Hypoglycemia (low blood sugar) is a condition in which there is an abnormally low level of glucose (sugar) in your blood. Normally your body keeps your blood sugar levels within a narrow range through the coordinated work of several glands and their hormones. But factors such as disease or a poor diet can disrupt the mechanisms that regulate your sugar levels. Too much glucose (hyperglycemia) results in diabetes, and too little glucose results in hypoglycemia.

Because glucose (sugar) is the brain's primary fuel, your brain feels the effects of hypoglycemia. The effects include the following.

• Headache
• Excessive sweating
• Blurred vision, dizziness
• Trembling, incoordination
• Depression, anxiety
• Mental confusion, irritability
• Heart palpitations
• Slurred speech
• Seizures
• Fatigue
• Irritability
• Coma

Hypoglycemia can be caused by the following conditions.

• Drugs (such as insulin or alcohol)
• Critical organ failure (kidney, heart, or liver)
• Hormone deficiencies
• Tumors
• Inherited abnormalities
• Lack of an appropriate diet, especially with a critical illness
• With strenuous exercise several hours after eating
• After gastrointestinal surgery

If your symptoms are not severe, your health care provider will order a blood test called a glucose tolerance test (GTT). If your levels are only slightly above normal, your provider may recommend diet and lifestyle changes. If your symptoms are severe, your provider will immediately give you glucose in either an oral or injectable form to bring your blood sugar level back to normal as quickly as possible. Additional tests can determine the cause of your low blood sugar.

It is important to treat low blood sugar immediately to avoid long-term serious effects. Hypoglycemia resulting from exercise several hours after a meal rarely produces serious symptoms. A glass of orange juice and a piece of bread can correct your blood sugar levels within minutes. However, in people with underlying diseases, fluctuating blood sugar levels are more serious and must be treated with oral or injectable forms of glucose. You can take oral glucose if you are able to swallow. If not, your health care provider can give you an injection.

• Oral glucose for people who are able to swallow (10 to 20 g carbohydrate)
• Intravenous glucose for people who are unable to swallow
• Subcutaneous or intramuscular injection of glucagon is an alternative to the above treatments, but the individual must also eat because the effect of glucagon is short.
• Intravenous mannitoland glucocorticoids may be used to treat an individual who remains in a coma after glucose levels return to normal.

Long-term treatment is aimed at the cause of the hypoglycemia, but alternative therapies may also be useful in regulating blood sugar in the short term. Nutritional support should be part of treatment.

Small frequent meals that are high in protein and complex carbohydrates are best, preferably five or six a day. Cut down on simple carbohydrates including sugar, refined foods, juices, and fruit. Eliminate caffeine, alcohol, and tobacco.

Vitamins and minerals that are important for regulating glucose levels include the following.

• Chromium picolinate: 100 to 200 mcg three times per day with meals
• Magnesium: 200 mg two to three times per day
• Vanadyl sulfate: 10 to 20 mg per day
• Zinc: 15 to 30 mg per day
• B complex: 50 to 100 mg per day
• Niacinamide: 500 mg per day
• Pyridoxine (B6): 100 mg per day
• Pantothenic acid (B5): 250 mg per day
• Vitamin C: 250 to 500 mg two times per day
• Vitamin E: 400 IU per day

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

• Siberian ginseng (Eleutherococcus senticosus) provides adrenal support. Use tincture 20 drops two times a day or dried extract 100 mg three times a day for two to three weeks with a one week rest before you start taking it again.
• A tincture of equal parts of licorice root (Glycyrrhiza glabra), gotu kola (Centella asiatica), Siberian ginseng, and ginger root (Zingiber officinale) may be used in combination to strengthen the adrenals and help hypoglycemic symptoms. Take 10 to 15 drops three times a day. Do not take licorice if you have high blood pressure.

May be beneficial in decreasing stress and increasing coping skills.

Any underlying condition that may be causing your hypoglycemia must be aggressively treated so that your episodes do not recur. If you have hypoglycemia when you exercise, carry a healthy snack with you when you exercise.

Do not ignore the signs and symptoms of hypoglycemia. Untreated, it can cause irreversible brain damage, coma, or even death.

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