basics
Outside of exercise, paying close attention to the timing and composition of meals and snacks can help manage reactive hypoglycemia.
Eating small meals and snacks no more than 3-4 hours apart throughout the day can help keep blood sugar stable.
High-fiber foods (whole grains, fruit, and vegetables), lean proteins (animal and non-animal sources), and healthy fats (nuts, seeds, avocado, fish, and liquid oils) as part of a well-rounded diet can help.
Limit or avoid simple high GI carbohydrate foods (soda, candy, etc.), particularly on an empty stomach. And if you choose to consume alcohol, avoid sugary mixers and be sure to have some food on board when you do drink.
Despite these dietary solutions, some individuals still struggle with reactive hypoglycemia. These are the cases where we need to look at and evaluate the use of specific nutrients which can help improve how the body deals with carbohydrates.
The botanical medicines Momordica charantia and Gymnema sylvestre slow how glucose is absorbed from the gut and support the pancreas (where insulin is made).
Chromium, vanadium, zinc, copper and magnesium are all minerals that play a vital role in how our cells interact with insulin. By supplying these nutrients, the pancreas releases insulin in a more measured way and the cell's ability to absorb and utilize sugars is improved as well.
Supplementing with all of these nutrients has helped a lot of our client-athletes minimize their reactive hypoglycemic symptoms along with getting more detailed with their diets as far as understanding each person's unique tolerance or intolerance to simple carbohydrates.
Everyone is different in how their body tolerates carbohydrates. If you do suffer from reactive hypoglycemia, experiment with the type and timing of meals prior to working out.
This is a treatable symptom of dietary imbalance that can be improved and corrected with strict attention to meal timing with exercise, type of carbohydrates that are tolerated by the individual, protein and fat to carb ratio, and supporting it all with the blood sugar balancing nutrients found in Glycemic Formula.