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Preventing Reactive Hypoglycemia with Exercise

by Dr. Jason Barker August 11, 2020

10 Comments

Preventing Reactive Hypoglycemia with Exercise


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.

Nutrient Solutions

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. 

We really like Glycemic formula because it contains all of these nutrients in a synergistic combination - it contains the 9 most effective natural ingredients known for their ability to optimize blood sugar levels so they stay balanced.  You can read more about how it works here.

  natural hypoglycemia support

 

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. 

 

 

References

  1. Glycemic Index. (2020, August 10). Retrieved from http://www.glycemicindex.com/.

  2. Jeukendrup, A. E., & Killer, S. C. (2011). The myths surrounding pre-exercise carbohydrate feeding.  Annals of Nutrition and Metabolism57(Suppl. 2), 18-25.
Dr. Jason Barker
Dr. Jason Barker


10 Responses

Aric Fleming
Aric Fleming

October 06, 2020

This is timely as I’ve been suffering from this over the last few years and more often this year. Hence the google search that led me here. Around the same time that I started suffering from feeling like I was bonking about 20-30minutes in to an easy run my family doc said that I need to shed a few pounds because my fasting glucose was getting in to pre-diabetes territory. Here’s hoping it goes away as I get to a healthier weight.

Dr. Jason Barker
Dr. Jason Barker

September 22, 2020

Mark – interesting. So, two thoughts: 1 – you might look into something like a micronutrient assay so you can assess nutrient status – when imbalanced or lacking, I could see something like this contributing to those symptoms. 2, also maybe consider a food sensitivity test – you might be having an extreme reaction to a food(s) you’re sensitive to as part of this.

Mark
Mark

September 22, 2020

Thanks for replying,
Yes, 3 different times for a week, months apart. No arrhythmias were detected, also 2 stress tests with an echo immediately following a heart rate of over 180 BPM. Some days there are no symptoms at all after a work out. That’s why I question if its diet related.

Dr. Jason Barker
Dr. Jason Barker

September 20, 2020

Hi Mark – were you wearing your monitor at the time of these episodes? It’s hard to imaging that if you’re feeling palpitations that a monitor wouldn’t pick up some kind of arrhythymia – hypoglycemia usually results in feelings of weakness, dizziness and or extreme hunger more so than palpitations and anxiety.

Mark
Mark

September 20, 2020

So for approx 6 years, I have been experiencing an event at times after approx 35-45 min of strenuous workout (Mainly moderately heavy weightlifting). I feel extreme anxiety, uncomfortable with heart palpitations. This usually last 10-20 min and I then feel relatively fine. At first I thought it was heart related, but it after multiple tests (EKG, Echo, Stress tests, weekly heart monitor, etc) there was nothing found to be wrong. Without a diagnosis, does this sound like hypoglycemia? It would be a relief if that is all it was. Also, would increasing in age make this more of an issue? I had no issues before 2013, then it started at a once a month frequency. I am 46 and have been weightlifting fairly regularly for 30 years. I am not diabetic and all my labs are excellent. Thank you, Mark

Dr. Jason Barker
Dr. Jason Barker

July 21, 2020

Hi Lou – thanks for your comments. What I mean when I say that hypoglycemia isn’t a medical condition is that it’s not an actual disease – hypoglycemia is a symptom or group of symptoms that results from low blood sugar. Maybe splitting hairs but that’s the true definition – is that it’s a symptom. Think of headaches – they’re not a medical condition, they’re a symptom of something else. Sure they cause issues, but that doesn’t make it an actual disease. Regardless glad you were able to help yourself!

Lou Gleasonick
Lou Gleasonick

July 21, 2020

I started getting this when I had been on low carb diet for many months then switched to carb loading for half marathon. I stopped running so much. My lows still happen but not as bad. I now belief the carb amount is the problem not the running. I never had to worry about this when I was young, I am 47. Doctors have not given me reason for problem or solution. Just to cope by eating 6 small meals spread through day.

Hypo Gleason
Hypo Gleason

July 21, 2020

You say this not a medical condition, but if you are incapacitated by low sugar, if the hypos disrupt your day, it is as bad as a medical condition, for all intents and purposes.

Sneh Gurdasani
Sneh Gurdasani

March 25, 2020

Thanks a lot!

Kat
Kat

November 12, 2019

I’ve suffering with this for years. I recently started working out again and I’m plagued with hypo. I think this has been the most helpful and thoroughly explained answer I have read. Thank you!

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